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Covid-19: NPHET members called for more enforcement of Level 3 measures before proposed move to Level 5

The suggestion was made at a meeting of the public health team last month.

Gardaí at a checkpoint in Dublin city
Gardaí at a checkpoint in Dublin city
Image: RollingNews.ie

MEMBERS OF THE National Public Health Emergency Team (NPHET) suggested stricter enforcement of Level 3 measures to curb the spread of Covid-19 when the team met to recommend the introduction of Level 5 measures last month.

Minutes of a NPHET meeting held on 15 October show that some members believed that greater levels of compliance with Level 3 restrictions were required before a move to a higher level of the Living with Covid plan.

The meeting was held the same day that Chief Medical Officer Dr Tony Holohan wrote to Health Minister Stephen Donnelly to recommend Level 5 restrictions for six weeks.

In his letter, Holohan noted his concern about the escalating number of cases in Ireland and across Europe, and expressed concerns about hospital capacity, community transmission and a rise in clusters at the time.

During the meeting, the team reviewed ongoing Level 3 measures, which were then in place across the country, including in Dublin for a month and in Donegal for three weeks.

Although the restrictions had only been implemented in the 24 other counties a week previously, NPHET said that it was “not satisfied” that Level 3 was having an impact.

It was noted that since being introduced on 4 October, the spread of Covid-19 appeared to be increasing, with “widespread community transmission evident across the country”.

At the time, the five-day average of cases was 946 cases per day, compared with a five-day average of around 400 cases per day now.

The 14-day incidence per 100,000 population was 207 (compared with the current figure of 120.44 cases per 100,000 people), and the R number was 1.4.

However, Holohan asked NPHET members whether they believed Level 3 restrictions should continue to see if a fuller picture of the effects of the measures could be obtained.

A number of unnamed members suggested that Level 3 restrictions “could potentially be sufficient” with full compliance and enforcement.

But following a discussion, NPHET agreed that delaying stricter measures would have been problematic because of the potential spread of the virus.

“Accounting for the current profile and trajectory of the disease, modelling projections, the level of demand across the health system, the NPHET, on balance, concluded that delaying escalation would pose too great a risk,” the minutes read.

Holohan then asked members of NPHET whether they thought Level 4 restrictions should be implemented.

Some members responded that Level 4 would be a “more proportionate response” to address the spread of the virus.

But NPHET again agreed to recommend a move to Level 5 instead. 

“Given the risk associated with Covid-19 spreading further to achieve this, NPHET reached a consensus that implementing Level 5 measures was both necessary and proportionate,” the minutes read.

The team noted that all the criteria for an escalation to Level 5 of the Plan for Living with Covid-19 were being met, as they were on 4 October when Level 5 restrictions were first recommended to the Government.

It was estimated that a two-week delay in introducing Level measures, with the R number at 1.4, would have lead to an additional 24,000 cases of Covid-19, around 1,000 hospitalisations, 140 admissions to ICU and 120 further deaths.

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NPHET added that further investment in the State’s public health response system and ensuring there was capacity in the health service to deal with Covid-19 cases were essential after Level 5 restrictions are lifted.

The restrictions were subsequently introduced on 22 October and remain in place until 1 December.

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