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'The pandemic is growing': Professor Nolan on why we're seeing high and growing Covid-19 incidence

More than 15,000 tests per day are going through public health labs.

Image: Alamy Stock Photo

THE LATEST WAVE of Covid-19 cases was triggered by a combination of factors, among them a change in people’s behaviour last month, Professor Philip Nolan has said.

Speaking at the first NPHET press briefing since August, the Chair of the Irish Epidemiological Modelling Advisory Group, Professor Nolan outlined why the incidence rate is increasing when there are such high levels of vaccine uptake and protection.

The growth rate in Covid-19 cases is currently between 2-3% per day, while the growth rate and the number of people in the hospital are also increasing between 2-3% per day.

Nolan noted that the explanation as to why the pandemic is growing in Ireland was “complex” but could be attributed to a number of factors, among them a high incidence rate prior to the completion of the vaccine programme, a reduction in risk mitigation, and increased social contact:

“Our incidence before the vaccination programme was very high, that was because early and hard exposure to the Alpha variant back in spring brought our instance up above the European average. And then followed by a hard and early exposure to the Delta variant, brought us to high levels of incidence in the partially vaccinated population.”

‘Collective behaviour’

Taoiseach Micheál Martin has said “collective behaviour must change” to meet the current increase in cases. 

Speaking at the Fianna Fáil parliamentary meeting tonight, he said antigen testing will be deployed for contacting tracing and also within the population “more generally” than currently.

“We have made enormous progress and we want to hold onto it and maintain it,” he said, going on to say that significant booster campaign is needed in the “short to medium term” to maintain the easing of restrictions. 

The reopening will continue but “with caution”, he added to TDs and senators, while guidance for different sectors will be based around common sense and practical advice.

Mortality rates

At today’s NPHET briefing, Philip Nolan said that given the increase in case counts, health officials are expecting mortality rates from Covid-19 to rise in the coming weeks.

Prof Nolan said the high level of vaccination across society has seen the risk of infection become “much more evenly spread among the population”.

“When we go back to July and August, where young adults were not yet vaccinated we saw case counts dominated by the 16 to 30 age group… and 75% of hospitalisations were  under 65s.

Now that the vast majority of adults are protected through vaccination, the risk of becoming infected is much more evenly distributed across the age groups in the population. It’s higher for the unvaccinated than it is for the vaccinated, but it’s evenly distributed across the age cohorts in the population.

“So now because the risk is even, we’re beginning to see more older people become infected, and they are being admitted to hospital.”

He also said that too many people are assuming that because they are vaccinated that they can’t catch or carry the virus and therefore run the risk of transmitting it onto others.

“We do know that vaccination offers very high protection against severe disease, we do know that vaccination offers really significant protection against becoming infected, but that protection is incomplete,” said Nolan.

“And then the recent increase [in cases and hospitalisations], it’s clear to us that the recent increase is because of a relatively small increase in mobility and effective social contacts since the end of September.

“And also there’s a sense that that socialisation is moving indoors and we know that indoors is a higher risk environment.”

Nolan added that NPHET is not suggesting that it was just the slow return to workplaces from 20 September that led to this rise.

Dr Cillian de Gascun said the increased circulation of Covid-19 can also be seen with other viruses such as the winter vomiting bug, Norovirus.

He said it’s not a criticism of people’s behaviour and need to socialise, but rather an indication of how many opportunities viruses have to transmit between people now that restrictions have eased.

“As we’ve learned over the last number of weeks with the vaccine is that we still need to continue to [socialise] safely,” he said.

Dr Tony Holohan said he accepted it was difficult to understand why the figures are so high given high vaccination rates but that the protection offered by vaccines had to be combined with personal behaviours, such as mask-wearing and social distancing.

“It’s going to be our basic and collective commitments to all the measures that we know will suppress, that have already suppressed this virus in the past, that we need to achieve, over the course of the next number of weeks and months, to mitigate and prevent some of the potential effects of the transmission that’s occurring,” he said.

During this evening’s briefing Nolan also raised concern over the significant uptake in the number of admissions to “already well-overstretched” intensive care units.

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He noted that demand for testing is also very high with more than 15,000 tests going through public health labs per day, and close to 5,000 a day going through hospital labs.

He said it was a concern to see that the demand for testing and the positivity rate increasing at the same time.

When asked why contract tracing had stopped in most school, Nolan defended the decision saying: “Very few of those contacts were found to be positive anyway, between 3-5%.

“So the cessation was in the context of it not proving to be an effective mechanism to interrupt transmission, and at the same time, being a hugely disruptive mechanism in terms of excluding very large numbers of children from school.”

Dr Holohan commented that the risk of transmission for children of school-going ages now comes from their experiences in the community. He added that people who are symptomatic need to stay out of schools, workplace and social settings, and get a PCR test.

With reporting by Christina Finn

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