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Q+A: Everything you need to know about the Covid-19 crisis and Ireland's response to it

There has been one confirmed case in the Republic of Ireland.

Image: RollingNews.ie

GLOBALLY, THERE HAVE now been more than 90,000 confirmed cases of the coronavirus Covid-19.

While the majority of these cases are in China, an outbreak in northern Italy has spread rapidly with over 1,800 confirmed cases in the country. 

The situation across Europe is now changing rapidly, with new cases and new advice being issued sometimes daily. 

On Monday, the European Union raised the threat level from coronavirus to “moderate to high”

There are two confirmed cases of Covid-19 on the island of Ireland. The first case of coronavirus in the Republic of Ireland was confirmed on Saturday evening. 

The patient is a child from Scoil Chaitríona in Glasnevin, Dublin 9. He is currently receiving medical treatment.

The school is currently closed for two weeks. 

Here’s everything you need to know about the current response in Ireland.

What is a coronavirus and what is Covid 19?

Source: TheJournal.ie/YouTube

Coronaviruses are a large family of viruses which may cause illness in animals or humans.

In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases – such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

The most recently discovered coronavirus causes Covid-19, with the first known cases in the Chinese city of Wuhan in December 2019.

The virus that has been spreading is officially called the severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2. But the disease this virus causes is called coronavirus disease, or Covid-19.

Viruses and connected diseases often have different names – HIV is the virus, the disease it causes is called AIDS.

The World Health Organisation (WHO) was worried that using the virus name (SARS-CoV-2) would cause unnecessary fear for some populations, particularly in Asia because of the 2003 SARS outbreak. So you’ll hear experts calling it Covid-19 or the Covid-19 virus.

What are the symptoms and how different is it to the seasonal flu?

Source: TheJournal.ie/YouTube

Symptoms of Covid-19 include:

  • Fever
  • Dry cough
  • Shortness of breath
  • Breathing difficulties
  • Tiredness

Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually.

There may be cases where a person becomes infected but does not develop any symptoms. 

Most people (about 80%) recover from the disease without needing special treatment. Around one out of every six people who gets Covid-19 becomes seriously ill and develops difficulty breathing.

Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness.

Cillian F De Gascun, director of the UCD National Virus Reference Laboratory, said last week that a lot of respiratory viruses cause similar symptoms – the difference here is the transmissibility and the severity of the illness.

“From a severity perspective, based on the cases that have been reported to date, it seems that the case fatality rate for the novel coronavirus is greater than that of seasonal influenza,” he explained.

“Now, it’s possible that the ultimate infection fatality rate will be lower, but at the moment, of the laboratory-confirmed cases, the case fatality rate is about 2%, which is about 20 times higher than what we would see for seasonal influenza.”

Why aren’t we restricting travel to Ireland from affected areas or screening as people come in on flights?

Several European countries have taken extra precautions following the Covid-19 spread in Italy. Austria, which borders Italy, has said people who are travelling from affected areas in Italy will be stopped from crossing its border.

Croatia said people returning from Italy will be questioned by border police and sanitary inspectors.

Here, the government is advising Irish citizens not to travel to a number of Italian towns, but is not placing any restriction on those travelling from affected areas. 

The EU has also said that closing borders in the Schengen area is not currently being discussed. 

De Gascun said screening at airports is not a good use of resources.

“It’s not terribly effective, because the majority of people won’t necessarily be symptomatic when they pass through an airport,” he explained.

Source: TheJournal.ie/YouTube

“There may be certain situations where you might target a specific flight from a specific region at a specific point in time, but as a general mechanism, it’s not recommended as a good use of resources. And it’s not recommended as an effective means of screening individuals.”

Instead, the HSE is asking people who believe they are showing symptoms to self-isolate and to contact their GP or Public Health. 

Health minister Simon Harris has repeatedly said that his department and the HSE will only put in place World Health Organisation-recommended measures and measures recommended by Public Health doctors in Ireland.

He has also been insistent that stopping flights from Italy would not be a “proportionate” or useful measure. 

There are protocols for passengers presenting with acute respiratory infection on an inbound aircraft and these have been used in recent weeks.

On Monday, Ryanair announced that it would be cancelling up to 25% of its Italian short-haul flights for a three-week period later this month in response to the Covid-19 coronavirus. 

The cancellations will occur between Tuesday 17 March and Wednesday 8 April. 

“Our focus at this time is on minimising any risk to our people and our passengers. While we are heavily booked over the next two weeks, there has been a notable drop in forward bookings towards the end of March, into early April,” Ryanair CEO Michael O’Leary said. 

Aer Lingus has also waived its change fees for anyone travelling to Milan, Venice and Verona within the next week. 

This is provided that travel occurs within 30 days of the original flight date and is to and from airports in Italy, Switzerland or Nice in France. 

What are the protocols in Ireland if someone is showing symptoms?

Anyone who has been to one of the following affected areas in the last 14 days is asked to call the HSE on 1850 24 1850:

  • China
  • Hong Kong
  • Iran
  • Japan
  • Singapore
  • South Korea
  • In Italy, the provinces, Lombardy, Piemonte, Veneto and Emilia – Romagna

If you stayed at the H10 Costa Adeje Hotel in Tenerife since 17 February and have symptoms, you are also advised  to contact your GP or local emergency department and to self-isolate. 

You should also contact the HSE if you have been:

  • in contact with a person who has coronavirus;
  • in a hospital or healthcare centre where people are being treated for coronavirus.

If you been to one of the affected areas but are feeling well and have not been in contact with coronavirus, you will be told to watch out for symptoms over the next 14 days.

You can continue with your daily life and go to work as usual.

If you have had close contact with a person who has coronavirus, you will be monitored for 14 days. A doctor will phone you daily to make sure you remain well. You will be asked to stay separate from other people as much as you can for 14 days. This includes not going to work.

If you’ve been to an affected area in the last 14 days and have a cough, fever (high temperature), feel short of breath or have difficulty breathing, you should:

  • phone your GP, emergency department (ED) or student healthcare centre immediately;
  • stay indoors;
  • avoid contact with other people;

People should follow this advice even if their symptoms are mild. 

Do not go to your GP’s surgery, the Emergency Department or a healthcare centre – phone them first. 

This is so you do not accidentally put other people at risk. Your GP or doctor will tell you over the phone what to do next.

The Department of Health and the HSE is also advising deaf people who believe they may have symptoms to ask a friend or relative to contact the HSE. 

On its website, the HSE also advises deaf people to contact the HSE using Irish Remote Interpreting Service, which is available from 9am to 7pm Monday to Friday and 10am to 4pm on Saturday. 

Who exactly needs to self-isolate?

Only people who have returned from an affected area within the last 14 days and who develop symptoms need to self-isolate. 

People who have returned from an affected area, but who haven’t had contact with another person who has the virus and who are not feeling unwell themselves, do not need to self-isolate.

This advice also applies to school groups who have travelled to affected areas – only those showing symptoms need to self-isolate. 

In a bid to reduce pressure on hospitals, the government has decided that an individual who has been tested for the virus can be asked to go home to self-isolate.

In relation to the school in Dublin, the HSE has said that asking it to close for two weeks is a “precautionary” measure. 

Chief Medical Officer Dr Tony Holohan, in a letter sent to the parents of all school children in the country, said: “Siblings not attending the school concerned, parents and other members of the community are not regarded as contacts and can continue their daily routines as normal.”

The HSE has also written to members of a teenage band in Clontarf, north Dublin to ask them to self-isolate as a precautionary measure. 

The Health Service Executive has written to members of the community musical group urging them to self isolate as a precautionary measure. 

No new case of Covid-19 is involved. All members of the band who attended the practice session are being treated as potential contacts and have been urged to self-isolate until 15 March. 

What is the test for the virus and how long does it take?

Source: TheJournal.ie/YouTube

Details will be taken from a person such as country/cities of travel, dates of travel and arrival in Ireland, contact with confirmed or suspect cases and visits to markets.

They’ll also be asked about the date of the onset of symptoms.

People only need to be tested if they have symptoms and have in the last 14 days:

  • been in close contact with a coronavirus case;
  • been in a country or region with an outbreak; or
  • been in a healthcare centre/hospital where patients with the virus are being treated.

If a doctor suspects a patient may have the virus, they will tell them where the test will be done. 

The UCD National Virus Reference Laboratory will then be informed before a sample is dispatched for testing.

A respiratory sample will be taken – this is a swab taken from the nose or throat.

At the lab, a molecular diagnostics method is used to detect small amounts of the genetic material of the virus. 

Estimated turnaround time is 12 to 24 hours.

The rugby match is cancelled – why? And what about the Paddy’s Day parade?

The IRFU has agreed to postpone next month’s scheduled Six Nations rugby match between Ireland and Italy.  

It had been due to take place at the Aviva Stadium on the 7 March. 

Two other games, the under-20s Ireland vs Italy game scheduled for 6 March and the women’s Ireland vs Italy game scheduled for 8 March, have also been postponed. 

52 people have died in Italy so far from coronavirus. 

As things stand, none of Ireland’s other games have been cancelled. The government is also looking at Dublin’s hosting of four Euro 2020 games this summer, Minister for Transport, Tourism and Sport Shane Ross has said. 

Looking ahead as to whether or not the St Patrick’s Day parades due to take place in Dublin and elsewhere should be cancelled, a decision is set to be taken in the coming days. 

Guidelines on mass gatherings are expected to be published this evening.

An expert sub-group within the National Public Health Emergency Team was established to develop criteria for the risk-assessment of mass gatherings.

These criteria will be based on guidance from the European Centre for Disease Control and the World Health Organisation (WHO).

Today, Taoiseach Leo Varadkar said that as of now there are no recommendations to cancel any large gatherings.

“We’re not advising anyone to cancel any gatherings at this stage but bear in mind the St Patrick’s Day festival and events are two weeks away and a lot can happen between now and then,” Varadkar said. 

“As of now, we’re not advising anyone to cancel major events or major gatherings such as that, but that could change and there will be new advice published later today and tomorrow on major gathering.”

When will there be a vaccine or cure?

In the US, biotech company Moderna Therapeutics has shipped the first batches of its Covid-19 vaccine to the National Institute of Allergy and Infectious Diseases, which will prepare the vaccine for human testing as early as April.

As reported by Time, the trial will be the first to test a drug for treating Covid-19, and will be led by a team at the University of Nebraska Medical Center. The first patient to volunteer for the study is a passenger who was brought back to the US after testing positive for the disease aboard the Diamond Princess cruise ship. 

Other patients diagnosed with Covid-19 will also be part of the trial. 

Speaking to TheJournal.ie last week, De Gascun said “there’s work ongoing on a vaccine already” but that it could take 18 months before one is available. 

Source: TheJournal.ie/YouTube

 “And a lot of work was done in the past with SARS and MERS (other versions of coronaviruses) so we can build on that – we’re not starting from, I suppose, square one, if you like. 

In addition, we also know that there are vaccines available against some animal coronaviruses. So the technology is there, there’s no reason in principle why we won’t be able to develop a vaccine. 
However, obviously safety will be paramount and efficacy will be just as important. So realistically, that will take probably 12 to 18 months before we see a vaccine on the market. 

“Because again, if you look at, say, something like seasonal influenza, even though we know what that virus is in advance, that takes us about six months purely from a manufacturing capacity and scaling up production [point of view],” De Gascun said last week.

How likely are we to have more cases here?

The HSE’s current advice states: “The risk of catching coronavirus in Ireland is still low. This may change.”

More than 100 people here had been tested as of last Thursday. An official update on that figure will be provided by the government today.

When the first case in the Republic of Ireland was confirmed, Holohan said that it was “not unexpected”. 

Ireland is still in the “containment” phase but today Taoiseach Leo Varadkar said that there is a “moderate to high risk” of more cases occurring.  

“A small percentage of those people may get very sick but it is important to bear in mind that at this stage we only have one confirmed cause in Ireland and that case was an imported case,” Varadkar said. 

“So, some of the actions that you see taking place in other countries are not necessary in Ireland at this stage, so there will be no panic but there will be no complacency.” 

A Cabinet sub-committee on Covid-19, chaired by Varadkar, is set to meet on Monday. 

Are the hospitals here prepared? 

Concerns have been raised about how prepared Irish hospitals are. 

The HSE has issued the following information about its preparations: 

  • All acute hospitals have identified isolation facilities specific to Covid-19 
  • Acute hospitals are establishing multi-disciplinary Covid-19 preparedness committees to oversee implementation of the Health Protection
  • The critical care services have developed management guidance for the care of any patients with Covid-19 who should require their services
  • The National Ambulance Service is actively engaged in risk assessment for all suspected Covid-19 cases and the appropriate response to case recognition and containment.
  • More than 13,500 Personal Protective Equipment (PPE) packs have been distributed to GP Out of Hours Services, Public Health Departments and GP Practices

In relation to capacity and isolation in Irish hospitals, Holohan said: “Obviously, we’re at the early stages of this … We’re currently looking at all of the relevant options around [a] surge, but at the moment that’s not facing us; we do have a capacity within the system for isolation.”

He added that the NPHET is “very aware” that ICU capacity is “well used right now”. 

“So from our point of view, as we plan and as this situation develops, we will ensure our national crisis management team look at capacity and surge and various requirements around search, not just for isolation but for overall capacity both in the hospital and community,” Holohan said. 

On Sunday, Dr Ronan Glynn, the deputy chief medical officer, said that Ireland’s “laboratory capacity is more than capable for managing the number of tests that are required at the moment”. 

Source: TheJournal.ie/YouTube

Are school exams going ahead?

No state exams, whether Junior Cycle or Leaving Certificate, are being postponed or cancelled because of the Covid-19 outbreak.

Leaving Certificate and Junior Cycle oral and practical examinations are still set to begin in all secondary schools on the 23 March and to will run until 3 April.

The Department of Education declined to comment on how Scoil Chaitríona, which is now closed for two weeks from Monday, will respond. 

But a spokesperson said that the State Examinations Commission said “many kinds of exceptional circumstances arise in schools each year immediately before, and during, the conduct of these tests”. 

The spokesperson said that the State Examinations Commission will engage “with school authorities to make any alternative arrangements that may be required acting in the best interests of the students concerned”. 

No other schools are being closed in response to the Covid-19 outbreak. 

How are employers responding?

On Monday evening, Google asked the majority of its 8,000 employees to work from home after a staff member reported flu-like symptoms. 

The person who is sick has not been diagnosed with Covid-19.

The Department of Social Protection has issued advice for workers who are diagnosed with Covid-19. 

Where an employee is diagnosed, normal workplace arrangements in respect of sick-absence should apply. 

The employee should be treated from a workplace perspective in the same manner as any member of staff who takes sick-leave for any other reason, according to the department. 

Employees diagnosed with Covid-19 can apply for income support from the Department of Social Protection in the form of illness benefit based on social insurance contributions or supplementary welfare allowance based on a means test. 

If someone has not been diagnosed with Covid-19 but has been advised to self-isolate can apply for income support from the Department of Social Protection if the employer ceases to pay them a wage. The same applies if someone is requested to stay at home by their employer as a precaution against the spread of Covid-19. 

How is it spread and what can I do to prevent myself from getting it?

Covid-19 can spread from person to person, usually after close contact with a person infected with the virus, for example in a household, healthcare facility or workplace. The virus can be spread either:

  • Directly, through contact with an infected person’s body fluids (eg droplets from coughing or sneezing)

or

  • Indirectly, through contact with surfaces that an infected person has coughed or sneezed on and which are, therefore, contaminated with the virus. It is still not known how long the virus survives on surfaces, although current information suggests the virus may survive a few hours. Simple household disinfectants can kill the virus. Surfaces should be cleaned first and then disinfected. 

While people are most likely to pass on the infection when they have symptoms, there are some indications that people may be able to spread the virus before they develop symptoms.

The NPHET has issued the following advice about how people can best protect themselves from getting Covid-19:

  • wash your hand properly and regularly – in general, and after coughing and sneezing; after toilet-use; before eating; before and after preparing food
  • cover your mouth and nose with a tissue when you cough and sneeze. 

Source: TheJournal.ie/YouTube

Should I believe information on social media?

Be very wary of what you see circulating on Twitter, Facebook or WhatsApp. 

The government has come under scrutiny for its decision not to name the school or even the location linked to the confirmed case of Covid-19. But there is no media blackout

And while some things you see online may have nuggets of truth, they’re often sowing misinformation and adding to the at-times cloudy conversation about coronavirus.

Rely on reputable news sources and the HSE website to inform you about the spread of Covid-19 and the precautions you should take. 

From now on, there will also be a briefing every day for the media on the spread of the disease. These will provide up-to-date information on cases and the spread of the virus in Ireland. 

Additional reporting by Gráinne Ní Aodha, Dominic McGrath and Nicky Ryan. Videos by Nicky Ryan

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About the author:

Michelle Hennessy and Órla Ryan

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