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Professor Sam McConkey: Prepare for Levels 4 and 5, yesterday just delayed the inevitable

Professor Sam McConkey says he understands the thinking behind yesterday’s decision by Government, but believes it won’t be enough to stop the second wave of Covid-19.

Professor Sam McConkey

A NATIONAL LEVEL 3 status is like a holding pattern over Gatwick: around and around, up-a-bit, down-a-bit, burning up fuel, delaying the landing, going nowhere and burning time.

Unfortunately, we are still in a pandemic and at the beginning of the second wave in Ireland. The first wave was in February and March: the second is growing now. During August it re-sprouted in Dublin, in September across the rest of the country.

Leaders across the world face the challenge of leading wisely through this unprecedented crisis, which, while it affects our health most immediately, also, affects all other aspects of our lives.

It affects our being with others, grieving for those we have lost, our ability to support the vulnerable in our society, our ability to provide a home for people to live in, our celebrating the great events of our lives, our livelihoods, the inequitable distribution of resources in our world. 

The Covid holding pattern

This infectious disease, like others, is intrinsically divisive and polarising, and at the same time retrogressive. It is affecting the most vulnerable people, families and groups disproportionately more than others. These features make more difficult the decisions that are needed to lead to the voluntary co-operation of most of five million people.

While Covid numbers in Dublin rose in August, over September there has been a gradual but persistent rise in the number of cases of SARS CoV2 in most counties of Ireland, outside of Dublin.

Again, we are experiencing outbreaks among vulnerable groups and in crowded housing, nursing homes, hospitals and crowded workplaces, as well as many in private homes. 

This rise was not as fast or as dramatic as the one in March, and most of the cases are in young people, who do not die quickly of lung failure, with rare exceptions.

Some of the young, however, may get scarring of their lungs or heart and may experience chronic fatigue. We also know that the virus is spreading presently to older people, who are getting sick. Predictably it is spreading into hospitals and nursing homes again.

The numbers of cases of Covid-19 and outbreaks and hospitalisation have levelled off in the last two weeks in Dublin, and the Level 3 restrictions seem to have had some impact. Perhaps the numbers might begin to drop a little bit more.

But this will take a very long time, much like losing your money at 1% negative interest per week. Levelling off just means staying the same, perhaps for months or years. That is years of Level 3 restrictions! 

In my view, this is not a desirable long-term way out of this pandemic. It is like flying around in circles for an unknown period of time in a holding pattern over Gatwick, as most of us have done for hours pre-2020: suspended time, delayed living until the plane runs out of fuel. 

Time is against us

So in my view, and the views of NPHET, we need decisive action soon to deal with this rise in Covid-19 in Ireland. The challenge is to do this while ensuring that as much as possible of the education of our children and of our productive economy succeeds and survives at the same time. 

Each business, and government department, in my view now should be testing and piloting plans for continuity of operations in level 4 and level 5 restrictions. The decision of the government yesterday, while it may give us time to prepare, just delays the inevitable need for more restrictions.

In our own personal lives, many of us have already wisely restricted the things that we do: like having people from solely one household in to visit us in our bubble, hand-washing, cough etiquette, wearing a mask in crowded places and working from home.

At an international level, Ireland can work with European partners for a Covid-19 free Europe. We can work with the UK on a joint approach to this, as two islands.

We in Ireland and Europe could achieve what most countries on the Asia-Pacific rim have done through a shorter period of more severe restrictions, where their economies and air travel and sports and social lives are now returning to what they want. 

The successful Asian and Pacific countries have diverse systems of government: some are authoritarian, and some are fiercely democratic. Internal flights in China have been up and running for months.

Travel between Covid-free Australia and New Zealand has opened up again. We in Europe could follow the same model into a future in which SARS CoV2 is controlled and its spread on our land is stopped completely, as we did for ‘SARS1’ in 2003. 

Our leaders have a difficult job and should be given the space and encouragement to lead us courageously, and from the front, in a way that protects health.

They have achieved this before by introducing the smoking ban in the workplace, or the tax on plastic shopping bags, or the ban on selling smoky coal in Dublin, or the unprecedented and effective actions to control Covid-19 in March 2020.  

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Prof Sam McConkey is Deputy Dean and Head of the Department of Tropical Medicine and International Health at the RCSI School of Medicine and Health Sciences and President of Infectious Disease Society of Ireland.

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Professor Sam McConkey

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