It isn’t over. Taoiseach Micheál Martin and Nphet insist the country remains on track for a further easing of regulations next Friday week. It should mark the end of physical distancing requirements and restrictions on risky activities such as visiting a nightclub, but the World Health Organisation (WHO) has warned against the complacency that will accompany normality.
Anything could happen this winter, WHO Europe senior emergency officer Dr Catherine Smallwood told the Sunday Independent.
“The virus is certainly not sick of us just yet,” she said.
Dr Smallwood has been leading teams of WHO experts studying the crisis for the past 18 months, examining outbreaks across Europe and issuing recommendations for critical public health measures that have been the cornerstone of responses to Covid-19.
Her message is that we are not out of the woods yet. For Ireland to consider the next phase of dealing with the pandemic a success, people and the Government need to accept responsibility.
“I think it will be important for us all to be ready to continue to make smaller adjustments to our lives that will contribute to us all being safer, and at the government level, on the national level, is very much to really stay vigilant — to make sure that a smaller earlier intervention is going to be much more successful than a later more restrictive type of intervention.”
The changing shape of the pandemic here is positive, she added, allowing us to evolve and reopen society because of an effective vaccination campaign.
More than seven million doses have been administered here since last Christmas, and experts are quietly optimistic that eight million could be reached before the campaign is a year old. Vaccinating children and providing boosters would be factors in hitting such a figure, but should not necessarily be a formality, Dr Smallwood said.
The HSE is currently rolling out a third vaccine to people with compromised immune systems, and last week the European Medicines Agency cleared the way for a booster Pfizer shot to be given to healthy adults. This comes as research published in The Lancet showed the effectiveness of receiving two Pfizer jabs declines after six months.
The same research also shows two jabs remain effective at preventing hospitalisations, and Dr Smallwood said this must be considered. She agrees with a third dose going to priority groups and people who are immunosuppressed, but a mass booster campaign for young and fit people is not something the WHO recommends.
Dr Smallwood said it is important that countries with poor access to vaccines are given a chance to catch up so successes elsewhere are not “undermined by what we’ve allowed to fester in another part of the world”.
“Unless we close all the borders, we remain at the mercy of what happens anywhere in the world, and we know that even by locking down and taking drastic measures like closing borders, we’re still going to be affected by what’s happening in other countries.
“Many countries around the world who have not received vaccines actually have quite strong programmes for rolling out emergency vaccination campaigns because they’re more used to doing it. So many countries in the African region and around the Middle East have been rolling out large emergency campaigns for diseases like polio. They do have the systems and resources that are needed for the vaccine roll-out.”
No vaccines have been approved for under-12s, and while some feel this is inevitable, Dr Smallwood does not think a roll-out among children is a formality, considering “the risks from Covid are pretty minimal for younger children”. However, other factors will need to be considered, including younger people spreading the virus to older cohorts, especially with increased mixing likely after October 22 and in the lead-up to Christmas.
In recent weeks, there has been heightened transmission among children after the return to school last month, but concern has eased in the past few days. Last week, Professor Philip Nolan, the chair of Nphet’s epidemiological modelling advisory group, said the incidence of infection in five to 10-year-olds was lower than the corresponding period a year ago. Similar patterns have been seen abroad, but Dr Smallwood has reason to urge caution. They were only temporary interruptions.
“That might be initially as schools return there was a surge in testing and maybe a surge in cases, but actually, at the European regional level, we’ve seen an uptick just in the past week again.
“It’s the season of respiratory diseases and respiratory viruses. Obviously, we’re not only talking about Covid — there’s also other viruses that are circulating, so I don’t think it’s possible to say that trend will continue on the down. It really depends what happens over the season, and certainly there’s a very strong rationale to expect that the cases will go up again.”
Vaccinations and new virus variants will dominate the coming months. Even if we negotiate mutations of the virus, there are other challenges waiting to be dealt with, especially around the psychological impact of rolling lockdowns.
It looks like Ireland has turned a corner by exiting an acute phase of the pandemic, Dr Smallwood said, but “we can’t be sure yet”. It is not over yet, it seems.
“Anything could happen this winter, but let’s take an optimistic view and, if as we come out or as countries or communities come out of this very acute phase, a lot of things are going to emerge as major issues.
“It’s extremely important, and not just in terms of the indirect consequences Covid has had on people’s livelihoods, family lives and ability to socialise as normal human beings, but also, the post-Covid conditions — so, long Covid.
“Long Covid will become something that a lot of people will have been affected by in many different forms, and some people will be struggling with that. The impact of that on people’s mental health is also incredibly difficult — people who were perfectly physically fit young, active, who are struggling six months or a year on with the continuing effects of a disease that may not have hit them very hard in the first place but has really kept its claws in people and that’s a struggle, especially if you think of the number of people who have had Covid. We don’t fully understand these post-Covid syndromes.
“We don’t have good surveillance data around it, we don’t know the burden of disease that it currently represents. So that will be a big, big piece of it, and we don’t understand why it’s happening.
“And then, of course, all of the undetected cancers and the disruption to the health system that’s going to become more apparent over the next few months and more difficult to deal with as the effect of that will materialise.
“We still need to take sensible decisions and not throw caution to the wind at this stage.
“I’m not saying that everyone needs to stay at home and not go out, but just remain somewhat cautious because we’re not quite out yet.”