We enter the new year in the midst of a third wave of COVID-19, with hospitalisations, ICU admissions and deaths rising. The coronavirus has already claimed the lives of over 3,500 people across the island of Ireland, and this death toll is set to rise over the coming weeks. As of early January, there have been close to 200,000 confirmed cases of Covid-19 on the island of Ireland, a number that is set to rise significantly over the coming weeks. This is a consequence of governance by parties that have stubbornly refused to learn lessons despite almost a year of “living with the virus”.
The third wave of the pandemic is unfolding against the backdrop of a pre-existing health crisis. Before Covid, Ireland had the longest hospital waiting lists in Europe and a broken two-tier system. Close to half of the population pay for private health insurance as an alternative to the under-resourced public system. When Covid hit, the under-resourcing, under-staffing and over-work endemic in the public system led to one of the highest healthcare worker infection rates in the world. Elective procedures and non-urgent care were forced off, further adding to waiting lists.
As of the end of November, 850,000 people were waiting for some form of care, and according to the National Treatment Purchase Fund, 612,000 were waiting for their first outpatient appointments. Thousands more people are also suffering the effects of an ever-worsening mental health crisis. Both of these crises in health are severe but they will grow deeper if the cycle of surges and lockdowns continues.
The strategy of “Living With Covid” pursued by both governments on this island has been a disaster. A massive opportunity to crush the virus for once and for all was lost over the summer and a second wave was seeded instead. Leo Varadkar’s government caved to business pressure and lifted restrictions too early. The Northern Executive followed the Tory line and promoted the “Eat Out To Help Out” scheme, adding significantly to the momentum of the new wave.
Since then, their approach has been to keep society open until levels of the virus are dangerously out of control. This makes lockdowns longer, harder and more disruptive. Holding out to eliminate uncontrolled transmission of the virus is never considered. This approach is to gamble with public health to protect profits.
In December they gambled once again for the sake of short term profits. The Southern government again disregarded the expert advice of NPHET, despite clear warnings about the risks associated with opening retail and hospitality, while also allowing family gatherings over Christmas. Predictably, cases soared. We enter another lockdown in the knowledge that thousands of people will potentially pay for this gamble with their lives.
Thus far, each lockdown has been wasted. Our health services remain woefully under resourced. Our case management systems are totally inadequate. And despite the best efforts of teachers, schools remain unsafe, with poor ventilation and overcrowded classrooms.
Both the Fianna Fáil-Fine Gael-Green government and the Northern Executive would have us believe that there is no alternative to the current strategy, but this is not true. The experience of Australia, New Zealand and much of South East Asia shows us that a Zero Covid strategy is not only possible, but necessary if we are to avoid thousands more deaths and untold suffering as people endure the economic damage brought on by rolling lockdowns.
Moreover, with a new, potentially more infectious strain of the virus now in circulation, the failures of the last year will have even more devastating consequences if they continue to be repeated. At the time of writing, Taoiseach Mícheál Martin has acknowledged that mass vaccination is unlikely to happen in the first half of 2021. Completion of the immunisation strategy may be as late as Winter 2021. Governments North and South are hoping to kick the can down the road until vaccines are rolled out, but a more contagious strain of the virus would mean many more people would need to be vaccinated in order to protect the population. Additionally, vaccination efforts will be made more difficult in an environment where transmission of the virus is high as healthcare workers get sick and services are disrupted.
It is critical that we break immediately from the failed “Living With Covid” strategy and implement a strategy based on elimination. This would allow us to get the level of the virus so low that it can be tested, tracked, traced, isolated and therefore contained so that there is no community transmission. The key is to contain the virus so it can be prevented from spreading. This can be achieved by proactively seeking out the virus as cases decline, by finding asymptomatic carriers as well as symptomatic individuals and ensuring that they isolate themselves, so silent links in the chains of transmission can be broken.
This document sets out the measures necessary to eliminate community transmission and to help people get through the coming period.