Covid-19: Ireland at 'delicate balance between suppression of the disease and further outbreak'

As the country recorded its highest daily death toll from the virus, new modelling suggests that Ireland may have turned a corner in the fight against the spread of Covid-19, with the virus now close to contained.

However, easing any of the current restrictions will need careful consideration to prevent a further spike in the disease. That’s according to the latest modelling carried out by the National Public Health Emergency Team (NPHET).

The latest study suggests that the reproductive growth rate of the virus, known as the RO, which measures how many people each infected person passes the disease onto, now stands between 0.7 and 1. At the beginning of the crisis, the RO here roughly stood at 4.

“The modelling suggests we may have reached a plateau,” said Philip Nolan, chairman of NPHET’s epidemiological modelling advisory group.“We’re at a moment of very delicate balance between suppression of the disease and further outbreak.”

There is currently no need to drive the RO any lower, said Prof Nolan.

“The challenge now is to find a way to keep it at that level using more liberal measures,” he added. “If we are thinking about relaxing measures, even slightly, we need to be very careful.”

Serious concerns have also been raised about the growing death toll in nursing homes and in residential settings. This followed the deaths of nine residents at a centre of psychiatry of old age in Portlaoise.

Eight of the residents at the Maryborough Centre at St Fintan’s Hospital tested positive for Covid-19. Measures are ramping up to control the spread of the virus in these homes, including more focused testing, according toTony Holohan, Ireland’s chief medical officer.

Minister for Health Simon Harris said stopping the spread of Covid-19 in nursing homes is now his number one priority.

“We need to have a serious conversation about how we care for older people in this country after this pandemic, the current model is not fit for purpose,” he said.

Ireland recorded its highest daily death toll from the virus yesterday, as a further 43 people lost their lives due to Covid-19. A further 724 new cases of the virus were also confirmed, bringing the total number of cases here to 13,271.

However, the epidemic had continued here unmitigated, Ireland would have been heading towards 7,800 new cases of the virus confirmed yesterday, said Prof Nolan.

“By [April 23], we’d be looking at 2,200 people requiring intensive care and we wouldn’t be able to look after them,” he said. “This is a very serious situation that was prevented by measures taken on March 28.”

Meanwhile, the temporary takeover of 19 private hospitals could cost the state more than €300 million over the next three months.Under the three-month deal brokered all patients attending private hospitals will be treated as public patients and no private work can be carried out.

While the Department of Health said details of the agreement with the Private Hospital Association were “commercially sensitive” and “confidential” it confirmed that the HSE has already made “advance payments” of €90 million to private hospitals for the month of April.

The deal, however, has also left 600 ‘private-only’ hospital doctors in limbo following a wrangle between the Irish Hospital Consultants Association (IHCA) and Department of Health over the ‘public-only’ terms of a proposed temporary contract.

The Irish Examiner has seen the terms of the agreement between the HSE and private hospitals, which specifies that “no private work” will be permitted and that staff costs will only be reimbursed up to a maximum salary of €200,000 per annum.

The agreement also suggests that the onus was placed on private hospitals to encourage ‘private-only’ doctors to sign up to a Category A type contract, which excludes all private work. To date doctors working exclusively in private hospitals have refused to sign, maintaining that their private patients should not be abandoned.