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Leah Farrell

Daily cases would be 'north of 10,000' without vaccines: The key points from today's NPHET briefing

Schools and nightclubs not driving latest Covid surge, when cases with plateau, and “public confusion” over antigen tests.

PUBLIC HEALTH OFFICIALS today reported 3,174 new cases of Covid-19 in Ireland, with 460 people in hospital with Covid-19, 86 of which are in ICUs.

The National Public Health Emergency Team (NPHET) said that there had been 56 deaths notified to them in the past week, bringing Ireland’s total to 5,436.

Today’s briefing was led by Chief Medical Officer Dr Tony Holohan, Chair of the NPHET Irish Epidemiological Modelling Advisory Group Professor Philip Nolan, Clinical Lead on Infection Control at the HSE Professor Martin Cormican, and Director of the National Virus Reference Laboratory and medical virologist Dr Cillian De Gascun.

Here’s a rundown of the main points made today amid an autumn surge in Covid cases.

The vaccine’s effectiveness

Prof Nolan was asked how many cases modelling estimates there would be if over 90% of Ireland’s population aged 12 and older had not been vaccinated.

“There’s different ways to answer that question. But the simplest way is to imagine that just right now, we could turn off everybody’s vaccine protection, rather than going back in time.

So if we turned off everybody’s vaccine protection now, within a generation time, which is 4-5 days, you’d see somewhere north of 10,000 cases a day.
If nothing else changed and everybody is freely mixing in society, 3-4 days later, there is no reason to believe you wouldn’t see four times that again.

“So they are unimaginable numbers, in a way. So it’s a very good question because it underlines this huge job that vaccine protection is doing in interrupting the very significant number in infections.”

NPHET still isn’t gone on antigen tests

Dr Tony Holohan said that they know that antigen tests are being used by people with flu-like symptoms to test whether they have Covid-19, “which is not a safe conclusion”.

In particular, it’s not safe in the context of having continuing symptoms and going on to do other things.

“So in other words, sending children to school when an antigen test is negative, even though they’re symptomatic, or going to work, or going to the pub, or going to wherever it is you need because an antigen test is negative.”

Dr Holohan said that the question around antigen tests hasn’t been should they be used, but rather when should they be used.

I think there is a substantial amount of public confusion about antigen tests, that they get applied in circumstances which they shouldn’t be applied, and used in situations where people are symptomatic, and other circumstances.

If you have symptoms of Covid-19, the official health advice is to not rely on the results of an antigen test and to get a PCR test.

Dr Holohan added that there are effective ways to use antigen tests.

“If you’re thinking about, for example, going to nightclubs, to socialise, and your antigen test is positive and you stay away, that’s a further positive contribution to reducing risks if you’re going to that nightclub in any case.

“And that’s a key difference in terms of the potential use of them in previous situations before nightclubs were open and people were saying, ‘if we could use antigen tests, we could we could open a nightclub that wouldn’t otherwise be safe to open’.”

Schools are not the cause of the increase

“I’d like to take the chance to talk to the children,” Prof Cormican said at today’s NPHET briefing. “The numbers we’re looking at now, it is not your fault. It’s not because you’re going to school.”

Prof Cormican said that “the least way Covid spreads” is for a child to give Covid to an adult, and the next least way it spreads is for a child to transmit it to another child. 

The next stage is for an adult to give it to a child, and the most likely way of transmission is for an adult to give it to another adult, he said.

Covid cases NPHET Department of Health Department of Health

NPHET officials said today that data indicates that the “adult mobile population” is causing an increase in cases due to “broad mixing”, and not the spread of Covid-19 among children alone.

Nolan said that international evidence, where groups looked at studies across the world; analysis of Irish modelling; and the contact tracing testing in schools being low in the first place, all together suggests that there is a low rate of transmission in schools. 

Nolan added that the mid-term break “forced infections” among children aged 5-12, compared to the week before where it appeared to stabilise. 

Neither are nightclubs alone

Dr Holohan said that though attending nightclubs is part of the increase in cases, it is not driving the current surge in infection, as the cases are increasing across a much broader base of activity and across all ages – as far as the mid-70s age group.

Covid-19 test positivity rate was 6% in mid-September, and has increased progressively over the weeks – it’s now in excess of 15%.

Test positivity is also increasing across all age groups – most markedly in those aged 13-30 years of age, but its “right across the full spectrum of ages”.

The resultant impact of that is an increase in age specific incidence right across the entire population, with the exception of the possible protection through boosters of those over 75.
“This isn’t about one age group or one particular behaviour,” Holohan said.

We don’t know when cases will fall

“It’s very hard to say when,” Prof Nolan said in response to questions about when it’s expected current cases numbers will level off, saying it was an “impossible question”.

“Some of our models, the most recent set of models that we’ve run, would suggest that will happen relatively soon – in the course of November.

“But an important caveat there is waning vaccine-induced immunity is not contained to those models yet. 

“It’s very hard to estimate how many people out there have become infected that we don’t know about because there were asymptomatic undetected infections, and if you change those assumptions, you get a very different profile over the coming months.

One set of models shows a peak or plateau developing in late November into early December, and cases declining from that point. But other models show later, longer, higher and much slower to decline peaks.

Prof Nolan added:

The cases we are reporting today are infections that occurred a week ago, maybe a little bit more. All we know right now, is how the virus was transmitting 10 days ago.

“The fundamental message is, sure – we’ve done this before, we’re tired, and it’s harder because we’ve done this before and we’re tired – but it is our job to clearly message the necessity, and we have to remain optimistic that people will hear that message.”

Will those aged under 60 be getting booster vaccines?

Professor Philip Nolan said: “It’s a much bigger question to ask yourself ‘Are we going to remedicate an entire population as a substitute for observing some basic public health measures like washing your hands or wearing a mask on public transport?’

I have no doubt in other jurisdictions have shown if you decide to re-vaccinate the entire population, you will cut transmission. It’s a very big policy question about whether that’s an appropriate thing to do.

Dr Holohan said that they don’t see boosters as a potential control measure.

Prof Cormican said that the biggest concern they have is for those who haven’t had a vaccine yet, as “that’s who we are disproportionately seeing in hospital”. 

“If you haven’t had it yet, we’d love to see you,” he added.

Ventilation on public transport

Prof Philip Nolan said that ventilation on public transport, though important, is not the main factor to prevent the spread of Covid-19 on buses and trains.

“The person beside you on the train, if they have Covid-19, they’re a risk to you, but they’re probably not much of a risk to someone 5 or 6 metres away on a bus.”

He said that the key to stop the spread of Covid-19 on public transport is for symptomatic people to stay away, and asymptomatic people wear their mask.

“The thing that is offering immediate protection is the mask wearing, and I think we need to get into perspective the virus being transmitted across long distances is rare, and is also mitigated by ventilation.”

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    Mute Bernadette Dunne
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    Nov 20th 2011, 4:13 PM

    Best of Luck to all and do not give up keep the pressure on even when yea feel like giving up this government are going away the people are not Best wishes

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    Mute John Woods
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    Nov 21st 2011, 2:13 AM

    If they are looking to close down a “house” to save money, I can think of one or two places which could be shut instead of this nursing home. Senate, Farmleigh, even Aras an Uachtarain for god sake.

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    Mute iWmTN8uK
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    Nov 20th 2011, 7:05 PM

    To those of you against this and other cuts, where do you propose money is going to majestically fall from? The trees?

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    Mute elaine
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    Nov 20th 2011, 8:47 PM

    Cut management who are clearly failing at their jobs, cut back office nobodies, do not take the homes out from under innocent vulnerable people!!

    68
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    Mute John McHugh
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    Nov 20th 2011, 11:29 PM

    I would hate to burst your bubble Micheal but the Euro is a fiat currency.
    So although it doesnt grow on trees, it is made from trees and holds as much value as there is nothing backing it.

    So ironically enough value wise it may as well grow on trees.

    But hey, karma’s a bitch.
    When you grow old and have your pension used as collateral for greedy gamblers so that they don’t have to put their hands into their own pockets, maybe your mark on society will leave you high and dry and out in the cold to die.

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    Mute Declan Carroll
    Favourite Declan Carroll
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    Nov 21st 2011, 12:29 AM

    Meanwhile our last Minister for Health, Mary Harney, is in receipt of E130,000 a year pension. Not bad for someone who’s very political philosophy lead to the ruination of an entire nation. What does that work out a week ? FFS !!!

    34
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    Mute John
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    Nov 21st 2011, 12:44 AM

    So…in your world, we all just lie down and let the establishment cut us back to a third-world society. I guess the “those of you” you refer to don’t come from the Banking World?

    24
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    Mute Niall Mulligan
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    Nov 21st 2011, 1:15 AM

    Attaboy, Declan.

    The biggest problem I see at the moment is that cuts and taxpayer pain seems like a soft option to our leaders, only way to make them change course is to have them fear the electorate. We need to seem more protests, hopefully this is only the start.

    22
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    Mute Bernadette Dunne
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    Nov 21st 2011, 3:54 AM

    There is money going out on HUGE SALARIES TO TD’s Ministers Senators county Councillors an Tanaiste Bankers and top Civil Servants management teams etc etc etc it is time that their wage be cut with a very sharp cut and now they are way overpaid

    15
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    Mute Carr Barnes
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    Nov 21st 2011, 8:11 AM

    What if the government told you you had to move out of your home to another area? And while imagining that take into account u.at you can’t just hop onto a bus or into a car to go see friends or family meaning you would be isolated in a place you don’t know with people you don’t know. These are people not boxes of junk.

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    Mute Daniel Dunne
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    Nov 21st 2011, 2:41 AM

    I attended this march today and it is sickening to see what those in power are willing to do to very elderly citizens. But reading between the lines, there is planning permission granted for a private nursing home within 100m of the current public hospital. It seems the “brown envelope” culture is still strong in our nation.

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    Mute Bernadette Dunne
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    Nov 21st 2011, 3:58 AM

    Is the private nursing home connect to James Reilly by any chance in abbeyleix

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    Mute John Ryan
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    Nov 21st 2011, 1:11 AM

    Michael, where did the money come from to pay back the bond holders? Seems there was no bother there. Let’s get our priorities straight and look after our own first instead of accepting our politicians arse-licking the fat cats in Europe who are effectively running the show now and it’s people like this who get left in the shit. Good Luck to them, I hope justice prevails!

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    Mute CMD
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    Nov 21st 2011, 5:46 AM

    Bernadette you have probably near enough hit the nail on the head. There is some vested interest involved – some fat cat will benefit from this closure. And the frightening thing is that ordinary people really have no power against this sort of thing for another 4 and half years till we get a chance to vote this shower out. I’d bet the next government will be made up of a lot of independents. People just won’t trust any party from now on.

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    Mute Dave O'Doherty
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    Nov 21st 2011, 6:37 AM

    CMD, it’s a pity that some people think that the people only have power once every five years. We have it all the time, 24/7.

    Problem is, we have such a short memory that our next government will probably be a coalition of FF and FG who will both still (amazingly) have enough support to get in after Labour are butchered like the Greens.

    We’re a country of lambs and lambs get slaughtered. Simples!

    11
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    Mute John
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    Nov 21st 2011, 2:34 AM

    Current Government Minister with an ‘Overwhelming Mandate’ in a rare moment of humble contemplation: “Hmmm…Imagine if the referendum on Oireachtas inquiries had passed and then we could have made an example of these obstinate protest march organisers (in matters of general public interest of course, and with little or no recourse to the Courts) for defying this Governments’ agenda on the Privatisation of Everything.”…Maybe in the next Referendum?!

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    Mute Frank McMahon
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    Nov 20th 2011, 10:25 PM

    the sign wouldve been more effective if it said “im NOT a celebrity, you cant get me out of here..”

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    Mute CMD
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    Nov 21st 2011, 11:20 AM

    Dave I agree with you about the “sheep” who will still vote FF or FG regardless of what either party do while in office. My point is that we really have no power at this moment to stop the closure of nursing homes, barracks or hospitals. They will be forced on us, we will be told it’s for the good of the economy or health and safety and in 4 years time a lot of these actions will be forgotten and the same merry-go-round of promises, speeches and bulls….t will start again. And most people will fall for it all over again. I’m long enough around to have seen it all many times. I just despair of this country. Then we have so many young people who won’t even vote – ach sin sceal eile!

    2
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