'There will be casualties': Decisions facing Govt 'most difficult' in 100 years
Associate Professor and Head of the Department of International Health and Tropical Medicine at the Royal College of Surgeons in Ireland (RCSI), Professor Sam McConkey has said that the decisions facing the government are the most difficult in the past 100 years.
The key questions are going to be what businesses should be supported and in what way. “There will be casualties,” he warned.
“There are many different models to look at how we support industries that we all feel are essential.”
Prof McConkey called for a “look at reallocating staff” to essential services like health care, utilities, distribution networks. “We need to find some way of reallocating work, to get people reskilled for the new ways that we're going to be working.”
“Our government have listened to public health and medical experts and got us into this in a very robust and very effective and very prompt way, they haven't dallied around waiting, they've been effective in taking unprecedented action rapidly,” he told RTÉ radio’s Morning Ireland.
When we look at the total death rate in Ireland over the last four, six, seven weeks, and compare it to what it was one to five years ago, we find that there's been very little change. That's very different from Italy, Spain, particularly London and shockingly New York so I feel the last six to eight weeks have been largely a success.
“That model of listening to technical experts has worked very well to get us into this, I don't feel it will work particularly well to get us out of this because a lot of the key decisions are about getting the economy going again about asking how do we pay for this, about what businesses do we support, how do we support those businesses, do we nationalise them, do we do a grant, do we do a guarantee? And those are intrinsically financial and political decisions.
“I believe that some of the hardest decisions we've ever made in Ireland in 100 years - I think we need broad cross party support for those really tough decisions.”
Prof McConkey said that he believed the whole of Irish society has been bearing the brunt of the restrictions, not just the over 70s. When asked if some restrictions should be lifted, he said: “I think the answer is yes that doing things outside while we're two to three metres away, particularly if wearing masks, is completely safe.
“Testing is really key, because inevitably the coronavirus is going start spreading again in Ireland either with reintroduction from outside or from small areas where it is still there, once it starts up in one area it's particularly important that we detect that really quickly and effectively, when I say quickly, I mean within a few hours.
“The things I'd like to see about the testing system is one that it is accessible that when a GP orders a test, that it can be done within a few hours, and get a result within a few hours, and then that their first level contacts are notified and actions taken at a community public health level to try and prevent the onward spread of that one infection that has been detected and that first contact, possibly even second degree contact can be notified certainly within six hours and perhaps even in a shorter time period so we've finished all the contact tracing by three or six hours and that prevents them, that one case becoming the seed of a new outgrowth of a new epidemic, of a new wave of infection in the contacts of that person, so I think testing is essential - as the number of cases dropping in the last few days - we'll be able to get more on top of it (testing problem).”
When asked if it was a case of health versus wealth, Prof McConkey replied: “I don't think it is a case of pitting health against the economy because the strongest predictor of health in any society or any individual or family is really their wealth, so unless we can get back to work to create value as individuals and society and communities who won't have the financial resources to provide basic things like medicine, like, food, like water, like nice housing, spacious housing, and the comfortable lives that allow us to have health.
“So I really think it is a false pitting of one thing against the other when people talk about is it health or is it the economy? Because you need wealth, you need education, you need all the things that come with wealth to be a healthy individual and healthy economy.
That's by far the longest predictor of long life expectancy or good health outcomes, is having a wealthy economy.
“The second most important one is equity - so my view is we need to consider also values - like to what extent do we want to rebuild our world in Ireland in a sustainable way that is ongoing sustainable for the next 50 or 100 years, to what extent do we want to have social equity, financial equity, wealth equity.
We've gotten more divergent in Ireland, we've gotten more inequitable in Ireland over the last 20 years, as have other countries, I am uncomfortable with this and I feel we need to look at social equity as a social value.
“Those debates in my view are best had, not necessarily on the airwaves, but actually in Dáil Éireann - our 160 elected representatives should be on Zoom or Facetime or whatever socially distanced way, having those discussions about trying to find strong support for centrist positions that the majority of us, 70-80 per cent of the population, and elected deputies can support about how we work together to get out of this. Because there are going to be casualties.”
The key questions, he said, are going to be – “Which industries should the public purse support? Should we nationalise them? Should we re-capitalise them with a controlling stake?
