Covid19: Public attitudes will show in numbers game to stop the spread

As it happens, going by Thursday’s giant jump to 191 cases in a single day, we could be looking at about 450 new cases come tomorrow night, writes Cianan Brennan

As it happens, going by Thursday’s giant jump to 191 cases in a single day, we could be looking at about 450 new cases come tomorrow night. Picture: iStock.
As it happens, going by Thursday’s giant jump to 191 cases in a single day, we could be looking at about 450 new cases come tomorrow night. Picture: iStock.

If the nation had any doubts as to just how serious the Covid-19 outbreak has become, the chief medical officer Dr Tony Holohan’s pronouncements on the HSE’s modelling of the spread of the virus in Ireland earlier this week should have put paid to them.

Some 78 new cases were predicted to have been recorded by Tuesday, 109 on Wednesday, rising to 355 cases by Sunday. That is tracking a daily growth rate of roughly 40%, a figure even greater than the 30% suggested by the Taoiseach on Tuesday evening.

As it happens, going by Thursday’s giant jump to 191 cases in a single day, we could be looking at about 450 new cases come tomorrow night.

All told, we could be looking at more than 16,000 cases by the end of March, assuming the current trend continues.

Dr Holohan said that these figures are not an indication that the social distancing measures in place across the country aren’t working as it will take a few weeks for those measures to kick in. Nevertheless they made for grim reading.

Let’s deal with what this could mean on two fronts - the positive and the negative.

Starting with the latter, the real problem raised by Covid-19 is the distinctly ill-equipped capacity of our own health system to deal with a situation like this - most worryingly in terms of the amount of ventilators at the State’s disposal.

We need ventilators because the 6% or so of patients who are severely affected by the infection most likely will need a machine to do their breathing for them and ease the pressure on their lungs while their body battles to neutralise the virus.

Up to the beginning of the crisis, it was generally accepted that there were about 500 ventilators in the country. Concerted efforts are in train to source more, in common with most health services worldwide.

Nevertheless, the HSE’s CEO Paul Reid says that 300 additional ventilators have been secured, with another 100 or so per week to be added to that number at an indeterminate date in the future.

Meanwhile, the health service has access to a further 500 ventilators, together with an ability to source a further 1,000 assorted respiratory machines, according to Mr Reid.

It should be noted that the Intensive Care Society of Ireland has contended that there are insufficient beds to accommodate the additional ventilators. Regardless, assuming that problem is solved, Ireland is looking at about 2,300 ventilators in the near term.

Now let’s look at the numbers. While we are not privy to how the HSE is modelling the spread of the virus, we can infer some basics - applying a conservative (per the results currently being seen) 33% growth rate until the end of March, we get more than 16,000 cases by the end of this month, which slightly outstrips the 15,000 figure posited by the Taoiseach.

Following the same logic, we have 291,000 cases by April 10. That’s just following basic (and non-scientific it should be said) maths. Thereafter the numbers become eye-watering and are most likely devoid of meaning.

Taking the 16,000 at end-March - if 6% of those cases need ventilation, that’s 960 people. Already we are at close to 50% of the country’s capacity to cope. And that’s just by the end of this month.

It doesn’t take much of a leap of the imagination to get from there to the place Italy now finds itself - where devastating decisions are being made not to treat older patients in favour of younger and healthier souls.

It does not bear thinking about, but it is hard to see how it won’t become reality.

Put in stark terms, people will die for want of a ventilator. And if that doesn’t make the 22% of the population who say they are defying the advice to stay at home rethink their thoughts on social distancing, nothing will.

Now let’s look at the positives. For starters, the above extrapolation does not take into account the fact that the Government has acted, as of last week, to shut large swathes of the country down.

The effects of that action will not be seen for about two weeks, the length of incubation for the virus. Once that time passes, we’ll see if Ireland has managed to flatten the curve, or delay the disease’s impact, to any appreciable extent.

We’ll start to get a handle on that answer from around next Tuesday on.

Secondly, the testing capacity of the country has, finally, been ramped up, with 34 testing centres now online.

This is good news because after the initial hysteria of everyone with a cough wanting a test, a huge amount of the people who’ve been wandering around unawares with Covid-19 will have been identified and isolated.

And thirdly, many people are starting to recover from the virus, and - hopefully - will have a deal of immunity to it as a result.

In summary, the country is in big trouble but if the social guidelines we’re now so familiar with are adequately followed, we may succeed in flattening the curve. And that will be the difference between life and death for many.

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