Letter to the Editor: Ireland and Covid-19 —a choice for our futures

Letter to the Editor: Ireland and Covid-19 —a choice for our futures

Because of a timely response the island of Ireland has managed to bring the Covid-19 epidemic under control. A range of emergency restrictions imposed by the two governments, following scientific advice, stopped our healthcare systems being overwhelmed and saved many lives. The public support these restrictions, and report that they clearly understood the need for them.

All this has come at a huge cost to our island. Enormous sums of money have been spent, many people have lost jobs, and many businesses wonder will they be able to open again.

Now we have come to a watershed moment, a fork in our road. The path we choose will determine our future for years to come. Our current policy is to live with the virus under a long-term mitigation strategy, with the risk of future surges and lockdowns until when, or if, a vaccine becomes available. We have another option: we can do as many other countries have done, choose to suppress and eliminate this virus: ‘Crushing the curve’.

People will once again feel confident in using public transport, returning to school, going out to eat and to shop, pressure on the healthcare system will be relieved, and trust in our economy will be restored. For the economies on our island, this would be enormously valuable. Vulnerable people will be effectively protected.

The restrictions so far have been very costly, and some argue that the job of our governments, and our peoples, is to get back to ‘normal’ as fast as possible. What does ‘normal’ look like if the virus continues to circulate? Right now, public transport is planning for 20% of “normal” capacity; pubs and restaurants 30%; and schools, at best, only 50%. The costs of childcare, already high, will be impossible for many. Many workplaces will need expensive redesign. Many people will drop out, or be pushed out of the labour force. All of these are real costs, and will, we believe, far exceed the short-term costs of lockdown.

For these reasons we strongly encourage the two governments to take resolute actions to suppress this pandemic at once. Eliminating the virus represents the most scientifically sound strategy in terms of public health and economics alike.

This can be done, if we all work together on the island. Several countries have already largely halted the virus, including South Korea, New Zealand, Australia, Austria, Greece, China and Iceland, by continuing public health measures, including the use of masks, active fast contact tracing and testing, and sensible restrictions on travel. All are now planned for both parts of this island, but they must be enhanced and coordinated with the aim of achieving ambitious suppression targets.

First, we must achieve suppression and elimination, and then we must maintain it. The above countries have achieved suppression, and some have demonstrated that they can also maintain it in the face of new cases, as seen in South Korea in early May. Each country has developed its own solutions, to fit its own needs, and we can do the same on our joint island.

All our sacrifices over the last few months have driven down the number of cases, and given us a precious window of opportunity that we must not squander. This is a decisive moment in the history of our island.

Our goal now must be to suppress the number of new cases to zero as soon as possible and to keep them there. Given political leadership, an agreed and scientifically sound strategy, and cooperation from our citizens — this can be done and done in weeks, not in months. When we reach this goal, new infections have to be closely monitored for the foreseeable future under a robust, rapid, and vigilant test/trace/isolate infrastructure.

If we decide to live with the virus, extensive, and expensive, restrictions will continue for the foreseeable future. A vaccine will take at least two years, and there is no established treatment.

Societies that have suppressed and eliminated this pandemic will enjoy considerably greater freedoms and prosperity than those where the virus persists. Travel, tourism, and trade with other successful countries would be straightforward and beneficial. Given our geography, population size, and social cohesion, suppression is a realistic exit strategy, a genuine way out of our current economic and social standstill. We propose that both governments on the island of Ireland immediately adopt a full-scale policy of suppression, and start working on a suitable strategy for both our countries.

There have been more than 1,000 signatories to this letter to date.

Professor Anthony Staines

[I]Epidemiologist, Dublin City University

Professor Gerard Killeen

[I]Infectious Disease Ecologist, Epidemiologist and Control Specialist, University College Cork

Dr Tomás Ryan

[I]School of Biochemistry & Immunology,Trinity College Dublin and Chair of FENS-Kavli Network

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