Maresa Fagan: Covid-19 numbers suggest picture will only become clear in three weeks
It will be another three weeks before we have a clearer picture of the extent of Covid-19 in Ireland, according to leading experts, who add that testing will also shape the numbers that emerge in the days ahead.
Here, puts the Covid-19 numbers into context and speaks to experts Professors Ivan Perry and Ultan Power to gauge what might happen in the days and weeks ahead.
It seems a distant memory since the first case of Covid-19 in Ireland was confirmed on February 29th.
A lot has happened since then.
In the month since, a further 3,234 cases of Covid-19 have been confirmed and 71 people have died, as of Tuesday night.
The Government responded from early March by phasing in a range of restrictions, chiefly on the movement of people, until it recommended the country go into lockdown mode last Friday.
Health officials now say there are signs the pace of infection spread is slowing but warned that a surge in the number of cases is coming and the next week to ten days will be critical.
There are many challenges ahead.
Among them the need to contain the more than 100 outbreaks or clusters in nursing homes, hospitals, private homes and other settings.
The exact location of these outbreaks is not yet clear but from the data available from the Health Protection Surveillance Centre, we know that Dublin and Cork have been most affected by coronavirus.
As of Monday last, Dublin had half of all confirmed cases of Covid-19 (1,487) in the country, while numbers grew in Cork to 238 cases.
Factoring in the population of each county, official figures further show that Dublin has the highest infection rate (110 cases per 100,000 population) followed by Westmeath (86 cases per 100,000 population), as the following map shows.
Coronavirus is affecting all ages, from children under the age of five to pensioners.
Those aged over 45, however, are more likely to be hospitalised (over 75% of all cases) or require intensive care (87% of all ICU admissions).
The infection rate among healthcare workers is also concerning - on average one in four of all Covid-19 cases were detected among doctors, nurses, and other healthcare staff at the frontline.
Of the almost 650 plus healthcare professionals infected with Covid-19, over half were doctors or nurses (56%), with the remainder made up of allied healthcare workers, healthcare assistants, and porters.
Figures published last night further showed that the majority of healthcare staff (61%) contracted the virus through community transmission and 26% through working in a healthcare setting.
Out of the more than 3,200 cases confirmed across the country, Covid-19 has led to 71 deaths. This suggests the mortality rate is at about 2%.
The number of deaths, however, is likely to increase in the days ahead and experts say it is difficult to confidently predict the number of cases or deaths.
Professor Ivan Perry, who heads up the school of epidemiology and public health at University College Cork, said it will be weeks before we have a clearer picture of the Covid-19 outbreak and the impact of the Government response.
“It will be another three weeks before we have a clearer picture but the signs are that we the collective efforts are working.
“We are at a somewhat lower level than what we expected to be in terms of the number of cases by the end of March.
"That reflects the efforts people are making to heed the advice of government and health officials and that is making a difference in flattening the curve,” he added.
Professor Perry said a reduction in the number of contacts reported for every confirmed cases was also encouraging.
Earlier in the month a confirmed case could have had 30 contacts but this has fallen to three in the past few days, after the lockdown was phased in.
Scientific and political leadership to date was good, he said, adding the timing of public health restrictions was not an exact science.
“We seem to be getting it right for the moment. There is no certainty as to what will happen but I feel the response to the epidemic is being well managed for the moment”.
Changes in the criteria for testing, which is now focussing on people with at least two symptoms of Covid-19, the vulnerable and elderly and healthcare professionals on the frontline, will also have a bearing on case numbers.
In the past week alone, this change has led to the number of positive test results increasing form 6% of all tests to 15% of all tests.
The extent of testing and how quickly tests are processed by laboratories will also impact the numbers we see emerging in the days to come.
To date more than 30,000 Covid-19 tests have been processed in laboratories across the country.
Laboratory capacity has been ramped up but this week hit a snag when labs began to run short of specialist reagents to process test samples.
The number of tests being processed is down to 1,500 per day and it could take more than a week to access reagent stocks.
Despite the temporary setback, Dr Cillian De Gascun, Director of the National Virus Reference Laboratory, gave assurances yesterday that laboratory testing will be scaled up to 10,000 to 15,000 tests per day in the weeks ahead.
Professor Perry said the number of tests and revised testing strategy will impact on future figures.
“The number of tests will definitely influence the number of confirmed cases and changes in the testing strategy will also influence the numbers we see in the coming weeks,” Professor Perry said.
“While we have to track the number of cases every day we shouldn’t place too much weight on the day to day fluctuations but instead focus on the underlying trend over several days,” he added.
The relatively low number of ICU admissions and number of deaths, Professor Perry said, were a more reliable indicator at present, adding the ultimate goal was to keep these numbers as low as possible.
Meanwhile in Northern Ireland close to 600 people have tested positive for Covid-19 and less than 6,000 tests have been carried out to date.
The Stormont Executive is following the advice of the UK government but some experts believe an all-island approach is needed to bring the virus under control.
Virologist, Professor Ultan Power from Queens’s University, said governments north and south of the border worked together in the past to eradicate foot and mouth disease and that a similar effort is needed to stamp out Covid-19.
Dr Power said complying with restrictions on movement and interacting with other people is a simple but effective way to keep the virus at bay and save lives.
In Northern Ireland, however, some employers remain open and this, Professor Power said, opens up the region to significant risk as these workplaces offer a potential breeding ground for Covid-19.
Testing, along with self-isolation, is key the Queen’s academic said, adding that testing and contact tracing should be ramped up further.
“Testing is mainly focussed on those showing symptoms. We know that 60% of people infected do not show any signs so that means we’re potentially missing out on a whole cohort of people, who may be infected,” Professor Power said.
“That is the biggest gap and the biggest concern.
"It is the biggest difficulty for trying to control the pandemic because you will never test them or know who they are, they will never appear sick but they will be transmitting the virus everywhere.
"This is why I have been calling for a more stringent lockdown,” he added.
He added that using technology, such as an app, could help hugely in contact tracing and identifying those likely to test positive for the virus.
Quarantining had also been shown to be effective in China and South Korea.
Professor Power said he doesn’t expect the numbers to increase in Ireland or Northern Ireland as quickly as observed in the US, Italy, or UK and that it could be up to four weeks before we see the true scale of infection and the impact of government measures.
“It could take three to four weeks before we see a significant impact on death rate and number of cases,” he said.
- Shop for essential food and household goods;
- Attend medical appointments, collect medicine or other health products;
- Care for children, older people or other vulnerable people - this excludes social family visits;
- Exercise outdoors - within 2kms of your home and only with members of your own household, keeping 2 metres distance between you and other people
- Travel to work if you provide an essential service - be sure to practice social distancing
CONNECT WITH US TODAY
Be the first to know the latest news and updates
