Covid-19 case definition significantly refined as total number of cases reaches 90

Ireland now has 90 confirmed cases of the novel coronavirus, Covid-19, after a further 20 new cases were confirmed by the National Public Health Emergency Team (NPHET) this evening.

Meanwhile, the case definition for those who are seeking a test for the virus has been refined significantly.

Six of the new cases are associated with people who have travelled from an affected region Dr Tony Holohan, the Department of Health’s chief medical officer, said.

Twelve are associated with contact with previously confirmed cases, four of whom are healthcare workers, he said.

Meanwhile, two of the new cases are associated with community transmission, or instances where the health authorities don’t know where or how the illness was contracted, bringing the total of such cases in the country to seven.

The largest cluster in Ireland is a group of 16 people, Dr John Cuddihy, director of the Health Protection Surveillance Centre, said meanwhile.

That group had travelled together to an affected area.

In terms of the case definition for the virus in Ireland, symptoms of a new fever of 38 degrees celsius will now be considered when assessing a person’s suitability for testing, while respiratory tract infections including coughs will also be considered.

Such a fever would generally be considered mild in normal circumstances - 37 degrees is considered a regular adult temperature.

NPHET said that all people returning from areas identified by the Department of Foreign Affairs as to be avoided for non-essential travel should now restrict their movements for 14 days.

Meanwhile, discharge criteria for self-isolating confirmed cases have been approved for implementation, the emergency team said.

In terms of advice for parents regarding their children’s playdates, a subject which received a deal of commentary over the course of the day, Dr Ronan Glynn, the deputy chief medical officer, said that parents “should try and avoid arranging playdates for groups of young children at this early stage”.

“However, rather than staying indoors, consider outdoor activities such as playing football in the open in small groups of three or four while maintaining social distancing of two metres,” he said.

“Children need to have a normal life, they will play with other children. What we don't want is big groups of children getting together."

“This is not a lockdown situation,” Dr Holohan said. He added that further guidance for parents will be hopefully available on the HSE.ie and Department websites from later this evening.

#COVID19 #coronavirusireland

Advice and information for parents and caregivers of children. Read it on our website here: https://t.co/JI64iMBciH pic.twitter.com/RXlFEGxpqz

— Department of Health (@roinnslainte) March 13, 2020

Regarding the issue of re-infection from the virus, likely to become more of an issue now that a number of people have recovered, Dr Glynn said that it remains “quite unclear” whether such a re-infection is possible.

“We don’t know the level of immunity conferred on someone who has recovered,” Dr Holohan said.

Dr Colm Henry, the HSE’s chief clinical officer, said that some examples of people who may had reportedly been re-infected in China may rather have been a case of a severely ill person not recovering fully from the illness in its initial phase.

Dr Holohan said that he agreed with the Taoiseach, in conflict with the World Health Organisation, that the illness can be slowed, but not stopped outright.

“There are limitations in terms of knowledge surrounding the virus which prevent us from being entirely certain,” he said.

In terms of the suggestion, apparently based on scientific modelling, that 1.9 million Irish people could eventually contract the disease in a worst case scenario, Dr Holohan acknowledged that he could not definitively rule that out.

“But it distracts us from what we can achieve right now in terms of reducing the burden on the health service,” Dr Henry said.

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