Nphet letter reveals sharp decline in Covid deaths but says situation remains 'concerning'

The risk of a fourth wave of infection in the coming weeks is very high if public health measures are relaxed too quickly, the Government was warned.

There has been a sharp decline in the number of people dying from Covid-19 in March, compared with January when it was almost 10-times higher, the Government has been told.

The number of deaths from Covid-19 fell sharply in March to 167 compared with 803 in February and 1,371 in January, Nphet has revealed to ministers.

Of the 167 deaths in March to date, 28 have thus far been associated with hospital outbreaks and 31 have been associated with nursing home outbreaks, Dr Ronan Glynn has stated in a letter to Health Minister Stephen Donnelly.

As of Monday, Dr Glynn confirmed there were currently 68 confirmed cases in critical care, compared with 82 on March 17.

The risk of a fourth wave of infection in the coming weeks is very high if public health measures are relaxed too quickly, the Government was warned ahead of its easing of restrictions on Tuesday.

In the letter, the deputy chief medical officer on behalf of Nphet, it was said that the R-rate of transmission of Covid-19 is now estimated to be at or above 1.

Dr Glynn warned: “Unfortunately, the significant ‘headroom’ that was available last summer when case counts were very low isn’t available now, and any increase in transmission will have significant impacts in a short space of time.” 

Precarious Situation

Dr Glynn stressed that Ireland’s epidemiological situation remains precarious, adding the level of infection is high, with a 5-day average case count of 620 cases per day and a 14-day cumulative incidence of 165 per 100,000.

“This is substantially higher than when restrictions were eased after previous waves of infection — approximately twice that experienced in early December 2020, and 50 times that in late June 2020. Table 1 below outlines the epidemiological situation when measures were eased previously,” Dr Glynn wrote.

He told Mr Donnelly that the dominance of the more transmissible B117 or UK variant means that, for similar levels of close social contact, viral transmissions will be 30%-70% greater than in 2020.

“This is already clearly evident in close contact testing data where the positivity rate for all close contacts has nearly doubled compared to late 2020 from just over 10% to around 20% now. 

"In particular, the levels of transmission within households has increased, with more than one-third of household contacts contracting the virus,” he wrote.

Nphet warned that the high level of infection significantly increases the risk associated with any increase in social contact and reproduction number. If the reproduction number increases, the number of new infections per day will rise very quickly from this high baseline.

Dr Glynn said the current epidemiological situation in Ireland remains “concerning”.

“Disease incidence has plateaued at a high level and may now be increasing. Although incidence has increased in those aged 0-12 years over the last four weeks, this may have stabilised in the last week. 

"Community test positivity rates, which had previously been reducing, have flattened at persistently elevated levels over recent weeks. Of particular concern, there continues to be a significant disease burden on the acute healthcare system,” he said.

“The total number of confirmed cases of Covid-19 in hospital has been slowly decreasing but remains high, at a level approximately equivalent to the highest observed in wave 2 in late 2020. 

"The total number of cases in critical care has also been gradually reducing but is still substantially above the highest levels seen in wave 2,” he added.

In total, 31 cases of B.1.351 (variant first reported in South Africa) have been confirmed by whole-genome sequencing.