Noel Baker: Covid-19 cases and deaths are rising, so why are we seeing some optimism?

Noel Baker: Covid-19 cases and deaths are rising, so why are we seeing some optimism?

The r-number is declining because people have "broken chains of transmission", according to Dr Ronan Glynn, Acting Chief Medical Officer, pictured with Dr Colm Henry, Chief Clinical Officer at the HSE at Thursday's Covid-19 press conference. Picture: Colin Keegan

In the past week, two contrasting stories illustrated the very real perils of the coronavirus and its varying impact.

Josephine Silo contracted the virus in April. On Wednesday, at the Sacred Heart nursing home in Raheny in Dublin she blew out the candles on her birthday cake. She has just turned 104 and told the media: "I'm doing grand. It wasn't too bad."

On the same day, news emerged of the tragic passing of Dr Syed Waqar Ali, a locum who worked on the frontline at a number of hospitals before contracting Covid-19. Like Ms Silo, the Tyrellstown resident first fell ill in April. 

His daughter, Dr Samar Fatima Ali, said he was an outstanding doctor and a hero. He is the eighth healthcare worker to die of Covid-19 in Ireland.

And there, but for the good graces, go any of us. According to the Health Protection Surveillance Centre, there have been 1,763 deaths, as of Thursday evening, related to the pandemic, each one a tragic reminder of the traumas of recent months, and 25,826 confirmed cases. 

The nine deaths announced on Thursday are understood to include eight from April, May and June and the more encouraging figure was the seven new cases announced by NPHET on Thursday.

The number of new cases has fluctuated of late, and there was alarm at stories of house parties, as well as the cancelling of GAA activities in some parts of the country linked to confirmed or possible cases. A case of Covid-19 was confirmed at a creche in north Dublin, while two building sites in the capital had to close as a result of workers testing positive.

So why, when nine deaths were announced on Thursday evening's NPHET press briefing, does there still appear to be some optimism here?

Some positivity is anchored around the r-number - the number of people that one infected person will pass the virus on to, on average. It is calculated by working backwards via the number of people dying, admitted to hospital or testing positive for the virus.

Much in the same way that, during the economic crash, we all became quasi-experts at watching the money markets and speculating as to whether Moody's would give us a decent credit rating, now all eyes are trained on the r-number.

On July 9, Professor Philip Nolan, Chair of the NPHET Irish Epidemiological Modelling Advisory Group, said: "We are seeing an increase in the number of reported cases over the last two weeks and the r-number is now at or above 1."

As recently as July 16, when 21 new cases were announced, Prof. Nolan amplified those concerns. 

Our best estimate of the r-number currently stands at 1.4 but it could be as high as 1.8. We have an opportunity now to maintain suppression of the virus.

At that time, health minister Stephen Donnelly said were the r-number to remain at such a high level, within three weeks (roughly towards the end of the first week in August) there would be as many as 150 new cases a day. He also referred to the 14-day cumulative case number. 

At that time, it had leapt in the space of a fortnight from 2.5 cases per 100,000 population to 3.9 cases, with the five-day average going from nine new cases a day to 22 new cases daily.

Now it appears to have edged down again, with Prof. Nolan stating on Thursday, "That the r-value has decreased is welcome news.

"However, it is tempered by the fact that this novel virus is still with us, and it only needs our complacency to spread widely once again as it wants to do."

This is a long game.

Dr Ronan Glynn, Acting Chief Medical Officer, said people had responded to concerns at rising case figures of a fortnight ago and "together have broken chains of transmission", while on Friday Minister Donnelly told the Dáil the r-number was back between 0.7 and 1.4, with 1.1 the best estimate.

Yet at the crossroads of history, there are plenty of grim landmarks.

This week, the number of people in the United States infected with the coronavirus sped past four million, while the tally in Europe is now three million. The Covid-19 virus has had a resurgence in many countries which had already lifted some restrictions in the hope the worst had passed. It seems the virus, not even in our vocabulary as recently as last December, is both the immovable object and the unstoppable force.

The public narrative in recent weeks has seen the re-opening of schools predicated on the continuing repression of the virus. That, every bit as much as details of an EU-wide rescue package or the Government's own stimulus proposals, will focus minds on the need to keep following the basics: wearing a mask, proper hand hygiene, using the Covid tracker app, maintaining social distance, being responsible. 

The next phase of re-opening - that pencilled in for August 10 and involving pubs not serving food - will present fresh challenges.

One of the frontrunners in the race for a vaccine, the ChAdOx1 nCoV-19 designed by the University of Oxford, has shown promising results, with the possibility of hundreds of millions of doses for potential delivery the end of this year. 

But it's a long game. We want to keep adding candles to the birthday cake.

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