• Sat. Dec 10th, 2022

This has been a year of unexpected memories, certainly nightmares for many. But there is time to change the narrative and the destiny of this virus, writes Fergal Bowers.

Dec 12, 2020

It’s beginning to feel a lot like a Christmas, different to all in living memory.
This has been a year of unexpected memories, certainly nightmares for many.
After such a difficult period, it’s understandable that people want to be out and about shopping now and preparing for the festive season.
It’s a time of some relief but also one of some trepidation too.
Cash could be king this Christmas, as bank transfers replace physical presents for many people, to cut down on socialising.
There seems to be an inevitability and an acceptance that virus rates will likely rise over the Christmas and New Year period, but by how much, no one is quite sure.
There are 20 days left of this ghastly year.
NPHET has modelled that the second week of January could see 1,200 cases a day.
Of course, it’s all in our hands and in the individual decisions people make over the next few weeks.
A party-now, pay-later approach could result in another lockdown of sorts in January.
The revival of social activity is set against the current backdrop of around 200 new cases a day and slowly reducing hospital admissions with Covid-19.
Certainly the road traffic is heavier, many more people are on the streets and social gatherings have increased, with the reopening of cafes, pubs and restaurants.
Ireland has also performed very well in terms of cases and mortality rates, when compared with many other European countries.
So some people will take the view that there must be a return on the investment people put into the lockdowns and the pain that came with them.
The news of significant progress on vaccination may also be fuelling a more relaxed attitude.
That could be a dangerous gamble.
The virus has not gone away. The physical task of vaccinating people here has not begun yet and will not start until January. So the price of an unsafe Christmas could be very high. The hope is that people will remain sensible and consider the potential impact on family and friends at this special time of year.
The pictures of the first people in Britain and Northern Ireland receiving the first vaccines certainly lifted hearts this week. It is also a testament to the extraordinary work by the community of doctors and scientists around the world in a collective effort to do the research to produce candidate vaccines and save lives.
Earlier this week, the Government published a provisional list of the priority groups for vaccination.
It envisaged that first to receive approved vaccines would be adults 65 years and older who are residents of long-term care facilities; frontline healthcare staff and people aged 70 and older.
There was some debate about the lack of a timeline and also the ranking of the 15 groups identified, including how fast people with certain medical conditions would be immunised.
The priority groups were outlined along with the rationale and ethical principles behind the decisions. Not everyone will agree with the proposals.
It generated an interesting intervention by none other than the former head of the HSE, Tony O’Brien, in his role as a strategic advisor to a communications firm, weare365.ie.
He said the Government will face critical comparisons with every other country for every choice it makes, as well as the effectiveness of the delivery of its plans.
Tony O’Brien predicted it would take many months to offer vaccinations to the whole population, possibly until well into the summer or even the winter of 2021/22.
“Those who get a safe and effective vaccine first will be at a very real advantage over those who go last. There will be contention, competing claims, strong arguments, even jealousy,” he predicted.
He also took the view that the announcement this week of the priority allocation groups was rushed, ahead of the implementation plan and the clarity of the decisions should have been tested first.
We have already seen several groups question the strategy and that will undoubtedly intensify once vaccines arrive in the Republic of Ireland. The allocation group list is a draft. It may change depending on what emerges from the European Medicines Agency about the effectiveness and safety of various vaccines.
This week the EMA said that the data submitted to it by Pfizer-BioNTech and Moderna for their Covid-19 vaccine candidates was “very robust”. A full decision is due on the Pfizer application before the end of this month.
A more complete picture of the side effects of these vaccines will be clearer when very large numbers have been immunised. Most drugs and vaccines have side effects, usually seen soon after the administration of the medicine. There can be rare side effects too. All of these will be monitored by the health agencies here in Ireland and at a European level. There will be a mammoth communications task to be undertaken by Government and experts to answer all the questions and concerns people will have. The information technology aspect of such mass vaccination will also be considerable.
It will be one of the biggest tests yet for the Government and the health system.
We know about the impact Covid-19 on the hospital system and screening services, due to reduced capacity. The number of cervical cancer screenings is down by over 50% compared to last year. Hospital waiting lists in certain areas have also increased.
While we can see clear statistics about how those areas have been affected, the impact on mental health is harder to define, but as important. This week the Irish Medical Journal published a report on the impact Covid-19 has had on mental health, by Dr Brendan Kelly, Department of Psychiatry at Trinity College Dublin.
He said that the available evidence is that one in five people has “significantly increased psychological distress” which is likely attributable to anxiety about Covid-19 and the effects of restrictions. That is a startling figure.
The rates of psychological distress among health staff were found to be around double those in the general population.
Dr Kelly said that self-harm and other presentations fell by 25% in April this year compared with April last year. However, this is not a reliable indicator of the extent of the issue as hospital presentations overall fell by 40%.
He suggests ways of relieving the negative mental effects of the pandemic by providing clearer information about lockdown protocols and ensuring that restrictions are maintained for no longer than required. For health staff, he recommends that they require careful rostering, the ability to take leave, organisational support from employers and where necessary, psychological first aid to protect their mental health.
While case numbers and hospitalisations have varied over different months, the pressure on health staff has been unrelenting.
At this point, the analysis from NPHET is that the level of Covid-19 infection is static, with the growth rate close to 0% and the R number estimated at 0.9-1.0.
While more people are moving about, the number of close contacts per confirmed case is stable.
The modelling shows a high risk of a surge in January, unless the R level remains close to 1.0.
At the moment, it feels like a lull in a battle, with growing anticipation of what comes next.
It’s the very time when people might be caught off guard.
The experience of this year tells us what will happen next, if there is significant social interaction in the weeks ahead.
We see it in a normal year with an increase in influenza cases and usually major hospital overcrowding at the start of the new year.
Covering the events of this year has been a remarkable effort by the RTÉ Covid-19 team and the reporters, cameramen, programme editors, directors, management and all staff who have contributed to keeping the public informed during a moment in history.
Other broadcasters, newspapers and media outlets have done fine work too. It has been a true collective effort to reflect the unprecedented events on the citizens of this country. There has been so much to document and the pace of daily developments has been so fast on occasions, it has been unlike any other news event to cover.
We still have a bit to go yet into 2021, but there is an expectation that things will improve slowly and perhaps by mid year, Ireland will have returned to some form of normality. The vaccines and the roll-out and uptake will play a big part in determining how fast and in what way the country and society reopens. Vaccination is not a silver bullet to solve the challenge of Covid-19 but it is a key part of the armoury in the battle against the virus.
So for the weeks ahead, it’s about everyone doing their best to follow the well-publicised public health advice.
It’s understandable that people are weary.
We must watch and wait to see how it all transpires.
People have heard the public health warnings from the experts.
Indeed, this year, we all became experts to some extent on Covid-19 as it touched everyone in some way.
For more than 2,100 people here, it contributed to their deaths and devastation for the families affected.
We remember them when we look to the night sky at this time of year and amongst the stars, the Star of Bethlehem.
For more than 75,200 people, they had to deal with the impact and fear of being infected and the knock-on anxiety for their family and friends.
And an unknown number of people are suffering from ‘long Covid’ and have not recovered.
For those who did not encounter the virus, it’s a time to be thankful.
Despite these chilling figures, most people, in fact about 90% of people, have not had the disease.
In some respects, coronavirus has barely touched the surface of the world’s population.
So it has the potential to do a lot more harm still.
We are not out of the woods by any means.
We know from Charles Dickens about the ghost of Christmas future.
That a reckoning awaits people who take a certain course.
But there is time to change the narrative and the destiny of this virus.
We all know what the best gift is this Christmas, which can not be bought in any shop, or online.
It’s a happy and healthy 2021.