Coronavirus surges across Ireland
19 October 2020
In the first phase of the coronavirus pandemic Ireland (both north and south) was viewed as having got off relatively lightly in terms of infection rates and number of deaths. The health services within both jurisdictions also continued to work within capacity (albeit at the cost of reducing non Covid services ). Throughout July and into August daily case numbers were in single figures or the low teens and there were extended periods when no Covid deaths were recorded. However, a deterioration in recent weeks has seen a surge of positive cases: increasing hospitalisations: and a rise in the number and frequency of recorded deaths. All the indications are that Ireland is now in, or about to enter, a second wave of the pandemic.
While there are parallels
with the situation back in March there are also differences. The
most striking of these is the attitude of political authorities in Dublin
in Belfast and their reluctance to introduce measures to halt the spread
of the virus. A return to lockdown has been ruled out with the emphasis
more on protecting the economy rather than public health and on managing
the virus rather than suppressing it. A clear demonstration of this
approach has been the rejection of advice from health officials.
The situation in the Irish state in relation to the pandemic has deteriorated rapidly over recent weeks. According to the Chief Medical Officer (CMO) Dr Tony Holohan: “Case numbers are growing across all age groups and throughout the country.” The National Public Health Emergency Team (Nphet) has stated that there is “exponential growth” of Covid-19 infection in Ireland along with “rapid increases” in the number of people being admitted to hospital and ICU.
In stark contrast to the months of July and August, when the number of cases were down to the teens and deaths were low and infrequent, the first half of October has seen daily cases rising to over a thousand and deaths (though still in single figures) being reported every day.
More cases were detected in the first week of October alone than in the whole month of August. Some 10, 377 cases have been recorded in the last 14 days. That there was a 82 per cent increase in the number cases in the latest seven day period compared to the one immediately previous gives a sense of the rapid spread of the virus that is taking place. This is reinforced by the increase in the percentage of positive cases which has risen from 2.3 in mid September to 3% at the start of October and to a current rate of seven (this is above the 5% level that marks the point at which a pandemic is out of control). The national 14-day incidence rate now stands at 217.9 per 100,000. Eleven counties have a 14-day incidence over 300 per 100,000 population, and another 11 have an incidence over 200. The reproduction number has increased and is now at 1.4 nationally. According to Nphet modelling, If current trends continue, by October 31st, the number of cases notified daily will be in the range of 1,800 - 2,500 cases with over 400 people in hospital.
At the time of writing 246 people are in hospital due to Covid-19, with 30 of those in intensive care units (ICU). Over the last seven days the number of Covid-19 hospital admissions has increased by over sixty per cent to the highest figure in more than six months. This is a quarter of the way to the admission rates recorded during the peak of the pandemic. Some hospitals are already using their intensive care surge capacity to cope with the recent spikes in cases in Covid-19. Out of 281 critical care beds across the country just 33 ICU beds are available, with none available in 11 of 28 hospitals.
The rapid increase in the number of the cases has also exposed the limitations in the the state’s tools for controlling the spread of the virus. Its test and trace system is struggling to cope with test results taking 36-48 hours to come through and the completion of all contact tracing for positive cases taking as long as five days. This is not fast enough to track the spread of the virus. One of the problems is that the state has not developed its system of testing since the earlier period of the pandemic. It is still relying on a uniform system, which is all PCR (polymerise chain reaction) based, and has not integrated newer technologies that have been used successfully in other countries. In Italy for example, rapid antigens tests - which have the potential to provide results in 20 to 30 minutes while maintaining a high level of sensitivity and accuracy - are being used in schools and airports. Nothing like this is being done in Ireland.
On October 4, prompted by the rapidly deteriorating situation, the CMO (speaking for Nphet) wrote a letter to the Health Minister Stephen Donnelly advising that the whole state be moved to the highest level of restrictions (Level 5) for a period of four weeks. In his letter the CMO presented evidence of the current high volume of community transmission of the virus. He also presented a projection of what this would mean in the coming weeks:
“Disease modelling shows that if current trends continue, 1600 to 2300 cases will be notified per day by November 7. The modelling also shows 43 people with Covid-19 being admitted to hospital per day by that date”According to letter the course of action advised by Nphet represented “the only opportunity to get this disease back under control while keeping schools open.” It stated quite clearly that “the measures currently in place are not sufficiently controlling the disease”.
Despite this stark warning the Government chose to disregard the advice and instead moved the whole country to Level Three. Moreover, it went on to publicly criticise health officials. The Tánaiste Leo Varadkar claimed that the recommendations from Nphet had come as "a bolt out of the blue" and had "not been thought through". His criticism was also highly personalised. He claimed that: "None of those people [in NPHET], for example, would have faced being on the Pandemic Unemployment Payment yesterday." And that none of them "would have to tell somebody that they were losing their job, and none of them would have had to shut their business for the last time". Varadkar also warned - and this can only be seen as a threat - that what happened with the letter “wouldn’t happen again”.
This populist rhetoric - of championing the cause of common people against the diktats of a bureaucratic elite - is straight from the Donald Trump playbook. Such posturing on the part of Leo Varadkar is particularly nauseating given the crushing austerity imposed by recent Fine Gael led governments and also the part he has played in that as minister for welfare, health and Taoiseach and now as Tánaiste in the new national government.
The public rift between the government and health officials also prompted discussions among government supporting TDs with reports that some of them had called for Nphet to be downgraded. One of the suggestions coming from the Fine Gael grouping was for the lead role on the pandemic to be given to the National Emergency Coordination Group (NECG) to allow a wider range of stakeholders (from the Gardai to the Department of Business) to have input into key decisions. The intention of this could only be to downgrade medical evidence and give greater weight to factors such as the economy.
The attack on health officials and the Trump style rhetoric isn’t a coincidence. It demonstrates that Irish government (along with other capitalist governments) has given up on suppressing the virus and instead adopted the policy (though it is not stated openly) of herd immunity. This involves re-opening the economy whilst trying to manage the inevitable increase in the prevalence of the virus. This is thrust of the official government strategy - 'Plan for Living with Covid-19'. The problem is this strategy - from a public health perspective - has been proven to fundamentally flawed. The pandemic rather than being managed is now running out of control with the consequence of increasing levels of illness and death. Since the controversy over the Nphet letter the situation has continued to deteriorate at an even more rapid rate than predicted. According to Dr Holohan the situation is worsening “beyond even what we projected a few weeks ago” and this is a matter of “grave concern”.
The restrictions that were introduced recently - such as banning household to household visits, increasing the number of vehicle check points and moving three border counties to Level 4 - have been ineffective in slowing the spread of the virus. Despite this - and despite reports that Nphet has for a second time advised a move to Level 5 restrictions (this time for six weeks) - the Government continues to resist, arguing instead for a graduated response. While it now appears that the Government will be forced by events to move to Level 5 the delay in acting on medical advice two weeks ago has undoubtedly resulted in a further spread of the virus and (in time) more deaths.
The situation in the north
is even worse than that in the south with data for Covid-19 infection rates
suggesting that Northern Ireland currently has among the highest in the
world! Over the last seven last seven days, 6,394
people have returned positive test results. Of these 1,311 were recorded
in the Derry and Strabane area which now has the highest number of cases
per 100,000 population in the UK. This period has seen the record
number of daily cases set and then soon surpassed with the highest (at
the time of writing) just below the 1,300 mark.
The estimate of the reproductive rate of the virus is between 1.3 and 1.8 for new positive tests and hospital inpatients. While there has been an increase in the number of tests compared to the earlier period of the pandemic this in itself does not account for the current rise in cases. Testing has increased by 25% while positive cases have more than doubled. Within the overall number of tests the percentage of positive tests also continues to rise. This has reached a figure of 12% over the lest seven days. To gauge the significance of that figure the World Health Organization suggests that anything over 5% reflects an epidemic which is out of control.
There are 228 Covid patients in hospital, with 30 in intensive care and twenty three of those ventilated. Hospital admissions for Covid are now around 50% of peak levels during the first wave of the pandemic. Currently there are only 12 ICU beds available across the northern health service (out of a total of 98). The frequency and number of deaths is also rising with an average of three deaths being recorded every day (this compares to figures in the mid twenties during the height of the pandemic).
In response to this deteriorating situation it was reported that the Chief Medical officer Dr Michael McBride had called for a six week lockdown across the north that would have included the closure of schools, bars and restaurants. The split between health officials and political leaders in that had occurred in Dublin was replicated in Belfast with the proposals meeting with resistance - particularly from the DUP. DUP leader and First Minister Arlene Foster, while claiming that “we will listen to our medical advisors”, immediately called that advice into question by suggesting that new restrictions could be avoided “if people go back to basics such as washing their hands and wearing a mask in the appropriate places.” She put conditions on her party’s support for public health measures arguing that they would “have to do a risk analysis as to the damage to other sectors in society, especially economic damage”. There was also a strain of right wing populism (similar to that exposed by Leo Varadkar) in her claim that “poverty kills as well as Covid”. (Stormont’s record on poverty - notably its adoption of the Tories punishing welfare reforms - makes such posturing particularly rank.)
Foster’s DUP party colleague Jeffrey Donaldson also weighed in with attacks on the Chef Medical Officer and the health minister. He demanded to see the data that justified a lockdown and questioned why contingency measures – such as the reopening of a Nightingale hospital at Belfast City Hospital – had not been rolled out if the situation facing the health service was so grave. In themselves these are legitimate criticisms given the lack of transparency there has been around data and also the failures of the Dept of Health in relation to the recent Covid outbreaks in hospitals; its test and trace system; and its lack of preparedness for a resurgence of the virus. However, in the case of the DUP such criticisms are insincere and have more to do with deflecting blame away from the party and the commercial interests it has championed than with public health.
The strategy of shifting blame has been underway for some time at Sormont. In recent weeks the focus from the Executive has been almost exclusively on the behaviour of the public - putting the rise in Covid cases down to people flouting regulations. Its first response to rising cases was to introduce stricter enforcement and higher fines for breaches. This completely ignores the fact that the rise in cases coincides with the Executive’s decision to rush ahead with an easing of restrictions that has seen the opening of bars and restaurants and the return of schools and universities. When new cases started appearing the leaders of the Executive tried to dismiss any connection. Arlene Foster made a big play of defending businesses in the hospitality sector (saying “the villain is not business”). She also made the dubious claim that the virus was spreading primarily in households. The fact that the hospitality industry and also activities around schools (transport, play etc) have now been identified as the main causes of transmission demonstrates the lack of credibility in such claims.
When the Executive finally got around to taking action the measures they came up with fell well short of what had been requested by health officials. It was announced that schools would close for two weeks (an additional week added to the mid term break); cafes and restaurants would move to a takeaway only service; while bars would shut completely (these restrictions on the hospitality sector and a number of other commercial activities to be in place for four weeks ). This compares to the reported six week period of enhanced restrictions requested by officials. In another sign of the the growing rift between medics and politicians the chair of the British Medical Association (BMA) in NI, Dr Tom Black, directly criticised the Executive, describing the restrictions as "too little, too late". He said that restrictions should have been brought in weeks ago and also have been more closely aligned with restrictions in the south. The half measures the Executive has announced will almost certainly fail. Just as was the case back in March delaying decisive action at an early stage will result in a continuing deterioration and the imposition of even more draconian measures later.
Stormont’s handling of the pandemic is very much in keeping with its general incompetence and dysfunction. There is a lack of co-ordination between departments while policies are constructed, not in accordance with best practice or expert advice, but through political fixes between the DUP and Sinn Fein. This makes for poor governance. It is also inherently unstable. Indeed, the latest political fix lasted just a matter days. Only hours before the restrictions were due to come into force the DUP minister Edwin Poots stated that his party opposed them. He also claimed that no scientific evidence had been presented to the Executive to justify such restrictions. This is particularly ironic coming from Poots whose long period as a minister has been marked by his continued rejection of scientific evidence, whether that relates to the origins of the Giant’s Causeway, blood donation by gay men or climate change.
With all things in the north sectarianism isn’t far from the surface. As the pandemic crisis deepens and relations between the parties become more fractious the language used by politicians has taken on a more sectarian tone. In another interview Poots made the claim that the was virus was spreading primarily within the nationalist population. Other DUP representatives have demanded a breakdown of the prevalence of the virus by post code and suggested that enforcement of Covid restrictions are not being applied consistently across the state. The clear message is that unionists are being made to suffer because of the irresponsible behaviour of nationalists. One section of the population are being portrayed as disease spreaders and, by implication, wreckers of the economy. This is really crude stuff but as the north heads into a deep recession such sectarian rhetoric is likely to be ramped up even further.
All Ireland approach
One of the major weaknesses of the response to the pandemic has been the absence of an integrated strategy for the whole of Ireland. There are natural advantages that arise from the geography of being a small island and being - from a medical science perspective - a single “epidemiological unit”. Yet these advantages have not been utilised and the level of co-ordination between north and south has been limited. While a memorandum of understanding was signed in the early stages of the outbreak it seems to have made very little practical difference.
What was required from the beginning was an integrated response that would have involved not only the sharing of information but also the adoption of common rules covering social distancing and mask wearing etc and also the operation of particular sectors of the economy. The latter would have avoided the situation that we now have of different rules relating to retail and hospitality on either side of the border that encourage people to move back and forth. Common rules on travel - particularly on international travel into Ireland - would have been a useful tool to prevent the spread and importation of the virus. The priority during and after the first lockdown should have been the development of an island wide find, test, trace, isolate and support system that would have allowed for control of the virus at a local level.
None of the above were even attempted, and are still not being contemplated, even with the resurgence of the virus. If anything the divergence between north and south is increasing. Throughout the pandemic unionists have opposed greater co-ordination with the south and insisted on following the UK approach even when this was seen to be failing badly. What limited moves there have been from Stormont towards alignment with the south have been political fixes worked out between the DUP and Sinn Fein - such as the decision on pub closing times - rather than effective measures to suppress the virus. However, it is not just unionists at Stormont who are impeding greater co-operation. The Dublin government has also been reluctant to push for an all-Ireland strategy and has continued to defer to the British government when it comes to the north. The Taoiseach has rejected any suggestion of an island-wide "circuit-breaker” in order to stem infection, specifically in border counties. Indeed, the existence of the northern state has become a useful excuse for its own failures on the pandemic. One of the lines of attack on Nphet officials was that they had failed to take the north into account when recommending a tightening of restrictions. Partition - and the political and practical consequences that follow from it - has been a major hindrance to the development of a strategy to combat the pandemic.
In addressing the question of what to do about the pandemic socialists - and the workers movement more broadly - must take an independent position. We should not just follow the panic driven moves from governments which have seen swings from lockdowns to business as usual and back again. Neither should we give the state a blank cheque when it comes to the draconian powers it has taken on to tackle the pandemic. We have already seen - in relation the BLM protests and the strike by Debenhams workers - how these laws and regulations are being used to restrict the fundamental democratic right to organise. We must also be attuned to the deteriorating material conditions of workers during the pandemic and avoid adopting a position that can be portrayed as trading off health against economic well being. This is the false choice that is being pushed by right wing politicians such as Leo Varadkar and Arlene Foster. It is outrageous that they are promoting themselves as champions of the working class. Even more sinister are the efforts by the far right to channel discontent. Both of these need to challenged through the mobilisataion of the working class and the development of a programme that directly addresses the health and economic crises.
The foundation of that programme must be that physical health and economic well being are inseparable - that there are no trade offs or balancing acts between the two. Indeed, this fact has already been confirmed in the course of the pandemic, with the economies of those countries (South Korea, Vietnam, Finland etc ) that have most successfully suppressed the virus and brought it under control recovering more quickly and the lives of their citizens returning to some from of normality.
In Ireland the most pressing task is to get the virus under control. While this will likely require some form of lockdown in the immediate term this is not a solution in itself. It can only be a temporary measure to prevent health services being overwhelmed and allow time for the establishment of an efficient testing and tracing system. The reason there is a resurgence across Ireland is because this was not done during and following the first lockdown. If this is not put in place now what will unfold will be a repeated pattern of lockdown then the easing of restrictions, followed by a rise in cases and another lockdown. Such a scenario will be utterly ruinous both to health and the economy.
An effective system of test and trace is the alternative to lockdown and widespread restrictions. It is the means through which the virus can be kept under control. Under this regime restrictions are applied to a relatively small number of people who have tested positive or are potentially exposed rather than the population as a whole. This allows people to conduct their lives as close to normal as possible in the period prior to mass vaccination. In addition to the demand for an effective testing system a workers’ programme would also include demands for all health facilities to be taken into public ownership; the creation of an inspectorate to ensure safety within workplaces; and the protection of workers living standards and security through a ban on evictions and rents increases; and through wage supports and enhanced welfare provision. A critical element of such a programme is that it would apply to the whole of Ireland.
This programme is not revolutionary - rather it is a platform of demands and reforms that would create more favourable conditions for workers. Its most important function would be to establish a distinct class position on the questions arising out of the pandemic and present a credible alternative to what is being pursued by the pro-capitalist administrations in Dublin in Belfast.
We also have to recognise that one of the biggest obstacles to creation of such a programme is the current trade union leaderships. They have been almost silent during the pandemic. They have endorsed decisions taken by governments even when these (such as the return of schools) have posed a threat to the health of their members. Where there has been walkouts over safety concerns - such as in food processing plants - the priority of unions has been to get workers back. At a political level trade unions leaders have promoted the belief that increased public spending, as a consequence of the pandemic, is somehow moving governments in a more social democratic direction. This is completely false. What resources are being deployed are overwhelmingly skewed towards business interests with the costs of that to be borne by workers in the form of future austerity. Indeed, this is already happening with wage supports and welfare payments being scaled back. We need only look at the financial crash and what followed to see how this is likely to play out.
It is clear that any challenge to the current disastrous strategy on the coronavirus must begin with a challenge to the current leadership of the working class. This is the only way an independent class position can be established and an alternative presented. While a huge task the multiple crises facing Irish society demand nothing less.