Pat Leahy: Second phase of vaccinations presents new challenges

Contrary to what many people appear to think, the first phase of Ireland’s vaccination programme has gone okay.

True, the public face of the programme has often been dominated by its failures: vaccines failing to be delivered; targets missed; disappointed grannies; frustrated GPs; and so on. And then when the vaccines did arrive, some of them found their way into the wrong arms – doctors’ children, private school teachers (wouldn’t you love to see the full list of Beacon recipients?), hospital board members, etc.

There is no doubt there have been missteps, and not much effort in holding people responsible for them. But we often fail to see the wood from the trees, fixating on the peripheral details and ignoring the main event. I think the more important detail is not that some vaccines have gone astray but that a million vaccinations have been done with reasonable – though far from perfect – efficiency. European comparisons would tend to bear this out.

And the benefits are astounding. Outbreaks in nursing homes, previously the most lethal locations, have all but been eliminated. Healthcare workers are now just 2 per cent of cases; over 85s less than 1 per cent. The vaccine is astonishingly effective in stopping the virus. The case for vaccinating as many people as quickly as possible has never been stronger.

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But too many people in Government fail to comprehend is the extent to which the second phase of the vaccination programme – which has already begun – will have to be different to the first phase if it is to reach anything like the numbers that are both necessary and promised.

The HSE was right to say the only constraint in the first quarter was deliveries of the vaccine. I have lost count of the number of times I have been told that they received a million vaccines and jabbed a million arms. But the deliveries – if the Government’s figures released this week after much badgering are correct – will no longer be the main constraint.

The challenge is not going to be getting the supply, it will be administering the shots that have been delivered. Four million vaccines are due in the three months of April, May and June; the promise is three million vaccinations, but if there are spare shots lying around, the HSE will have to find the capacity to use them. I gather the real target is to have the four million shots in arms by the end of June. That will require an operation that is on a completely different level to what we have seen.

The only way four million vaccines will get done is if the GPs, pharmacists and the 38 vaccination centres are all up and running at full capacity, seven days a week, before long. That is something entirely new: a new mass vaccination scheme. It is a dramatic pivot and it has to happen now. The online booking system (to be unveiled next week) has to work, and work first time: you go online, you get an appointment, you turn up, you get vaccinated.

Driven half demented by the UK’s success, EU officials grew fond of saying that it was a marathon, not a sprint. Wrong. It is a sprint – the quicker you do it, the more lives you save. It’s just a sprint that goes on for a very long time.

The seven-day nature of the operation is vital. Up to now, the numbers of vaccinations has fallen off noticeably at weekends. For example, the HSE was immensely – and justifiably – proud of doing 30,000 jabs on Good Friday. But the numbers dropped like a stone over the Easter weekend. The new system needs to be different because it will be dealing with big numbers all the time.

Lack of confidence

Several senior officials and politicians express a high degree of confidence it will work; from the outside, I find it hard to be so bullish. The lack of transparency of the numbers of vaccines expected and the number of jabs planned does not bespeak a confidence that targets will be hit. The numbers are not routinely released publicly (and I think they should be) but I understand they expect 120,000 jabs this week and 180-190,000 next week. So let’s see. The somewhat farcical coincidence that the one millionth jab was carried out during the HSE chief’s weekly press conference reeks of gimmickry, not gimlet-eyed efficiency.

One worried official points me to the hospital discharge figures: they show a huge fall-off in the numbers discharged at weekends, and then a big jump on Mondays. This was true in January and early February, when the health system, we were constantly told, was on the verge of collapse. But even then, hospitals were fuller at weekends than they needed to be, presumably because people (naturally) like their weekends off. I don’t think that approach will be sufficient on the vaccination programme.

Post-Covid challenges

For the Coalition, it is impossible to overstate the importance of getting the second phase of the vaccination programme right. If the Government is seen to have handled this vital and transformational phase relatively well – and the measure for that will be shots in arms in the millions before the summer, not the ubiquity of early snafus – then it can look forward to the type of bounce that Boris Johnson recently enjoyed and that has followed Fine Gael since it led the caretaker government during the first phase a year ago.

Now I don’t expect that would last. But it might at least enable the Government to approach the great post-Covid challenges of restarting the economy, rebalancing the budget and building houses with some degree of stability and momentum. Success on vaccination in the coming months is certainly no guarantee of continued success in other matters. Failure, however, would probably be fatal.