The National Public Health Emergency Team (Nphet) reported a further 301 confirmed cases of the disease on Sunday, bringing to 74,246 the total number of cases in the pandemic.

No new deaths of Covid-19 patients were reported to the Health Protection Surveillance Centre.

This left the total number of Covid-related deaths in the State at 2,099.

Hospital Report

Of the new cases, 119 were in Dublin, 32 in Donegal, 16 in Cork, 13 in Kildare and13 in Kilkenny with the remaining 108 cases are spread across 18 other counties.

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The median age was 32 years and 64 per cent were under 45 years of age.

On Sunday afternoon, there were 231 Covid-19 patients in hospital, including 28 in ICU. There were eight additional hospitalisations in the previous 24 hours.

The national incidence of the disease fell slightly to 80.7 cases per 100,000 people over the past 14 days. Donegal, the county with the highest incidence, recorded a small increase since Saturday, with an incidence of 224.9. Kilkenny and Louth had the next highest incidences by county, while Leitrim, with an incidence of 15.6, had the lowest.

Earlier on Sunday, newly-published minutes of Nphet meetings showed that members of the group last month called for the weekly imposition or lifting of pandemic restrictions as case numbers varied.

Nphet also heard a proposal that people be limited to six contacts outside their family for six months but this was rejected as “unrealistic”.

This week-on-week approach was proposed by “some members” to take account of the changing epidemiological situation but other Nphet members questioned its “practicality”.

Instead, Nphet resolved to recommend a two-phased approach to the lifting of Level 5 restrictions before Christmas in order to “mitigate any rush” if shops, restaurants and other services were to open on the same day.

This involved an initial easing of measures from December 1st and, later in the month, a further relaxation “in recognition of the holiday period”. Afterwards, restrictions would be tightened up again to the December 1st level for at least three weeks “to assess the impact of the Christmas period”.

The Government ultimately opted for a phased approach to lifting restrictions but raised them earlier and more widely than recommended by Nphet.

Concern was also raised at the November 12th meeting of Nphet about the plan to re-open on December 1st “and whether this date would be too early with regard to Christmas, potentially causing a significant rise in numbers in the pre-Christmas period”.

“Members stated that they would favour a conservative approach in the beginning of December, followed by a social period with very clear guidelines, then a return to more conservative measures following the holiday period.”

Superspreading in hospitality

In relation to the hospitality sector, “many members” of Nphet raised the issue of superspreading events and asked that it “examine why some settings should open, as opposed to justifying why they should remain closed”. But other members pointed to the rules in other countries on capacity limits and opening hours as as potential examples for what should be implemented in Ireland.

The meeting also heard of concern about incidence rates in Co Donegal, which were then – and now – more than twice the national rate. Cross-border travel, as well as large outbreaks at wakes and funerals, were identified as some of the factors driving the trend.

Officials said Irish data was needed on the types of settings and activities linked to increased risk of virus transmission. Consideration should also be given to retrospective contact tracing and well-designed case-control studies.

The meeting resolved that consideration be given to the types of supports needed to enable people to safely self-isolate at home.

Health Information and Quality Authority members told the meeting a small proportion of cases ultimately seed the majority of local transmission of the virus. The highest-risk areas were indoor, high occupancy and poorly ventilated environments, where there is shouting and singing, insufficient use of face coverings, and prolonged contact.

The range and/or intensity of public health measures may need to differ for settings and activities conducive to superspreading, according to Nphet. These settings include “health and social care settings, meat and food processing plants, cruise ships, prisons, shopping malls, religious settings, bars, nightclubs, restaurants, gyms, offices, weddings, and large shared accommodation”.

The particular issue of poorly ventilated environments and the risk they pose for spreading the disease was highlighted at the meeting, and experts in ventilation are to be drafted in to build on previous research work.

The Department of Health said there was now more understanding of high-risk environments, activities, and behaviours, in addition to greater knowledge on community transmission and the impact restrictions have on the spread of the virus. There were further lessons to be learned from the recent exit strategies employed by other countries, it said.

International travel

On international travel, the meeting heard that “many people” have contacted the Department of Foreign Affairs to ascertain if travelling to see family at Christmas is considered essential.

Nphet said the progress made during the Level 5 restrictions could be compromised by importing cases through international travel and emphasised the need to effectively manage this risk.

Christmas planning was also discussed at a meeting on November 5th. According to the minutes, “the distinction between pubs and restaurants was noted as important, and the idea of a pub/restaurant as providing a more controlled environment, when guidelines are strictly applied and enforced, than a private house should be considered”.

“Emphasis on how to make higher risk activities safer was highlighted, with particular regard to guidance on ventilation for pubs/restaurants/retail which was noted due to super-spreader events that occurred previously.”

Nphet’s communications team made a “safe socialising” proposal under which “people should socialise with an exclusive group of six people from outside their household for the next six months or until a vaccine is distributed”. Young adults living at home would be allowed have a “group of six separate to their parents”.

“Many members of Nphet expressed concern that the expectation may be unrealistic, especially when tied to the arrival of a vaccine. It was also noted that it may be exclusionary, particularly among younger cohorts,” the minutes record.