Coronavirus: Harris warns surge could see some surgeries cancelled

‘We are nowhere near that at this stage,’ says Minister – but service may have to ‘prioritise’

Both Covid-19 cases confirmed in Ireland to date have involved people who travelled from Italy. Photograph: Audrey McAvoy/AP.

Non-essential surgeries may have to be cancelled if the health system experiences a big rise in coronavirus cases, according to Minister for Health Simon Harris.

A surge in cases would force the health service to “prioritise” and could lead to elective surgeries being cancelled, “but we’re nowhere near that at this stage”, said Mr Harris.

Dealing with the outbreak is “likely to be with us for many weeks and months and possibly beyond”, the Minister told Newstalk FM on Wednesday.

He said public health notices would be issues to help trace contacts of confirmed cases if this was required. But to date “this hasn’t been necessary” in the two cases that have occurred.

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Mr Harris emphasised the authorities have the power to ensure that people self-isolate if they are diagnosed with the virus.

“I don’t want to engage in hysteria by outlining measures too bluntly. But the reality is Covid-19 is now a notifiable disease, this is a normal public health precaution we take. We would have done the same with Sars [severe acute respiratory syndrome],” he told RTÉ radio’s News at One.

The Minister said he had signed a statutory instrument, a piece of secondary legislation, a week-and-a-half ago. “That makes it a notifiable disease, that does give our authorities the powers to ensure people isolate. But let me be very clear our experience in this country is that people co-operate and take very seriously public health advice. It’s important to be proportionate, that we listen to doctors and experts.”

When asked about the possibility of cancelling the St Patrick’s Day festival, Mr Harris replied: “My view is that my view shouldn’t matter, the advice as of today is that it does not need to be cancelled [but] that might change. It’s about making the right call, the situation could evolve.”

Meanwhile, Irish policymakers will have difficult decisions to make in relation to the coronavirus in the coming weeks, flu virus experts have said

The latest bulletin comes following confirmation of the State’s second Covid-19 case on Tuesday.

Prof Kingston Mills, of Trinity College Dublin’s centre for immunology, on Wednesday questioned why more stringent measures to deal with the virus had not been introduced. He also queried if flights between the Republic and Italy should still be operating.

Both cases confirmed in Ireland to date have involved people who travelled from Italy. The woman at the centre of the latest case is now receiving appropriate care, according to the National Public Health Emergency Team (NPHET), and efforts to trace people who have been in contact with her are underway.

“If the HSE cannot contact the people [identified through contact tracing] then they will make a public announcement. That hasn’t been necessary to date,” Mr Harris said earlier on Wednesday.

The woman’s illness is unrelated to the first case, which was confirmed last Sunday and involves a school student from Dublin. A total of 397 people have been tested for the virus to date with only two cases confirmed.

Mr Harris said the key to containing the virus is people coming forward and maintaining patient confidentiality.

All non-essential travel to four regions in Italy – Lombardy, Veneto, Emilia-Romagna and Piedmont – is now being advised against by the Department of Foreign Affairs. It updated its travel advice, which previously said non-essential travel in Italy should be limited to 11 specific towns, on Tuesday night.

Essential travel

Commenting on this development, Prof Mills asked what the definition of essential is when it comes to travel and how a person should judge this.

“We need to look more seriously at means of curtailing travel to that region [in Italy].”

Speaking on RTÉ’s Today with Séan O’Rourke show, he also queried HSE information about the virus being transmitted only after 15 minutes in the company of an infected person.

“I’m surprised at that 15 minutes figure. You could be infected in 10 seconds if a person [with the virus] sneezed on you,” said Prof Mills.

He acknowledged that the longer a person spends in the company of an infected patient, the greater the risk of transmission.

“Fifteen minutes is an arbitrary figure,” he said.

He warned that hand washing could give people a false sense of security. “Hand washing is one way to stop the spread of the virus, but the biggest risk is from someone coughing and sneezing in your vicinity.”

Chairman of the State’s coronavirus advisory group Dr Cillian de Gascun said on Wednesday that there is still no evidence of community transmission in Ireland. But he warned the situation is evolving rapidly.

He told RTÉ radio’s Morning Ireland that two weeks ago there were only three cases in Italy, but in the space of 11 days this had risen to 2,000.

He acknowledged that the “significant containment” efforts by China had helped give other countries time to plan and prepare. Dr de Gascun said that if Ireland were to see a similar rise in cases then plans would have to change. The Irish hospital system is “as prepared as it can be” to deal with the virus but it is under pressure, he added.

Mass gatherings

Guidance on mass gatherings is to be publishing in the coming days, following cross-Government review, said the State’s chief medical officer, Dr Tony Holohan who saw no reason “as things stand” as to why the St Patrick’s Day Festival could not go ahead.

Dr Kim Roberts, influenza virus researcher and assistant professor of virology at Trinity College Dublin, said the Irish authorities should expect more cases of the virus.

“It was always a case that we would have another, we should expect more,” she told Newstalk Breakfast.

“There is a balance that needs to be struck especially early on in an outbreak within a country, to make sure that information gets across in a way that can be absorbed and not create fear and panic. But we do need to explain to people that this situation is changing and . . . we may see evidence of community transmission.”

The Department of Health has said the testing of suspected cases is to be moved from hospitals to the community, most likely in people’s homes. Dr Holohan said this would take further pressure off hospitals and that the tests would be carried out by paramedics.

Issues relating to vulnerable people, healthcare workers, medicines supply and the preparedness of hospitals are to be examined by four separate sub-committees, the NPHET also announced.

Measures being taken to counter the spread of the virus have wider societal implications, Dr Holohan acknowledged and these would be addressed by a Cabinet committee that has been established to examine the issue.

Self-isolation

Dr Roberts said that if the authorities could “act swiftly and decisively with identified cases, with identified people infected with this virus and they self-isolate and take that self-isolation seriously, we can reduce the spread.

“Policymakers have difficult decisions to make. I think we should expect that policy will change swiftly over the next few weeks, depending on what the evidence is saying about community transmission in Ireland and the UK.”

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.