Ireland can eliminate Covid-19 over the course of the summer but repeatedly imposing, lifting and reimposing restrictions is a dangerous gamble, according to an Irish expert in infectious diseases.
Prof Gerry Killeen said that it would only require a modest amount of additional effort to eliminate Covid-19 from Ireland over the coming months but failure to continue with strict restrictions could prove costly in the long term.
He warned that complete elimination of Covid-19 could only be achieved by preventing reintroduction from outside the country which would require a rigorous isolation programme for anyone coming here.
"The quiet tail of a fading epidemic may be just as dangerous as the silent onset," said Prof Killeen who works at the Environmental Research Institute at University College Cork.
Prof Killeen, who has worked in Tanzania and Kenya combating malaria as well as Zika and Dengue viruses, has conducted modelling analyses on how Covid-19 spreads and he is in no doubt about the risk it still poses.
He said that as Ireland gradually begins to emerge from lockdown, it should look to countries with ambitious national strategies to crush the curve of their Covid-19 epidemics, such as China, Korea, Japan and Australia.
"With their approaches to eliminating the virus with sustained and uninterrupted restrictions, their timelines to that exit point are about three months and New Zealand is already there," he said.
"Countries like Ireland, France, Spain, Italy and the United Kingdom, where daily incidence rates have been slowly falling, may well have achieved 80 per cent suppression of transmission.
“Their epidemics could slowly fizzle away if current measures were maintained, so why would these countries not build upon their successes by pushing even just a little further past this crucial tipping point?
“Faster progress towards elimination would obviously be better and these timelines could be shortened if we were to push ahead now with even more stringent and effective restrictions.”
Prof Killeen, who has published his analysis in the journals, Infectious Disease Modelling and the European Journal of Epidemiology, has predicted Ireland's recent rates of Covid-19 reduction could lead to zero cases over the summer.
However, he has warned that, on the other hand, repeatedly imposing, lifting and reimposing restrictions until the epidemic hopefully burns itself out, through herd immunity, could see it lingering at great cost for many years.
“It’s likely Covid-19 could establish itself as a permanent disease with unpredictable waves every few years,” said Prof Killeen, adding failure to completely eliminate the virus now risks greater long-term economic damage.
“On the economic front, incomplete suppression of the epidemic means extending the damage over years rather than months, asking business to spend more time, operating under restrictions that push them into the red.”
"However, such a bold choice would require a dramatic rethink of our national strategy, broad support from the public at large, and co-operation with our trading partners across Europe and the rest of the world."
Stark consequences
Prof Killeen said that it was essential for politicians, health professionals, journalists and the general public that as many people as possible understand the stark consequences of the choices that lie ahead for Ireland.
“Eliminating the virus within months would require only a modest amount of additional effort, compared to merely suppressing the epidemic and allowing it to persist for years, decades or even indefinitely,” he said.
“Unfortunately, once we have eliminated the virus and can completely relax domestic restrictions, even the slightest easing of travel or importation controls could cause a rebound.”
Prof Killeen said that the complete elimination of Covid-19 from Ireland can only be maintained by preventing its reintroduction from outside the country which means more rigorous controls on those coming to Ireland from abroad.
"That means isolation of all incoming travellers, except those coming from countries that may be certified as free of local transmission by the World Health Organisation in the future," he said.
Failure to introduce rigorous isolation measures for people coming from countries that have not been certified free of local transmission by the WHO was “essentially identical to doing nothing in the first place,” he said.
Last month, a group of scientists wrote an open letter urging the Irish government to "crush the curve" on an all-island basis rather than pursuing the current "long-term mitigation strategy."
Prof Killeen said it was vital that both citizens and governments, who are considering relaxing unpopular lockdown restrictions, instead embrace intensified containment, elimination and exclusion efforts.
“Unless we all respond constructively to the recent WHO appeal for genuine national unity and global solidarity, it appears unlikely that we can collectively defeat the Covid-19 pandemic.”
