The Republic’s first case of the coronavirus at the weekend made it the 61st country in the world to succumb to a disease that is now present across the globe.
That figure alone explains why the case, involving a young Dublin man who had returned from Italy, came as no surprise. For weeks, experts here had been saying it was only a matter of time before Covid-19 made its way to Ireland; the wonder was it took so long to arrive when other countries were falling like nine-pins.
That delay bought Ireland valuable time in which to prepare for the inevitable, and this learning will now be tested in the weeks to come.
Those in contact with the case are being identified and will be contacted by Public Health doctors in line with best international practice.
— HSE Ireland (@HSELive) March 1, 2020
We actually have two cases, as the case reported in Belfast earlier in the week involved a woman who passed through the Republic on her way home. It is not as though viruses respect national boundaries.
The two cases change everything – and nothing. The arrival of the virus in our midst will inevitably ratchet up concern and, for some, fear. When this is given expression through correct precautions and maintaining hygiene, this is useful; expressed as panic, it is counter-productive.
For public health doctors, our approach remains the same; we are still in a containment phase in relation to the disease. Aside from treating the two patients, the focus is on tracing their contacts to prevent the onward transmission of the disease and, as before, on minimising the chances of further cases arriving.
Containment phase
Ireland will stay in a containment phase – as opposed to switching to a mitigation approach, where the focus is on those with the most severe symptoms – so long as there is no person-to-person transmission here. The UK, for example, remains in the containment phase, despite notching up at least 35 cases.
The young man now being cared for in a Dublin hospital will have provided doctors with information on his travel routes. It is understood he was not showing symptoms during the return home from Italy but developed them afterwards. As a result, the early emphasis in contact tracing has been on his movements back in Ireland, and this has led to the extraordinary closure for two weeks of the school he was attending.
We may see more of this over the coming weeks, as the current two cases are dealt with and if further cases emerge. It is a relatively simple process to track down an airline passenger who may have sat beside someone who later tested positive for the disease; most of us, if organising our own travel, have to supply addresses and contact phone numbers when booking flights.
The woman who tested positive in Belfast took a taxi from Dublin airport to Connolly Station. Gardaí working with public health staff looked at CCTV footage from the taxi rank in the airport and were able to identify the cab she took. That driver is now in self-isolation for two weeks. Public health officials say tracing is now complete in this case, meaning those who were in close contact with this so-called index case have been tracked down, and are being monitored.
The second case, which has forced the closure of a Dublin school, shows the challenges intrinsic to contact tracing when people move freely in the community but are later diagnosed with an infectious disease.
The school is being closed as a precautionary measure and the risk to other pupils and teachers is said to be low. Understandably, though, parents are likely to be concerned. Some will think the closure too drastic; other will worry whether it is sufficient, whether their children should self-isolate and even whether they should be tested.
Instead, students are being advised, rather, to restrict their movements and only to self-isolate if they develop symptoms. Public health officials have deemed this approach appropriate to dealing with the situation that has arisen. These are the same officials whose approach has helped ensure Ireland is one of the last countries in Europe to have a coronavirus case, and whose work in previous epidemics successfully kept other threats at bay. This should give the public confidence that the right approach is being adopted.
