Tánaiste Leo Varadkar said something puzzling recently. He pointed out that Belgium took into account "hospitalisations, ICU capacity and . . . deaths" in its Covid response. "Maybe we should be focusing on that," he mused to online publication, The Currency.
There are valid criticisms to be made of the National Public Health Emergency Team (Nphet); for example, about the breadth of expertise it draws on, the rationale for some of its recommendations, or why it failed to identify the looming crisis in nursing homes in the spring. But this was not one of those valid criticisms.
Hospitalisations, ICU capacity and deaths are three of the metrics Nphet does consider. The criteria are laid out in the Government’s Plan for Living with Covid. They’re right there in Section 3.1, for the Tánaiste or anyone else to read.
Hospital Report
Did he really not know? Or could it be that, even before last Sunday, he was playing to the gallery of understandably frustrated business interests by taking a swipe at Nphet?
What was his end game? What was anybody’s in this week of tireless sniping, clashing egos and forensic examination of Minister for Health Stephen Donnelly’s phone records? Who in Government knew about the impending earthquake of the Level 5 recommendation, and when? Who leaked it?
Who cares?
Here’s another question. Who cares? These inquiries may have inspired a week of fevered excitement among political commentators, but they’re beside the point for an increasingly anxious, distrustful public. Too much valuable air time was sucked into that sideshow political drama, when there are only two Covid-related questions that matter: what is the trajectory of the virus, and what should our response be?
It might have been more helpful to focus on what changed between Thursday, when acting chief medical officer Dr Ronan Glynn assured us there was no need yet for a nationwide move to Level 3 and Sunday, when chief medical officer Dr Tony Holohan came back from leave, and Nphet pushed for Level 5.
The clue is partly is in the question: Holohan was back with what he might call renewed resolve, or what an incandescent Mattie McGrath preferred to characterise as swinging his sixgun.
But that wasn’t the only factor. By Saturday, the 14-day average of cases per 100,000 people had gone from 84 to 108. The virus was spreading among the over 65s. There were outbreaks in nursing homes and direct provision centres, and a 50 per cent increase in hospital admissions on the previous week. Two people a day were being admitted to ICU.
A more rigorous enforcement of Level 3 might have been a better intermediate step than a blanket move to Level 5, but Nphet has to be allowed to make its recommendations independent of political interference. The Cabinet can then decide whether to act on them. Everything worked as it should, until the leak that sent the country into a tailspin of Sunday night blues.
There is a narrative taking hold that the Irish public is catastrophising the virus, in comparison to our reportedly insouciant European neighbours. But we have good reason to be more worried than them. A 2009 report commissioned by the Department of Health recommended critical care beds should be increased from 289 to 579 by 2020. At the start of the pandemic, we had 225 critical care beds. Now we have 281, with surge capacity for 350. This was enough during the last peak in March. Will it be enough this time? We keep hearing that ICU beds can’t be mustered up overnight. But they’ve had seven months.
That wasn’t the only point that got lost this week. So did something arguably more critical at this juncture: public confidence.
Solidarity
The belief that individual actions make a difference was carefully seeded at the beginning of the crisis, and became a key driver of solidarity. Now, the only thing that unites many of us is a gloomy sense of inevitability. We're on a train bound for Level 5, and there's no way off. Seven out of 10 of us believe "the worst is yet to come" according to the latest Irish Times/Ipsos MRBI poll.
So we're getting the few bits done while we still can. If you wanted to see the national spirit of nervy fatalism in action, you just needed to look at the queues forming outside Smyths toy superstores. Or the traffic clogging the M7 on Wednesday, every one of the drivers convinced theirs was essential business. Or the Archbishops insisting that mass isn't a gathering, but a "profound expression of who we are", as though Covid will appreciate the difference.
A worrying dichotomy has opened up between what people say they want, and how they are behaving. One in three claimed in the Ipsos/MRBI poll to want tougher restrictions, but many seem to mean tougher restrictions for everyone else. One woman vox-popped at a service station on Wednesday was strongly in favour of fining people. Asked where she was going, she said she was returning home to Dublin from a lovely break in Kerry.
The big question of the week isn’t what Holohan said to Donnelly; or what Donnelly said to the Taoiseach; or how the Tánaiste responded. It’s how to persuade us that this isn’t the time for minibreaks or post-match celebrations or for having a few friends round for a takeaway.
Amid all the hectoring, I didn't hear anybody make the point that we don't need to wait until Level 5; some parts of the country were showing signs of turning the surge around even at Level 2. Carlow had just one case in five days. Waterford was back to the lowest 14-day incidence rate in the country on Thursday.
There may be reputations and pride at stake in the fractious relationship between Nphet and the Government. But it’s the relationship these two bodies have with the public we should be worried about.