I want things to open up again as much as anyone else. I want to be able to see my family and friends and give them a long-overdue hug. I want to be able to hang out and laugh and eat and drink and be merry. I’d love an overseas holiday somewhere with reliable sunshine and new places to visit. However, I don’t want these things at any cost. And I especially don’t want to have a repeat of the December reopening, where we exchanged three weeks of hurry-up-and-eat-your-substantial-meal for five months and counting of lockdown, and thousands of avoidable deaths.
This week the Government has been discussing plans for the reopening of hospitality for summer. The arguments appear to be exactly the same as those we heard in December – all about how important this period is for the sector, and not enough about science-based policies to make it safer. We are yet again having discussions about the distance between tables, the number of minutes you can stay and how many people can sit together. But the virus is airborne and doesn’t care about your two metres, and certainly doesn’t care that even though your tables were only one metre apart, you stayed for less than 105 minutes. To pretend otherwise is to play dumb and invite disaster. Instead of magical-thinking guidelines about numbers of adults, numbers of children and numbers of minutes, we need sensible, evidence-based standards for any reopening activities. This means proper ventilation, suitable distance (one metre is too close), and masks whenever possible.
High risk
The Irish Government has adopted a “wait for the vaccines” strategy. However, they weren’t upfront about how long that wait would be. We are now in a situation where we are lucky enough to have numerous very effective vaccines available, and our vaccine rollout is keeping pace with supply. Even so, many over-60s, as well as younger people with significant medical vulnerabilities, have yet to be fully vaccinated (and many within group seven – people aged 16-64 who are at high risk – have not even received their first dose).
Nonetheless, some people seem to be under the impression that we can reopen without risking a surge in hospitalisations or deaths. But even in the UK, where vaccination rollout is ahead of Ireland, a looming risk of a surge worse than January exists because of the apparently increased transmissibility of the B.1.617.2 variant, first identified in India. This is because increased transmissibility means a huge number of cases, and even in the unvaccinated younger age groups, where the percentage of negative outcomes is lower, this is a problem – a small percentage of a very large number is still a large number.
In a matter of weeks we will have significantly more clarity about the dangers posed, or not, by B.1.617.2
The B.1.617.2 variant has now been recognised as the dominant variant in the UK, and Matt Hancock was reported as saying that they “are in a race between the virus and the vaccine”. How did the UK end up in a neck-and-neck race, when only a matter of weeks ago things looked comparatively smooth? Boris Johnson and his cabinet failed to heed the early warnings of the likes of the Independent Sage group and other epidemiologists and public health doctors who warned that to wait for certainty was to flirt with disaster. The only way to be certain that a new variant of concern is indeed more transmissible is to observe the pattern of infection and cases. It means waiting until it is already too late. We must not make that mistake in Ireland, and we must listen to the alarm bells the world-class genomic surveillance of our nearest neighbour affords us. The variant B.1.617.2 is already here – we must not allow it to spread.
Red lists
That means preventing more cases arriving from Britain, and it means ensuring our local public health units are properly resourced to stamp out and contain the cases that are already here. It’s a challenge, but we did this before. Not long ago in Ireland we found cases of the P.1 variant first identified in Brazil, but this appears to have been successfully contained by a combination of mandatory hotel quarantine and the excellent work of our public health doctors. These things work. We need to extend our quarantine system to include at least all countries where variants of concern are common, including Britain. Other EU countries have already started to restrict travel from Britain, with Germany and France both planning on imposing quarantine. If we don’t take action, B.1.617.2 will spread here, and Ireland could find itself on these travel restriction lists.
In a matter of weeks we will have significantly more clarity about the dangers posed, or not, by B.1.617.2. The cost of waiting is only a slight delay so that we can make informed decisions. By then we will know more about its transmissibility, and the vaccines’ efficacy. We can use that time to properly formulate ventilation criteria for indoor spaces, so that they can be made safer. We can safeguard our domestic summer.
While holidaying within our own beautiful country, we can celebrate the good news of increasing numbers of our friends and family getting vaccinated. We can achieve herd immunity through vaccination by getting about 80 per cent of our total population fully vaccinated. We are lucky in Ireland that we have such enthusiastic vaccine uptake that this is a realistic prospect. When we get to that stage the virus will find itself in a hostile environment. We shouldn’t spoil this hard-won chance with impatience.
Aoife McLysaght is professor of genetics at TCD