Absent in Ireland is any visible debate on how we are doing on the fight with covid-19. On one side there is the government who are setting the narrative with NPHET. On the other side there are the opposition parties who are saying very little. The main input from the Labour Party has been in response to #golfgate. Sinn Fein, who portray themselves as governors denied, have disappeared. A brief foray into the nursing home debacle months too late was as good as it got.

Luckily, holding the politicians to account in Ireland is a free and dogged media. Everyday we hear the 4th estate engage the government approach in a constructively critical manner, facilitating the dialogue between differing opinions, and informing the public of ideas and thoughts that are not being shared by the authorities.

No, we don’t. The reportage in Ireland was, like Sinn Fein, months too late to the game on the nursing home deaths and refused to play a role in elevating the voices that were concerned before hundreds of lives were unnecessarily lost. Right now, the leading story on the main Irish news websites concern Phil Hogan and his will he/won’t he, did he/didn’t distraction. Once the story runs its course, RTE will need to let go half of its news staff as they don’t seem to have anything else to work on. The rest of the time is spent repeating government and NPHET speaking points with no interest in engaging the content, veracity or appropriateness.

When Tony Holohan spoke, Ireland was expected to be deferential because we were in the midst of an existential crisis. When Ronan Glynn speaks, the science has spoken and policy is expected to follow suit. Neither the science nor the logical consequences of the science are up for discussion. This is not how it is supposed to work. Science is not settled and the information, data, statistics can be interpreted in various ways. Depending on what is highlighted, what is downplayed, and what is ignored or buried, the science can look very different.  The adage ‘lies, damned lies, and statistics’ is forgotten right now but probably never more appropriate.

We are treated to omnipotent statements on government policy and little in the way of serious questioning or alternative approaches is presented.

There are views divergent from the politicians, the media and the ‘settled science’ that are out there. Some of these views come from people with very credible credentials. They are not quacks. Yet, they have been treated so. The discussions about nursing homes, hydroxychlorquine, wearing facemasks, trustworthiness of rushed vaccines, questioning the presented emphasis of the statistics etc ad infinitum, have been treated as tinfoil hatted conspiracy theories by those that control the levers of power. Anyone who dared talk about Sweden or herd immunity was quickly rounded on as a despicable pensioner killer.

There is no serious analysis when Simon Donnelly says the future of Ireland is going to be local lockdowns. There is no questioning when we are told we are going to be living with coronavirus for years. We are supposed to accept this, and accept that the economic, social and health impacts that go with this strategy will be with us for a long time. This is essentially the government telling us that the future is out of their hands. They are passive victims of the coronavirus, held hostage to fortune, and just good people doing their best in unprecedented times.

We are no longer in unprecedented times. The times now have a precedent. We are six months into managing the outbreak. None of the predictions of mass fatalities have come to pass either here or anywhere else. The same government narrative persists pretty much unquestioned.

Where is the hard debate about how long we can continue to subsidise Ireland in the present manner? Where is the analysis on where the economy will be in six months? What will our deficit be? How will we pay it? How will this impact on the ability of the government to pay for services? What kind of tax increases will be needed to bridge from the gap from a contracted economy and tax base?

There is almost silence on the issue of getting the balance right between restrictions and a functioning economy. The country continues to be paralysed by the fear that was instilled earlier in the year when society accepted severe restrictions in the face of the dire predictions of Niall Ferguson in the UK where 500,000 deaths were predicted if nothing was done, and the harrowing images from Bergamo in Italy. The earlier fear was understandable but we know a lot more now yet still seem to be living in the past, and the new government cresting along on the wave of fear.

The idea of safetyism seems to supercede every other consideration. Facemasks have, all of a sudden, changed from being not useful to be imperative, even in settings where wearing them seems to make no sense. You walk into a coffee shop wearing them and once you sit down for a protracted period you take them off. At the same time, official government advice is that at least 15 minutes within 2 metres of someone carrying the virus is needed to catch an infection.

There are many issues that need to be debated and there needs to be a national dialogue before the government and the NPHET lose the confidence of the people. A mature discussion is needed on the dangers of the virus. We knew in May that in 88% of deaths there was an underlying condition, and the median age of these deaths was 83, the same as that for all deaths. We knew that 62% of deaths occurred in care homes, which, if looked at without prejudice, were avoidable if the virus was better understood and there was less panic about protecting hospitals.

We learned in July that the excess mortality due to coronavirus was likely 1,072 rather than the official figure of 1,709. HIQA said that this is may be due to the likely inclusion within official COVID-19 figures of people who were known to be infected with SARS-CoV-2 (coronavirus) at the time of death who were at or close to end-of–life independently. This tells us that the virulence of the virus is not what we feared and that a new strategy is needed to address the safetyism that has paralysed the country and positively learn to live with the virus if we are not to eliminate it.

(Whether it can be eliminated is also not being discussed with any rigour. We instead listen to platitudes that the virus does not respect borders. Nonsense. Of course it does. It doesn’t respect them if they are wide open.)

Of course, that is not to say that the restrictions were not useful and necessary. We don’t know exactly how things would have worked out had we not put restrictions in place – the fear of a Bergamo-like were not misplaced at the time, and there is no doubt the need to flatten the curve and protect the health service from being overwhelmed was genuine and well-intentioned.

Credit where it is due, this never came to pass, but at the same time, learnings from other locations tell us now that it was unlikely to have occurred.

Sweden, however much maligned, offers us a real-world control to compare competing strategies of government enforced restrictions versus social adaptation. Sweden has not fared as well as its Nordic neighbours but compares favourably to many countries in Europe. Economically, Sweden has fared substantially better than the EU average of 11.9 per cent, with France’s economy down 13.8 per cent, Italy down 12.4 per cent and Spain down a staggering 18.5 per cent. Sweden’s has dropped by 8.6%. In a study of economic contraction versus deaths due to coronavirus, Sweden’s sits almost bang in the middle of the European table. It has not had an absolute catastrophe and may well fare much better in the face of managing subsequent spikes, and working its way out of the pandemic. Inevitably, most countries when considering how to respond to a second wave, are considering replicating how Sweden managed and learning from that. In Ireland, the threat of lockdowns continues to be waved in parallel with an escalating fear.

We also learned in Sweden, from a study by the health authorities in the Östergötland region which covers 122 people who died outside a hospital setting – either at home or in accommodation for the elderly – and whose deaths were attributed to Covid-19. Half of this group were aged over 88. Of the 122, 111 were judged to have extensive comorbidities and 11 had moderate comorbitities. Not one of those who died, in other words, was in good health. In only 15 per cent of cases was Covid-19 judged to be the direct cause of death. In 70 per cent of cases Covid-19 was a contributory cause and in the remaining 15 per cent death was judged to have been caused by another underlying cause – most often heart disease. This underlines what we are seeing in Ireland yet we are not responding to this reality. Government policy is not to discuss the nuances but to treat the virus as if it puts everyone at risk equally and that the impacts of the virus are equal.

Source: https://www.hiqa.ie/sites/default/files/2020-07/Analysis-of-excess-all-cause-mortality-in-Ireland-during-the-COVID-19-epidemic.pdf

There are other places that may possibly have achieved herd immunity where government intervention was poor or absent. In New York, there are areas where antibodies are present in over 50% of the population and the virus seems to have retreated rapidly with no explanation readily available. In India, more than half the residents of slums in three areas in India’s commercial capital, Mumbai, tested positive for antibodies to the coronavirus, a survey has found.

The Amazonian city of Manaus saw a rapid retreat of what seemed an uncontrolled epidemic among its 2 million population. Excess deaths, which had been running at 120 a day in May, have dropped away to virtually nothing. The epidemic seems to have died away of its own accord. The virus staged a similar retreat in the Ecuadorean city of Guayaquil.

It has to be noted that these are not necessarily examples to be followed as Manaus had a massive excess mortality, though nowhere near what Niall Ferguson predicted, but it provides more indications that we do not need to plan for years of lockdowns and restrictions.

Another area of contention is the more recent debate of whether to open schools, or if masks should be worn in schools. The dialogue here in Ireland is minimal. There is no substantiated discussion of evidence from here or from abroad on whether and how safe schools are. Reported in The Spectator as the UK moved towards re-opening is analysis from the 1 million students that went back to school in June, there were  “70 children and 128 staff who tested positive for Covid-19. 67 of these were isolated cases – where staff or pupils were presumably infected outside school. The remaining cases were linked to ‘outbreaks’ within school – an ‘outbreak’ defined as two or more people. Across the country there were 30 outbreaks of Covid-19: for every 1,000 nurseries, 0.5 suffered an outbreak. For primary schools the figure was 4.8 and secondary schools 1.6. In two thirds of cases of in-school transmission, the infection passed from staff to staff, or staff to students. There were very few cases of students passing the infection to each other or students passing the infection to their teachers … the PHE research suggests that schools are not significant seed-beds of Covid-19 infection. During the period in which 198 staff and pupils tested positive for Covid-19 in schools, 25,470 cases were identified in England as a whole.”

We do not hear this in Ireland. We have lost the ability for reasoned discussion and the default response is stonewalling, and then polemics in return. We live for ad hominem attacks. We revel in it. There has been little attempt beyond the type of scaremongering used by Minister Donnelly as he warns his people that we are on the verge of another national lockdown even though the recent past nor the current figures indicate that this is a necessity, nor the continued destruction of the economy. The opposition parties are silent: no probing questions as to why this might be necessary, or to ask the Minister for an explanation. They are sat on their hands and the media merely parrot the words of the government.

Maybe this is all too complicated for the opposition to understand. For the media too. So, why don’t they facilitate the experts to engage in the conversation? Are they too scared to suggest something other than restrictions and lockdown? Are they scared of being wrong? Is it a case that they prefer to stay quiet and let the Government suffer the consequences of the side effects of the non-strategy they are following while hiding beneath the cover of the fear of the virus that still persists?

Yes, it is a new disease, and there is much that is unknown. But looking to England and Wales, the coronavirus is not killing near as much people as the regular summer ‘flu. Five times as many people were dying of ‘flu as the coronavirus across the Irish Sea. Do we think it is much different here? Do we know? Why do we not talk about it? Depression in the UK has increased from 9.7% of the population in the nine months prior. to 19.2% during June. Is it any different in Ireland? Do we know? If we do, why do we not talk about it? And that is not even discussing the economics, or the knock-on health impacts such as delays in cancer screening that will inevitably lead to deaths down the line. We don’t really talk about those either.

 


 

Dualta Roughneen