For several weeks now Ireland has been in a strange place with Coronavirus, wherein the numbers of people with confirmed cases has been consistently creeping up, but the number of people in hospital and intensive care has remained flat, and there have been barely any deaths. This has exposed a real tension at the heart of policymaking, with people asking (perfectly reasonably) what the point in aggressively responding to an increase in cases – but not in deaths or hospitalisations – is.

Well:

Overnight figures show a small rise in the number of patients in hospital confirmed as having Covid-19.

There are 50 patients with the virus in hospital, with six of these in intensive care.

It compares with 48 confirmed cases in hospital on Saturday and 33 this day last week.

There are also 61 suspected cases in hospital, with seven in intensive care.

The hospitalisations number is, in reality, much more important than the case number, especially since the relationship between the two numbers doesn’t seem to be linear or predictable. Ireland has about 450 intensive care beds. The equation is very simple: If it looks like a reasonable prospect that those beds are going to be filled, then the country will have no option but to go into a second lockdown, no matter what your views are. Cases are one thing, and people can very reasonably make the case that Irish policy is over-reacting to a spike in cases (a case with which yours truly tends to agree).

But if hospitalisations spike, and there’s a risk that people who need a bed cannot get one, and will die, then there’s no other option left but to go back to a full shutdown to try to ease the pressure.

How likely is that, though? Well, here’s a bad sign:

PUBLIC HEALTH OFFICIALS have expressed concern at a recent increase in the number of Covid-19 cases among older people.

The majority of coronavirus cases in August were among young people, with a median age of around 30 years, but there has been an increase in cases among older people in the last week.

Speaking at a Covid-19 briefing last night, Professor Philip Nolan, chair of of the Irish Epidemiological Modelling Advisory Group, said 70 cases of the virus among over-75s were reported in the past fortnight, compared to “almost none” at the start of August.

We all know, by now, that the virus is more deadly in the old and the sick and the so-called “high risk” categories. Up until now, much of the recent increase in cases has come from the young and the healthy – hence the gaudy case numbers and low deaths.

But the problem from a policy point of view is that young healthy asymptomatic people have older, vulnerable, relatives, and may not even know that they are contagious.

And there is, without any doubt at all, a cohort of people who simply will not comply with any social distancing or disease mitigation efforts. In an ideal world, it would be possible to open up the country fully, provided that people used common sense. Unfortunately, a lot of people either don’t believe the virus is real, or, more commonly, believe themselves to be very unlikely to catch it or pass it on.

If this was only resulting in a surge in cases in the young and healthy, it arguably wouldn’t be much of a problem. But when it results in hospitals coming under pressure, action will have to be taken.

We’re not there yet, and we’re not even close to getting there yet, thankfully. But the hospitalisation number, not the case number, is the one you should be watching. If the number of people in hospital with Coronavirus rises into the hundreds, don’t be surprised to see the Taoiseach on your television set, balefully announcing a second lockdown.