Ireland's epidemic has been shadowing the trajectory of most European countries, most closely Denmark, but also countries like Spain and Greece.

It's Greece I'm going to focus on, due to a few similarities, to try offer encouragement that recent measures in Dublin can help.
2 months ago on July 20th, this was the picture:

14-day incidence per 100,000:

Spain: 18.0
Ireland: 4.8
Greece: 4.6

Hospital admissions, ICU admissions and deaths were low and stable in all 3 countries.
Over the next month, the virus gained traction as people gradually began to embrace the new normal.

By August 20th, all 3 countries were in identical proportions to July, except with ~6 times more infection:

14-day incidence per 100,000:

Spain: 138.7
Ireland: 25.4
Greece: 25.3
Deaths, hospital admissions, ICU admissions were still very low.

Today, September 20th:

14-day incidence per 100,000:

Spain: 300.5
Ireland: 63.2
Greece: 33.5

Ireland are still closely shadowing Spain in relative increase - but Greece somehow managed to slow the tide.
Spain, in not slowing their epidemic, meant the tremendous surge in cases eventually translated to a surge in funerals.

July 20th to August 20th: 391 dead

August 20th to September 20th: 1,682 dead

Death lags weeks behind cases, and it creates a false sense of calm.
That's what Ireland is trying to avoid, ultimately, people burying their loved ones.

So it's worth trying to drill down into whether Greece did something different to (for now) slow their growth rate to less than half the European average.

The answer is yes, they did a lot.
Testing, August 20th to September 20th:

Spain: 2,731,164
Greece: 385,763
Ireland: 309,485

Tests per capita, August 20th to September 20th:

Ireland: 309,485
Spain: 290,549
Greece: 177,771

One consideration is Greece tested less and therefore found fewer cases.
But if you test fewer people when infection is widespread, more of the ones being tested should have it, and the positivity rate should rise markedly.

Except it didn't rise much at all, so what else could explain their slowing it down?
On August 12th, a raft of deeply unpopular measures went into effect in Greece.

Among those measures, curfews were imposed, added restrictions put on restaurants and pubs, Sunday church and other mass services cancelled.…
They did this with 24 hour notice leading to uproar.

Some Greek restaurants had to dump food because the additional restrictions meant it would go off.

They complained about the lack of notice and all of this should sound familiar.…
Greece acted pre-emptively at a 14-day incidence of below 25.0 per 100,000.

Their rationale for doing so is they have a lot of old people and don't have enough ICU or hospital beds to cope with any big surge in autumn or winter.

That should feel familiar, too.
The results so far are tentatively promising.

While 14-day incidences are vulnerable to rapidly changing, and can always prompt the introduction of even stricter measures, for now Greece turned back the European tide.

That's not to say everything is peachy for them, either.
Right now, today, the 14-day cumulative deaths per 100,000:

Spain: 2.3
Greece: 0.5
Ireland: 0.3

But the difference between 33.5 and 63.2 infection is enormous when deaths are a lagging metric, and they will see fewer deaths than us when our deaths lag - which they will.
Athens has a 14day incidence of 42.7 per 100,000 (Dublin 123.6).

Even that has prompted more pre-emptive measures in effect tomorrow.

Included in them is banning both indoor and outdoor gatherings of 10 people, closing cinemas, mandating work-from-home.…
The reason Greece picks a much lower 14-day incidence to react swiftly, is they have proportionately a lot of old people.

All of their pre-emptive measures hurt the economy but their goal is keeping older - all - people alive and to prevent ICU from overwhelming.
Picking Greece to compare can seem very arbitrary, and not very instructive on causation vs coincidence, but they do have similar ICU constraints and their measures prompted the same criticisms.

Meanwhile Western Europe were doing mostly same thing - and getting same results.
We shadow all of these.

14-day incidence per 100,000:

July 20th:

Belgium: 16.4
Netherlands: 6.4
Denmark: 5.9
Ireland: 4.8

August 20th:

Belgium: 55.5
Netherlands: 46.8
Denmark: 30.2
Ireland: 25.4

September 20th:

Belgium: 105.4
Netherlands: 104.4
Denmark: 74.1
Ireland: 63.2
At the moment, with very few exceptions (essentially Scandinavia and the Baltics), the entirety of Europe - particular Western Europe - are following very similar trajectories.

Even Germany, doing so well, the virus is decimating their nursing homes again in recent weeks.
Ireland have not been as pre-emptive as Greece but we have chosen to be more reactive than Spain.

We are somewhere in the middle of those different approaches.

7 weeks after Greece reached for those "premature restrictions", they are experiencing slower growth.
This is written to give people hope that measures in Dublin can help, not to say which approach is better.

Dublin's recent measures will hopefully work to achieve a similar outcome of slowing growth and keeping people alive.

That's what all of us want.

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More from @Care2much18

27 Oct
If Irish media insist on giving this "herd immunity" guy a platform in the interests of balance, there should be fact checking at the bottom of his articles because some of his claims are stupidly misleading.

Fine I'll do it myself. /1…

"The HSE published (December 2018) the recorded data which showed a Flu mortality (CFR) of 2.14 per cent; that is almost 10-fold higher than Covid-19. Undoubtedly, this is an overestimate but there was a vaccine"

Gonna file this under "completely misleading bullshit".
2018 Flu season:

Notified cases: 11,889
Notified deaths: 255
CFR: 2.14%

Dr. Feeley is then saying this Flu CFR is 10-fold higher than Covid-19 fatality rate.

Interesting argument, and by interesting, I mean embarrassing sleight of hand trickery.
Read 11 tweets
27 Oct
Belgium's positivity rates are reflecting their new policy of not testing asymptomatic close contacts.

As a result, positivity rates in Liège are running well over 33% and the age-specific positivity in those over 80-years-old is even higher.

It is looking desperate. /1
In terms of ICU, it was reported that Belgium asked Netherlands to accept some of their patients but Netherlands declined, on the basis they themselves already had to ask Germany to accept some of theirs.

Maximum capacity in Belgium is 2,000 but the rate of admission is the key.
There's 809 admitted into ICU in Belgium, which is a doubling rate of 8 days with +50 daily.

Belgian experts anticipate ICU will be overwhelmed like Lombardy by November 9th if they can't get the admission rates down.

Germany will accept Belgian patients into ICU, which helps.
Read 6 tweets
26 Oct
This is popping up everywhere as an example of an expert getting a prediction laughably wrong.

Make no mistake, it IS laughably wrong - today.

But you have to consider what this tweet was saying back then, not now, and when you do that, it's not laughable at all. /1
The tweet was written on September 14th.

3 population-level interventions were implemented since this tweet was written:

-Level 3 imposed in Dublin, September 18th
-Level 3 imposed in Ireland, October 6th
-Level 5 imposed in Ireland, October 21st
Tweet projected 5,000 cases a day in Dublin alone at the end of October with no intervention.

That is a considerable distance from Irelands 1,283 cases peak notified on October 18th and obviously leaves him wide open to mockery.

But there were interventions.

3 of them.
Read 12 tweets
25 Oct
I see some discussion about the Level 3 impact in Dublin, and more broadly whether Level 3 was working nationally.

You'd need to agree on what 'working' means but I'll take a look at the relevant case rates here and try discuss if it worked.
Dublin went into Level 3 on September 18th while at a 14-day incidence of 120.9 per 100,000.

120.9 was over double the national incidence which stood at 62.4 per 100,000.

No other county was above 100.0, with Louth 2nd highest at 93.9.
14-day incidence progression for Dublin (+/- 1 week difference):

Sep 19: 123.6
Sep 20: 136.4
Sep 21: 138.0
Sep 22: 136.9
Sep 23: 140.3
Sep 24: 144.5
Sep 25: 146.6 (+20%)

Sep 26: 148.7
Sep 27: 152.9
Sep 28: 160.3
Sep 29: 156.0
Sep 30: 159.3
Oct 1: 162.9
Oct 2: 168.2 (+14%)
Read 15 tweets
25 Oct
The complete breakdown (ROI and NI) is here.

The most concerning part of the Northern Ireland situation is undoubtedly in nursing homes and hospitals, in that order.

There is less pressure on hospitals here but we are far from out of the woods.
14-day cases per 100,000

NI: 749.0
ROI: 302.9

Derry City & Strabane: 1,393.8
Belfast: 1,053.2
Mid-Ulster: 1,013.4 ⬆️
Cavan 981.9 ⬇️
Lisburn & Castelreagh: 683.6
Meath: 652.7 ⬇️
Antrim & Newtonabbey: 647.6
Causeway & Glens: 572.6
Newry & Mourne: 571.6
Fermanagh & Omagh: 498.1
Good ✅:

-Derry & Strabane has fallen significantly from the peak (which reached almost 1,800.0). In around 6 days they will likely fall below Belfast if current trends hold.

-Cavan and Newry & Mourne improvements continue.

Bad ❎:

-Mid-Ulster growing, Belfast too high.
Read 7 tweets
25 Oct
I was praising Germany for what they have done to help others.

It was meant to be an uplifting tweet but you immediately want to be miserable, turn it into a negative and talk about politics.

Ok lets see what Ireland has done for others in the pandemic:
Ireland has donated €123 million so far in Covid aid to other countries.

€46.5 million went to initiatives like the UN’s Covid19 Global Humanitarian Response Plan.

That is an effort to help the poorest countries in the world gain access to tests and medical supplies.
€76.8 million went to other partnerships, such as Team Europe Covid Response, the EU's initiative to help other countries.

Countries like Gambia, to ensure they have enough oxygen in their hospitals and public services to stay afloat.…
Read 7 tweets

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