The exponential growth in SARS-CoV-2 infection in Ireland should make each and every one of us stop, think, and resolve again to do our part to suppress the virus, now and quickly. 1/7
The call to action is the same as it has been for weeks, but much more urgent now: radically limit our discretionary social contacts, maintain physical distance and safe practices when we do meet, self-isolate and call for help with any symptoms of COVID-19. 2/7
We have seen rising cases, now we are seeing rapid increases in the number of people admitted to hospital and ICU. 3/7
We had, on average over the week to Tuesday 6 October: 131 people in hospital; 13 admissions per day; 21 people in ICU; and 2 admissions to ICU per day. This afternoon there are 172 people in hospital (22 admissions in the last 24 hours) and 27 in ICU (3 admissions). 4/7
It is worth noting that at the peak of the pandemic we were at worst seeing 60-80 admissions to hospital and 10-15 admissions to ICU per day, over a limited period of 4 weeks. We are nearly a quarter of the way to those admission rates. We must change course now. 5/7
The number of people in hospital is now growing exponentially. We did this simple exponential fit to the hospital data last Friday 1 October; while we expected it, it still worries me that the numbers are tracking this exponential curve. 6/7
There are very few counties where the incidence is not increasing, and no county where the incidence is not a cause for concern. We are in this together. We can reverse these trends. The simple measures work. Keep it up. #HoldFirm 7/7
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We should not ignore or dismiss the rising numbers of SARS-CoV-2 infections. We monitor hospitalisations, intensive care admissions, and with great sadness, deaths, and we know where these numbers will go if we do not suppress transmission of the virus. 1/9
Case numbers have been growing exponentially, at approximately 4% per day, since late June. The daily average case count on 23 June was 9 cases. If you add 3.9% every day, you get 12 cases on 1 July, 40 cases on 1 August, 131 on 1 Sept, and 430 today. 2/9
Hospitalisations are delayed, but now also growing at about 4% per day. The daily average number of people in hospital with confirmed SARS-CoV-2 infection on 3 August was 12; increase that number by 4% per day and you get 37 on 1 Sept, and 121 on 1 Oct. 3/9
We don’t have SARS-CoV-2 under control in Ireland. We need, as much as we ever did, to work together, with one voice and one intention, to suppress the virus. Let’s remember the fundamental protection: keep your distance. 1/6
We need and crave social contact, but the virus exploits the moments we come close as an opportunity to transmit. It’s spreading rapidly right now, between households, especially in young adults. 2/6
The message: mix with one other household, keep your distance when socializing (even in your own home), get outdoors, limit your social contacts to those that are really important to you, stay home and seek a test if you feel unwell. 3/6
A useful article. The conclusions are broadly correct, but the calculations are right only if we were randomly screening large asymptomatic populations. We mostly test people with symptoms and close contacts of known cases, so the proportion of false positives is much lower 1/10
If you have symptoms, or are a close contact, the prior probability of having SARS-CoV-2 infection is much higher than the population prevalence. A close contact has about a 1 in 10 chance of being infected. 2/10
Specificity and sensitivity of a test are harder to measure than you might think. The specificity (probability of test being negative where there is no virus) used in the article is probably generous. If the specificity is 99.7%, 3 in every 1000 tests is a false positive. 3/10
How are we doing? The number of new cases per day remains high. It’s possible that incidence is rising more slowly in recent days, but it’s too early to tell. If we are starting to suppress the virus again, take this as encouragement to maintain and redouble our efforts. 1/7
It’s important to look at Dublin separately. This is daily incidence per 100,000 population for Dublin, Kildare-Laois-Offaly, and the remaining 22 counties. If every county had an incidence of 5 per 100,000, it would translate into about 250 cases a day across the country 2/7
Incidence remains high in Dublin, and is rising in the rest of the country. If we look at 14-day cumulative incidence for individual counties of interest, we can see high incidence in Dublin, and the recent rapid increase in Donegal 3/7
We must protect the vulnerable in our communities from SARS-CoV-2. It is our responsibility more than theirs, because the primary means to protect them is for the rest of us to suppress transmission of the virus and keep circulating virus at very low levels. 1/8
If we look back to March through to June, the number of cases in any given county in people aged 65 and older correlates with the number of sporadic cases in the community. High levels of virus in the community increase the risk for older and other vulnerable people. 2/8
This is a lethal virus, and mortality rises quickly with age. The case-fatality rate for those cases reported March to June was 0.2% in those aged 20-39, but 33% in those 85 and above. 3/8
It is reasonable to ask: why close restaurants and pubs if there are so few outbreaks associated with those environments? However, this is misreading and misinterpreting the data on outbreaks and clusters. 1/10
If I went out 5 days ago and caught the virus in a restaurant, it will have multiplied silently inside me for 3 days; then I will have started shedding virus, and potentially infecting others, for 2 days; today I become symptomatic, self-isolate, and get a test. 2/10
Public health only ask me about my contacts for the 48 hours before I developed symptoms. They don’t need to know where I got the virus; that happened 5 days ago. They want to know where the virus is going, who I might have infected, and prevent onward transmission. 3/10