We face difficult decisions if we are to suppress again the spread of SARS-CoV-2, and different voices should be heard. However, such contributions should be grounded in the facts, and public health expertise and experience. This article is neither. 1/12 irishtimes.com/opinion/jack-l…
A public health specialist would give you a much better critique than I could of the errors and misconceptions in the argument; I’ll confine myself to highlighting some factual inaccuracies. 2/12
The article states that “it is reasonable to make an educated assumption that tens of thousands of cases were circulating undiagnosed throughout the country” in March and April, implying that 500-1000 cases now is less of a problem than it seems. 3/12
This “educated assumption” does not stand up to any scrutiny. We know that people with SARS-CoV-2 infection remain infectious for 7-14 days, so a good estimate of active infections is the 14-day cumulative incidence. 4/12
Our 14-day cumulative incidence of detected cases in April peaked at 170 per 100,000 population, so for a population of close to 5 million, this is about 8,500 diagnosed active infections. 5/12
The SCOPI seroprevalence study shows that for each detected case, we missed two mild or asymptomatic cases, so at peak in April, there were about 17,000 undiagnosed active infections. This is not the kind of number suggested by the phrase “tens of thousands”. 6/12
How does this compare with today? Our 14-day cumulative incidence is now 207 per 100,000, so if we are detecting, say, 70-80% of infections, we have 12,000-14,000 active infections now compared with about 25,000 at peak. 7/12
This is about half the peak, not the order of magnitude difference suggested by the article. The article also states “we only had the capacity to test 500 per day at the National Virus Reference Laboratory” compared with 80,000 per week now. 8/12
Leaving aside the rhetorical device of comparing the number per day then with the number per week now, we were in fact doing on average 5000 tests per day in April, 3000 through NVRL and 2000 in hospitals. We’re doing 14,000 per day now. 9/12
So we are doing three times as many tests now as in April, not 20 times more as the article states, and the level of active infections now is probably half what is was at peak, not, as the article implies, less than one tenth. 10/12
We have 228 people in hospital (868 at peak) and 30 people in ICU (157 at peak). We are halfway to April in cases, one quarter of the way there in hospitalisations, and one fifth in critical care. This is not the time to downplay the significance of these indicators. 11/12
If the basic facts are so badly incorrect, how valid and useful is the opinion? 12/12
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