Let’s protect the vulnerable. Keep your contacts to a minimum between now and Christmas and then celebrate with a small circle. Meet outdoors if you can. If indoors: limit numbers and duration, use masks and keep your distance, gentle natural ventilation. 1/5
It’s good that numbers in hospital and ICU are falling. Behind each number is a human story of illness and loss. Hospitalisations lag behind cases, and sadly what we are seeing now is the impact on older and vulnerable people infected towards the end of the recent surge. 2/5
A semi-log plot clearly shows the delay between rising cases and rising hospitalisations, and equally the delay between the suppression of infections in the community and the decline in the number of severely ill people in hospital. 3/5
This is why we worry about high case numbers, and the risk of a third wave in January. If we see a rise in cases we cannot wait around until we have increasing numbers of people in hospital and ICU to convince ourselves we have a problem. We’ll need to act quickly. 4/5
The fundamental message: a small, safe, careful Christmas with those that matter the most to us will limit the levels of disease in January, and save lives. 5/5
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The move to Level 5 restrictions was a difficult decision for Government, and is very hard for people whose lives and livelihoods are most affected, but it was necessary to interrupt uncontrolled exponential growth of the pandemic. 1/5
We can, collectively, suppress transmission of the virus again, if we fully enter into the spirit of these measures, and eliminate, for the next six weeks, close contacts other than our household, ‘bubble’, school or college, or essential work. 2/5
Our modelling shows that to make a success of this, we need get viral transmission down to very low levels. A reproduction number of 0.9 or 0.7 won’t be enough, we need to aim for R = 0.5. 3/5
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
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 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