Thread by @StuartDNeilson

Caution meets wind.

Baseline NPHET modelling predicts a substantial rise in case in the next few months. Upper end predictions are for thousands of cases per day.

Vaccination rollout (18% of over 65s so far) will have little impact on illness and death in the short term.

"Our health system remains extremely fragile & health care workforce is exhausted following the most recent wave of infection. The number of COVID-19 patients in hospital & critical care remains high & in the case of critical care, at levels greater than peak of the 2nd wave."

"The high starting point of 600 cases per day means that case numbers rise rapidly to over 2,000 per day within 4 weeks."
— Letter from CMO to Minister for Health re COVID-19 (Coronavirus) - 29 March 2021.
gov.ie/en/collection/…

Speech by Micheál Martin, 30 March:

"together", "us", "our" - 52 times
"safe", "safely" - 6 times
"protect", "save" - 4 times
"success", "effective" - 2 times
merrionstreet.ie/en/news-room/s…

CMO letter of 29 March projects future illness and death "assuming that vaccination offers those aged 70 and over 100% protection".

1. Effectiveness is NOT 100%
2. Vaccinated people possibly transmit infection
3. New variants may change effectiveness

"When comparing the risks of levels... we need to take into account... changing levels of immunity in the population as a result of past infection and vaccination."

"HERD IMMUNITY" ????

235,854 confirmed positive cases in Ireland, 4.7% of the population, or 9.4-14% assuming positive tests represent 30-50% of all infection.

NPHET modelling assumption: "As of late March/early April, 15% of the population are immune" (including vaccination).

"The vaccination programme will continue according to the current supply schedule."

Vaccine supply to date has been less than contracted or scheduled, and scheduled vaccination rates are (by any reasonable interpretation) unlikely to be met.

"N.B. vaccination is associated with continuing controls on viral transmission through NPIs (reduced contacts, physical distancing, face coverings, hygiene & ventilation) & need to remain in place in some form unless & until herd immunity is achieved through vaccination."

NPHET's own modelling of a Conservative, Low and Moderate scenario, imply 3,000-23,760 hospitalisations, 400-3,168 ICU patients and 200-1,584 deaths at the upper end of the credible intervals.

This sounds like Meaningful Summer, and should be debated.

"The vaccination programme will protect more older adults aged 55-70 years, & vulnerable adults, before younger adults are vaccinated, & thus will reduce hospitalisations more rapidly than it will reduce numbers of infections and cases."

I.E.: Infect the young, vaccinate old.

According to this thinking, vaccinate from oldest downwards, without regard for exposure. Frontline workers are as much an "infect the young" vector as anyone.

The INTENT is for immunity-by-infection to proceed up age & vaccination down age, meeting in middle age in September.

Note that 4.5% of the total population is fully vaccinated, with 19% of over people over 65. On the basis of current vaccination rates (as opposed to the schedule), 18% of the total population and 75% of over 65s will be fully vaccinated by the end of September.

These figures would imply "immunity by infection" of the unvaccinated 82% of the population, and "immunity OR DEATH by infection" of 25% of people over 65.

"The same modelling suggested we might have 39,000 deaths by today"
— Jim Breslin, 19 May 2020
data.oireachtas.ie/ie/oireachtas/…

Possibly not coincidentally, the Office for National Statistics is now quoting 54.7% immunity to Covid-19 in England, with antibodies reflecting vaccination AND previous infection. (NB: UK reports 45% "vaccinated", but only 5.7% fully vaccinated).
en.brinkwire.com/news/more-than…

NPHET modelling is explicitly EU+UK28 centred, and "To further place the epidemiological situation in Ireland within [the current very challenging] EU/UK context" we have done well.

In a WORLD context, the EU+UK28 has performed poorly. MOST of the world has performed better.

In a WORLD context, Ireland is a part of the world representing 20% of global population and 80% of global deaths from Covid-19.

In a WORLD context, we should be emulating the countries with policies that have limited Covid-19 illness and death, not emulating the EU+UK28.

NPHET, according to RTE reports, has consulted "ALL the mathematicians in ALL the universities..."

Many epidemiologists, modellers and mathematicians might disagree @ISAGCOVID19 @Stephen58820389 @killeen_gerry @TJRyan_77 @astaines @GabrielScally

https://twitter.com/NoSpendingCash/status/1377314703970603009?s=20

In an EU+UK28 context (Ireland's risk environment, without 100% mandatory quarantine) the incidence rate of Covid-19 is currently rising in 18/28 countries. The mortality rate (which lags behind incidence) is rising in 14/28 countries.
Ireland is on an unstable boundary of R ~1.0

Stating the obvious (again and again), MOST of the world has suppressed Covid-19 below nuisance levels. Note that fully HALF of the low incidence & low mortality countries have outbreaks, & suppress them.

Emulate Laos, Vietnam, Tanzania, Taiwan, Burundi, Cambodia, Thailand...

Europe accounts for over half of the highest mortality countries in the world. No European policy has been effective, and Europe is stubbornly ignoring the evidence that suppression of Covid-19 saves both lives and the economy.