ELIMINATION WON'T WORK.

How do you know that? Did some mathematicians prove that elimination is impossible? Was it something you heard in the media? Did Tomás Ryan put you off the idea? (No one would blame you!) Well, there's a lot more to elimination than lockdowns, and restrictions, and border quarantines.

I don't think I've seen one piece of research that even suggests, that elimination isn't possible in Ireland. I've heard Philip Nolan rubbish the idea in the media, but he had nothing to back it up. He could offer no explanation as to why it was an "utterly false promise". In fact, all the available evidence seems to suggest that a small island like ours is exactly the kind of place where an elimination strategy would work. There are some hurdles for sure, but there are hurdles to everything worth doing. That doesn't mean it's impossible or that we shouldn't try.

Elimination has already been achieved at various stages in various countries around the world, including New Zea…

BUT WE'RE NOT NEW ZEALAND!!

...well, I wasn’t finished my point, but OK. That is correct. Ireland is definitely not New Zealand. Gold star for you.

Ireland is also not Taiwan. It’s not Australia, Tasmania, Singapore, or Newfoundland either. Yet every one of those islands has eliminated the virus AND done a very good job of keeping it out, thereby allowing their people to live normal, healthy, civilised lives. And they weren’t even the top performers in the world – the Pacific Islands did better than all of them! Fiji and Samoa and company put their defences up good and early, and they did an excellent job of protecting their people and their societies.

 

Jamaica, Trinidad and Tobago, and most of the islands of the Caribbean did a better job than Ireland. They may not have eliminated the virus, but their cases per million and deaths per million statistics make it clear. The Faeroe islands, the Channel Islands, Sri Lanka, Madagascar, Hong Kong, Macau… We have a large, diverse data set of the world's islands. Among them, you will find islands with less money, weaker health care systems, higher population densities, and lower levels of trust and social cohesion than Ireland. Some of them were even closer to the outbreak and that had less time to react. And yet, despite all these weaknesses, they all did better than Ireland.

Instead of making lame excuses for one thing or another, we should be asking ourselves what these islands did, that we did not. If they did better than Ireland, well, what did they do? What were their policies, how did they differ from ours, and what can we learn from them?

These are the questions we must ask, otherwise we'll find ourselves back in the same situation.

WHAT ABOUT THE BORDER?!

I’m guessing you mean the border with Northern Ireland? Because we also have a border with the rest of the world, and the mismanagement of the external border in Q1 2020 did a lot more damage to this country than 'the border' ever could have.

Yes, people from Northern Ireland crossed the border and infected people in the Republic. We can be sure of that. Equally, we know that people in the Republic crossed the border to infect the people in the North. This will continue to happen, but the effects of these movements pale in comparison to the harm caused by the gross negligence of leaders on all sides of every border on these isles.

 

There are a lot of people in Ireland who like to bitch and moan about the border because it’s easier for them to blame everything on the North than it is to face up to their own shortcomings. These people have an understanding of Anglo-Irish relations that hasn’t evolved beyond Junior Cert history, and they neither realise nor care that their fecklessness and xenophobia hurts the Republic, the North, and everyone on the island.

 

The border isn’t important. It’s just an arbitrary line in the ground. What matters is the people on either side of it, and how they communicate and relate to each other. Northern Ireland is a different country. Yes, it is. So pick up the phone and talk to them. And when we're done, we'll pick up the phone and talk to Westminster. Boris Johnson spent £100 billion on rapid tests, and the way things are going, he's going to have an awful lot left over. He might be interested in a plan that could use up a lot of that spare capacity.

 

While we're at it, we should call Edinburgh, and Cardiff too. They might be willing and able to lend a hand. By reaching out to all 5 governments, we reframe the project as one that serves the health and well-being of everyone on the archipelago. In doing so, we take the pressure off the North-South and Westminster-Stormont relationships, and our efforts stand a far greater chance of being rewarded.

WE CAN'T CLOSE OUR BORDERS BECAUSE OF THE EU

Yes, we can. They're OUR borders. We can do what we like with them.

 

The EU serves its member nations, not the other way around. We don’t have to ask the EU for permission to protect our people. If the health of the Irish nation is at risk, Ireland’s policymakers are obliged to do whatever is necessary to protect it. If that means closing our international border, then that is what they do. Just as many other EU nations did.

 

Italy blocked flights from China on the 31st of January. Had the EU been in control of the crisis, it would have coordinated every country in the EU to do the same. That one act would have massively diminished (by a factor of 10) the size of the global outbreak. Instead, the EU kept its borders open as a matter of ideological imperial pride, the continent became a breeding ground for the virus – killing hundreds of thousands of its own people – and a launchpad for its spread into the developing world.

 

In March, Slovakia, Estonia, Denmark, the Czech Republic, Lithuania, and Finland closed their borders to all foreigners – whether they were EU members or not. In doing so, they protected the health of their people, and prevented the virus from spreading onwards from their countries. Ireland should have done the same. Instead, Ireland never closed its border. It was the only country in the EU not to do so.

 

The EU, like the border with the North, is just another convenient excuse made by lazy policymakers who want all of the celebrity and status that comes with a leadership position, but none of the responsibility for making the decisions on which the lives of 4.2 million Irish people depend.

WE HAVE THE VACCINE, THIS IS A WASTE OF TIME...

First of all, there is no “the vaccine”. There are several vaccines, and they are all different. Some are more effective. Some are more expensive. Some are easier to distribute. The existence of one or many is of little comfort.

 

We need to get the vaccines into the population, and we need to get enough people vaccinated, and with sufficiently effective vaccines, so that we can protect the health of every person on the island and return our lives to normal. At the time of writing (mid-February), that does not seem likely to happen for at least another 6 months, and in a bad scenario, it could feasibly be the new year before restrictions are lifted.

 

Transmissibility increases over time. The more time we give the virus, and the more infections that we allow to occur, the more opportunity the virus has to mutate and the more contagious it will become. That’s natural selection at work, and it never stops. Evolution is a one-way process.

 

The virus has undergone one major set of mutations so far. It has more than enough time to perform another, and the next set of mutations will make it more contagious. It might make the virus more virulent or more resistant to treatment, or it could make our tests and our vaccines less effective. If our vaccines are less effective, then a larger share of the population will need to be vaccinated to reach herd immunity which means we will spend even more time in lockdown. Which gives the virus more time to transmit and mutate...

 

Waiting for vaccination is a vicious circle. Let's eliminate the virus.

IT'S TOO EXPENSIVE!

Are you a Fine Gaeler?

 

The Government is providing financial supports including the PUP, the TWSS, the Short-Term Work Support and the Enhanced Illness Benefit Payment. Businesses can also avail of Government supports, including direct payments and grants, credit guarantees, and lending. The Government must also continue to fund the additional costs on the health care system brought about by the waves of infection that will inevitably follow over the coming months.

 

This massive increase in the Government’s expenditure is taking place while tax revenues from all sources are falling. As a result, the government will need to borrow more over the coming years. The debt will incur additional interest costs and it will take decades to pay off. In summary, the Government’s finances will continue to deteriorate until either the virus has been eliminated or widespread vaccination has been achieved.

The deterioration of the Government’s finances reflect the trauma that is being experienced in the private sector, but especially in the most ‘contact-heavy’ industries of hospitality and events, arts and entertainment, and tourism. Most disturbingly, the companies that have been most harmed by this policy are Ireland’s SMEs. The nation’s already weak indigenous businesses have taken another blow while the large, international corporations with larger cash buffers and greater access to credit have less illiquidity and insolvency risk, and some have even grown through the crisis. And there is potential for widespread insolvencies and defaults which could lead to another financial crisis.

 

​All told, the financial cost of the pandemic is running at about €500 million a week. That will continue until we have vaccinated the vast majority of the population. Your guess is as good as mine as to when that will happen, but I think it’s fair to say we’re going to be down at least another €10 billion by then.

 

Meanwhile €500 million would buy all the rapid tests we need to make elimination work.

 

Do you REALLY think elimination would be too expensive?

NO ONE WANTS A 4 MONTH LOCKDOWN!!

Agreed!

I have no interest in a 4-month lockdown  not for me, not for you, and not for anyone else. If the best idea I could offer was a harsh, 4-month, national lockdown, I wouldn't waste anyone's time pretending I had a solution.

Fortunately, we have better options.

 

Rapid testing is a cheap, simple, flexible tool that can be used to achieve multiple public health goals, including to suppress transmission via population-level screening or to achieve elimination through high-volume focused, regional testing.

 

Rapid tests can be performed at home, at work, or at entrances to public spaces, like restaurants, bars, or shopping centres. Kids could take a rapid test every morning before school. Parents could do the same before work. This is a population-level screening approach to testing that could be integrated into our lives in such as a way that we would barely know it's there  which lies in stark contrast to our current situation.

 

While an individual rapid test produces at a lower level of sensitivity than a PCR test, a program of serially testing the population with rapid tests produces a similar level of sensitivity as PCR, while also being cheaper and easier to use. A single rapid test with a sensitivity of 50% becomes 75% accurate on the second day, and 87.5% accurate on the third day. By taking advantage of this multiplicative effect, the repeated rapid testing regimen is quicker and more accurate than PCR testing, and in the context of an elimination framework, significantly more effective.

 

Rapid testing is a key feature of ICAN’s 7-Stage Elimination Framework. By maximising the amount of testing resources available to detect the virus, we reduce the amount of time people spend in lockdown. The medium of suppression is transferred from the sacrifices of the people to the intelligent policies of their leaders. This will bolster public morale, speed the elimination process, and lower the total costs of the pandemic.

 

Rapid testing should have played a central role in our pandemic response, and it is disappointing that NPHET have neglected this powerful and versatile public health measure.