This is Stage 1 of ICAN's 7 Stage Elimination Framework. You can read the Introduction here.
Goal: To take all necessary preparatory actions so that the elimination plan is fully functional at initiation.
Timeframe: Preparation begins at the earliest possible date and continues until initiation of the plan.
An elimination protocol cannot be implemented at short notice and the preparatory stage is of crucial importance as it lays the foundation for all the work that will follow.
The successful implementation of an elimination plan requires the commitment and the coordination of multiple layers of stakeholders, including policymakers, government agencies, civic institutions, businesses, essential service providers, and the people. Every cohort in the county must understand the structure of the elimination process, the policies that will be implemented at each stage, and their roles and responsibilities within them. These protocols must be communicated and discussed in the planning phases, and the government must ensure that lines of communication to all groups are opened early and used frequently.
A large stockpile of rapid testing capacity must be acquired and distributed across the county. This is a key responsibility, as the plan’s success depends in large part on the volume of rapid tests available during its implementation. The Department of Health also ensures the availability of sufficient health care workers and support staff in the local area for the duration of the plan. The Department of Finance will establish additional financial supports to ensure jobs and businesses are protected for the duration of the elimination process.
Implementation | Communication with The People
The government communicates the Framework and its protocols to the people through citizens’ assemblies, local government structures, community representatives, and other civic institutions. Representatives explain the protocols to the people, answer their questions, take surveys and receive feedback. The survey information (e.g. isolated individuals, high-density households, potential volunteers) will add more detail to the plan at the local level, which helps us to anticipate problems before they occur and aids the overall planning process. The representatives explain the process for both essential and emergency travel, and begin conversations with individuals who may need clearance.
Implementation | Communication with Businesses
The government can communicate the Framework’s standards and protocols to essential retail service providers directly, as their numbers will be small. The policies and their timeframes will also be communicated to non-essential business through their industry bodies. Wherever possible, policymakers seek to identify spare capacity in the private sector that can be built into the plan, and they will prioritise businesses and sectors that have been most disadvantaged by the pandemic. For example, representatives from the tourism industry could be engaged to discuss locations for potential quarantine and isolation facilities. Similarly, taxi drivers could be incentivised to provide delivery services while the stay-at-home advice is in place.
Implementation | Health Care Resources
In a traditional war, the side with greater resources usually wins. While the COVID-19 pandemic isn't a war, the same principle applies. Instead of soldiers, weapons, and ammunition, Ireland needs health care workers, medical facilities, and tests. The greater the State’s resources, the greater its control over the outbreak.
The government must source enough rapid tests to suppress and eliminate transmission of the virus. All individuals in the county will receive multiple tests over the course of the plan. An estimate of the minimum requirement for the elimination protocol to be successful would be 10 tests per person, so a county with a population of 100,000 would require at least 1 million rapid tests. Some of the test kits will be distributed in advance to high-risk households (large, shared accommodation), high-risk individuals (health care workers and support staff) and to families and individuals living in isolated areas.
A mass testing program will lead to a sharp, short-term increase in the resources devoted to test, trace, and isolate cases. Where possible, the DoH and the HSE should seek to add capacity in the health care system in order to absorb that initial shock, including stockpiling key equipment and materials, and accessing spare capacity in the private sector.
Implementation | Financial Supports
The DoF establishes the financial supports necessary to guarantee that all jobs and businesses are protected for the duration of the elimination protocol. If the people can be confident that the period of elimination will not threaten their livelihoods or their financial circumstances, they will have less reason to oppose the plan and adherence will be higher. Equally, all unemployment benefits, including pandemic-related payments, should be increased by €50 a week until Stage 7 – Reopen, both to encourage the people to adhere to the protocols and to recognise the sacrifices they are making for the nation.
International | Communication with International Partners
If the elimination protocol was applied at the national level, early communication with all neighbouring governments would be necessary. Clearly, a national elimination plan for Ireland could not succeed without the participation of Northern Ireland. The government would need to communicate the nation’s intention to pursue an elimination strategy to representatives in Northern Ireland at the earliest possible date. The government should also seek to include them in the planning process. Indeed, the plan would likely need the support of the United Kingdom too, and so the Irish government would contact all four governments to seek their support. The sooner they are made aware of our intentions, the more time they have to consider the proposal, its effectiveness, and the potential implications for their nations.