Department of Health Department of Health

THE LEVEL OF infection is reducing. 

Over 6,500 new cases of Covid-19 were confirmed across Monday, Tuesday and Wednesday – compared to more than 11,000 new cases reported over the same period last week and 19,000 cases in the preceding week. 

Yet hospitalisations, ICU admissions and mortality remain extremely high. 

Chief Medical Officer Dr Tony Holohan -  in a letter to Health Minister Stephen Donnelly last week – said mortality will increase, and Ireland’s health system will continue to be under enormous strain. 

Due to “a large number” of outbreaks in long-term residential facilities and hospitals, “it is anticipated that a total of at least 500-1,000 deaths may occur in the month of January,” said Holohan. 

So far this month, 532 people have died with Covid-19. 

It could be a number of days before a person who is infected with Covid-19 – or who tests positive – requires hospital admission or Intensive Care. This explains why infection rates could decline but hospitalisations, ICU admissions and deaths continue to rise. 

Dr Holohan, in his letter, said – based on optimistic projections – Ireland could see 800 – 1,600 cases per day by 31 January. 

Incidence Rates

It is clear, looking at viral infection rates, Ireland’s Third Wave has peaked. 

Ireland’s national incidence rate is 1140.7 cases per 100,000 of the population on a 14-day rolling average, according to data from the Health Protection Surveillance Centre – compared to 1,497.0 on this day last week and 936.4 the week previous.

Looking at 14-day incidence rates in individual counties, Monaghan has the highest incidence of Covid-19 in Ireland at 2,134.0 cases per 100,000 – a 20% reduction in incidence since last Thursday. 

Louth is the second-highest county in Ireland with a 14-day incidence rate of 1,680.6. Waterford is third-highest with a 14-day incidence rate of 1,582.1

Looking at Local Electoral Area data, Belmullet in Mayo remains the area with the highest individual incidence of Covid-19 at 5555.6 cases per 100,000. 

For a breakdown of Covid-19 incidence rates in LEAs around Ireland, see here. 

Counties with the current lowest incidence rates include Leitrim (468.1), Longford (516.2) and Westmeath (588.0).

Transmission

Health officials remain fearful that the decline in case numbers seen since 10 January may begin to slow, however. 

Community Transmission levels remain high. This is where the source of infection is unknown.

Professor Philip Nolan, Chair of NPHET’s Irish Epidemiological Modelling Advisory Group said last night that Ireland’s Reproductive Number is estimated at between 0.5 and 0.8. 

It was estimated at between 1 and 1.3 last week. 

So, what does that mean?

There is the basic reproduction number (R0), which is the number of people who will be infected if no other factors are taken into account.

Then there is the effective reproductive number (Re) - the number of people who will be infected if you take into account other factors, such as immunity through previous infection or vaccination or behaviour which has been altered by social distancing measures.

It is estimated that SARS-CoV-2 has an R0 of between 2 and 3. NPHET estimates the Re was now between 2.4 and 3 in Ireland, essentially meaning that the virus spread as if no measures were in place seven to 14 days ago.

“We have to keep it below 1.0 if we are to successfully emerge out of this current wave,” said Professor Nolan. 

However, NPHET warned last night that the UK variant – which accounts for 60% of recently detected cases – will make it more difficult to sustain progress and further drive down infection. 

Meanwhile, The Department of Public Health Mid-West has said that over 1,600 Covid-19 cases were reported there in the past seven days.

Over the past 14 days, there have been more than 3,100 cases recorded in Limerick, over 1,500 in Clare, and over 600 in North Tipperary.

Dr Mai Mannix, Director of Public Health Mid-West, said: “While we have seen few indications of slowdown in the transmission of the disease, the level of infection remains significantly high across the region.

“The Third Wave continues to leave its devastating impact on our community as we are still some time away from seeing signs of relief.”

Hospital & ICU

There have been 122 hospital admissions in the last 24 hours and 125 discharges. 

There are – as of this morning – 1,969 confirmed Covid-19 cases in hospital and 214 people in Intensive Care Units.

There were 1,789 confirmed Covid-19 cases in hospital and 169 people in Intensive Care Units last Friday. 

A further 300 people are in hospital wards receiving advanced respiratory support. 

Last week, the HSE said hospitals had started moving into their intensive care surge capacity as the number of Covid-19 patients requiring advanced care increased.

The system can surge to 350 patients in ICU, providing the same level of care as traditional intensive care settings.

Here’s a closer look at our hospitals’ surge capacity.

Clusters & Outbreaks

Health Protection Surveillance Centre data shows a total of 37 outbreaks reported in nursing homes between 9 and 16 January. 

According to data released by Mid-West Public Health Department, 18 outbreaks have been reported in nursing homes and long-term care facilities between 3 and 18 January. 

Provisional data shows there have been more than 360 cases linked to these outbreaks.

Between January 3 and January 18, there have been 17 reported Covid-19 deaths in the Mid-West associated with nursing homes.

“This high incidence rate…among our most vulnerable population is a result of the severe impact of the pandemic’s Third Wave,” said Dr Mannix.

“We continue to manage and investigate a number of serious outbreaks in nursing homes and long-term care facilities following an unprecedented level of widespread community transmission.”

HPSC data shows that – after nursing homes and private homes – workplaces are third-highest in terms of outbreaks with 41 new outbreaks reported since last week. 

Department of Health Department of Health

Testing & Tracing 

Testing had ramped up to almost 25,000 per day in early January. It slightly reduced to an average of 23,000 per day last week and has reduced further to an average of 22,000 tests per day this week. 

Although testing is close to its highest level yet, it is still being curtailed by demand. Close contacts of confirmed cases are no longer being tested as the HSE prioritises people with symptoms.

The HSE indicated to TheJournal.ie that it will not recommence automatic testing of asymptomatic close contacts until cases stabilise at 1,500 per day. 

On 17 December, approximately 83,000 tests were carried out over the previous seven days, an indication that incidence was rising in the lead-up to Christmas. The positivity rate had risen to 3.2%. 

On 7 January, approximately 174,000 tests had been carried out in the previous seven days. The positivity rate was 22.7%. 

Approximately 167,000 tests were carried out between then and 14 January. The positivity rate reduced further to 17.9%.

This week, approximately 154,000 tests have been carried out in the past seven days. The positivity rate is currently 11.8%. 

Vaccinations 

Finally, 121,900 vaccinations have been administered in Ireland. 

Of the 121,900 vaccines administered so far, 48,800 have been in long-term residential care settings with 73,100 administered to frontline healthcare workers. 

The HSE has said it plans to administer 3,900 second doses of the vaccine by Sunday. 

It said yesterday that vaccines have been administered at over 200 long-term residential care facilities. It is planned that a further 6,551 vaccines will be administered in 78 of these settings next week. 

A total of 47,000 second doses are due to be administered to frontline healthcare workers and at long-term residential care facilities next week. 

Healthcare workers with direct patient contact as well as residents at long-term residential care facilities over the age of 65 have been first to receive the vaccine. At the weekend GPs also received their first jab at vaccination centres. 

Both vaccines currently being used in the roll out – the Pfizer vaccine and the Moderna vaccine – are mRNA vaccines that require a two-dose schedule.

The Government expects AstraZeneca’s vaccine to be approved by the EMA on 29 January, paving the way for 100,000 vaccinations per week in Ireland.