THE RELATIONSHIP BETWEEN the government and the National Public Health Emergency Team (NPHET) has “changed forever” after the events of the last 36 hours, according to one senior government source.

There was always going to be a time when the government would have to reject NPHET advice in some form, and yesterday that happened.

While it has deviated on some issues – such as not accepting mandatory quarantine for passengers from abroad – it had never so roundly rejected NPHET advice before.

On Sunday night, following a long meeting of the public health team, news leaked that a Level 5 lockdown was going to be recommended by it to government on Monday.

The anger in government circles was visceral after the news broke, with many ministers saying that they only learned the news on Twitter.

The crux of ministers’ confusion was that NPHET said on Thursday of last week that the epidemiological advice was not present to move the entire country to Level 3 – but three days later it was recommending a serious ramp-up of restrictions.

While ministers acknowledged that politicians do leak information to press from time to time, they said leaks from public health professionals about something so serious was unacceptable, particularly as it put government on the back foot in terms of when ministers could meet to decide on such advice.

The Cabinet was due to meet today, but this meeting had to be moved to Monday in the wake of Sunday night’s news.

On Sunday night, one minister said the “system [was] in shock” when the news landed, with another source saying that there was surprise over the Level 5 recommendation as there did not seem to be a rationale for it.

Yesterday, the Chief Medical Officer Tony Holohan, the deputy officer Ronan Glynn and NPHET’s Professor Philip Nolan met with Taoiseach Micheál Martin, Tánaiste Leo Varadkar, Green Party leader Eamon Ryan as well as Health Minister Stephen Donnelly, Finance Minister Paschal Donohoe and Public Expenditure Minister McGrath.

Government sources described the meeting about whether to place the country on Level 5 as “interesting” and “bizarre”, saying that the CMO and team admitted to party leaders that the recommendation was not in line with the Government published plan.

It is understood party leaders and ministers at the meeting were told that the move to Level 5 would be outside the norm in Europe but it was argued that Ireland is “braver”.

Leaders queried the mention of nursing home clusters standing at 31 in the letter NPHET sent to government recommending Level 5, saying that as nursing homes stay open for 28 days after having no cases, this was not a rationale that should be relied upon.

The CMO was also told that Thursday’s letter from NPHET and Sunday’s letter to government were “irreconcilable”.

Data

Health Minister Stephen Donnelly explained at a press conference yesterday evening in Government Buildings that one of the reasons the government said no to NPHET on this occasion was they did not believe  the data had “sufficiently changed in those three days” to justify a Level 5 lockdown. 

The minister said the government would have liked to see longer term data trends presented to them “given the severity of the recommendation” and the “seriousness of what was being recommended” by NPHET. He said the government would have wanted to see a bigger difference in the underlying data. 

Following yesterday’s meeting, the talk in government circles was that NPHET tried to ‘bounce the government into a circuit breaker’ without consultation.

The idea of a ‘circuit breaker’ in this instance is a short, sharp period of tightened restrictions intended to curb a rise in coronavirus cases. It has been mooted recently for Northern Ireland in order to help lower Covid-19 numbers there.

Some in government believe a circuit breaker might not be the worst idea for Ireland, but that if it was even to be considered it would need to be thought through. This would include looking at how people would be supported for the period, how long would it last and how the restrictions would be enforced.

Concerns were also raised by government as to what the next step would be if Level 5 did not work. However, it is understood NPHET members told the room it had “not contemplated” what the next piece of advice would be.

This point was highlighted by the Tánaiste Leo Varadkar on RTÉ’s Claire Byrne Live programme last night. He said this idea was proposed by NPHET but there was little or no thought as to the impact such a move would have on the society. 

In one of his most colourful political contributions, he said those sitting on NPHET come from a medical, scientific or civil service background, and do not know the experience of having to get the Pandemic Unemployment Payment (PUP) or having to let someone go from their job.

'None of those people would have faced being on #PUP, none of them have to tell someone they are losing their job, none of them will have to shutter a business for the last time' - Tánaiste Leo Varadkar on #NPHET #cblive pic.twitter.com/ZAw7sDxGLo

— Claire Byrne Live (@ClaireByrneLive) October 5, 2020

Varadkar said he has full confidence in Dr Tony Holohan as CMO, but added that he has “confidence in NPHET to dispense public health advice”.

“But that is what they do,” he added.

They don’t advise the public, they advise the government and government decides.

“None of those people, for example, would have faced being on the pandemic unemployment payment yesterday. None of them would have to tell somebody that they were losing their job, and none of them would have had to shut their business for the last time. And I’m not talking about the economy, I’m talking about something that could have happened to half a million human beings tomorrow, and sometimes the reason and why politicians make these decisions is because we’re the ones who can see the bigger picture.”

While Varadkar was seething over in the Montrose studios, the health minister was pushing the line ‘nothing to see here’.

When asked numerous times about the relationship between government and NPHET, and whether they were happy with how the news was put into the public realm, the minister said: 

“This hasn’t changed the relationship. We live in unprecedented times.”

He said “unprecedented decisions” have to be taken. 

Minister for Health Stephen Donnelly says the relationship between Govt and NPHET has not been damaged. He says there has been "robust engagement", but there is "respect and a strong working relationship" | https://t.co/nPM6fe3aXF pic.twitter.com/QjKoBrE9Zz

— RTÉ News (@rtenews) October 5, 2020

“I would expect robust debate and interrogation – to not do so would be remiss but there is respect and there is a strong working relationship and that will continue,” he said.  

“The relationship with NPHET is absolutely fine. ”

Neither Donnelly, Finance Minister Paschal Donohoe or Transport Minister Eamon Ryan would comment on Varadkar’s comments, saying they would wait until they had seen them.

But despite this, sources on NPHET have acknowledged that damage has been done over the past two days. 

One NPHET source said time was compressed, and it was “a failure of communication” that occurred over 48 hours. They acknowledged that the Taoiseach should have been given advance warning, while another said there should have been plenty of advanced warning.

There is also a concern that Dr Holohan does not have a lot of experience with this Government. The previous established lines of communication meant that the Government always knew a letter was coming – but this wasn’t flagged this time.

Concerns were raised that in the transition of Dr Holohan’s return, something went wrong. The thought process behind the manner in which the information was brought into the public was dubbed by some as “very irresponsible”.

“It has been damaging all round,” said one senior source.

A number of TDs also raised serious concerns about the fear and anxiety the leaks injected into the public.

One TD said no one could defend NPHET’s handling of the last 24 hours or say that it was in anyway appropriate. They said they spent the majority of yesterday on the phone to worried business people and parents, who had had a sleepless Sunday night about what the morning might bring. 

“The handling of this has done a lot of damage,” they said, stating that whether it is true or not, the public believe NPHET got political this week, in a bid to bounce the government into a circuit break. 

“That damages them into the future,” said this source.

Additional reporting by Cónal Thomas