LAST UPDATE | 6 Oct 2020
TÁNAISTE LEO VARADKAR stands over his comments about NPHET’s advice made on RTÉ’s Claire Byrne Live programme last night, according to his spokesperson.
There are concerns about the future of the relationship between the government and NPHET after Varadkar blasted the Level 5 advice, stating it “hadn’t been thought through, and there hadn’t been prior consultation”.
Ahead of Cabinet today, Public Expenditure Minister Michael McGrath said today that the relationship needed a reboot after the last 36 hours of controversy.
Chief Medical Officer Tony Holohan has not responded to Varadkar’s criticism of NPHET’s Level 5 proposal as of yet.
Holohan was spotted entering into Government Building’s today, but spokespeople for the Tánaiste and Taoiseach said he was not there to meet Varadkar or Micheál Martin.
When asked if the Taoiseach agreed with Varadkar’s comments, the government press secretary replied:
The Tánaiste is entitled to his opinion.
When asked if the Tánaiste stood over his interview, Varadkar’s spokesperson said “absolutely”, but added that last night Varadkar also said government and NPHET now has to “get on the same page”.
That is the view of both government and NPHET on the matter, he added.
The spokesperson added that the points Varadkar was making was that the move to Level 5 would have a major impact on society, it was not within the government’s roadmap, and the HSE disagreed with NPHET’s assessment that the health service was facing the immediate prospect of being overwhelmed.
It is believed his views are widely representative to Fine Gael TDs, while there are mixed views within Fianna Fáil.
Speaking on Morning Ireland today, Minister for Health Stephen Donnelly struck a more conciliatory tone, saying NPHET and Chief Medical Officer Dr Tony Holohan, who returned to work yesterday, “have done a very good job and I think they will continue to do a very good job”.
Donnelly said the government believes moving the entire country to Level 3 of Covid-19 restrictions is “the best decision”.
The National Public Health Emergency Team (NPHET) had recommended the entire country move to Level 5, the highest level of resticions, but this advice was rejected by the government yesterday.
“It’s not about who’s right and who’s wrong, it’s about trying to make the best decision we can given the evidence we have.”
Donnelly said if the government was looking at the situation “purely from a public health perspective” and “needed to consider nothing other than the suppression of the virus”, Level 5 may have been the right path.
“If we didn’t need to consider the entirety of the country, then clearly one could make an argument that says well everyone just needs to go home, close down businesses, don’t leave your house. And obviously, we know that the virus would be suppressed.
“But we have to make what we believe is the best decision on behalf of the entire country, that is what we have done.”
Donnelly said NPHET has to advise the government on “what they believe is required from a public health perspective to suppress this virus”, but the government “has a different job”.
“Government has to make decisions, and we have to take that public health advice in the context of the entire country, in the context of our society, our communities, jobs, and our economy, and given that we decided to move to Level 3.
“There’s a lot of talk about not moving to Level 5, but let’s not lose sight of the fact that moving to Level 3 is a very, very serious thing, and there will be a lot of people listening this morning thinking about how it affects them, how it affects their families, how it affects their businesses, how it affects their jobs,” Donnelly stated.
‘Squaring up to NPHET’
On the same programme, Sinn Féin leader Mary Lou McDonald said she believes the country was “not ready to go to Level 5″ because not enough protective measure for people are in place.
McDonald also said the government “squaring up to NPHET and answering them back” was not the right approach. She said Varadkar’s comments amounted to an “unseemly squaring up to Tony Holohan and to NPHET, which I think was unnecessary”.
She said the Tánaiste should have instead focused on “how exactly capacity in the health service is going to be enhanced quickly”.
“And I would like to hear them say that income support, such as the Pandemic Unemployment Payment, will be returned to a reasonable and sustainable level.”
On the way into Cabinet this morning, Public Expenditure Minister Michael McGrath said the working relationship between NPHET and the government must be based on “mutual respect and mutual trust”.
McGrath acknowledged it “has been a difficult couple of days”.
“There’s no point in saying otherwise, but we have to reboot the relationship because the pandemic is going to be here for quite some time unfortunately, and we are going to rely on each other to make the right decisions,” he said.
ICU capacity
Part of the reason NPHET recommended moving to Level 5 was concern over the lack of ICU capacity in hospitals around the country.
NPHET said that admissions to critical care services have grown to an average of two per day, with 243 out of 281 critical care beds now occupied.
If current trends continue, it said 1,600 to 2,300 cases per day will be reported by 7 November, with 43 people being admitted to hospital per day.
Dr Catherine Motherway, Consultant in Intensive Care Medicine at University Hospital Limerick, told Morning Ireland: “We would expect to see more admissions as the numbers rise – logically the more cases there are, the more likely you are to see patients.
“We know that a lot of these cases are younger patients, less likely to need our services, thankfully, but there is still a significant increase I understand in patients who have this disease over the age of 65 have a much higher likelihood of meeting us.
“And there’s always a lag between diagnosis, presentation to hospital, and subsequently presentation to intensive care, so we will see an increase in cases.”
Motherway said if there is a surge in the number of people needing hospitalisation or intensive care, elective or scheduled services will need to be cut – something she said should be avoided if possible. Beds in private hospitals may also have to be used, she added, as was the case earlier the pandemic.
The HSE’S Winter Plan includes funding for 500 new acute beds in hospitals and 17 additional intensive care unit beds, which would bring the total number of ICU beds to around 300.
Enforcement
Speaking on the same programme, Antoinette Cunningham, General Secretary of the Association of Garda Sergeants and Inspectors (AGSI) criticised the lack of clarity on enforcement measures coming into effect from tonight.
Cunningham said gardaí have “enjoyed a very good relationship with the public right throughout this pandemic, and we want to continue with that ‘policing by consent’ that we have had so far”.
“But it has to be said that at midnight tonight, our members would be policing Level 3 restrictions nationwide. And we haven’t had any guidance on what that might mean.”
Cunningham said gardaí have to manage the expectations of both the government and members of the public and meet somewhere in the middle.
“It’s forgotten that by 12 o’clock tonight, this would be the problem of ags and the members of the AGSI to police these enforcement restrictions and yet we do not know at this point what they actually are.”
With additional reporting by Christina Finn
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