CHIEF MEDICAL OFFICER Dr. Tony Holohan has said the reintroduction of Covid-19 measures “cannot be fully ruled out” in the future due to the uncertain nature of the virus.

Holohan and other members of NPHET are due to speak before the Oireachtas Health Committee tomorrow with the CMO set to outline an “uncertain trajectory” for the virus despite “very high uptake” of vaccines.

Holohan is also set to make a plea to employers that self-isolation for symptomatic employees should be facilitated in the upcoming autumn and winter months.

The Dáil returns tomorrow following the summer recess with TDs returning to Leinster House after the enforced temporary move to the larger Dublin Convention Centre. 

Despite the in-person return for politicians, Holohan, Deputy CMO Dr Ronan Glynn, NPHET’s Professor Philip Nolan, and NIAC Chair Professor Karina Butler will make their presentations remotely to the Oireachtas Committee. 

In a letter to TDs and Senators ahead of the hearing, Holohan outlines that there is “high incidence” of Covid-19 in the country that creates uncertainty. 

“While incidence in those aged 19-24 and 13-18 years has fallen in recent weeks, we have noted an increase in testing rates and confirmed cases in those aged 5 to 12 years. This trend, and in particular the impact of the return to school and the opening of the third level sector, will continue to be monitored closely over the coming weeks,” Holohan says in the letter.

The CMO notes that numbers in hospitals have “begun to reduce” and that the numbers of Covid-19 patients in ICU have “stabilised”. Despite this, he writes that NPHET is monitoring a recent increase of Covid-19 infections in nursing homes.  

Holohan’s letter states that the vaccination programme has “fundamentally changed the risk profile of this disease” but that vaccination alone will not suppress transmission to a level that sees the reproduction rate fall below 1. 

“This means that through this coming autumn and winter, possibly in the face of high levels of infection, we will remain dependent upon public understanding and buy-in to the basic public health measures in order to minimise opportunities for this virus to transmit,” he says.  

The CMO specifically references “a focus on the importance of rapid self-isolation if symptomatic” and says that this need should communicated between employees and employers. 

Holohan also stresses the ongoing need for mask-wearing in public places but says that the reimposition of other restrictions in the future cannot be ruled out. 

We cannot predict with certainty the future trajectory of the disease and, consequently, we cannot fully rule out the possibility that the reintroduction of measures may be required in the future. We must continue to ensure our response is agile and flexible, with an ability to pivot rapidly and respond to any emerging threat.

Booster jabs

NIAC chair Professor Karina Butler will also tell the committee that the global availability of vaccines must be considered when determining the wider need for Covid-19 booster vaccines in Ireland.

Butler writes in her opening statement that there are principles of “moral equality” to consider and that vaccine access “should not depend on country of origin or residency”. 

Speaking about NIAC’s recommendation for Covid-19 booster jabs, Butler will outline that an additional dose should be provided in the coming months to those aged over 80, those aged over 65 in care facilities and any person over 12 who is immunocompromised. 

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The boosters are set to be provided by the HSE as part of the winter flu vaccination programme with the two jabs potentially given at the same time or at any interval apart.

The decision to provide a booster vaccine to those in elder categories, Butler will say, is due to this group having “a poorer response to the primary vaccine course and more rapidly waning immunity”. 

The immunity provided by Covid-19 vaccines is still being studied and is dependent on various factors but NIAC has said it is “at least as good” as the six to nine months of immunity following infection with Covid-19. 

Butler also addresses the potential need for booster vaccines for “other groups” beyond those currently recommended, including high-risk groups and and healthcare workers. 

Among the considerations for these groups are the overall level of Covid-19 in the community and “whether additional doses are safe, needed, and can provide benefit”. 

She also references the global demand for vaccines and the moral considerations in ensuring people globally have access to vaccines. 

“NIAC is conscious of the global demands on vaccine supplies and recognises that facilitating vaccination on a global level is important on a humanitarian and global equity basis, and essential to limit the continuing threat of COVID-19 in Ireland. NIAC is cognisant of the WHO position and advice on global vaccination and our duty to address inequities.”