Anti-alcohol zeal of public health experts peppers reopening debate

It is the second week of March, 2020. Ireland has shifted into full blown emergency mode to cope with the pandemic, which officially landed on our shores a fortnight earlier with the first infections.

The economy is beginning to shut down, while people are encouraged by public health experts to limit their social interactions in work, play and life in general. Near panic is around the corner.

However, the organisers of one global conference that is pencilled in for Dublin Castle are determined to defy the trends sweeping Europe and forge ahead with their three-day event. It seems to be a particularly stubborn decision in the circumstances. There are 38 separate discussions planned over the course of the conference, as well as a “welcome reception” and a gala dinner on the second night in a city centre hotel.

Some reports suggest there may be 1,000 attendees but the final numbers reveal 340 conference delegates showed up. They come from 47 countries, however, so there is a real risk that this could turn into a virus super-spreader event.

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We know far more about the transmission of coronavirus now but, even back then, most of us understood that such large public gatherings were deeply problematic. For example, the cancellation of St Patrick’s Day had already been widely accepted by a frightened public.

The three-day Dublin Castle conference did eventually capture the attention of public health experts, the Department of Health and the-then minister for health, Simon Harris. But not in the way that you might expect.

Public health experts did not, for example, criticise the gathering for risking people’s health and lives. Instead, they sat in the audience as delegates. The Department of Health did not ask its officials to lean on the organisers to postpone. The Department of Health was, in fact, the event’s organiser.

And Harris did not lambaste the attendees for administering “a kick in the gut and the middle finger” to the rest of us, in the way that he scolded young people who were dancing in Dublin’s Berlin Bar in a viral video a few months later. Instead, the minister gave the conference its opening address.

“When the public health lobby get together, we can achieve great things,” the minister told his audience.

The event, which stuck out like a sore thumb as the country entered crisis mode, was the Global Alcohol Policy Conference, co-sponsored by the World Health Organisation, which took place in the city between March 9th and 11th.

The fact that an anti-alcohol industry event drawing doctors from across the globe would be among the precious few to go ahead, right as the world entered a virus crisis, demonstrates the almost messianic zeal with which some public health officials view their mission to fight drink consumption.

Blame game

"We are here," the US anti-alcohol academic David Jernigan said in his stirring conference closing speech. "We will not be stopped by an industry, or a virus, or an industry that uses viral marketing."

Meanwhile, on the same day that he addressed 340 people in Dublin, Ireland recorded its first virus fatality.

Since March, a similar kind of anti-alcohol zeal has repeatedly bled into the public debate over how to handle the pandemic, restrict public activity or reopen the economy and society. We are in the middle of it now, once again, with the discussion over how or even if to open the pub sector for Christmas.

There is anecdotal evidence globally that indoor alcohol-serving venues have been a factor in virus transmission. The theory seems perfectly logical: pubs are indoor environments where people are less inhibited, so the virus can spread.

But despite the obviousness of this argument, the statistical evidence for widespread transmission due to alcohol consumption is strangely flimsy at best – just 22 of the 9,062 Irish virus clusters identified so far have been attributed to pubs, although alcohol may well be a factor in some of the 6,869 clusters in homes. That is just a guess, however, as we simply do not know the full truth.

Still, if only it were that private houses received as much policymaking attention as public houses when it comes to the virus blame game.

At times, it has seemed as if the virus and the battle to influence people's personal behaviour have almost taken a backseat to the real war, which appears to be on the cursed drink itself. Rarely have we seen ministers and public health officials so exercised as when they were excoriating young people for drinking in Dame Lane, Berlin Bar, South William Street and Grafton Street in Dublin, or on the streets of Galway, where a senator once called for soldiers to be deployed to control students for Freshers' Week.

When the first lockdown reopening plan was devised at the beginning of May, pubs were not supposed to reopen until the final phase in August. Tony Holohan, the chief medical officer, told RTÉ Radio that there was no "realistic prospect" of earlier reopening.

Ireland had the lowest case numbers in Europe at the time, but only when the industry revolted against the Government’s obduracy did policymakers devise the spurious distinction between “wet” and “dry” pubs, the latter comprising those serving food.

The reopening of dry pubs was brought forward by six weeks, while the reopening of wet pubs was kicked further down the road, as officials stuck to their guns that the virus would rage as long as people had a pint in their hands.

National stereotype

Public health academics began writing in to newspapers warning that pubs should not reopen at all or disaster would befall us. Soon, ministers such as Harris and Heather Humphreys, the minister for social protection, were calling for curbs on off-licences, as if such a ridiculous measure would have any real effect on virus transmission, beyond appeasing the anti-drink lobby.

When the history of this pandemic is written in future, it may well turn out to be the case that alcohol consumption is proven to be a major factor in its transmission and that Ireland benefited by continually limiting alcohol sales. Or it may not. The data has not yet been presented to support the theory.

In the meantime, the messaging is obvious: public health experts and ministers do not trust the majority of Irish people to behave in a reasonable way if they are permitted to get even a sniff of alcohol.

Many people will nod along with that. But it still plays into an outrageous national stereotype that if, for example, it was purveyed by a British Tory would have us all in a self-righteous lather.

It also sits uneasily with the hard truth that the only real way to combat the pandemic is to trust people to fine-tune their own personal behaviour. Either we trust them to do that, or we do not.