Everybody has been wrong in pandemic - let's hope it is Nphet's turn with the Delta variant

Everybody has been wrong in this pandemic. With its modelling of the Delta variant and its judgment to pause reopening, let us hope this is the turn of the National Public Health Emergency Team (Nphet) to be wrong again. If its dire models are right, an economic and social catastrophe is on the way.

Nobody is right all the time. Nphet was wrong on its resistance to face masks early in the crisis. It was also wrong when it initially told nursing homes on March 10th, 2020, to lift a visitation ban. Meanwhile, the Health Service Executive was wrong to dismantle the contact-tracing system and leach resources from public-health teams during 2020’s summer lull.

Those people who always oppose every restriction were wrong when they dismissed the virus as a seasonal bug that goes away in summer. Here we are, with a surge in the UK in sunny June and July.

Zero-Covid campaigners were wrong when they said their preferred strategy meant the end of lockdowns. Try telling that to the people of Australia, who have been locked down numerous times over the past year. Ireland’s economy is also in no worse shape than Australia’s, another area where empirical data has shown certain arguments for zero Covid were overblown.

Reopening and Delta variant debate requires cool heads

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The Government was wrong to allow the reopening of indoor dining last December for a totally unvaccinated population when case numbers were already so high. Those of us who thought the risks were overstated were also wrong to push so hard for it, even though research shows the decision was supported by the majority of people. The proof of the mistake lies six feet under the ground all over Ireland, victims of a spike that was exacerbated by indoor socialising.

Those in our midst who lathered themselves in righteous fury were wrong when they blamed hospitality industry lobbying for the all that happened in January. It must be obvious now, even to them, that the more transmissible and initially unknown Alpha (UK or Kent) variant did most of the winter damage. That is the lesson that policymakers and commentators alike should learn from the Christmas surge, and which explains the cautious stance now over Delta.

The Government was also wrong to eschew the opportunity to design a vaccine pass when it had the chance when things were quiet during spring. Ministers’ lives would be far easier now if they had done it, even as a contingency. Anti-pass campaigners are also, in my view, wrong now to decry it as “apartheid”. It’s a compromise to enable near risk-free economic activity to keep people in jobs. That is all it was ever meant to be. If 10 of your friends were detained in a camp, and you only had room in your car to bust six of them out of the gate, would you leave all 10 imprisoned together on a point of principle? I’d free six immediately and figure out another way to free the other four later on.

And most of the media, public health and political establishment, including hordes of opportunists in the Government’s political opposition, were wrong when they said that Ireland was missing a trick, a “no brainer” they said, by not introducing mandatory hotel quarantine.

What virus advantage has it given us over the rest of the European Union that, correctly, rejected MHQ as unworkable in this part of the world? None. MHQ was to keep out the Beta and Gamma (South Africa and Brazil) variants. In which EU countries where MHQ was eschewed are Gamma or Beta now raging? They're not.

Being wrong is not an exclusive club. Nobody here is untouched by fallibility.

Delta modelling

This brings us back to Nphet's gloomy Delta modelling, which appears to have scuppered the planned reopening of indoor trade for the hospitality industry on July 19th. Most of the attention has been on the chief medical officer, Tony Holohan. But the modelling is more the responsibility of Nphet member Philip Nolan, the president of Maynooth University.

Like everybody else, Nolan has slipped on a few banana skins himself in this pandemic, such as the time last year when he dismissed the tracking by public-health teams of the sources of outbreaks as merely “an academic exercise”. It turns out it is actually one of the linchpins of a properly functioning public-health response to a pandemic.

Nphet’s modelling formed the basis of the Government’s decisions this week. Most people do not have the scientific competency to present contradictory figures. But we do have the wherewithal to point out that Ireland is, again, an outlier with its approach in Europe, and ask reasonably if that might be a red flag.

If Nphet’s call is right, it would also mean that almost all of the decision-makers in the UK and their medical advisers are currently wrong. Despite being the bastion of Delta, the UK senses enough of a slowdown recently in the rate of growth in hospitalisations to feel confident it can muddle through.

Sage, the UK equivalent of Nphet, modelled on June 9th that British hospitalisations per day by June 28th would be about 350 under its “optimistic” scenario. It predicted they would be above 650 under its “central” scenario, and 1,250 was its “pessimistic” one, echoing some of the language and tone used in Nolan’s predictions to Government.

The actual number of UK hospitalisations on June 28th was 244, or 30 per cent below even the most optimistic forecast. It might be an overstatement to say Sage has been proven conclusively wrong. But it certainly has yet to be proven right. Maybe it will in time. But the undershooting of even its most optimistic projections obviously convinced the British to forge ahead on reopening.

It is possible that Nolan’s projections are prescient and one of his four potential scenarios lands. If it is between Central 2 and Pessimistic, which respectively envisage 7,690 and 12,985 hospitalisations between July and September, that would put a Delta surge at or ahead of the January surge, in terms of its impact on the health service. The weekly peak of hospitalisations in January was 1,340 in the week ending the 15th of that month.

What is being left unsaid at the moment is that, if that kind of steep trajectory becomes apparent, the Government will inevitably move to lock down the entire country in August. This could end up being about more than indoor pints.

It may also be possible that Nolan’s central numbers are too pessimistic. He did not model an indoor dining “shut” scenario versus indoor dining “open”, which would have made the accuracy of some of the predictions easier to judge in hindsight.

But if our numbers still come in at Sage’s current run rate (which isn’t guaranteed to hold) and undershoot “optimistic” by 30 per cent, then barely 1,000 people will be hospitalised from now until the end of September. That would be easily manageable and a most welcome outcome. The other extremes of possibility laid out in Nphet’s calculations would be a social and economic disaster.

For the economy and people’s health and also their peace of mind, it doesn’t matter a whit whether Nphet is in touch or out of touch or has too much power or not enough influence. It matters only if its biggest calls are right or wrong, and by how much.

In the meantime, the beleaguered hospitality industry is being forced to foot the bill while the rest of us wait and see what happens. This State and its citizens owe the businesses and workers in that part of the economy for their sacrifice.