Despite low ICU numbers and drop in hospital cases, new Covid wave is predicted

There were only 15 confirmed Covid-19 cases in ICU and 257 in Irish hospitals on Friday, according to the latest HSE update - indicating the latest wave of the virus has passed.

Both the HSE and medical specialists, however, have underlined the likelihood of another wave caused by a new variant in coming months, which could coincide with a high number of flu cases over the winter.

For much of August Covid hospitalisations were consistently over 300, though numbers in ICU remained below 20. Daily confirmed cases confirmed by PCR peaked at 3,828 on July 9th while the BA. 5 variant and related BA. 4, which can evade vaccine protection, accounted for the vast majority of cases.

[ Marked decline in take-up of second Covid-19 boosters compared with first booster doses ]

Sam McConkey, professor of infectious diseases at the Royal College of Surgeons in Ireland, said the country was “in a good place” in dealing with the pandemic, but could not be complacent given ongoing risks, though it was difficult to predict was might happen over the winter.

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He told The Irish Times, they were not seeing people with Covid dying from “Type 1 respiratory failure” due to lack of oxygen in recent months. As most people were vaccinated, lung failure was not arising, he confirmed.

With so many people having had Covid or three to four vaccines, the latest variants were more transmissible “but less pathogenic to the lungs”.

Most hospital cases, he noted, involved older people with delirium and brain disturbance; those with bowel trouble and patients with compromised immune systems who were vulnerable to viral infection. These cases could be dealt with as “fortunately, we have proper antiviral drugs”, Prof McConkey added.

He was not convinced of the seasonality of Covid in terms of being a greater risk during winter. But another wave was likely within three to six months, he said, with the hope it was getting progressively weaker, but there was a one-in-five chance of a more infectious mutant.

On flu risk, he said there was historical evidence “it comes back with a big bang, after a low period”. As levels were so low during the past two years, he recommended everyone should get the flu vaccine and that it should be provided by the State.

There has been severe flu season this year in the Southern Hemisphere - which could a seasonal harbinger for Europe. Flu is surging in Australia for the first time since the pandemic began.

The World Health Organisation warned in mid-July of rapidly escalating cases of the virus, especially in Europe where cases tripled in six weeks, and accounted for nearly half of all global cases. It predicted the situation will get worse in the autumn and winter and urged countries to act before it was too late.

It warned: “It’s now abundantly clear we’re in a similar situation to last summer - only this time the ongoing Covid-19 wave is being propelled by sub-lineages of the omicron variant, notably BA. 2 and BA. 5, with each dominant sub-lineage of omicron showing clear transmission advantages over the previously circulating viruses.”

The HSE’s national lead on Covid-19 test and tracing, Eileen Whelan, has warned there is still “a small but really important number” of people who have not yet been vaccinated. Ms Whelan told RTÉ Radio’s Today with Claire Byrne show that between 150,000 to 200,000 people have not been vaccinated, with a disproportionate number of people being hospitalised as a result of Covid-19 being unvaccinated.

The HSE is encouraging those eligible for the booster vaccine to come forward as the vaccine remains the best protection against the virus, she said. While there was a “lower” uptake in the 65-69 cohort, there has been “a small upsurge” in the other age groups now eligible for the booster which is now available for the 50-64 cohort. Ms Whelan echoed WHO concerns, adding there was a “fake sense of confidence” it was gone.