Legislation being prepared for possible reintroduction of compulsory masks in event of Covid-19 surge

Legislation is being prepared to allow for the potential reintroduction of compulsory mask-wearing and other Covid-19 public health measures “in certain circumstances”, according to a Department of Health report.

The measure is precautionary and designed to ensure all elements of preparedness are in place for any future surge in infections, the report on future strategies for dealing with the disease states.

The reintroduction of mask mandates and other compulsory measures will require a “point-in-time assessment of a constellation of indicators” to determine “the most proportionate and least restrictive course of action”, according to the report.

These will include the type of variant in circulation and the risks it poses; overall immunity in the population, especially in vulnerable groups; pressures on health services; and the public health capacities for testing and tracing, outbreak management and genetic sequencing.

“If required, the introduction of mask mandates in certain settings (eg, transport and healthcare) will involve a point-in-time assessment of a constellation of indicators with due consideration of the personal, ethical and public health perspectives,” it says.

“Any such mandate will be pursued in a proportionate manner, will be the least intrusive measure to achieve the identified legitimate public health goal(s) and will be of limited duration.”

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Ten European countries have issued recent recommendations on the use of face coverings. A number require them to be used in transport and other key settings, while some countries are allowing mandates to expire.

The pandemic is not over and there continues to be uncertainty regarding the future trajectory of the disease, new chief medical officer Prof Breda Smyth notes in an introduction to the report.

“Notwithstanding Ireland’s high level of vaccine-induced and naturally acquired population immunity, Sars-CoV-2 is likely to present a significant public health challenge for the foreseeable future,” she said.

Under emergency plans prepared by the HSE, temporary testing centres would be rolled out across the country, along with “appropriately targeted” contact tracing.

The “enhanced response” plan envisages scaling up testing to 150,000 PCR tests within eight weeks of a surge occurring, with the additional availability of 300,000 antigen tests a week.

[ Worst-case winter could see 17,000 hospitalised for Covid and 4,350 for flu, according to HSE projections ]

Antiviral prescription

Vaccination against Covid-19 is now largely routed through local GPs and pharmacies, but in the event of large-scale vaccination being needed again, the programme will be “positioned to respond” by vaccinating/boosting the entire eligible population of 4.1 million people, according to the report.

The report says it is essential there is ongoing monitoring and evaluation of emerging treatments for Covid-19, and that the effectiveness of existing treatments is kept under continuous review.

By mid-September, just 1,239 prescriptions for Paxlovid, an antiviral that can prevent serious illness in infected people, had been issued.

“Use of Paxlovid in Ireland has been much lower than would be expected to date relative to recent and current epidemiological experience and it has not been aligned with the proactive usage seen in other countries,” it says. “As we approach the autumn/winter season it is essential that measures are now taken to promote further use to prevent progression to severe illness and hospitalisation.”

[ The Irish Times view on the coming Covid-19 wave: a health service bracing for winter ]

A public information campaign explaining the importance of good ventilation may be “particularly useful,” the report suggests.

There are currently no plans to review the current rules on travel, the report says. Digital Covid-19 vaccine certificates will continue to be issued though they are not longer required for international travel.

Modelling of future infections will be carried out by a new unit within the Health Protection and Surveillance Centre. Previously, this work was done by a working group with links to the State’s universities.

Prof Smyth urged people to keep up to date with their vaccine schedule and to receive a booster dose as soon as they are eligible. The HSE has begun to administer Covid-19 booster vaccines and flu vaccines together to eligible groups.