Donegal needs to "turn around" its high Covid-19 infection rates, public health officials have warned, amid rising case numbers in the county.
Nationally, compliance with public health guidelines has fallen off clearly since January, according to research carried out for the National Public Health Emergency Team (Nphet).
As well as Donegal, there are concerns about high case numbers in north Dublin and Kildare, officials told a Nphet briefing on Friday.
If incidence was as high in the rest of the country as it is in Donegal, Nphet would not have recommended the easing of restrictions this week, chief medical officer Dr Tony Holohan said.
There are clear examples of non-compliance across the county, said Dr Holohan: “The kind of things that even the dogs on the street in Donegal know shouldn’t be happening.”
Incidence in the county has been almost continually above the national average since last September and currently stands at almost 300 cases per 100,000 people, compared to 127 nationally. In Milford, incidence stands at 675 and in Letterkenny it is 600.
Birthday and other parties, funerals and wakes, and meet-ups among secondary school students have been implicated in the outbreaks there.
Dr Holohan described the easing of restrictions as a “welcome and deserved turning point in our collective efforts to get through this pandemic”
“However, incidence around the country varies. Some areas are in a more precarious position than others. This is extremely concerning for public health doctors locally.
“We are calling on community leaders in areas such as Donegal, where the virus is still circulating at dangerous levels, to encourage the people there to stick with the public health measures, especially if they are vulnerable or have yet to be vaccinated.”
Nphet needs to “see something turn around” quickly in the county, he warned.
He refused to rule out a differential approach that could see areas with high incidence excluded from any future easing of restrictions.
Dr Denis McCauley, a general practitioner in Donegal, said there are a number of factors at play and correlations between high rates of the virus in patches of Northern Ireland “have to be taken into account” when considering viral hot spots in Donegal.
It is no coincidence, he said, that the incidence rate is much higher in Milford and Letterkenny where there would be “quite a lot of mixing with Northern Ireland”.
Dr McCauley said the incidence rate in his locality in north Donegal has mirrored that in Derry city. “Last week it was high, this week it is lower because the incidence in Derry is lower.”
In the south of the county, there is much less “natural mixing” with Northern Ireland. Still, Dr McCauley said the high case numbers in Donegal are a “worry; that is without a doubt”.
If the viral rate is high in Derry, there is not the same level of worry there because 30-year-olds are now being vaccinated. This is not the case in Donegal where vulnerable groups are still not fully inculateded, he said.
Prof Pete Lunn, head of the behavioural research unit at the Economic and Social Research Institute, described the overall falloff in compliance with public health measures as a concern.
“However, the average number of people that each individual met from another household, the number of social visits to homes, and the likelihood that people had close contacts, all of which had been increasing during February and March, did not increase further over the Easter period.
“Data also show that despite news stories surrounding a very low risk of blood clots associated with some vaccines, people’s intention to take the vaccine remains very high. Over 80 per cent say they will take the vaccine when offered it.”
Almost half the population reported meeting nobody outside their household in the previous 48 hours, he said.
A further four deaths of Covid-19 patients were reported by Nphet. This brings to 4,903 the total number of deaths in the pandemic.
Nphet also reported 545 confirmed cases of the disease, bringing to 248,870 the total number of cases in the Republic.
Of the new cases, 264 were in Dublin, 58 in Kildare, 50 in Cork, 29 in Donegal and 28 in Galway, with the remaining 116 cases spread across 21 other counties
The 14-day incidence of the disease now stands at 127 cases per 100,000 people nationally. Donegal has the highest county incidence, followed by Kildare. Clare has the lowest incidence.
The median age of cases is 29 years and 77 per cent are under 45.
The reproduction number, a measure of how many other people a case infects, now stands at "just above 1," according to Prof Philip Nolan, chair of the Nphet epidemiological modelling advisory group.
Prof Nolan said the outlook was broadly positive though significant uncertainty remained. The background level of disease is stable though high
It was important the disease does not “get out of control” in young people. He said 500 cases per day in people under 40 would translate into six to eight hospitalisations every day and a death every 10 days.
“We do need to keep it under control in that cohort or we will be in trouble later in the summer,” he added.
On Friday morning, 139 Covid-19 patients were hospitalised, of which 44 were in ICU. There were eight additional hospitalisations in the previous 24 hours.
Up to Wednesday, 1,487,043 doses of vaccine had been administered in Ireland: 1,067,378 first doses and 419,665 second doses.
