Coronavirus: Ireland 'may have reached a plateau' but 43 die in one day

The number of new cases of Covid-19 has plateaued and should start to fall shortly, according to research provided to the National Public Health Emergency Team.

While the daily number of deaths reached a new high of 43 on Thursday, overall the rate of growth in cases, intensive care unit (ICU) admissions and deaths has slowed considerably since the start of the month, the new analysis shows.

The number of newly confirmed cases of Covid-19 is peaking "around now" and should decline in coming weeks, Prof Philip Nolan of NUI Maynooth, who leads a team modelling trends in the epidemic, said.

“We may have reached a plateau,” he told a NPHET briefing on Thursday, though he warned there remained “a delicate balance” between suppression of the disease and the risk of its spiking again.

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Since April 3rd, the growth rate in new cases has been “close to zero”, he said, and ICU numbers have been stable since that time.

In order for the outbreak to be suppressed, each person with the disease must infect no more than one other person on average. At present, Prof Nolan’s research shows, the so-called reproduction number of the disease is below this level, at 0.7-1.

Prof Nolan warned any easing of restrictions after May 4th would have to be approached “exceptionally carefully” as it could spark a fresh surge of cases. In some scenarios, these could be controlled by a reimposition of measures, but if the disease spread too widely, the new spike in cases could be “unmanageable”, he said.

Had the measures not been introduced, there would have been 1,700 deaths so far, not the 486 reported by NPHET on Thursday, chief medical officer Dr Tony Holohan pointed out.

The 43 deaths reported on Thursday included 22 males and 21 females.

Registering deaths

Some 34 of the deaths were in the east, four in the west and five in the south. A total of 27 of the patients were reported as having underlying health conditions. There have now been 486 Covid-19 related deaths in the Republic.

Dr Holohan said he had written to funeral directors about the importance of registering deaths early so that the most complete data on Covid-19 deaths becomes available quickly.

The chief medical officer has also written to clinicians emphasising the importance of reporting to public health authorities and coroners deaths that could be related to the current outbreak.

“That doesn’t always happen in as responsible a way as possible,” he said, adding that he wanted doctors to be aware of the importance of having tests done on people who were unwell, even where the clinical symptoms were not necessarily suspicious.

At its meeting on Friday, NPHET will review measures taken to tackle the large number of outbreaks that have occurred in nursing homes and other institutional settings.

Dr Holohan said there had been 254 outbreaks in residential settings, of which 163 were in nursing homes.

Some 302 of the deaths so far have occurred in residential settings, including 253 in nursing homes.

"The data clearly shows that there are two very different experiences of Covid-19 in Ireland today," he acknowledged. "In the population at large, the virus is contained and effectively suppressed. However, the experience of the disease in long-term residential care settings continues to be a source of concern.

No forgotten frontline

“In order to protect the vulnerable, the first task was to suppress the virus in the population at large. We are increasingly confident that we are achieving this. All of our efforts now need to be on extinguishing Covid-19 in our community residential settings, including nursing homes.”

Speaking in the Dáil, Taoiseach Leo Varadkar said nursing homes would not be the forgotten frontline in the war against coronavirus. But he said the fact that the problem was not being dealt with as quickly as he would like was a reflection of the scale of the Covid-19 crisis.

At the briefing, officials also defended the "robust" handling of an outbreak at the Maryborough Centre in Portlaoise, where eight residents died of coronavirus over the Easter weekend. None of the remaining 17 residents have been transferred to hospital, but are receiving treatment and care on-site with the assistance of staff from Portlaoise hospital.

Local Sinn Féin TD Brian Stanley said he understood many of them had already tested positive for Covid-19.

Demanding that the HSE did more to protect patients and staff, he said: “The deaths of over one-third of the patients last weekend have shocked people. It is also very traumatic for the staff and the families of the deceased.”

Northern Ireland too is "at, or very close to" the peak of the coronavirus outbreak, according to the scientist responsible for modelling the virus's progress.

However, the North's Public Health Agency announced on Thursday that 18 people had died in the previous 24 hours.