Coronavirus Q&A: What is behind the spike in cases in Ireland? Should we be concerned?

Should we be concerned about a spike in Covid-19 cases this week?

Well, acting chief medical officer Dr Ronan Glynn, Ireland's most senior public health official, said he is "very concerned". Announcing 85 new cases on Thursday - dramatically pushing the daily average up from around 20 to the low 30s - Dr Glynn said the coming days will be crucial in understanding whether this was just a "blip" or whether the spread of the virus is starting to escalate again after weeks of remaining stable. "Clearly we need to watch this closely," he said. A further 38 new cases were confirmed on Friday, bringing to 123 the number of cases confirmed over the past two days.

A survey of GP’s has indicated that the vast majority of patients who had contacted them with Covid-like symptoms in the past week had not been self-isolating since the onset of their symptoms, which is a further concern.

What is behind the surge in new cases?

84 of the 123 cases are linked to known outbreaks or clusters or are close contacts of other confirmed cases. These included family homes and building sites but also, notably, a pet food factory in Co Kildare. More than a fifth of the 85 newly confirmed cases on Thursday were among workers at Irish Dog Foods in Naas. The factory, which employs around 200 people, closed down a week ago for a deep clean while workers who tested positive for the coronavirus were ordered to self-isolate. A Health Service Executive (HSE) outbreak control team was also assigned to the plant.

Overall 44 cases over the past two days are located in Kildare, 33 are in Dublin, 11 in Clare, 10 in Laois, eight in Limerick and the remaining 17 are located across 10 counties.

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Why was there an outbreak at the pet food factory?

Public health officials have yet to get more detail on the transmission of the disease through workers. In May, there was a wave of clusters at meat factories around the country, where employees work in prolonged close proximity to each other, increasing the risk of transmitting the virus.

Irish Dog Foods said it has “a full range of measures in place including appropriate PPE (personal protection equipment), enhanced cleaning and hygiene regimes, social distancing measures, temperature screening and regular staff health and hygiene training and communications to help combat the virus.”

Are there any other factors at play in the surge?

A number of the workers were living in direct provision centres, where residents often share bedrooms, washing facilities and other areas which makes it difficult to socially distance. HSE outbreak control teams have been dispatched to two direct provision centres in Co Kildare, where the virus spread from workers at the pet food factory. Residents were mass tested on Wednesday at The Eyre Powell Hotel, in Newbridge, which has around 134 residents, according to Lucky Khambule, of Movement of Asylum Seekers Ireland. So far, 20 have tested positive and have been moved to isolation facilities at Citywest, Co Dublin, while others are awaiting results, he said.

The Hazel Hotel in Monasterevin, which has around 89 residents, has been less affected, said Mr Khambule. No-one has been seriously ill, to date, but the strain of living among a cluster was taking its toll on residents' mental health, he said.

“It is a very stressful time, it’s alarming, it is scary for everyone. You can’t social distance when there isn’t the space. Strangers being grouped together is asking for trouble. You don’t know where the other person has been during the day, and when they come back they are lying right next to you. Even now, five or six months into the pandemic we are still talking about the overcrowding in direct provision.”

Conditions at direct provision centres don’t sound ideal for controlling a pandemic?

Nick Henderson, of the Irish Refugee Council, said the latest outbreaks unfortunately vindicate its warning that centres are not suitable for social distancing.

“The legal advice we have received states that the government is obliged to provide accommodation for those in direct provision where they can not distance or isolate. At the moment there are at least 1,600 people in centres who are still sharing bedrooms.”

Mr Henderson said the risk of Covid-19 outbreaks in direct provision centres remains higher than in other parts of society. Furthermore, he said there are “ongoing issues” that factory bosses need to address in relation to workplace safety to make sure staff who live in direct provision can continue to work.

So, is it just factories and direct provisions that are the problem?

No. Dr Glynn said it “wouldn’t be unreasonable” to assume some of the clusters over the past week arose from people gathering in restaurants, bars and other settings. Going into the bank holiday weekend, he pleaded with the public to keep up social distancing and hygiene measures to make sure Ireland doesn’t “go the direction of other countries.”

“This isn’t going away, it hasn’t gone away . We can see what has happened in other countries if restrictions are relaxed. Ironically, the lower the number of cases, the more we have to work to keep it down.”

Of the 123 cases confirmed over the past two days at least 19 have been identified as community transmission while 20 cases remain under investigation. “We may be beginning to see more cases which we cannot link to outbreaks or close contacts," Dr Glynn said.

Is travel also an issue?

Dr Glynn said a minority of cases detected in the Republic were linked to international travel including just two of the 85 cases reported on Thursday.

There was a risk that debate about Irish people going on foreign holidays could detract from the “core message” of each individual having power to control the spread of the virus, he added.