Over the past few days the world appears to have reached a turning point in the two-month battle against novel coronavirus.
The Covid-19 disease is now in active transmission in a number of countries outside China, where it originated. In many cases it is clear cases are occurring that have no direct connection with China.
Even more worrying, there is evidence of under-reporting in some countries and a failure in some instances to identify the root cause of local outbreaks.
And the virus has shown it can spread rapidly in a contained environment such as cruise ships and prisons.
Calls are multiplying for the outbreak to be designated a pandemic, although the World Health Organisation (WHO) no longer formally uses this term. With countries as diverse as Italy, Iran and South Korea now in the throes of their own outbreaks, the definition of a pandemic – an epidemic spreading worldwide – seems to have been fulfilled.
Yet far more important than quibbles over definitions is the approach countries need to take in response to the growing threat posed by the disease.
Up to now the approach has been one of containment led by China. It imposed a lockdown on Hubei province where the outbreak started that shut schools and businesses, banned most travel and forced millions of people to stay indoors for weeks.
In Ireland, containment has involved the early identification of suspect cases and their separation from the rest of the population. Fortunately, of the scores of tests so far carried out here all have proved negative.
Multiple centres
But in a situation where the virus is spreading rapidly in multiple centres, where information is lacking on its origins and its transmissibility, and where systems are threatened with overload, it may make more sense to switch to a policy of mitigation.
This means the focus switches from prevention to an attempt to slow down the spread of the disease through the population.
Ireland might seem to be a long way off needing mitigation measures, but consider how quickly the Italian authorities have had to react over the weekend to a massive surge in cases there. Their actions – effectively placing the residents of a dozen towns in quarantine and cancelling many public gatherings in the wider region – are a game-changer in European terms, with obvious knock-on implications for the rest of the continent.
Expect to hear a lot in the coming days about the need for “social distancing”, which may mean the cancellation of mass events and the curtailment of travel plans, especially ones involving Italy.
Not all the news is bad. The number of cases in Hubei is in decline thanks to the stringent measures taken by the Chinese authorities. The disease may not be as dangerous as first thought because less serious cases may be passing under the radar. Covid-19 hardly affects children, and is not serious for most people under age 60.
Health service
We remain in a race against time. The longer Ireland can avoid having a case, the more time the health service has to be prepared. With time scientists will discover more about the virus and about treatment options and, eventually, a vaccine.
Though doubts have been expressed about the ability of the Irish health service to cope with a large number of coronavirus cases, at least it seems to have prepared itself for what might happen. That cannot be said for other sections of society.
Are schools and colleges ready for long closures, even if for precautionary reasons?
How will businesses cope if key staff are unable to come to work for health reasons?
Could we not do more to highlight essential hygiene measures such as handwashing and not touching your face? Shouldn’t hand sanitisers be provided in all public places?
Public health experts say that when trying to anticipate infectious disease outbreaks, we hope for the best but prepare for the worst. So far,we’ve been fortunate on the first count, yet it’s questionable whether Irish society has truly readied itself for what might be to come.
