With shops and restaurants open again and the festive season approaching, the battle for the soul of Christmas is a joint one.

On the one side are businesses hoping to make up for the devastating losses they have suffered over months of lockdowns during the coming weeks, traditionally their busiest time of the year. The vast majority will follow infection control rules to the letter but the very fact they are operating will facilitate transmission of Covid-19.

On the other side are public health doctors who have not held back this week from painting a gloom-laden picture of what is to come if their advice is not followed.

Hospital Report

By now, after two surges of the virus, they have precedent on their side with their forecasts of up to 1,200 cases a day by mid-January if it gets out of hand yet again.

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It is also clear there has been little or no honeymoon period or “tail” after the ending of Level 5 restrictions, as politicians had hoped. Rather than continuing to fall since then, case numbers are static and even rising in some counties, especially those near the Border.

"We've realised the full extent of gains around the virus," Prof Philip Nolan of the National Public Health Emergency Team told its briefing on Thursday evening.

So six weeks of punitive lockdown, which followed weeks of earlier restrictions, managed to reduce cases by 80 per cent and keep the lid on ICU admissions and deaths. But it didn’t come anywhere near suppressing the virus to the level seen last May.

‘Seasonality’

What conclusions should be drawn from this performance? Is the solution yet more lockdown, with all that implies economically and socially? Or can lockdowns achieve only so much, so other solutions have to be found to the challenges posed by the pandemic?

Prof Paul Moynagh and other immunologists have pointed to a strong seasonal component to the behaviour of the virus. "Seasonality was our friend last summer, but not now," he says.

These are the peak months for coronavirus infections, thanks to cold temperature and dry indoor conditions created by heating systems. So maybe it was never going to be possible to get down to the 50-100 cases targeted by public health officials at the end of Level 5.

And that’s before the declining buy-in of the population is considered. Nphet’s opinion polling shows continuing majority support for its approach but it also reveals declining compliance with the rules, especially among younger people.

Traffic and other mobility data paints the same picture of people getting on with their business to an extent that is not supposed to be possible with the travel limitations in place.

Warnings

Declining adherence to public health rules makes it harder to achieve the aims of lockdown, and needs to be factored into decisions about imposing future restrictions.

This week has been filled with dire warnings against socialising over Christmas, but with the trends showing case numbers heading upwards already, is Christmas really the problem?

The incidence of Covid-19 in Ireland is currently the lowest in Europe. We have excelled in keeping deaths low this time around. But we haven't found the solution to avoiding repeat surges.

The imminent arrival of a vaccine doesn’t get us off the hook either. It will take months before a vaccine is fully distributed and shown to be working safely and effectively. Until then, we have to keep the virus in check, as well as finding a way of keeping the economy open.