More than two weeks after the sudden lifting of almost all Covid-19 restrictions, the indications are that the Government was right to take this decision at the time it did.
Yet the pandemic continues to cast a long shadow on the health service, and is one of the main reasons for the record overcrowding now being experienced in hospitals.
The lifting of restrictions led to an increase in social mobility that has allowed the virus to continue circulating but there is no sign of any significant rise in Covid-related hospitalisations or ICU admissions.
Hospital Report
This might have been expected by now on foot of the massive rise in cases after Christmas, but the rate at which these translate into hospital admissions has been slashed since the less virulent Omicron variant became dominant. A year ago, there were up to 50 admissions for every 1,000 cases; now there are fewer than seven.
So instead of hospital admissions rising, they have been falling or, in recent days, stable. The number of hospitalisations fell below 600 on Thursday, and half of these are patients testing positive for Covid-19 who are in for something else.
Proper analysis is hampered by a lack of detailed data. For example, antigen test results have been submitted in respect of a 122-year-old, which would be a world record for longevity
The switch to antigen testing for much of the population in January has made it difficult to compare trends in case numbers from when these were determined by PCR tests alone. Overall, antigen and PCR positives seem to be up somewhat on last month’s figures, so the pandemic is growing again. But the growth is small, and hardly unexpected given the greater freedoms we now enjoy.
Worldwide, there were a record 100 million cases last month, so the virus is far from gone.
At home, proper analysis is hampered by a lack of detailed data and late notifications. To give one example, antigen test results have been submitted in respect of a 122-year-old, which would be a world record for longevity.
There were 19 deaths from Covid-19 in the week to Tuesday, and 32 the week before. Excess deaths appear to be within the range of previous winters.
Child hospitalisations
There has been talk of a rise in hospitalisations among children, but this is impossible to confirm in the absence of age-specific data over time. There were 20 children with Covid-19 in the three Dublin children’s hospitals last Tuesday, compared with 24 a month earlier. This included three children in paediatric ICU, compared with one on the same day in January.
There could be other under-18s in adult hospitals but the available data doesn’t tell us how many.
Despite the absence of flu, and the decline of the RSV virus that particularly affects children, the health service continues to struggle this winter. On Thursday morning there were 380 patients in hospitals awaiting a hospital bed, but only 90 beds available, with a further 250 closed as a result of Covid-19.
Even incidental virus cases in hospital require separate care pathways and infection control procedures. Meanwhile, hospitals are struggling to discharge well patients in the normal manner because of outbreaks in about half of the nursing homes to which they might be sent.
Last week saw more people than ever turn up at emergency departments. There seems to be considerable pent-up demand for healthcare, particularly among older people, and many of these are sicker for having waited for help.
In what is another insufficiently heeded impact of pandemic restrictions, many older patients are “deconditioned”, according to HSE officials, and need longer spells in hospital before they recover.
The pandemic has resulted in massive additional investment in the health service, with more than 800 additional acute beds provided. Yet this doesn’t seem to have been sufficient to offset the (predictable) needs of an ageing population and the lingering impact of the pandemic.