Health policy on Covid-19 failing to resonate with sizable minority

A slight uptick in Covid-19 cases has public health officials fretting once again. For a week now, the five-day average of cases has been trending upwards. Over the weekend alone, it increased from 354 to 392.

At the same time, social media images of pint-toting, non-social distancing crowds carousing on Dublin city centre streets at the weekend have unleashed another wave of criticism.

The pictures tell a story all right, but not one that differs from earlier stages in the pandemic. Even in the deepest of lockdowns last spring, you still could buy alcohol “takeaway” from an otherwise shut pub and then consume your drinks on the street outside.

We have no measure of whether more of this is happening now, or even less, other than the grainy images on social media – the 21st-century version of the “squinting window” – which tell us everything and nothing.

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It seems remarkable that only now are there moves to clamp down on this abuse of the rules, with the Cabinet on Tuesday considering a clampdown on pubs selling takeaway drinks.

As usual, there is a dearth of data that might help explain the recent rise in case numbers. As well as outdoor drinking, National Public Health Emergency Team members have mentioned workplaces and funerals as problem areas, without giving many details.

It may be the disimproved figures are a hangover from Halloween, which is traditionally a time of heightened socialising. Although this year’s Halloween was more subdued than usual, it wasn’t altogether quiet in many parts of Dublin.

The team’s nervousness may be prompted by trends in the capital, where the falloff in case numbers has been uneven. We’ve been here before. Last month, Dublin initially responded well to a tightening of measures, but then the figures took off again.

With hospitalisations, intensive care admission and deaths all stable, it’s hard not to see the focus on case numbers as a form of advance sparring over what should happen once the Level 5 restrictions end on December 1st.

Though these decisions are made by Government, the team is once again making the running. Last week, chief medical officer Dr Tony Holohan said people abroad should forget about flying home for Christmas. On Monday, team member Dr Mary Favier said it would have "problems" with any opening of pubs next month.

Drinking on streets

This is decision by soundbite, rather than due deliberation. Pubs are problematic, but are they worse in terms of disease transmission than uncontrolled drinking on streets, in parks and in people’s houses? We don’t know.

Policy now has to be crafted in the knowledge that a sizeable minority of the population no longer heeds the public health message. It may be that they don’t feel they are at risk; they may be tired of the mixed messages; or just tired, period.

One of the reasons the current restrictions are more bearable is because more people are interpreting them as they see fit. Most people are adhering to the rules on social distancing and masks, for instance, but are they sticking to 5km? Just look at the traffic on the roads.

Meanwhile, the team’s messaging has become increasingly reductive, highlighting the risk in virtually all areas of human activity, even the most deeply personal and spiritual; and urging people to think of themselves as infected, even when they’re not.