Public health officials are concerned about a “plateauing” of Covid-19 case numbers. So should we all be concerned? And even if we are, is there anything we can do about it?

Given the uneven history of this pandemic, it was inevitable the rapid decline in case numbers since early January would hit a bump in the road. This seems to have come now in the form of a slowing-down in the decline of cases over the past seven days, according to National Public Health Emergency Team (Nphet) members.

Having hit the vertiginous heights of up to 8,500 cases a day early in the new year, case numbers are down to under 1,300 a day, but the curve is flattening in the wrong way.

Hospital Report

In fact, the downward slope over recent weeks is slightly misleading, due to a backlog in reporting cases at the height of the peak. The graph of cases, by date of infection rather than date of reporting, shows a slightly gentler decline than the one displayed by Nphet officials at their briefings.

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Even so, there has been a slowing-down in progress in recent days, despite all the hardships people are enduring, and the question is why.

One definite contributor is the decision to resume testings of contacts from last Friday. Typically, up to 10 per cent of contacts were testing positive until this was stopped when the system got overloaded in December. Those types of cases were still out there last month, but are only showing up in the system again from last Friday.

More transmissible

Officials think the B117 variant that was first identified in the UK is also retarding progress. This more transmissible strain now accounts for 70 per cent of cases in Ireland.

B117 is more opportunistic in jumping from person to person in contact situations, they believe. Previously, they believe, someone could have “dropped their guard” briefly and not paid the price, but now this is more likely to result in a new case.

This may be conjecture, but of note is the rise in workplace outbreaks – 29 last week – in manufacturing, food and meat processing, and construction settings, all the kind of high-risk settings that may be indoors, have poor ventilation, require close working or involve cooled air.

GPs report seeing patients who have waited too long with their symptoms before seeking a test, thereby exposing others to potential infection

The flattening-off of cases is also more marked among adults aged under 65, who are more likely to be in the workforce.

Despite the relentless focus on travel in recent weeks, it can’t be contributing much to case numbers, given the tiny numbers involved. Indeed, the entire debate will be moot if we can’t get a grip on our domestic cases.

Nphet also maintains the hospital and nursing home outbreaks are not to blame, as these have finally started to decline.

Limiting

The figures also show that, by and large, people are staying home and limiting their contacts, which are essential to halting the spread of infection. Traffic levels might not be as low as during the first lockdown, probably because slightly more activities are open. People are also more likely to use their cars in the winter due to the bad weather.

Many of us who have cooped ourselves up at home for weeks now have difficulty understanding how it is that 15,000 people still require testing every day. While some of this is due to serial testing, we seem to be a very long way from suppressing the disease.

GPs report seeing patients who have waited too long with their symptoms before seeking a test, thereby exposing others to potential infection. The high number of outbreaks among intellectual care facilities and travellers at present is also a concern. One would have to wonder whether public health messaging, while drowning the rest of us, is reaching the groups it needs to reach.

Nphet, which was previously projecting a fall to 200-400 cases by the end of February, will update its forecasts later this week. Its options, should it feel further restrictions are needed, are limited, with polling showing boredom and frustration are on the rise as the winter, and the lockdown, drags on.