Chief medical officer Tony Holohan has written to the Minister for Health saying Level 5 restrictions will be needed to control the spread of Covid-19 after Christmas, it has emerged.

It is understood that Dr Holohan wrote to Stephen Donnelly on Monday afternoon. Sources said that in the letter, Dr Holohan told the Minister that Level 5 would be needed to control the virus in the coming weeks.

It is understood that the letter is not an official letter from the National Public Health Emergency Team (Nphet), but is rather written by Dr Holohan in his capacity as chair.

Hospital Report

He said the measures set out in Level 5 would be necessary after Christmas, but did not give a specific date on which they should be introduced.

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Dr Holohan’s letter is also understood to raise concerns about the advice given to people who are household contacts of those identified as close contacts of a confirmed case. Under European Centre for Disease Prevention and Control (ECDC) guidance, these household or “secondary” contacts should restrict their movements until the close contact is given a clear test result. However, Dr Holohan raised concerns that this is not being implemented by the HSE, sources said, raising concerns that it may be of particular importance due to high levels of anticipated mixing over Christmas.

Nphet is set to meet to discuss the worsening situation on Wednesday.

Members of the team briefed the Cabinet subcommittee on Covid-19 on Monday evening, alongside senior civil servants, HSE chief executive Paul Reid, and the CSO, sharing modelling that suggested cases could be between 1,300 and 1,800 per day by early January. Mr Reid is understood to have told the meeting that hospitals are coping, but that the HSE remains concerned that any surge in cases will likely have an impact on hospital capacity in January.

The recommendation will go to Cabinet on Tuesday that hospitality should close on Christmas Eve, sometime in the middle of the afternoon. The advice will be that this measure should apply to businesses such as hairdressers and manicurists as well as cinemas and galleries.

Non-essential retail is to remain open, with strict guidelines on numbers permitted in store and safe queueing protocols. Extra supports for businesses impacted will be recommended to Cabinet.

However, the subcommittee did not arrive at a decision for recommendations on intercounty travel and household visits, which will be discussed at Cabinet on Tuesday. A Government source said what would be recommended would be closer to Level 5 than Level 3, and that there was a recognition of the seriousness of the situation.

On Monday, a further 727 Covid-19 cases were reported in the State. No new deaths of coronavirus patients were reported. This leaves at 2,158 the total number of deaths in the pandemic.

Dr Holohan told the Nphet briefing people should stay at home and stop socialising due to the rapidly deteriorating situation with Covid-19.

This is not a time for going to restaurants and pubs, he said.

With public health officials saying we are firmly in the throes of a third wave of the pandemic, Dr Holohan said it was important that people revised their plans for socialising before Christmas and to rethink meeting up with family members who may be over 65 or with medical conditions that make them vulnerable.

“It is important to make safe choices to protect yourself and the people you love,” he said.

Dr Holohan said in a statement that “our current disease trends are gravely concerning”.

No new deaths of Covid-19 patients were reported by Nphet on Monday. This leaves the total number of deaths in the pandemic at 2,158.

Nphet also reported 727 confirmed cases of the disease, bringing to 80,267 the total number of cases in the Republic.

Of Monday’s 727 cases, 311 were in Dublin, 51 in Kilkenny, 48 in Wexford, 44 in Donegal, 44 in Cork and the remaining 229 cases were spread across 19 other counties.

We are now clearly in a third wave of the pandemic, with rapidly rising case numbers, according to Prof Philip Nolan, chair of the Nphet epidemiological modelling advisory group.

There were 3,373 cases in the week up to Saturday, up 71 per cent on the previous week. The 14-day incidence of the disease is rising at the fastest rate seen since last March, he said.

Case numbers are rising equally rapidly in Dublin and in the rest of the country, with a more than doubling of the daily rate in the capital in the space of a week.

Prof Nolan said the situation in Dublin was “as bad as it was in the October peak” of the virus.

He expressed grave concern that older people were “catching it early” in relation to the virus in this wave, unlike the second wave when they were protected in the early stages.

The growth rate in cases is now 5 per cent a day, compared with 5-7 per cent in October, and is increasing day on day.

The doubling time for cases is 10 to 14 days “and probably less”.

Meanwhile, the reproduction number, a measure of how many other people a case infects, “could be as high as 1.5-1.6”.

Prof Nolan said numbers in hospital “may be starting to increase” while ICU numbers were “not yet decreasing”.

He forecast up to 1,800 cases a day by January 6th if cases grow by 7 per cent daily

Asked about the new variant of the virus identified in the UK, Dr Cillian de Gascun, director of the National Virus Reference Laboratory, repeated that it had not been identified here, based on genetic sequencing done to date.

Although UK analysis indicates the new variant could be up to 70 per cent more transmissible than other variants, Dr de Gascun said the evidence for this has not yet been seen and lab studies have yet to be completed.

However, he added that there was “enough to make us concerned” about the variant, with more mutations than would have been expected.

“Based on the rate of spread they have seen in the UK . . . I think it’s prudent for European governments and our own to operate on the precautionary principle until we have more information.”

Prof Nolan said the rise in cases in Ireland could be explained by increased socialisation since September without recourse to issues around the new variant.