It has been a long time coming, but Monday marks a significant step on the long road back to normality after Covid-19.
Ireland’s longest lockdown yet continues, but the return of remaining school classes, the reopening of construction and the slight easing of travel limits will make a big difference to tens of thousands of people.
Though we have had false dawns before, this time there is a reasonable prospect of steering towards the end of the pandemic, largely thanks to vaccination.
Hospital Report
Over the past month, an eerie calm has set in around the figures for new virus infections. The graph of daily cases has bobbled up and down, increasing slightly for two consecutive weeks in March before falling 9 per cent last week.
The relative stability of the figures masks an intense underlying battle between the more transmissible B117 variant on the one hand, and the suppressive impact of lockdown and vaccinations on the other.
Our seemingly endless lockdown has helped offset the pernicious ability of the variant to pass on infections between people at close quarters, notably within families and in workplaces. But it only worked to an extent, and something new was needed to reduce cases to the low levels seen last summer.
Vaccination when combined with lockdown is now tipping the balance in favour of suppression of the disease, though success is not yet a given. This is why the National Public Health Emergency Team last month pleaded for two more months of restrictions, during which the proportion of people protected by vaccination should rise significantly.
Outdoor activities
The onset of longer, warmer days in spring should further help to suppress Covid-19, as outdoor activities are far safer than those that take place in poorly ventilated indoor spaces.
Daily case numbers remain high; the current incidence of about 400 cases a day is twice what it was in early December 2020 and 50 times the level seen last summer. However, the balance of cases between different age groups has once again shifted towards younger people, who are generally less likely to experience serious illness from Covid-19.
Cases among older people are down to levels last seen in November. Thanks to blanket vaccination of this age cohort, there were no deaths among over-65s last week.
As time goes on and more people are vaccinated, the risk-benefit calculus changes. Daily case numbers will tell us less than they ever did. Many will simply be the result of positive tests on people with no symptoms. Others testing positive will, through vaccination, have partial or full protection against serious illness.
Reassuringly, many school classes reopened last month without provoking a surge in cases. There have been fluctuations, which Nphet has ascribed to increased testing or a heightened awareness of possible infection as children returned to the classroom. There is no reason to think the return of the remaining years of education – after a closure lasting almost four months – will cause significant problems, provided the usual measures are followed.
Rapid testing
Workplace outbreaks have been a recurring problem in recent months, so the return of construction may pose a challenge. Many experts believe an effective way to keep businesses open is through frequent use of rapid testing, but Nphet experts remain unconvinced of this option except in the most limited circumstances.
The abolition of the 5km travel rule will at least end the fiction that this restriction was being adhered to. The real point of the rule was to discourage people from travelling to meet others or visiting locations such as shops where infections can spread, so new ways of discouraging people will have to be found.
People can take encouragement from recent improvements in the way we respond to the virus. Testing is speedier and available at greater volumes than at any previous time during the pandemic. The recent opening of walk-in test centres and greater use of retrospective contact tracing shows the system is finally learning to become more agile.
The path of the pandemic has been anything but predictable so further unforeseen twists can be expected. We appear to have the latest crop of variants of concern under control, but new variants could emerge that are either more transmissible, more lethal or effective in resisting current vaccines.
Even if this happens, it is likely our current vaccines can be tweaked to address the threat.
And while vaccines are in demand now, it may be a struggle to reach the level required for herd immunity, especially if the AstraZeneca soap opera continues unabated.
The real challenge now is to use the coming months to find a way of safely reopening other sectors so the economic carnage of the pandemic can be curtailed.