Holohan sets out rationale for lifting of almost all Covid-19 restrictions

Covid-19 cases were towards the most pessimistic projections during the Omicron wave of the pandemic but serious clinical outcomes were “much less than expected”, the Chief Medical Officer has said.

In his letter to the Government recommending the lifting of all restrictions, Dr Tony Holohan said there was "clear evidence" nationally and internationally that the variant is associated with a "significantly reduced population level of severe disease despite continuing high levels of transmission".

Omicron, which emerged in December, now accounts for 97 per cent of all Covid-19 infections in Ireland and has led to record numbers of cases.

However, Dr Holohan observed that the “overall epidemiological position is improving, and the most recent data indicates that we have now passed a peak in this wave of infection”.

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Underestimation

There were 375,000 PCR confirmed cases between December 30th and January 19th and 25,635 positive antigen tests uploaded to the HSE system, but even the 400,000 cases were a vast underestimation of the numbers infected.

Dr Holohan said at the peak of infections there were two to three times as many cases as was reported. This would equate to between 800,000 and 1.2 million people being infected with Omicron recently.

But hospital admissions of people with Covid-19 remained stable, peaking at 1,063 on January 10th and then falling below 900 as the average number of newly confirmed cases fell.

Despite record case numbers, the number of patients in intensive care (ICU) peaked at 126 on November 23rd before the Omicron surge and fell to 73 on January 18th. Approximately half of confirmed cases in ICU are unvaccinated.

Transmission opportunities

Case numbers are decreasing at an average of 6 per cent per day at present, but Dr Holohan anticipated that they may rise again.

“As case numbers and numbers in hospital decline and the threat recedes, population mobility and social contact will increase, creating additional opportunities for viral transmission, a process which may be accelerated by an increase in social contacts following the relaxation of restrictions. Infections and detected cases may then stabilise or start to increase,” he wrote.

However, Dr Holohan said the level of immunity in the community as a result of infection and the booster vaccination programme should ensure that rising case numbers will not result in a high levels of “serious disease or an unsustainable demand on healthcare”.

In addition to recommending the lifting of almost all restrictions, Nphet stated that there is no longer any justification for a curtailment of health services such as community day services.

Nphet will review the impact of the lifting of restrictions on February 17th.