Nphet warned Government that Covid-19 cases could rise to 2,000 a day within four weeks

The State’s public health team warned the Government on Monday night that coronavirus cases could rise to 2,000 a day within four weeks, it has emerged.

The Cabinet on Tuesday agreed the first general loosening of Covid-19 restrictions since the State entered Level 5 last December.

In a letter to the Minister for Health Stephen Donnelly on Monday night, the National Public Health Emergency Team (Nphet) warned that Ireland does not have the “headroom” that was available last summer when case counts were low.

The team told the Government that Ireland’s epidemiological situation remains “precarious”.

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“There are a number of reasons for this. First, the level of infection is high, with a 5-day average case count of 620 cases per day and a 14-day cumulative incidence of 165 per 100,000. This is substantially higher than when restrictions were eased after previous waves of infection — approximately twice that experienced in early December 2020, and 50 times that in late June 2020.”

The second reason given was that the dominance of the more transmissible B.1.1.7 variant means that viral transmissions and the effective reproduction number “will be 30-70 per cent greater than in 2020.”

Thirdly, the reproductive number is is estimated to “already be at or above 1”.

“The high level of infection significantly increases the risk associated with any increase in social contact and reproduction number. If reproduction number increases, the number of new infections per day will rise very quickly from this high baseline.”

This was illustrated in a series of modelling figures provided to Government.

The scenarios were based on the reproductive number increasing to 1.6 from a baseline of 10, 200 or 600 cases per day.

“The high starting point of 600 cases per day means that case numbers rise rapidly to over 2,000 per day within 4 weeks. Starting at 200 cases per day, case counts increase to 700 cases per day after 4 weeks, it takes 7 weeks to reach 2,000 per day.

“Starting at 10 cases per day, even after 11 weeks case counts only increase to 500 per day. Unfortunately, the significant ‘headroom’ that was available last summer when case counts were very low isn’t available now, and any increase in transmission will have significant impacts in a short space of time,” the letter says.

Meanwhile, new modelling presented to Government on Monday night is also understood to show that if all goes well with the vaccination programme, it will begin to reduce risk from May 2021 and suppress cases through June and into August.

Mortality is expected to radically decrease, with 11 deaths per 1,000 cases in the most recent wave dropping to two. However, until there is greater vaccination, the effect will not be as pronounced on hospitalisations, which will drop from 50 to 30, per 1,000 diagnosed cases, with admissions to ICU falling from five to four.

This is because while deaths have been concentrated in the over-70s, hospitalisations and ICU rates are more evenly spread in other cohorts, which are not yet vaccinated.

Sources said that projections were for between 80,000 and 500,000 cases between April 5th and the end of September, depending on the level of socialisation that takes place.

It shows that vaccines will reduce hospitalisations more quickly than numbers of infections and cases. Government was warned that the next eight weeks represent a “critical window” where any significant increase in indoor social mixing would give rise to a wave like that in October last year or this January.