Tony Holohan: ‘It is now deemed timely to conclude the work of Nphet’

After more than two years at the centre of the State's response to Covid-19, chief medical officer Dr Tony Holohan has told the Government that it is "now deemed timely to conclude the work of the Nphet".

Mr Holohan has also recommeneded that testing will no longer be needed for people under-55 who have symptoms.

The National Public Health Emergency Team met on Thursday for the last time to consider the remaining pandemic measures including compulsory mask-wearing on public transport and in shops, and social-distancing and pods in schools. It has recommended that these measures are no longer needed from Monday, February 28th.

Taoiseach Micheál Martin has already said the Government is following Nphet’s advice “in its entirety” including the disbandment of Nphet itself.

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The Nphet for Covid-19 - chaired by Mr Holohan - was established on January 27th, 2020, after reports of a new coronavirus emerging in China.

Following its meeting on Thursday, Mr Holohan wrote to Minister for Health Stephen Donnelly.

His letter says the pandemic is not over and there is a need for continued vigilance as Ireland enters a "transition phase" in its response to Covid-19.

He says: “This transition will entail a shift from the emergency type processes and measures of the last two years while also necessitating the maintenance of high levels of readiness for Covid-19 outbreaks and the emergence of new variants of concern, with significant strengthening of existing disease surveillance systems.”

But he adds: “As discussed at the Nphet today, as we move out of the emergency phase of the pandemic and given the significant mainstreaming of the Covid-19 response, the continuing impact of the vaccination programme, and the programme of work already completed by the Nphet, it is now deemed timely to conclude the work of the Nphet.”

Mr Holohan says his office will continue to closely monitor the epidemiological profile of the disease and he says he has proposed an appropriate structure and process for this.

He adds: “My Office, of course, remains available to provide any further advice and recommendations that may be of assistance to you and Government in relation to ongoing decision-making processes in respect of the Covid-19 pandemic.”

Mr Donnelly published Mr Holohan’s letter on Friday afternoon.

Masks

The letter recommended that mandatory mask wearing on public transport and in retail and other indoor settings can be dropped from February 28th.

It also recommended that public health measures in creches and schools including physical distancing measures such as pods, and mask wearing can go from the same date.

Mr Donnelly said: “The current epidemiological profile of Covid-19 continues to provide a broadly stable and positive outlook.

“The advice from Nphet to remove mandatory mask wearing is a key indicator that we are moving forward in terms of our ability to live with Covid-19.

“Our ability to ease restrictions is thanks to the response and support of people across the country and our successful vaccine programme.”

Mr Donnelly thanked the members of Nphet for their “expertise, commitment and guidance through what has been such a difficult period” saying: “Their contribution cannot be overstated.”

He added: “Whilst mask wearing will no longer be mandatory in certain settings, the Nphet recommended that masks should still be worn in healthcare settings, and on public transport where physical distancing can be difficult and where those who are more vulnerable to the severe impacts of Covid-19 do not always have discretion to avoid.

“It also recommended that other public health protection layers, including hygiene measures, ventilation and staying at home if symptomatic, are continued.”

Schools

Teaching unions have raised concern at the dropping of the requirement to wear masks.

In his letter Mr Holohan highlighted how Nphet noted the importance of continuing infection prevention and control measures schools and early learning settings including ventilation, hygiene measures and advice to stay at home if symptomatic.

He also said: “there will be some children who will wish to continue wearing masks and that no child who wishes to do so should be discouraged.”

Testing regime

Mr Holohan separately outlined a change in the Covid-19 testing regime to focus on those at high risk of severe disease.

He said people with symptoms of Covid-19 should self-isolate but that testing will no longer be needed for clinical or public health purposes for otherwise healthy people under-55 who have symptoms.

PCR testing is still being recommended for a number of groups of people with symptoms including over-55s who have not had a booster vaccination, people with high-risk medical conditions and those who are pregnant.

Anyone diagnosed with Covid-19 should follow the current guidance of self-isolating for seven days from date of onset of symptoms, or if asymptomatic, from the date of first positive test. They can exit from self-isolation after day seven on basis that symptoms have substantially or fully resolved for the final two of those seven days.

Mr Holohan outlined how “significant concern” was expressed by Nphet members that some healthcare facilities “continue to apply onerous restrictions that are in excess of national guidance and of any reasonable requirements at this stage.”

He said: “This is impacting negatively on the wellbeing and the rights of patients and residents to share in the resumption of normal social and family life that the wider society is benefiting from.”

Nphet recommended that nursing homes and residential care facilities should “move as quickly as possible to restore the activities and social life that provide a stimulating environment within the home for residents.”

Hospitals and care homes should not have more restrictive visiting rules than the national guidance unless it is on the basis of specific advice form a public health doctor or other expert.

Those enhanced restrictions must also be for defined period of time and “based on a risk assessment that is reviewed regularly and is publicly available.”

Mandatory vaccination

The Nphet also discussed a paper on mandatory vaccination and “the complex ethical and human rights considerations pertaining to this public health policy.”

Mr Holohan wrote that mandatory vaccination policies “represent a considerable interference with individuals’ liberties and autonomy and as such require strong justification and supporting evidence that the measure will achieve the intended goal”.

He said: “It was recognised that the successes Ireland has already achieved in relation to Covid-19 have been largely based upon trust and transparency rather than penalties and enforcement.”

Nphet did not recommend mandatory vaccination in the context of the current epidemiological situation and given the high levels of immunity in the population as a result of vaccination and natural infection.

It also did not reccommend mandatory vaccination for healthcare workers (HCWs) as it considers the current “intervention ladder” approach to be “sufficient and proportionate”.

Mr Holohan wrote: “The Nphet recognises the particular ethical and professional duties of healthcare workers to do no harm and advises that any change in vaccination policy for this cohort would have to be informed by a more complete understanding of Covid-19 vaccine uptake in HCWs, both in health and social care settings.

“Less intrusive measures must first be shown to be ineffective before more intrusive measures are considered.”