Perhaps the most alarming aspect of the healthcare crisis in Northern Ireland – exposed and exacerbated by the pandemic – is the erratic and sometimes sluggish nature of the political response. SDLP leader Colum Eastwood's call for vaccine passports did not win immediate all-party support. It may have taken the worst Covid infection rates in Europe to align the supposedly power-sharing DUP and Sinn Féin on lifting restrictions. DUP First Minister Paul Givan agreed with Sinn Féin Deputy First Minister Michelle O'Neill at last week's Executive meeting on no immediate change but said further meetings soon would discuss relaxations.

Yet infection figures have at times been double those south of the border. Vaccination uptake is the lowest in the UK. Operating theatres are unused because ICU nurses are tasked one-to-one to Covid patients. An exhausted health service, with the largest backlogs in the UK for elective surgery even before Covid, has sought medical staff reinforcement from the recently retired and newly qualified as well as the British Army. Public health specialist Dr Gabriel Scally and northern GP representative Dr Tom Black have pointed up the mutual risks in lack of all-island coordination. Sinn Féin and the SDLP would have liked to keep in step with cross-border regulations and have called for cooperation. The doughty Ulster Unionist health minister Robin Swann has noted Dublin's lack of consistent reciprocal enthusiasm.

The DUP, keen to follow English practice despite the Johnson government’s vacillation, see-sawed on lockdowns through their torrid year of leadership heaves. June 2020’s elaborate gatherings for former IRA leader Bobby Storey’s funeral still shadow Covid pronouncements by O’Neill. But she made a powerful impression on return to work after contracting the virus, urging people to take the vaccine and expressing anxiety that the health service might “topple over”.

Hospital Report

When she emerged from a visit with Givan to Belfast's main hospital, the Royal Victoria, they both appeared shaken by witnessing what O'Neill termed near burnout in staff. Givan promised a "measured approach" on restrictions. Meanwhile the former leader of his party, Agriculture Minister Edwin Poots, who appointed Givan, urged the annual gathering of farmers at the Balmoral Show to ignore anti-vaxxer conspiracies to protect themselves and their families.

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The north's rate of new infections, perhaps beginning to drop off slightly, has outpaced all of Europe except Greece in recent weeks. Its Covid death rate has been three times higher than that in the Republic. The serious and coordinated messaging from the big parties in the last week was urgently needed. They will have to sustain it, and back it up with actions – including, if necessary, the retention of more restrictions – if the crisis is to be brought under control.