With 90 per cent of the State’s adult population now fully vaccinated against Covid-19, the link between the disease and severe illness has been dramatically weakened. It makes sense, then, for the State to consider how it can scale back the huge crisis-era infrastructure it bulit to monitor and intercept the virus. But that must be done without undermining the country’s ability to stay ahead of the disease. Covid is not going away. It looks set to become endemic, requiring the health service to maintain its vigilance but to do so in a way that more closely resembles its approach to other established or recurrent diseases in the community.

It is against that background that the National Public Health Advisory Team (Nphet) is considering whether to recommend that the State’s large testing operation be reduced in order to strike a more appropriate balance between the public health benefits and the high social and economic costs of that system. It’s important that this process not begin just yet. It will take a few weeks to see how the reopening of schools, combined this time with large-scale reopening of commercial and social activities, will cause the virus to behave. But assuming any rise in cases among children levels out, as occurred after previous reopenings, then the path will clear for easing some protocols among younger people. The obvious place to start would be the requirement that non-symptomatic contacts must isolate. Another would be the testing of young children with mild cold-like symptoms.

One of the risks in this process will be that a wholesale dismantling of Covid surveillance infrastructure will make it harder to reassemble it if required. That occurred in the autumn of 2020, when testing and tracing was slow to pick up after a relative lull over the summer, resulting in a dramatic and sudden spike. That may be less of a problem now that most people are vaccinated, but it would be a very significant problem if a vaccine-resistant variant were spreading. While most of the rest of the world remains unvaccinated, that continues to be a very real risk.

Hospital Report