Dr. Ronan Glynn:

There is no doubt that when this virus gets into a household it is very difficult to stop it spreading within the household. If we listen to our clinicians or GPs all across the country at the moment, any time one hears them speak it is very evident that containing spread within households had become much more difficult in recent weeks. That is most likely linked to the increased transmissibility of the new variant B117. However, to say that that was the primary factor, I do not think we could conclude that at the moment. NPHET was clear about the significant risk. I am not attributing this to any particular sector or setting. We were worried that in the first three weeks of December, there would be an opening up of society which younger people would take advantage of and meet with each other. They would stick within the guidelines but there were far more opportunities for them to interact. What we were concerned about was that would lead to a volume of disease within a cohort of our population and then that would be followed through the Christmas and new year period by very significant intergenerational mixing where, unfortunately, that would lead then to very significant volumes of disease in those who are most vulnerable and elderly. Unfortunately, that has played out.

We can see from the mobility data that on 22 and 23 December we were back to levels of mobility in this country that were equivalent to what we saw pre-pandemic. That is the only time it happened since last February and that was in the week leading up to Christmas. Again, without being specific to a sector, and certainly not in any way seeking to attribute blame, I said in December that just because people could do something did not mean that they should do something. The reality is that people could do an awful lot. Unfortunately, we are where we are and it will take time to separate out the relative contribution of each of those elements.

Did we misread the threat? To misread a threat one has to be aware of the threat and it was only notified by the UK authorities, and I would need to double-check for sure, but I think it was 19 or 21 December. We acted on that immediately. We can see from our own data that we had very low levels of the variant in the country. Looking back, there was probably less than 2% in the country up to 13 December, certainly less than 10% up to the week after that and then rising to approximately 16% in Christmas week, which is the week in which we first became aware that this variant was an issue. So there is no doubt that the variant is playing a significant role now and will be a significant challenge for us as we seek to achieve further suppression of this disease. There is no doubt that it played a role in making things as bad as they have got. Again, it was one contributor in a crowded field of contributors to the situation that we have found ourselves in.

Regarding the annual vaccine, on a positive front, the wonderful thing about the mRNA vaccines and the new technology we have is that it appears, in relative terms, that it is simple to swap out the key part of that vaccines and swap in other elements that can help to address the threats posed by other variants of this virus. That is not entirely clear at the moment but the scientific community seems reasonably confident that the swaps to update these vaccines will not be as onerous as the process that we had to go through to develop the vaccines in the first instance. In any event, this is not just about vaccination because were this vaccine to have the effect that we want it to have it needs to have an effect all over the world. If populations all across the world do not get this vaccine and are not immunised, we are going to see the emergence of new variants in other parts of the world.

They will eventually arrive here and will have very significant implications for public health in this country. It is in all our interests to do what we can to ensure that there is equitable access and supply across the world to vaccines.