Dr. Samuel McConkey:

My thanks to the committee for the invitation to appear. It is a privilege to be asked to speak to it.

I have been talking a good deal about this in Ireland since the middle or end of January. I have been saying really that something is happening here. Unfortunately, in recent weeks it has been clear to anyone without any brilliant mathematics or epidemiology that we are in the beginning of a second phase, wave or grip - whatever we wish to call it. At this point, three steps are needed. The first is to bring down the number of cases. If the number keeps rising like it has been and we keep doing what we have been doing, we will end up with increasing numbers in intensive care units and more death and disability. The only tool we have now is social and physical distancing. I propose that we should do this not only to flatten the curve or push it down, but to crush the curve completely into the ground. We need to do better than we did in April and May.

The second thing is to keep cases down. We have heard from Professor Giesecke about the need to use contact tracing, outbreak investigation, face-to-face contacts and genetic sequencing. We should use the power of our biotechnology industry in universities and add molecular epidemiology in order to understand how the virus is spreading when it is very low so that we can control, in a tight way, any possibility of it coming back. We had some good control in June but we have clearly let it out of control again.

The third aspect is to prevent reintroduction into Ireland. That involves control of incoming travellers. Ireland is one of the few countries in the world that kept its borders completely open to everyone during 2020. Of course, we have asked people to stay restricted at home for 14 days. We need to continue that, perhaps with home visits or testing or perhaps by shortening the duration of restrictions if people test negative. This has worked elsewhere, namely, in almost all of Australia. People may believe it has only worked for exceptional places like China and New Zealand. However, most of Australia has done this and it has worked. There is still an outbreak in Melbourne but it is coming under control. Similar measures have worked in South Korea, Japan, Malaysia, Vietnam, Greenland and Bermuda - I accept these countries have small populations but they have been effective at this. Many countries have succeeded in controlling this. We are not seeing these countries taking the view that they did it wrong and suggesting what they did was too restrictive. They have not suggested going like the USA, which has seen 12,000 extra deaths per week, or 200,000 deaths in total. The latter is 70 times the number of deaths that resulted from the events of 11 September 2001. That is not a choice people in countries that have controlled it well are calling for.

Living with community transmission of SARS-CoV-2 is like living with a large tiger in the house. It will come back and bite us. None of us would do that. As Dr. Giesecke said, those above the age of 60 are particularly susceptible but we are all one community. We live with and care for people over 60. We look after them in hospitals, nursing homes and our own homes. It is not possible to divide those over and under 60 into two separate bubbles, even though it sounds like a good idea in theory. It has not even been possible to keep influenza out of nursing homes. SARS-CoV-2 is even harder to keep out because of its presymptomatic and asymptomatic transmission.

If I am allowed, I would like to share my time with Dr. Tomás Ryan and keep some time for myself.