Dr. Kirsten Schaffer:

I thank the committee for the invitation to speak. I believe my notes have been circulated, as the committee might not be as familiar with me as an expert as it is with others who have been more prominent in the media. I am an infection prevention and control doctor and I have been working on the front line of this since March. I believe we should stop aiming for a Covid-19-free Ireland, or even for levels as low as at the end of the lockdown in July. I believe this is because Ireland is a European country with a land border with Northern Ireland.

A significant proportion of the workforce in Ireland is young and international. I refer, in particular, to healthcare workers and colleagues of mine, for example. The economic and social impact would be devastating.

We should keep community transmission low enough to allow hospitals to function at full capacity, protect the vulnerable and permit as much economic and social life as possible. To achieve this, we need two pillars. The first is optimal laboratory diagnostics and public health measures to contain the virus in the community. The second pillar is the need for a public willingness to adhere to the wearing of masks and social distancing. How do we achieve this? The first point relates to how to improve lab diagnostics and public health interventions. Looking at the serial interval of Covid-19, it is estimated to be somewhere between four and five days. This means that it takes four to five days for a person infected by an initial person to develop symptoms. So in four or five days, we must identify the person with the symptoms, run the Covid-19 test on that person, communicate the test result to the patient and public health authorities and we must do contact tracing. This is where we must improve. It is something we do not achieve consistently in the community now. It takes too long to get a test appointment and we just do not manage to get the test results out fast enough.

The second point is how to improve public adherence to social distancing measures. We must start by becoming more informative, transparent, logical and consistent. The main issue is that we need more Irish epidemiology information for the public and we must tell people where are the outbreaks. Do they come from family homes, weddings, restaurants or flights? We must be open and transparent so people can understand from where the recommendations come. We should tell the public what percentage of contact tracing we achieve. Speaking to public health colleagues, I know we achieve levels up to 90% outside Dublin. In Dublin, contact tracing can be more difficult and we might not achieve 90%. We should also tell the public that only approximately 50% of close contacts are willing to be tested at day seven. Why is this?

All the information should be open and transparent so the public has the information and can understand where the measures are coming from. Based on the epidemiology information we should advise logical rather than crude interventions. We should really base them on epidemiological information and outbreaks that have been identified.