Dr. Tony Holohan:

I thank the committee for the invitation to update it on our Covid-19 response. I am joined today by the deputy chief medical officer, Dr. Ronan Glynn, and Professor Philip Nolan, the chair of our modelling group. I will provide an update on the current epidemiological situation, the impact that our vaccination programme is having on the risk profile of the disease, and recent developments regarding further easing of public health restrictions, as the committee requested. I also have a short slide set with me today and I can take members through that if it is helpful to better describe the current epidemiological situation and related matters.

The last 18 months has seen a considerable burden placed on individuals, communities, and society as a whole. We wish to thank the public for their solidarity to date and their continued efforts to help stop the spread of Covid-19. We also wish to extend our sympathies to those who have lost loved ones to Covid-19 despite our collective best efforts as a society. The epidemiological situation in Ireland at present indicates high incidence with an uncertain trajectory. While incidence in those aged 19 to 24 years and 13 to 18 years has fallen in recent weeks, we have noted an increase in testing rates and confirmed cases in children aged five to 12 years. This trend, and in particular the impact of the return to school and the opening of the third level sector, will continue to be monitored closely by us over the coming weeks.

The total number of confirmed cases of Covid-19 in hospital has begun to reduce and the total number of confirmed cases in intensive care units, ICU, has stabilised recently. There continues to be low mortality relative to the number of Covid-19 cases. While the majority of infections are occurring largely in the young, unvaccinated population, the current force of infection is resulting in a significant number of infections in older, vaccinated people. At the same time, the number of outbreaks notified in settings with vulnerable populations, such as nursing homes, has increased in recent weeks and this is being closely monitored by the HSE, in the first instance, and also by us in NPHET.

Ireland’s Covid-19 vaccination programme continues to make significant progress. As of yesterday, 14 September, 88% of those aged 16 years and over are now fully vaccinated, with 90% having received at least one dose. Vaccine uptake and completion has been very high in all age groups, ranging from 81% completion in those aged 16 to 49 years, through to 95% completion in those aged 50 to 69 years, to an almost universal vaccination, in those aged 70 years and over. However, vaccination has been offered to younger people relatively recently, and many younger cohorts have yet to receive their second dose. Those aged 16 to 29 years, given their high levels of social contact and partial vaccination, have still the potential to sustain a large wave of infection until such time as this cohort achieves very high levels of immunity through vaccination. Fortunately, uptake in younger cohorts is high.

Covid-19 vaccines are providing very effective protection from severe illness and have fundamentally changed the risk profile of this disease. This will facilitate a transition in our approach to managing the pandemic over the medium term, entailing a shift from a focus on regulation and population-wide restrictions to one that is appropriately based on public health advice which will facilitate the exercise of personal judgment and personal protective behaviours. However, notwithstanding the great benefits that vaccines have brought, it is likely that the Delta variant will continue to circulate extensively globally and in this country in the coming months, particularly among individuals who have not yet been vaccinated or those who have not been fully protected through vaccination.

In the context of this highly transmissible variant, it is unlikely that vaccination alone, even at the high levels of vaccine coverage that we are achieving compared with many other countries, will bring the effective reproduction number below 1. This means that through autumn and winter, possibly in the face of high levels of infection, we will remain dependent upon high public understanding and buy-in to the basic public health measures that we have emphasised all the way through this pandemic in order to minimise opportunities for transmission of the virus. As a result, here will be an ongoing requirement for: clear guidance and communication for the public on the evolving disease profile and the strategies they can take to mitigate those risks; a focus on the vital importance of rapid self-isolation for those who have symptoms of respiratory viral infections; a partnership approach between employers and employees to ensure that the importance of self-isolating when symptomatic is understood, communicated as well as facilitated; sector-specific measures to ensure safe environments, including formal requirements for mask wearing in certain settings such as healthcare, indoor retail environments, and on public transport; and, importantly, robust public health surveillance and response capacities, including testing, contact tracing, surveillance and sequencing capacities for Covid-19.

Throughout the pandemic, focus has remained on protecting those most vulnerable to the severe impacts of Covid-19 and on protecting health and social care, education, and childcare services. These continue to be and must be prioritised. The continued burden of Covid-19 and the significant backlog of non-Covid care, due to both the demand for Covid care in the early part of this year and the recent ransomware attack suffered by the HSE, means that our health and social care system and, in particular, our hospital system, remain in a challenging position. Should Covid-19 admissions begin to increase once again, this will place additional pressure on the hospital system and will have a significant impact on the delivery of non-Covid care.

We cannot predict with certainty the future trajectory of the disease and, consequently, we cannot fully rule out the possibility that the reintroduction of any given measure to enable us to respond to the disease and what challenges its transmission might pose for us. We must continue to ensure our response is agile and flexible, with an ability to pivot rapidly and respond to any emerging threat that might arise.