The affected families in the Meath village of Ratoath could no longer wait for the HSE.
They knew they were in close contact with someone who had tested positive for Covid-19, and as they eagerly awaited a call from the public health, Option B became increasingly attractive.
One by one, they called a private testing company, and for a princely sum, a paramedic came to their home and tested them all. The results came back within a few days; some were negative, some were not.
“It never came, so I called the private test number and he came out at 11:30 pm and did the test. Two days later, the HSE contact tracer called. It’s totally messy.
“In another family, a mother who tested positive on an HSE test is still waiting for a trace call for her husband and daughter who live with her.”
While some have opted for the mobile testing service, other Ratoath locals have gone to a private drive-through facility where express tests use the “lamp” detection method. It is not recognized by the HSE for a Covid-19 diagnosis and therefore positive tests are not tracked. An alarming surge in the number of Covid cases in Ratoath has created widespread fear and panic, according to locals.
Some of the positive cases do not go into the public health system. Others are being pursued too slowly, and even more are not being pursued at all.
An atmosphere of fear and distrust has gripped the community, parents are pulling children out of the local school and well-known companies are closing their doors. It’s a situation that could well be a microcosm of what’s happening across the country, as Tony Holohan admitted Thursday night that the extent of the infection is now beyond the capacity of a level of resource contact tracing processes.
The comments, made during a National Public Health Emergency Team (Nphet) press conference, came after Dr. Holohan had written to Health Secretary Stephen Donnelly recommending a nationwide move to Level 5 restrictions for six weeks. Two weeks after a similar recommendation, it was a move that didn’t surprise UCC Professor Gerry Killeen.
“The numbers have gotten too big for anything but Level 5,” he said.
“We have to throw a blanket of fire on it now and six weeks of level 5 will not be enough. It’ll take longer based on the numbers.
“With any pathogen like this – Ebola, Sars, whatever – there are limits to what you can do with contact tracing. This is why the world is moving heaven and earth to contain Ebola outbreaks because if they get too big we are in trouble.
“You have to reduce it to a certain size before contact tracing can really take hold. Despite all the limitations of our system, there is no contact tracing system in the world that can handle whatever we’re dealing with. ”
On June 30, Ireland reported the lowest 14-day incidence of Covid-19 cases in Western Europe. According to Prof. Killeen, who worked in Haiti during the Zika outbreak and has extensive experience with lockdowns, things went downhill from there.
“The numbers have been increasing since the end of June and that growth rate has remained stable,” he said.
“The trajectory since summer has always led us to where we are today. We took our foot off the gas in June and didn’t quit the job. Cork was six weeks away from zero in June and Donegal was Covid-free for two weeks.
“Even if it had entered the 40-day countdown, Donegal would have been declared Covid-free in a month. We should have brought the virus down to zero or close to it. Then your public health teams will not contact tracers, they will contact trained doctors. ”Would have been able to erase new outbreaks.
“In epidemiology, we call it a sticky endpoint. It’s hard to get there, but once you are it’s a lot easier to manage. And that’s exactly what we need to do after this level 5 lockdown. Otherwise we’re just on a roller coaster where we spend a lot of it in and out of locks. ”
Antony Staines, a professor of health systems at DCU, says the virus got out of control a month ago.
“We lost control in the first week of September,” he said. “If you look at Nphet’s own data and models produced by Philip Nolan, they show a steady, steady increase. It has been rising slowly since August, but it starts to rise faster in September and continues at this rate through October. If anything, it has risen faster in the past few days. Nphet’s models predicted it. ”
A change to level 5 must be implemented immediately, says Prof. Staines.
‘The government has been very good so far with support. It is necessary now to provide the means to sustain a long period of restrictions. If that means we need to borrow, so be it. We face a scenario where either the health system collapses completely or we accept serious restrictions. ”
The focus is on hospitals and intensive care units, which may have difficult decisions to be made.
“This is the ultimate fear for health professionals,” said Catherine Motherway, an intensive care consultant at the University of Limerick.
“Fortunately it didn’t come to that, but no one can be confident in the face of a global pandemic. We have already seen what this can mean for one of the better resourced health systems in Italy.
“We have to accept that we can no longer live the way we used to. I don’t think people fully accepted that.
“We’re coming into winter, the evenings are getting dark and it’s depressing, but it may be necessary. If we are to meet carefully and safely this Christmas, it may be necessary now. That could pay off. ”
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