Covid-19 data and restrictions
Deputy Naughten argues that Irish Covid decisions should be driven by Irish data and questions the reliability and completeness of the systems being used. The Taoiseach agrees data matters, urges calm between public health and politics, and says restrictions and household limits have helped reduce case numbers.
In the House on 3 November, I pointed out to An Taoiseach that we need to use Irish data to inform Irish decisions and not continue to rely on NPHET advice, which is based on what the EU health authorities are saying.
On 6 November at a meeting with the Taoiseach, he will recall that I questioned Dr. Holohan, the Chief Medical Officer, on his presentation as to why the rate of decline of Covid-19 infection in Dublin had stalled. While I did not get an answer I specifically stated that we needed to have a further meeting to go into those figures. That did not happen. However, the rate of infection in Dublin continued to stagnate and we now see the same situation being replicated across our country.
Yesterday morning Microsoft announced that it is to create 200 software engineering jobs to support, among other things, cloud services for its global customers. The HSE is one of those customers using its Microsoft dynamics CRM, customer relationship management package. This is a system designed to help companies manage and maintain customer relationships and deliver actionable data. As we speak we have over 500 people working in 11 contact tracing centres inputting large volumes of data every minute on to this system. This data has the capacity to generate reports on who, where and how people are getting infected with Covid-19.
This is information that the Government urgently needs to make the right decisions on how we exit from the current lockdown, allow people to live again, allow businesses to open up and, more importantly, ensure that we do not face a further lockdown. To do that we need to know what this virus is doing in Ireland’s population, which is both geographically and culturally very different to other EU countries.
The Government will make decisions this week on an educated guess, on anecdotal evidence, on partial data but sadly, not with all of the hard, cold facts. It is akin to making up a flat-pack kitchen but refusing to look at the instructions. While a bit of putty will cover over any mistakes in making up a kitchen, if this Government and its unaccountable advisers get this wrong, then our children and their children will be paying for it.
Who is interrogating this Microsoft dynamics CRM to generate the data on what is actually happening with Covid-19 in Ireland to provide the evidence for the policy decisions that the Taoiseach’s Government will make later this week?
Comment on this
My first point is that we should stand back from creating unnecessary rows and tensions between public health advice, Government decisions and the views of the Oireachtas. I accept that people have different perspectives on Covid-19 and the steps we must take to keep the virus down, open up society and relax restrictions.
We should never question the good faith of people on all sides, particularly in the public health realm and NPHET, whose fundamental objective is to protect lives and public health. We should not lose sight of that in the debate.
Second, the Deputy is correct in saying data are very important. We have done extra work in the past while in assessing data and doing work on them — it is essentially data analytics — within my Department and in conjunction with NPHET and others. The data will inform the next steps. That is an important point to make; it is not guesswork. Some of the steps may not be palatable while some will be. I said at the outset, when going into level 5, that we wanted to come out in or around level 3.
I can see that we are all fatigued by Covid but the bottom line is that Ireland is second best in Europe in dealing with the second wave. One would hardly realise that with the tension about the place, the attacks, criticism and giving out. I repeat that our performance is the second best in the European Union in terms of keeping the virus down. Will someone acknowledge that? I believe it needs to be acknowledged. Our figures are low because of a series of restrictions and the hard work of the Irish people. The Irish people have adhered to these restrictions, to be fair to them.
Comment on this
At a cost, yes. I accept that. It is a big cost but the Irish people are adhering and it is working. We would like the figures to be lower. I would prefer them to be lower again. They are still coming down. Last evening, the 14-day incidence per 100,000 was 108.7. Finland is ahead of us, with about 50 per 100,000. Other European countries are in a much more difficult space.
The big challenge for us as decision-makers in the Oireachtas is that what we do will pose risks as we move into December. There will be risks as we move into the Christmas period. How we mitigate those risks will be the key challenge facing us. Fundamentally, our job is to represent all the people of the country and to protect them and their livelihoods. There is an enormous economic cost to the restrictions, particularly in travel, tourism, hospitality, food and accommodation. This is where I sense the biggest impact has been. One should remember these level 5 restrictions have taken place in the context of the schools being reopened and staying open, which has been a tremendous boost to the parents of the children. Many of them have to go to work but would not be able to do so if schools were not open to the children in all the school communities. We have kept health services open alongside the Covid services, which was not the case in the first lockdown. Construction has kept going in terms of constructing badly needed houses and infrastructure. Manufacturing has continued.
Comment on this
Our job is to make decisions based on evidence. The Taoiseach should not allow himself to be fobbed off and told the output from the CRM system is being used because it is not. The Health Protection Surveillance Centre is using data from a laboratory reporting system that was never designed for this pandemic. Hospital-based occupational health doctors and some public health doctors investigating outbreaks do not use the CRM so many other health-related outbreaks are not entered on it. We are still seeing a huge number of cases associated with hospitals and care homes, involving both patients and staff. From my investigations, I have learned Covid is spreading in these settings and spilling over from staff into communities. I understand that 12 hospitals currently have restrictions on elective procedures because of Covid outbreaks. If we were to use the data we have, it would allow the Taoiseach to tell the people with authority what they need to do to control this virus.
Comment on this
I thank the Deputy. I do not disagree with him on the utilisation of data to inform decision-making. That is important. Various sets of data can inform decisions. The Deputy is correct in saying there have been outbreaks in certain healthcare settings, which has been problematic for those settings in dealing with the normal throughput, services and so forth. To inform our decisions, our approach is based on analysing data.
Without question, I believe I am safe in saying that, after level 3, the decision to restrict visits to households was a key decision that impacted on reducing numbers, even prior to level 5 coming in. The spread within households has been significant overall in terms of the spread of the virus. I said yesterday - we can apply this to both households and other locations - that where we have gatherings associated with events and alcohol, we do get a spike. The data show that in certain areas and certain contexts fairly unequivocally. Deputy Naughten is correct in his broader point in terms of using data as best we can.
The higher we go in restrictions, the blunter an instrument they represent. Fundamentally, public health officials want congregation down as low as possible. That is up to us. People have been very good in adhering to this for six weeks. We are going to have to maintain our vigilance on this. The fact that vaccines are on the horizon should be a reason for doubling down now on best behaviour and ensuring we keep the virus as low as possible until we have more widespread use of the vaccine in the population.