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Decision to depart from NPHET’s advice may have far-reaching implications

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There was no doubt about it but the 24-hour period between late Sunday and and Monday was a fiasco and one that could have long-term consequences.

The whole thing was an unsightly mess, one Cabinet minister reflected ruefully yesterday evening. “It should never have happened in the way that it did.”

And where did the blame lie for this? Was it with the National Public Health Emergency Team (NPHET), which made an announcement on Sunday evening that came like a bolt out of the blue, that the entire country should be put to Level 5 with immediate effect? Or was it with the Government for not having a fit-for-purpose process in place to make sure such information did not go into the public domain in the way that it did?

There was no doubt about which direction Tánaiste Leo Varadkar was pointing his finger during an extraordinary appearance on RTÉ’s Claire Byrne Live on Monday night. He launched into a full-blooded attack on NPHET, and by extension on Chief Medical Officer Tony Holohan, for the Sunday bombshell.

The Tánaiste said he had confidence in NPHET in relation to its public health advice but there were other considerations that needed to be taken into account. Photograph: Niall Carson/PA
The Tánaiste said he had confidence in NPHET in relation to its public health advice but there were other considerations that needed to be taken into account. Photograph: Niall Carson/PA

Members of NPHET were taking aback by the ferocity of the criticism – it was a filleting, pure and simple. There was no pulling of punches, no euphemisms, no sugaring of the words. There is no doubt that, downstream, this episode will have consequences for the relationship between the two entities. At this moment in time, none of the outcomes look good.

The substance of Varadkar’s point need to be parsed. His argument was NPHET had landed the Government with a Level 5 recommendation “out of the blue” without prior consultation. In other words, by its unilateral action, it had almost backed the Government into a corner.

Moreover, its rationale had not been thought through. He said its proposal of a “circuit break” (a short sharp shock) had not been tried anywhere else in Europe. Where it had been tried, in Israel and Melbourne, it had not worked out as planned.

And it did not stop there. Varadkar said NPHET wanted the Government to go on a “solo run and pursue a strategy that is totally at variance with our European peers”.

And then there were the stinging words when presenter Claire Byrne asked him if he had confidence in NPHET: “I have confidence in NPHET to dispense public health advice. That’s what they do. They don’t advise the public, they advise the Government and the Government decided.

“I do think one thing that needs to be borne in mind: very good people, 40 of them, but all coming from medical or scientific or civil service backgrounds. None of those people, for example, would have faced being on the Pandemic Unemployment Payment yesterday.

“None of them would have to tell somebody that they were losing their job and none of them would have to shutter a business for the last time. And I’m not talking about the economy, I’m talking about something that could have happened half a million human beings tomorrow and the reason why politicians make these decisions is because we’re the ones who can see then bigger picture.”

Sinn Féin’s Mary Lou McDonald portrayed Varadkar’s intervention as “gratuitous”. Even some of his Cabinet colleagues thought it was over the top, and in marked contrast to Taoiseach Micheál Martin’s qualified criticisms.

Sinn Féin leader Mary Lou McDonald. File photograph: Gareth Chaney/Collins
Sinn Féin leader Mary Lou McDonald. File photograph: Gareth Chaney/Collins

Varadkar might have been talking in his role Minister for Enterprise but the public might not see that, instead seeing it as another example of straight-talking Leo sticking the boot in.

His argument had much that was valid. There are places such as Spain where the crisis is worse but the measures are not as severe as Level 5. The framework was designed to be incremental and did not provide for a two-level jump or three-level jump, as was being proposed by NPHET. The HSE did not agree with the NPHET assessment that it was facing an imminent crisis with capacity because of this surge of Covid. The notion of a circuit break was new in Europe. Varadkar argued: why should Ireland be the guinea pig? And, he went on, Level 5 would have horrible economic consequences.

But against that NPHET had not plucked its recommendation out of the air. The figures – especially in the past week – have been dramatic and they are all going in one direction. The five-day average jumped from 310 to 462 cases per day. The 14-day rate for the entire country jumped above 100 per 100,000 (it’s now 108 per 100,000) for the first time since March and April.

NPHET pointed out increased hospitalisations, increased incidence in over-65s, another seven clusters in nursing homes in the past week. If action was not taken, it argued, cases could rise to between 1,600 and 2,300 per day by November 7.

The view from NPHET was that Level 3 had not worked in Dublin and that was the reason it was recommending such a radical jump. In a sense, its proposal was a rejection of the Government’s five-level alert plan.

The failure is also that of Government’s. While its argument against Level 5 might hold water, the communications around this was shoddy. The Coalition had introduced a new filtering system to prevent this happen. Instead of NPHET going straight to Government, its reports would be parsed by a new oversight committee of senior civil servants for review. It, in turn, would review the findings and then make its own recommendations to Government. That system clearly did not work last weekend. That was a huge failure.

Another key issue is enforcement. People scoffed last week when a Galway senator called for the army to be brought in. That might have been excessive, but it is clear that the community cohesion of the spring had not lasted into the autumn. There has been widespread infractions of guidelines – and that was borne out by images of excessive celebrations after GAA club finals last weekend. The volume of traffic, of travel, of congregations suggest that, for many people, the rules apply to others, not them. That’s particularly true for the 15 to 24 age cohort, which now comprises 25 per cent of all cases.

The stark reality – both societal and political – is that the curve must be flattened again. The Government has taken a risk by not adhering to the scientific advice and plumping for Level 3.

To achieve that, Ireland will need to look like a police state for the next three weeks, with gardaí visible everywhere to make sure people are staying at home, not going on unnecessary journeys or not congregating in houses or parks.

After three weeks, if the country needs to move to Level 4 or 5, Monday’s fateful decision to depart so strongly from NPHET’s advice will have the most far-reaching implications for this coalition and its leading personalities.

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