ISAG calls on Government to reconsider plans for a full opening up of Ireland on Friday October 22nd. COVID case numbers are high and rising and, as expected, more people are being admitted to hospitals and intensive care. So far, the government’s policy has been lurching in and out of lengthy lockdowns, despite advice from the World Health Organization that these are not an effective long term control measure.
With available ICU bed numbers already worryingly low, we anticipate that the burden on the health service from those already infected in recent weeks will be severe. It’s the responsibility of the government, not the public, to put in place the additional measures needed to control cases.
Whatever the Government decides to open, ISAG endorses a Vaccines-plus strategy of Prevention, Vaccination and Control (PVC), as follows:
· This means wider use of CO2 monitors, with a ‘clean air’ threshold of 700-800ppm to estimate the adequacy of ventilation.
· HEPA filters, which are a portable, cheap and practical means of improving air quality if ventilation is inadequate.
· “Scores on doors” to indicate ventilation capacity and status of indoor spaces. These would mean any potential occupier of the space (customer, staff, client, student etc.) can have confidence in the freshness and purity of air on the premises.
b) Masks of at least FFP2/KN95 standard
· These should be required on public transport, in schools and colleges, including primary schools, and in workplace or retail settings.
a) COVID passports
· These can be required for any setting where large numbers of people are expected to spend significant time.
b) Completing existing vaccination programme.
· We need to get vaccines to the under-served people in our communities. HSE has already done great work with homeless people and others, and this needs to be supported and extended.
c) Booster vaccines
· These should be offered, in the first place, to those at high risk.
a) Find, test, trace, isolate, support
· This has yet to be done properly. Far too many cases are ‘community transmission’ which means “We have no idea how you came to be infected”. People still lose income waiting for test results, or while isolating.
b) Antigen testing
· Rapid antigen tests have a role to play in COVID19 control. They are not a cure-all, but they can make a useful contribution to reducing exposure. They should be supported and more widely and appropriately used.
c) Resource local public health teams
· Ireland currently has a highly centralised system without sufficient emphasis on the public health teams at the local level. They have a major role in preventing community transmission and suppressing the virus at local level.
Adoption of a full suite of measures by owners of businesses, pubs, restaurants, nightclubs, etc. makes it much more likely that they will be able to open up and stay open. For example, optimising ventilation, putting in HEPA filters, building COVID passports into standard procedures, putting information about vaccines and airborne spread in bathrooms and public places, and providing access to antigen tests. Similarly, ventilation and mask standards in schools and colleges will protect the access to education of our young people.
For the population as a whole we envisage these steps as moving us closer to something like a food safety approach – an unobtrusive, yet extremely effective set of control measures. No customer at a restaurant is required to verify the safe operation of fridges, the temperature of cooked meat, or the absence of food-poisoning bacteria in the salad dressing. All this is done by a network of food safety regulation, and their enforcement across the industry. This hard work is invisible to the customer, and creates no obstacle to access, and requires no expert knowledge or judgement of risks. For respiratory viruses, regulation of ventilation and crowding could - and should - play a similar role.
We believe that this combination of owner responsibility combined with customer provision of Digital Certs, and mask wearing where appropriate, offers a highly achievable and cost-effective public health pathway to controlling the spread of COVID-19 more effectively.
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