When Dr Tony Holohan was plotting the lifting of the first lockdown last year, those who worked closely with him recall how he appeared more relaxed as the summer approached.
We have to give people the summer,” he told the Government privately at the time.
A similar mindset is likely to have informed the chief medical officer’s thinking last week as he and Nphet recommended a loosening of public health restrictions across May and June that surprised the public and some in Government.
But Dr Holohan is, as several Coalition insiders put it last week, “a pragmatist” and knew something had to give after four long months of lockdown. His letter to Health Minister Stephen Donnelly on Wednesday cited data suggesting that levels of worry and self-reported compliance has “now fallen to its lowest level since summer 2020, with a particularly steep fall in recent weeks”.
People have moved out of lockdown themselves, whether the Government is advising them to or not.
But the letter goes on to say that this lack of compliance has not been driven by people “abandoning public health guidance but rather reflects the reality that more and more people are gradually ‘pushing the boundaries’ on measures currently in place”.
Crucially, while population mobility (a fancy way of saying people moving around) is now at the levels seen in early September 2020, the number of close contacts per adult confirmed case is “relatively stable” at approximately 2.6.
Any sharp rise in this metric in the coming weeks will likely trigger a reassessment of the recommendations to relax restrictions.
“Vaccine magic”, as one senior Coalition figure called it, means high case numbers are decoupled from hospitalisations. The decision to wait until May 10 and not May 4 to begin the wider relaxation of restrictions, including allowing inter-county travel, will mean an extra 200,000 or so jabs in people’s arms.
“The vaccines have fundamentally changed the risk assessment. Israeli data shows once you reach 40pc fully vaccinated you can reopen safely,” said a Government source.
Nphet warned last week that the recent increase in incidence of the virus is most marked in those age cohorts under 40, including people aged 13 to 18. Many people in these age groups will be waiting until June for their vaccination.
But case numbers, although high, are not at the levels the Government expected. “We were expecting to go into May dealing with 1,000 cases a day,” said one official.
Dr Holohan’s letter also observed there had been an interesting development in March — a time when the public health messaging was coming in for sustained criticism.
On March 18, deputy CMO Dr Ronan Glynn faced a backlash after urging the public to do “that little bit more than you’ve been doing over the last week or two” in the weeks ahead. A clip of his comments posted by RTÉ News on Twitter attracted over one million views — and a tonne of abuse from a lockdown-weary public who felt they had no more to give.
Dr Glynn later apologised and acknowledged the public’s frustration. But the data suggests that people listened to that message. “It does appear however there was improvement in these behaviours toward the end of March, again perhaps reflecting the focused messaging on the need to avoid indoor inter-household mixing,” Dr Holohan’s letter last week states. In other words, the public may not have liked the message but they got it. In fact, as exhausted as people are, approximately 60pc of the public expect some restrictions to be in place for at least another nine months, according to Nphet research.
Nphet’s overarching rationale for recommending a loosening of restrictions was that it presented a “low to medium risk” — a phrase parroted by the Taoiseach and m inisters in their public commentary last week.
After Dr Holohan and Dr Glynn verbally briefed Stephen Donnelly on the Nphet recommendations at the Department of Health on Wednesday, the m inister rang the Taoiseach to run him through the advice. Micheál Martin was not surprised by what he was hearing down the phone, said one source close to him. “Most of it was being planned for anyway,” they said.
Donnelly practically bounced over to Government buildings for the Covid Cabinet sub-committee meeting that evening, stopping to tell the media: “There are a few nice things in there.” Inside the room there was a sense of “pleasant surprise from people around the table”, according to one of those present.
After the full Cabinet signed off on the measures the following day, one minister observed that there was a “massive release of pressure all round” with the news. “As long as people don't go mad,” the minister said, “we will continue to make progress.”
Indeed there remains a level of nervousness among many in Government about what might happen over the next few weeks.
Donnelly has publicly said he will be “getting up every single day through May nervous”.
Privately the joke in Government circles is that the much-maligned but almost permanently optimistic Fianna Fáil minister is like Fr Dougal in Father Ted holding the “Careful Now” sign.
The public health messaging will change in the coming weeks, Dr Holohan’s letter said, citizens will no longer be told what the rules are and what they should avoid doing.
“This new phase is one of responsible empowerment,” his letter states. “New targeted public health messaging will speak to what citizen cohorts can do safely and responsibly, in the spirit of mutual trust, which fully respects the dangers of the virus.”
Another factor that has informed Government thinking on reopening is the cost of keeping the economy shut down — a source of constant worry for Finance Minister Paschal Donohoe and Public Expenditure Minister Michael McGrath
On Thursday, it is understood the Cabinet was told that the combined cost of the State’s three main support schemes —the pandemic unemployment payment (PUP), the old and current wage subsidy schemes, and the Covid Restrictions Support Scheme (CRSS) — was now approximately €13.5bn or nearly 6pc of national income. This is amongst the highest level of direct supports in the eurozone.
The full return of construction, and the reopening of hairdressers and retail this month will, it is estimated, take around 200,000 off the PUP. But it is the reopening of the accommodation and hospitality sector in June that will have a major impact given that the sector currently accounts for exactly 101,367 PUP recipients — over 25pc of the total number getting the payment of up to €350 a week.
But ministers were privately warned last week at Cabinet that this decline in the numbers receiving PUP does not take into account the possibility of a higher level of scarring on businesses which may prevent or delay reopening following the further lockdowns in recent months, or the challenge of getting people to return to the work. There is some evidence that people did not return to work over the Christmas period when the country reopened for three weeks.
Effectively, the Government is being advised that opening up will not necessarily end the huge financial burden on the State. Other costs will arise.
Last Friday, Tánaiste Leo Varadkar told the Seanad that the Government intends to do a new round of restart grants for businesses and suggested that those businesses that were unable to avail of either the restart grant or CRSS previously, because they did not have rateable or physical premises, could also get financial support. He’ll be asking Michael McGrath for the money before the month is out.
This coming Thursday, the Cabinet committee on economic recovery and investment will meet to begin hammering out the details of a National Recovery Plan which will outline the future of many State Covid supports.
The Cabinet is also understood to have been informed last week that there are still over 1,000 health staff members absent due to Covid-19- related illness or self-isolation .
While this is down on the January peak of 7,000 absentees , there will be an unknown number of staff affected by longer-term debilitation due to Covid, m inisters were told.
Recruitment of staff to meet demand, the continued staffing demands for vaccination clinics and the effects on productivity of personal protective equipment and social distancing are further challenges for the non-Covid areas of the health service, the Cabinet was told.
While the burden on society is easing, there will be no let up for the Coalition in the months ahead.
