THE attempt to ‘live with the virus’ is not much of an option for Ireland due to historic neglect of public health and poor pandemic preparedness, according to an Irish public health expert in Australia.
Australia won praise for its tackling of Covid-19 and less than 28,000 cases have been reported in the country, which has a population of around 25 million people, since the start of the pandemic. Around 900 people have died from the virus nationwide.
Despite the fact that a second wave did rear its head, particularly in Melbourne, Australia stuck with its elimination strategy, reimposing strict lockdowns in places.
Now, the country is emerging from that lockdown and life is returning to some sense of pre-Covid normality.
Some 15,000 miles across the globe, Ireland is witnessing a different scenario with six weeks of Level Five restrictions.
Dr Niall Conroy is an Irish consultant in public health medicine working in Queensland.
Speaking to The Echo, Dr Conroy explained the different approaches to tackle Covid-19 adopted in Ireland and Australia.
“The main difference was that Ireland has opted to live with the virus, whereas Australia has aimed for elimination of the community spread of the virus. Australia has implemented border quarantine for all international arrivals to achieve this. That means anyone arriving into the country has to quarantine themselves in a hotel room for 14 days. The reason for that is so that we can find cases at the time of arrival, before they’re able to circulate in the community.”
Dr Conroy said the Australian method has been very successful, but has “been really difficult to do”.
“But now we can go to sporting events and concerts and shows and pubs and restaurants,” he added.
The differing results of both Ireland’s and Australia’s approaches were, according to Dr Conroy, entirely predictable.
“Ireland has gone for the ‘living with the virus’ approach, which involves recurring lockdowns, so they’re getting recurring lockdowns,” he explained.
“Australia has aimed for elimination, so they’re almost there — 95% of the country is now Covid-free.
“When you adopt a recurring lockdown strategy, the aim is to maximise the amount of time that society can reopen between lockdowns, so Ireland’s plan is to keep things open for as long as possible once they reopen before the inevitable happens again,” he added.
Asked whether he thought ‘zero Covid’ is even possible in Ireland, Dr Conroy responded: “There are two sides of this to look at — the public health disease-control side and the political side.
“It’s 100% possible from a communicable diseases perspective. If you confine a virus like Covid-19 to an area inside a border and chase it down relentlessly, eventually the transmission chains will either fizzle out or you’ll eliminate them.
“There’s no real question about that, from a scientific perspective, but just because something is scientifically feasible, doesn’t mean it can happen operationally.
“My understanding is that the decision in Ireland not to attempt an elimination strategy is because it would be politically and economically too difficult, and wouldn’t be palatable to a section of society on the island, as you’d either need to establish an all-island border or a border between Northern Ireland and the Republic of Ireland.”
While he said he respects Ireland’s decision-makers, Dr Conroy said the approach requires “more scrutiny”.
“Implementing a mandatory quarantine strategy has significant economic costs but it’s hard to imagine that it would hurt business any more than recurring lockdowns,” he explained.
Dr Conroy emphasised the need for greater engagement with Northern Ireland and the UK on the issue of Covid-19 spreading across the border. He explained that having two jurisdictions on one island makes it “enormously difficult” when trying to manage a pandemic. However, Dr Conroy also highlighted the need to strengthen public health for any strategy to succeed.
“Whether you want to live with the virus or eliminate it, you have to take public health seriously,” he said.
“It’s bizarre that, nine months into a pandemic, Ireland hasn’t hired a single consultant in public health medicine yet.
“That says a lot about how seriously they take public health,” he added.
“As long as Ireland’s public health units are among the least-resourced in Europe, it will be difficult to keep on top of case numbers without population-level restrictions.”
While he said aiming for elimination is the best strategy, Dr Conroy said Ireland’s latest lockdown should work well in what it aims to do — prolong the period between now and the next lockdown.
“The problem, of course, is that lockdowns don’t change any of the underlying conditions that allowed the virus to spread in the first place. That means cases inevitably go up when restrictions are lifted.”
While Australia was more prepared than most for a pandemic, Dr Conroy explained that Ireland’s neglect of the public health sector and lack of preparedness left the country particularly vulnerable.
As a result, living with Covid may not be a realistic option for Ireland, he said.
“Many western European countries didn’t have a sophisticated pandemic planning programme in place.
“There was probably a feeling that it was unlikely to happen to them,” he added.
Australia was also ambitious, explained Dr Conroy. “Aiming for elimination of community transmission was a politically brave decision but it’s paying dividends now, with most of the country being free of the disease.
“Australia also has a much stronger public health system, so we started off from a better position.
“Public health medicine as a speciality has long been valued here. Public health units are well resourced and public health medicine consultants like me are supported to do our job.
“Ireland is definitely starting out from a disadvantaged position, having neglected public health for many decades.
“That’s all the more reason to be ambitious in thinking about whether elimination is possible, as living with the virus isn’t much of an option.”