Covid-19: Letter signed by Irish researchers seeks policy rethink

Eliminating Covid-19 through tougher short-term measures represents the "most scientifically sound" strategy for Ireland, according to a group of Irish researchers.

In an open letter published on Monday, the group of scientists and academics says Ireland has “come to a watershed moment . . . the path we choose will determine our future for years to come”.

They acknowledge the huge impact already on the economy but suggest measures now be deployed to “crush” the virus on an all-island basis, as many other countries have done. This, they add, is possible over a number of weeks; not months.

Signatories include public health specialists; infectious disease experts, virologists, immunologists, and doctors including respiratory and intensive care consultants working in acute hospitals – many of whom worked on the frontline during the height of the pandemic.

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“Our current policy is to live with the virus under a long-term mitigation strategy, with the risk of future surges and lockdowns until when, or if, a vaccine becomes available. We have another option: we can do as many other countries have done, choose to suppress and eliminate this virus – ‘crushing the curve’,” they suggest.

‘Normal’

Because of a timely response the island of Ireland managed to bring the epidemic under control, they point out.

“A range of emergency restrictions imposed by the two Governments, following scientific advice, stopped our healthcare systems being overwhelmed and saved many lives. The public support these restrictions, and report that they clearly understood the need for them.”

All this had come at a huge cost, they note, with enormous sums of money spent; many losing jobs and businesses wondering if they will be able to open again.

People will once again feel confident in using public transport, returning to school, going out to eat and to shop, pressure on the healthcare system will be relieved, and trust in our economy will be restored, they accept.

“For the economies on our island, this would be enormously valuable. Vulnerable people will be effectively protected.”

There was, however, a push to get back to “normal” as fast as possible. “What does ‘normal’ look like if the virus continues to circulate? Right now, public transport is planning for 20 per cent of ‘normal’ capacity, pubs and restaurants 30 per cent, schools, at best only 50 per cent.

“The costs of childcare, already high, will be impossible for many. Many workplaces will need expensive re-design. Many people will drop out, or be pushed out of the labour force. All of these are real costs, and will, we believe, far exceed the short-term costs of lockdown.”

“For these reasons we strongly encourage the Governments to take resolute actions to suppress this pandemic at once. Eliminating the virus represents the most scientifically sound strategy in terms of public health and economics alike.”

"Several countries have already largely halted the virus, including South Korea, New Zealand, Australia, Austria, Greece, China and Iceland, by continuing public health measures, including the use of masks, active fast contact tracing and testing, and sensible restrictions on travel."

Such measures were planned for both parts of this island, “but they must be enhanced and coordinated – with the aim of achieving ambitious suppression targets”.

This should be on the basis of first achieving suppression and elimination of Covid-19, “and then we must maintain it”.

Realistic exit strategy

These countries achieved suppression, and some have demonstrated they can also maintain it in the face of new cases, as seen in South Korea. “Each country has developed its own solutions, to fit its own needs, and we can do the same on our joint island,” the scientists underline.

“All our sacrifices over the last two months have driven down the number of cases, and given us a precious window of opportunity that we must not squander. This is a decisive moment in the history of our island.”

The goal should be to suppress the number of new cases to zero as soon as possible, and to keep them there. Given political leadership, an agreed and scientifically sound strategy, and cooperation from citizens, “this can be done, and done in weeks, not in months”.

“When we reach this goal, new infections have to be closely monitored for the foreseeable future under a robust, rapid, and vigilant test/trace/isolate infrastructure.”

Alternatively, if the country decides to live with the virus, they believe, “extensive, and expensive, restrictions will continue for the foreseeable future. A vaccine will take at least two years, and there is no established treatment”.

Societies that have suppressed and eliminated this pandemic will enjoy considerably greater freedoms and prosperity than those where the virus persists, the signatories predict. Travel, tourism, and trade with other successful countries would be straightforward and beneficial.

Given Ireland’s geography, population size and social cohesion, suppression was a realistic exit strategy; “a genuine way out of our current economic and social standstill”.

Lead signatories are epidemiologist Prof Anthony Staines of DCU; infectious diseases ecologist Prof Gerard Killeen of UCC and immunologist Dr Tomás Ryan of TCD.

The letter and signatories are available at http://crushthecurve.ie/

* An early version of this story incorrectly stated that 1,000 scientists had signed the letter. While the letter had attracted over 1,000 signatures, a minority of signatories were researchers and academics.