Opinion: A hands-off, worry-about-it-later approach to containment is exactly what will help COVID-19 spread

  • Society

So, we have several confirmed cases of novel coronavirus, COVID-19, in the Republic of Ireland.

Several such cases in a country of 4.8 million might not seem like many – and some will no doubt view international media coverage of the outbreak as grossly disproportionate – but it’s important to remember that the virus is still a new arrival in Europe. How governments mobilise and respond now will determine its length and severity.

A hands-off, worry-about-it-later approach to containment is precisely how a disease spreads and takes hold. Once a certain critical mass of people is infected, a disease becomes uncontrollable, and treatment switches from preventative to curative. This places massive pressure on a country’s healthcare system and virtually every other part of its economy and society.

Ireland’s health service can confidently handle isolated cases of COVID-19; it will struggle if there is a sudden influx of thousands. Businesses will go bust if no one is able (or wants) to leave their home. The economy may even teeter into recession. At that point, a response will be far too little, far too late. ship. (Kyodo News via AP)

The Chinese response

COVID-19 is spreading, and international efforts to contain it have been mostly haphazard. Attempts to quarantine the cruise ship Diamond Princess failed and may have actually helped to spread the infection.

Large-scale containment protocols in advanced countries like Japan, South Korea, and Italy have also proved ineffective. The only country that has managed to greatly reduce the rate of infection is the source of the outbreak, China.

In Wuhan, the epicentre of COVID-19, 1,800 teams of government and medical officials, each with five epidemiologists (who study and analyse the spread of disease), have worked with extreme thoroughness to trace those with potential exposure to the virus, isolate and quarantine them, then carry out diagnosis and treatment.

Since the outbreak, Wuhan, a city with a population more than double that of the island of Ireland, and the surrounding Hubei province, which numbers some 55 million people, have been placed under cordon sanitaire, which is essentially full medical lockdown.

Unnecessary social interactions and travel have been strongly discouraged or restricted entirely, and residents are only allowed to shop once every three days.

All railways, air routes, and roads in Hubei have been closed, and there are strict restrictions on travel in and out of the province. In early February, the world watched in disbelief as the Chinese government erected an entire hospital dedicated to new COVID-19 cases in just 10 days.

Although China still has by far the greatest number of confirmed COVID-19 cases and deaths, because of a concerted effort to contain further spread, the rate of new infections there is on the decline, from up to 4,000 a day to fewer than 200.

Ireland must act now

Of course, we must acknowledge that the Chinese approach to containment has been draconian, authoritarian and has been implemented forcefully by the ruling Communist Party. This is thankfully not the way things work in Ireland.

What is important, however, is action. We must act quickly and decisively, using all the powers of our liberal, parliamentary democracy, to build consensus-driven solutions in full public view – preferably with public input – within these next two critical weeks.

Our political leaders, no matter the current state of government, should now consider forming a temporary COVID-19 ‘cabinet’ of national unity composed of the leaders of our largest parties.

This cabinet would plan, lead, and implement our nation’s response to the outbreak in conjunction with at least 10 all-Oireachtas sub-committees dedicated specifically to combating COVID-19.

In a short timeframe, these sub-committees, working with technical experts, would need to consider and debate some difficult questions, then deliver solutions that actually contain and halt the spread of the virus.

We may, for example, need to close schools, cancel mass gatherings of all kinds, restrict travel, and force all non-essential workers to stay at home. Entire neighbourhoods and towns could require quarantining, but what body will be responsible for carrying out and maintaining it?

Our hospitals, too, need surge capacity to deal with the hundreds, potentially thousands, of people with COVID-19, in terms of beds, infrastructure, and medical staff.

This will be an immensely difficult ask, considering the HSE’s current capacity issues, but a workable plan must nonetheless be put in place.

Close partnerships with local technology and pharma companies and universities could inspire novel solutions. Artificial intelligence, for example, could help trace individuals suspected of exposure to COVID-19 by reviewing massive amounts of phone GPS data and CCTV footage.

Factory production lines could be temporarily repurposed to ensure a continuous supply of protective masks, gowns, and goggles.

Time is of the essence

What might otherwise take democratic governments months or years to implement must now be accelerated into weeks. Simultaneously, these processes must be fully transparent and open to public viewing and commentary.

This will be extremely hard. However, without immediate purposeful action, our several cases of COVID-19 could easily become several thousand.

This article was originally published on on 9 March 2020

Prof. Samuel McConkey is Head of the Department of International Health and Tropical Medicine at RCSI and President of the Infectious Disease Society of Ireland.