‘Nothing is certain other than uncertainty’: Dr Padraig McGarry on Covid-19 and what happens next

Dr Padraig McGarry

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Dr Padraig McGarry

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President, Irish Medical Organisation

Dr Padraig McGarry

Dr Padraig McGarry

If ever we needed a reminder of the fragile reality of Covid-19, it came this week with the news of outbreaks of clusters of infections in the midlands – with lockdown of counties Laois, Offaly and Kildare.

The number of clusters – mainly arising from food processing plants and direct provision centres – has brought home the stark reality of the uncertainty which is Covid-19.

With hopes high for the Stage 4 reopening of society on August 10, encouraged by the news of schools reopening later this Autumn - the mood somewhat tempered by the delay in reopening of pubs - the news of these clusters and their effects brought us firmly down to earth.

Such clusters were predicted by Public Health as the norm but, nevertheless, when confronted with them the reality is stark.

Happily, most of these clusters are relatively contained in limited environments but their scale clearly endangers spilling over into the community with community transmission rising – something which has been low to date.

As Dr Mike Ryan (WHO) says, if we take pressure off the virus it will certainly rise again. This rise is mirrored in many European countries who had similarly come out of lockdown and, with 20 million cases of Covid-19 reported worldwide, this virus certainly is not going away soon.

Public Health Teams have been quick to arrange appropriate contact tracing, which will inevitably result in increased numbers over the following days but it is one of our main methods of containing the spread in the community.

Each week, we learn more about the virus, its mode of transmission, its lethal effects across a wide spectre of society – not just the elderly and at risk groups – the young and healthy are legitimate targets for the virus.

Perhaps a sense of complacency had set in as the pandemic lingers on, understandably with pure fatigue a factor. In early March, many felt that by August we would have seen the worst and would be getting back to normality.

Unfortunately this may not be the case. Shutting down society was relatively easy – opening back up is much more problematic.

The Government have prioritised, correctly, the reopening of schools in early Autumn and much work has been done in the planning for this – but has been met with significant speculation as to the consequences.

Unfortunately, nothing is certain other than uncertainty. There has been significant discussion about the emergence of a vaccine by end of 2020, with many hopeful contenders in the race to produce an effective vaccine but there remains significant issues to be overcome before this is a reality.

Remdezivir has been mooted as a significant tool in the treatment of Covid-19 sufferers who end up in ICU beds – but clearly one needs to try and avoid getting there in the first place. The US Government have bought up the entire world supply of this drug – prompting serious ethical debate.

As we enter autumn and winter, circulating viruses which are seasonal are going to further confuse the issue and likely to cause significant disruption.

We do not have a single answer to all these problems – but we can tackle them individually and collectively to mitigate their effect.

In mid-September a national flu vaccine campaign will be launched by the HSE and the Irish Medical Organisation is encouraging as many individuals to get their vaccine early – the vaccine will be available from their GP. Healthcare workers need to lead by example and get vaccinated early.

We need to heed the expert advice from our Public Health doctors – currently led by Dr Ronal Glynn. This group have collated the experience of different jurisdictions and have arrived at a considered position.

We need to heed such advice , take such advice from reputable sources and not fall under the spell of populism which infects so much of social media.

We need to examine our own behaviour and take personal responsibility as it is the collective effort of the individual which has the greatest impact. It is not necessary to become paranoid but increased awareness certainly trumps a blasé approach – something I feel many of us have fallen foul of.

There is a certain repetitiveness in the advice and I make no apology for this – the message on the basics have not changed and the message has to be clear and consistent: maintain social distancing; adhere to regular hand washing; maintain cough etiquette; use facial coverings where appropriate; if you become symptomatic contact your GP who will advise you on the next appropriate steps.

Delay in presentation when you have symptoms could result in unnecessary spread – perhaps to a family member, a friend, a work colleague.

Remember the words of Dr Faucci: it is not about “I” – it is about “ we”.