This column looks at how a speedy roll-out of the various Covid-19 vaccines across Ireland is just as critical to combating the virus as suppressing it, both fronts in the war on Covid-19, both are equally important.
I also examine how a decade of under-investment in our emergency services, particularly the Defence Forces and Gardaí has left the state with very little spare capacity to tackle emergency situations, such as this pandemic. This column first appeared on Broadsheet.ie on January 4th 2021
Though the daily Covid-19 numbers are spiralling ever higher and the prospect of even tighter restrictions looming large, we must hold on tightly to the belief that we are almost through the worst of this pandemic.
For most of the last year we have fought this pandemic on just one front, that of containment. It is a fight that we have waged with reasonable success, due to the efforts of the government and – most especially – the thousands of essential workers from medical staff to delivery workers to retail personnel.
Now, a critical second front against the vaccine has been opened with the approval and distribution of vaccines. We now have two fronts and the speed of progress on both fronts will decide whether we are weeks or months away from progressing steadily back to some form of normality.
But, as if to prove the adage that the darkest hour is just before the dawn, the vaccines have come on stream just as the pandemic surges across the globe.
Here, the massive community spread of the virus has left the HSE struggling to do the necessary contact tracing and testing at precisely the very moment when it also must deliver the biggest vaccination programme in our history. They are not alone in this predicament. Across Europe we are seeing other countries struggle too.
It is undoubtedly a difficult task, but as the Israelis and others are showing, it is not an impossible one. Not long ago Israel was in the depths of a massive infection surge, but now it leads the world in vaccination roll out with over 12% of its population already vaccinated, including 50% of its seniors and others at risk. Israel vaccinates 150,000 people per day, every day, calling up army reserves and others to help deliver the vaccination programme.
It is clear from what the Taoiseach, Minister Donnelly and HSE say about the strains the current surge has placed on the services here, that we will not come close to matching what Israel is doing. It is equally clear however, that we need to put the same effort into the vaccination front as we have put into suppression front.
I was astonished, at the end of December, to see several Fine Gael and Fianna Fáil TDs and councillors proudly posting vaccination timetables for nursing homes in their constituencies. Timetables which, in many cases, didn’t start until mid-January and didn’t finish until early February.
It was if someone at a senior political level thought this was an acceptable time frame. It wasn’t. We hopefully are seeing some signs this week that this reality has dawned on them.
No matter how you look at it – and I am not looking to criticise anyone in the government, NPHET or HSE here – the government’s vaccination rollout plan still looks unambitious.
Minister Donnelly says that 78,000 people in the nursing home settings will be vaccinated by the end of January, as well as tens of thousands of hospital staff (HSE employs about 120k medical personnel). The government is right to prioritise both groups. But it should be looking to add other front line works to that list too.
This is possible as within that end of January timeline, Ireland will receive around 200k doses of the Pfizer vaccine (40k per week), this should be enough to cover a first jab for everyone in the nursing home and health service. But that is just one vaccine.
On Wednesday (Jan 6th) the European Medicines Agency (EMA) is expected to authorise the use of the Moderna vaccine. So, within that same January timescale we can expect to receive supplies of the Moderna vaccine. The EU has purchased 300 million doses of the Pfizer vaccine and 160 million doses of the Moderna vaccine.
Taking these numbers pro-rata, Irish authorities should reasonably expect to receive up to 300,000 vaccine doses by the end of January. Doesn’t this mean we should have a matching capacity to vaccinate 300,000 people with the first of their two shots by the start of February?
I mention February as the EMA is expected to authorise the AstraZeneca/Oxford vaccine, which is already in use across the UK, including Northern Ireland, for use in the EU in February. The EMA is then expected to approve the single dosage Johnson & Johnson vaccine sometime after that.
While the EU has bought 460 million doses of the Pfizer and Moderna vaccines (to be delivered over several months) it has also purchased a combined total of 800 million doses of the AstraZeneca and the Johnson and Johnson (400 million) vaccines.
Securing doses of these vaccines and others (such as CureVac and Sanofi-GSK) is positive, but the key is getting folks vaccinated. The focus must therefore be on getting vaccines into people’s arms as soon as possible. This means front loading the immunisation programme.
Starting today, we need to be every bit as focussed on the daily vaccination numbers as we are on the new Covid19 cases. In truth, we need to be even more focussed on these vaccination numbers as these will determine how long it takes for us to start safely unlocking our communities.
We must treat the vaccination programme and suppressing the spread of the virus as national emergency. If the expert advice is that we introduce curfews or close schools beyond January 11th then we will have to do that, but we also must direct the same energy and vigour into vaccinating 24/7.
In time, when this crisis is over, we can assess the effectiveness of the state’s emergency response. There will be plenty to laud with agencies and individuals performing to the best of their ability, and beyond. But, looking back, we will also see just how much we have lost by sustained under investment in our emergency services in the years before the pandemic. Covid19 has exposed how little spare capacity we possess to cope with such sudden emergencies.
Whether we like it or not, we do not have enough Gardaí. It is not that we are critically under policed or in the throes of a huge crime wave, but we do not have enough Gardaí to cope with the huge range of responsibilities and duties beyond policing and crime investigation we assign to them. As we so tragically saw in Dublin 15 last Wednesday, we don’t just expect the Gardai to tackle crime, we expect them to deal with critical mental health issues.
The situation is even more obvious when it comes to the Defence Forces. In an excellent analysis piece in the Business Post, RACO’s Sec Gen, Conor King, highlights how, with just over 8,100 fully trained personnel, the Defence Forces are operating at only 85% of their minimum designed strength.
Mr King is being unduly charitable to the government here, as he uses the government’s 9,500 figure as the minimum force strength baseline. The true baseline number is higher. 1,000 higher. The landmark 2000 White Paper on Defence set the establishment strength of the Defence Forces at 10,500. This figure wasn’t plucked randomly out of mid-air but decided after months of discussion and debate.
That 10,500 was summarily reduced by 1,000 by an Bord Snip Nua to 9500 as part of the 2009 public spending cuts. The cut was based on bottom line accountancy and intended a temporary measure, one to be corrected when the economy returned to growth. The last government ignored this fact and has tried to make a perfunctory cut permanent to understate its neglect of our Defence Forces.
Take the true 10,500 number as the baseline and you realise that the Defence Forces are operating closer to just 75% of their establishment strength.
Yet, as with the Gardaí, despite these pressures on manpower and resources they have been a vital component in delivering the State’s Covid19 response. The Defence Forces’ Operation Fortitude has provided vital logistics and hard capabilities to the State’s response from supporting contact tracing and constructing community testing centres, to flying Irish Covid tests to German laboratories and delivering vital PPE.
As I say, there will be time for these discussions when the crisis has passed. In the meantime we must all do everything we can to suppress the virus so the HSE can get the country under a vaccination programme as soon as is possible.