Michael Smith

Government should focus on the elderly, as it should have done in March; Varadkar and Martin both outrageously breached the lockdown. By Michael Smith Perspective The Covid-19 infection rate of Irish healthcare workers at 32% of total infections is the highest in the world. Nursing homes account for nearly two-thirds of deaths, while the international average is just 25%. Yet those who predicted swamped ICUs, scandalous shortages of equipment and overflowing morgues were utterly wrong. 1800 deaths though tragic, is at the extreme benign end of the predicted spectrum. Annual deaths in Ireland from the flu are 200 to 500. Nevertheless, we are actually a shocking eighth worst in the world for deaths per million people, a key indicator of incompetence, and indeed of misery, though admittedly we peaked early in global terms and otherswill surpass us. It seems a major reason for this is we simply applied the lockdown a week later in the cycle than many other countries. Media failed If you haven’t realised all that, nuanced as it is, you weren’t following. Ireland’s media in general failed in their duty to keep the public aware of the evolving pattern of Coronavirus cases in Ireland over the last four months. There was a pattern of reported cases it is just that the media did not follow it. Their job was not to convey this as a certainty but as the probability, based on the curves – the data. They failed the most vulnerable in society– the very elderly in nursing homes. Instead, all their energy went into plying pictures of improvised morgues, invitations to submit stories about deceased love ones, pieces about our nonexistent devastating shortages of PPE and ventilators, and of rockstars organising emergency imports of it. It was implied healthcare workers were dying on a serious scale when seven have died in a sector that employs 120,000 – a rate lower than the average rate for the population and around the same number as that of healthcare workers likely to die in road fatalities and drownings this year. Figures from the INMO showed that up to the end of May, a total of 8,018 cases of infection of healthcare workers were reported. Some 66 percent or 4,823 remain out sick. New Scientist reported in late June that one in five of those who need ICU treatment may suffer permanent lung damage but that suggests no more than 100 patients in total. Non-mortal infections, evenon a disturbingly large scale, do not constitute catastrophe. Ireland’s misplaced healthcare-worker catastrophism was enabled by the fact that many countries and in particular the two countries from which we draw most of our external news, the US and the UK, genuinely faced shortages of equipment and facilities and rampant deaths, as well as base, brutal, science-defying incompetence from the very top. The authorities Some credit is due to those who imposed the lockdown efficiently (and of course those who observed it – and the healthcare services). The reality The rates of infection and indeed of death worldwide have been really quite small (around 360 deaths per million in Ireland; 400 in the US; 700 in Britain, the ignominious world leader, after dysfunctional Belgium). In Ireland, 65% of cases have come from three sectors: healthcare workers, nursing homes and residential institutions like Direct Provision centres. The incidences of people outside particular hotspots of this type catching Covid-19 have been low. As to deaths, nursing homes alone account for 62%. And 92% of deaths have been of people over 65 (who comprise just over a quarter of cases; with the median age of death 83), mostly (nearly 90%) with underlying health conditions, “comorbidities”. Many of these people would have died within a few years anyway. On the one hand, it is the case that it is far worse for younger people with a long life expectancy to die, but on the other, it is extraordinary that it was allowed to happen, with so little real interest in covering the experiences of those in the homes or addressing the predicament of the elderly generally while the virus rages. The priority for journalism now should be to analyse and draw lessons from what happened in the nursing homes and ensure the most vulnerable, especially the elderly, are better protected against a likely second wave of the pandemic. Whistleblowers That is not to say even outside the care-homes all was above board. Village understands there were cases where whistleblowers about potential PPE shortages in hospitals were pressurised to remain silent. An organisation called WhistleblowerAid Ireland has been established to investigate possible corruption surrounding the handling of the Covid-19 crisis. It is affiliated to the charitable legal aid firm which recently advised the whistleblower who triggered the impeachment of Donald Trump. There should be an inquiry into what happened and major public concern at apparent failures. Guarding a realistic perspective does not mean we should not investigate incompetence. What happened? Inertia then catastrophism but mainly inadequate regard for nursing homes Let’s start by looking at the sequence of what happened in Ireland. There was a very bad start. The Department of Health oversaw a system underprepared for a pandemic and then specifically underestimated the dangers from China – on 20 February the Chief Medical Officer TonyHolohan ineptly faced a camera and said: We don’t expect to see anything more than individual cases occurring that we believe we’ll be well-positioned to manage within the next couple of months. Within a few weeks, however, the official view had flipped the other way and by 8 March Paul Reid, CEO of the Health Service Executive (HSE) was endorsing a report in the Business Post which quoted the health authoritiesmassively overestimating cases. The lead story in that newspaper on that day, apparently teed up with the health authorities, predicted 1.9 million infected cases for Ireland which would have implied 68,000 deaths, since the death rate given by theWHO at the time was 3.4%. The report did not say there “might” or