Tag: Philip Nolan

[This post got a bit longer than planned and you might not have the time to read the whole post, but I can promise you that it is worth it, because there is some amazing and unheard of news towards the end of it!]

After more than a month in “lockdown”, with a significantly changed infection rate and considering what is happening in other countries, it is now time to think about the trust we can or should have in the politicians in Ireland to do the right thing.

While the picture here is by far not as shocking as in the USA, where Trump suggested to put UV light “inside people” to kill the virus or maybe to inject disinfectant (www.youtube.com/watch?v=33QdTOyXz3w) so that the virus dies, we still need to keep a close eye on what is done with our lives and to us by the people who are in power.

Because I do believe that we are dealing with a virus, a virus that is more dangerous than other viruses (I will write another time about THAT discussion and the Conspiracy Theories that are connected to it.), I do think that the soft-ish lockdown that we were put under, was the right thing to do.

But I am wondering of the people in charge are the right ones to get us out again.

Who is in charge?

First let’s have a look at the power structure in Ireland to see who is really in charge right now.

It seems that the following people and organisations/forums are on this list: Taoiseach Leo Varadkar, Health Minister Simon Harris, National Public Health Emergency Team (NPHET), Chief Medical Officer Tony Holohan and maybe also Professor Philip Nolan, who is leading the modelling team.

This is an interesting list for many reasons:
The majority of people on it are seemingly un-elected and are employees or subcontractors of the Department of Health. It seems to be really difficult to find out who is part of the NPHET (I wasn’t able to!) and the NPHET doesn’t release any minutes of their meetings anymore. But it seems that the two elected politicians (Don’t worry, I will come to that!), Varadkar and Harris, leave ALL or nearly all decisions to the NPHET. Alan Kelly, the Labour leader, has some justified concerns about NPHET: www.thejournal.ie/taoiseach-nphet-alan-kelly-5082184-Apr2020/

In a setup like this, there is a huge risk that experts are experts ONLY in their area, but don’t really see/understand or want to care about any other aspects of their decisions. You probably know the saying, to a man with a hammer, everything looks like a nail!

Because a modeller cares very much about his models and a Chief Medical Officer cares very much about the medical aspects of this pandemic, they definitely have to be PART of the advisory group, but after that should it not be the elected politicians that carry the responsibility and also then make the decisions and announce the decisions?

Yes (I am getting to that now!), I am fully aware that neither Harris nor Varadkar are confirmed in their roles after the recent election. And strictly speaking, they lost the election and would have to get re-elected or re-appointed before they are confirmed in their roles. However, they are – according to the Irish Constitution – rightly and correctly continuing in their roles until a new Taoiseach is elected and a new Minister of Health has been appointed.

On the way into the lockdown, I think they did do the right thing and performed well. But a critic could say that the getting into a lockdown is easy and you can’t do much wrong, the way out of the lockdown is MUCH more complicated and requires completely different leadership.

I am not convinced that the people in power are the right ones to get us out of the lockdown. The Chief Medical Officer will be judged by the only statistic he focuses on on a daily basis: Number of newly infected and number of deaths. The Modelling expert, only looks at the virus reproduction number R (and surprisingly for an expert he seemingly doesn’t understand that R0 and R are not the same!! R0 is the max reproduction number and R or Reff is the REAL reproduction number. Prof Nolan got it wrong here www.gov.ie/en/publication/ea86cc-covid-19-modelling-data-thursday-16-april-2020/). And if you are judged by ONE specific result or number, then naturally you only focus on that one single issue and tend to loose sight of any other issues.

So who will look at the other effects and impacts? There are social, mental, economic, educational and political impacts as well.

This is the sphere were politicians need to make decisions, but to do that, they might have to tell the medics and modellers that they appreciate their advise but might choose not to follow it for now and do we think Varadkar and Harris would do that? I don’t think Harris would and I am not too sure about Varadkar.

NO politician anywhere in Europe or even worldwide KNOWS what to do in the current situation, so we can’t be tooo harsh with our judgement. No medic or modeller really has reliable and 100% correct data! Apart from the number of deaths, everything else is pure guess work. We have NO idea how many people have been infected. We don’t even know exactly how the infections happen and why some people have a weak reaction and others have a strong reaction to an infection. So all the people in power are totally winging it! Not only in Ireland, but worldwide.

So what can be done? In my opinion, we should watch closely what is happening in other countries. Austria, Germany, Denmark and Czech (and a few more) are starting to ease the restrictions and our politicians should look at that to 50% and listen to the experts with the other 50%.

But this expert forum has to change now! Medics and modellers are still needed, but in addition we need to add people that know about mental health, that are experts in education and in economy. The expert group that will ADVISE our politicians (not lead instead of the politicians) has to spread wider and cover more bases.

How come I dare to say that? Do I think that all the deaths are not real? Do I think that we are over the hospital emergency?
No, I do not think that at all! What our health care workers experience is definitely real and we definitely need to continue the work on easing the pressure they are under.

But we also need to be aware that Covid-19 is not the only health issue in this country. There are people avoiding hospitals that urgently should be seen and possibly operated. And we need to take into account that there is NO good justification for some of the restrictions and the renewed clamping down that gardai have announced for this coming weekend. There is a good justification for the physical distance, but NOT for the 2km radius for exercise and also not for the travel limitations (as long as you continue to keep the physical distance wherever you go to).

And if business life doesn’t continue in some shape of form, we will NOT be able to pay for the out of work aid that is being paid at the moment and we will NOT even be able to keep financing the hospitals. Heck, we were not able to finance hospitals sufficiently to avoid overcrowding when the economy was going well, so how can it be possible when the economy has stopped?

I am NOT talking about a “getting back to normality”, but I am talking about moving out of emergency shutdown mode into a emergency handling mode in the same way as these other European countries do it.

And YES, it could happen that we will get back into lockdown mode again for another 2 weeks or so. Maybe even a few times. And that is absolutely ok, but we now need to work on a plan for getting out and I am not sure we can trust the people who are currently in charge to have the ability to do that in a reasonable way.

I should mention something else as well and I have to admit that it influenced my opinion a good bit. It is a very important aspect and maybe I should put up a separate post about this, because it is VERY surprising:

The deaths that we are currently experiencing is the only reliable number. We don’t know in a lot of cases if a death was caused by Covid-19 or not and for the dead person or his/her family it is not even relevant. But we know that these deaths are real! The ridiculous and brutal restriction to just 10 family member at a funeral, no matter how big the church or funeral venue is is also real and there is not the slightest justification for it. Thanks NPHET for one of exceptionally nonsensical rules!
But I discovered something else this week and I have not found ANYBODY writing or talking about it!!

There is a European Project that has the cute name “EuroMOMO”, but is not cute at all. EuroMOMO is a European mortality monitoring activity, so they cound the number of deaths that happen in Europe. And the goal of EuroMOMO is to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats.

So, the 24 participating countries report their number of deaths to EuroMOMO and EuroMOMO creates graphics and reports to show if and to what degree the deaths in a certain period of time are above or below the “normal” death rate. In normal years the deaths that are above the normal death rate are considered as influenza deaths if they happen between October and May. EuroMOMO has a lot of graphs and stats on their website, but the most relevant is the Z-scores by country and you should have a look at that here www.euromomo.eu/graphs-and-maps/#z-scores-by-country

The results are shown on a time graph and the Z-score shows by how much the current number of deaths varies from the normal number of deaths. In Belgium, France, Italy, Netherlands, Spain and UK you see a significant peak. That shows that they are having significant more deaths than in normal years.

But now check Ireland! And you will be surprised to see that Ireland has LESS deaths in this Covid-19 period than it would be normal this time of the year. LESS!!!

I have no idea why that is, maybe it is because there are less other hospital operations. Maybe because there are less accidents because people stay at home. Maybe the fact that people avoid going to hospital if they have some other issues, keeps them alive longer? I have no clue! It also doesn’t mean – and I repeat that on purpose again – that Covid-19 is not happening or that it is harmless or that it is just like a normal flu. NO! That is all nonsense! And the numbers in other countries clearly show that. But if our excess mortality at the moment is lower than normal, then maybe the 1014 deaths (as of yesterday) are at least in Ireland, just normality. And if that is the case then we have to continue keeping the virus under control by keeping a physical distance, but we have to wonder if the current lockdown is justified in its current form!

Soooo, can we trust the people in charge? What do you think?