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The lack of publicly available information makes it difficult to properly understand current trends in relation to Covid-19, in particular the focus on the increasing cases in Dublin and Limerick.
Public health officials have singled out the two cities for particular expressions of concern and may decide to recommend new restrictions to slow the growth of the virus there.
In Dublin, attention has focused specifically on the city center north and west, where two emerging swabbing centers have opened in recent days.
The National Public Health Emergency Team (NPHET) obviously has at its disposal the most up-to-date information on current trends, as well as indications of what lies ahead.
The rest of us rely on a sometimes confusing array of data from the HSE, its Health Protection Surveillance Center (HPSC), and the Department of Health. NPHET officials also release information at their briefings that is not in the public domain, and journalists sometimes obtain more information through media inquiries.
Evidence
As of Wednesday, the evidence to point to trends in Dublin and Limerick was not evident, and Tipperary and Kildare had similarly high transmission levels.
However, the latest HPSC daily epidemiological report shows that Dublin is slightly ahead of the rest of the country with a 14-day incidence of 70.8 per 100,000 population. This compares with 69.2 in Kildare and 66.2 in Limerick.
NPHET will have access to the seven-day incidence figures, which are slightly more up-to-date and may point to a more pronounced increase in Dublin and Limerick relative to the rest of the country.
However, the same HPSC reports show that the highest incidence in Dublin is in the southeast of the city, not the north or west, at 84.9.
Officials have access to more detailed data on new numbers of cases in local electoral areas, and at the beginning of the pandemic, the HSE published a map showing where the cases were occurring, but this is not published now.
The department said yesterday that it was “not feasible” for the HPSC to provide a breakdown of the 14-day incidence rate by polling area, given its heavy workload. Even a request from The Irish Times for separate figures for the city and county of Limerick could not be met.
Therefore, people cannot find out exactly how much the virus is circulating in their area, and therefore cannot adapt their behaviors accordingly.
The department, which maintains that it provides more geographic details than many other countries, says steps are being taken to agree on the best way to provide more detailed information without breaching confidentiality.
Clusters
A separate HPSC report on clusters shows how this is a disease that now spreads within households. Last week, there were 122 new outbreaks in private homes and seven in extended families. The number of outbreaks elsewhere was negligible: six in workplaces, three in residential institutions, and two in nursing homes. No outbreaks were reported in daycare centers, hotels, cafes / restaurants, pubs, or shops.
Epidemiologists distinguish between controlled and uncontrolled settings; By now, many places where people do business, work, learn, or eat have introduced effective controls, but many home environments are clearly uncontrolled and this is where the virus is thriving.
How bad do things have to get before restrictions are introduced? No one will say precisely, but the health service traffic light system provides a rough guide. This is green up to an incidence of 20, orange up to 60, amber up to 120, and red thereafter.
Kildare hit a 14-day peak incidence of 180 at a point before its lockdown, but with the slightest restrictions envisioned, they are likely to kick in long before that point.
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