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The impact of the Christmas holidays on the rise in Covid-19 cases is projected to be up to 15 times worse than pessimistic predictions made just weeks ago by public health officials who led the response to the pandemic.
In letters to Health Minister Stephen Donnelly in late November through December, Medical Director Tony Holohan outlined grim forecasts for how case rates would rise after the holiday period.
In his November 26 letter, Dr. Holohan said that the National Public Health Emergency Team (Nphet) was modeling two scenarios during December: one with Level 3 restrictions, with closed hospitality and limitations on home visits, and the other with open hospitality and domestic restrictions eased.
The first scenario would likely see an R number, a measure of how the disease spreads, of between 1.1 and 1.2, and the second, bleaker detailed scenario would likely see an R number of between 1.4 and 1.6.
Then Nphet modeled for “more intense” interaction as families and friends gathered amid even more relaxed restrictions between December 22 and January 6.
The predictions for this period during the Christmas holidays assumed an R number of 2, meaning that each infected person would spread it to two others.
The scale of the increase in cases as a result of the holiday period would depend on which of the two scenarios in the run-up to December 25 preceded it.
Dr. Holohan told Donnelly that if the worst of the two detailed scenarios prevailed, an R rate of 1.4 to 1.6 before Christmas, a rapid acceleration of the disease could be expected with “more than 400 cases per day at the beginning of January 2021 “.
Nphet’s latest predictions that up to 6,000 cases per day could be reported in the next few days is a 15-fold increase from the 400 cases per day scenario.
In November, Nphet recommended Level 3 restrictions for much of December and January, with further relaxation between December 21 and January 3 “in recognition of the social importance” of Christmas.
Although he warned that the epidemiological situation was “fragile” and Ireland remained very vulnerable to a “sudden surge” in the case of coronavirus.
On December 3, Holohan told Donnelly that the number of daily cases was decreasing, but that model projections of the probable future trajectory of the disease had worsened during the previous week, as it seemed unlikely that the daily rate would fall by below 200.
Nphet projected at the time that the R number would be between 1.2 and 1.4 through Christmas and New Years, suggesting there would be between 300 and 600 new cases per day by the second week of January.
However, he added: “This is probably a conservative projection.”
But again, looking at the possibility of the R number rising to 2, assuming relaxed restrictions between December 22 and January 6, their scenario was well below current daily rates.
Based on this prediction, Nphet suggested that there would be between 300 and 450 cases per day by New Year’s Day and between 800 and 1,200 per day by the second week of January.
By December 10, Dr. Holohan was simply warning the government that model analyzes show a “high risk” of an increase in new cases in January.
A week later, when the R number was estimated to be between 1.1 and 1.3, the modeling again pointed to a high risk that “transmission until early January may have a greater impact on public health.”
With daily rates at the time increasing rapidly, Nphet said the situation was “considerably more worrying than had been projected at the end of November.”
Four days before Christmas, the government was warned that the situation was “rapidly deteriorating” amid clear signs of exponential growth in the spread of Covid-19 that was “similar or worse” than the second wave.
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