Covid-19 mortality rate at 150 deaths per month, according to Dr Holohan

In a letter to the minister for health, Stephen Donnelly, the chair of the Covid-19 national public health emergency team, Dr Tony Holohan, highlighted a 53% increase in the number of Covid-19 cases.

A total of 27,440 cases were reported in the seven days to November 10^th, which represented a 53% increase from the previous week’s 17,911 cases.

An assessment of the figures also shows a 125% increase from the last NPHET meeting on October 18^th, when 12,206 cases were reported.

Of the 45,352 cases notified in the past 14 days to midnight 9th November 2021, 67% have occurred in people under 45 years of age; and 9% were aged 65 years and older.

Incidence has risen very rapidly in those aged 19-24 years, increasing almost threefold over the last two weeks, along with an increase across all adult age groups up to 75 years of age.

Dr Holohan said Covid-19 incidence across the country has been increasing at a concerning rate.

However, he did point out that the impact of the recent booster vaccination on those aged 80 and older is evident with this being the only age group in which incidence is declining.

In his letter to the minister for health he pointed out that of the cases notified in the past 14 days to midnight November 9^th 2.4% (1,072) were healthcare workers and 0.9% (414) were determined to be travel-related.

• From 3rd – 9th November, there were 169,858 community test referrals. Overall, total referrals have increased by 11% in comparison to the same time-period in the previous week.
• According to the Contact Management Programme (CMP), from 1st – 7th November 2021, the total number of close contacts was 50,027, an increase of 150% on 20,240 in the previous week. The average number of cases managed per day increased from 2,704 to 3,585, an increase of 33% over the same time period.
• For the 4,111 household close contacts created the week ending 24th October, 33.3% (1, 367) had a positive result.
• Of the 3,394 close contacts aged 12 and older who received a call from the CMP for the week ending 7th November and who self-reported their vaccination status, 61.7% (2,093) were fully vaccinated and considered to be significantly protected based on the time elapsed since vaccine administration and their medical history.
• Of the 541 Covid-19 patients admitted to ICU between 1st April and 6th November 2021, 192 had received either one or two doses of vaccine and 147 were considered to be fully vaccinated (had an epidemiological date 14 days or more after receiving all recommended doses of vaccine). Of the 132 ICU admissions occurring during the month of October 2021, 69 (52%) were unvaccinated, 4 (3%) were partially vaccinated, and 53 (40%) were fully vaccinated.
• As of 10th November 2021, there have been a total of 5,566 Covid-19 related deaths notified in Ireland. This is an increase of 74 notified deaths since the previous weekly update on 3rd November. To date, 46 deaths have been notified which occurred in November 2021, 185 deaths in October, 171 in September, 82 in August, 21 in July, and 18 in June.
• Over the period 1st August 2021 to 6th November 2021, 281 out of 433 (64.9%) Covid-19 related deaths were classified as vaccine breakthrough cases.
• There were 34 outbreaks associated with schools notified in week 44 (21 in primary schools, 10 in secondary, 1 in a special education school, and 2 not specified). However, 32 of these outbreaks occurred during May and June 2021 and were retrospectively notified. No cases were linked to outbreaks in school settings in week 44.
• There was one outbreak notified associated with a university/college in week 44, while of the 24 workplace outbreaks 10 were associated with manufacturing, four were in the commercial sector, four in office settings, and six in ‘other’ workplace settings.
• The new outbreaks were associated with public houses, three were associated with hotels, and one was associated with a restaurant or café in week 44.
• In terms of other locations, seven related to social gatherings; five related to retail outlets; three were associated with religious/other ceremony; one related to personal grooming; two to extended family outbreaks; while there were 39 private house outbreaks; and one related to associated travel/transport;

Dr Holohan said the overall demand for testing continues to be very high and is increasing. Community test positivity has increased from 7% in late September to 18% in recent days. Test positivity is increasing across all age groups.

Given the recent trajectory in terms of the disease profile, Dr Holohan said, ‘These indicators of severe disease may increase further in the coming weeks and will require ongoing close monitoring.’

He said it was also important to highlight that the number of Covid-19 cases currently in the community and in the hospital system is ‘placing a very significant additional burden on delivery of non-Covid care given the substantial pressures that the primary care and acute health systems are presently sustaining.’ And he said these pressures are likely to further increase over the course of the winter period.

The figures show that mortality related to Covid-19 is relatively constant at approximately five deaths per day, or 150 deaths per month.

Dr Holohan said this may increase, given the very high case counts, although the impact of booster vaccination in older age groups should mitigate against this.

He said the level of infection is having a disproportionate and highly disruptive impact on non-Covid care across the entire health care system, and that many other countries across the EU are facing similar challenges.

While the NPHET is not currently recommending the re-imposition of social and economic restrictions, hDr Holohan said, ‘this cannot be fully ruled out.’

In the meantime, NPHET reemphasised the importance of continued adherence to basic public health measures as well as a continued focus on wearing masks correctly and the wearing of masks in crowded outdoor settings, such as outdoor spectator events.

'As we move into winter and increasingly socialise indoors,' Dr Holohan said, ‘it is timely to remind individuals and sectors of the importance of ventilation in both private households and public settings.’