The National Public Health Emergency Team has said the current set of restrictions imposed by the Government to combat the transmission of Covid-19, may not be enough, and additional measures may be required if there is continued deterioration.

NPHET's view is set out in a letter from the Chief Medical Officer, Dr Tony Holohan, to the Minister for Health, Stephen Donnelly, yesterday. 

In the letter, Dr Holohan recommends that strict Level 5 "stay at home measures" should be put in place for six weeks. 

However, he goes on to say there may still be some element of under-reporting in the figures as a result of the festive period, and that coupled with the additional risks posed by strains detected in the UK and South Africa, could cause a further deterioration in the situation in the coming days. 

He said NPHET cautions that the additional measures recommended may not be sufficient to bring the disease under control and that additional measures may be required if there is further deterioration. 

Dr Holohan said NPHET would continue to monitor the situation closely in the coming days. 

In the letter, Dr Holohan said NPHET had specifically considered reopening schools and was of the view they should reopen as planned.

However, he said NPHET noted that the high levels of community transmission would be a risk to the continued operation of primary and secondary schools unless the levels of transmission could be addressed. 

NPHET will also continue to review this issue over the coming weeks. 

Dr Holohan said there was a very considerable risk that the continued protection of the core priorities of protecting the vulnerable, ensuring the provision of non-Covid 19 health services, providing safe childcare and keeping schools open would be jeopardised in the short term.

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Dr Holohan said it represents "an immediate and grave threat to all key public health priorities".

He said that incidence of the disease was rising across all age groups, especially in those aged 19-24, which he said was "of significant concern"

The growth rate of the virus is estimated to be at least 7-10% per day, he said, adding that this was doubling every 7-10 days. He warned that growth rates are "now greater than those seen approaching the peak of the second wave". 

Dr Holohan said that while deaths per day are static at the moment, they are "likely to increase very soon" in line with an expected lag effect.

NPHET sought a period of full Level 5 restrictions for six weeks, according to the letter, and cautioned that the situation was "extremely fragile".

The letter shows that NPHET noted "high and rising levels" of community transmission that "will become a risk to the ongoing provision of education at primary and secondary level", unless those levels of transmission were addressed.

Modelling scenarios outlined in the letter show that if the R number, currently between 1.6 and 1.8, were reduced to 1.4 from today, then we would see 2,000 cases per day by 9 January, and 3,000 per day by 23 January with between 800-1,300 in hospital. 

NPHET cautioned that it is "unlikely" that such significant suppression would be achieved in so short a time frame, and so actual case numbers are "likely to exceed these latter projections".

Additional reporting Daniel Quinn