Whatever we do now to defeat this pandemic needs to be bold, ambitious, and injected with strong leadership, writes Health Correspondent Fergal Bowers.

This was the week when the public mood turned quite cold and there has been a lot of anger visible in response to the latest developments.
Getting the prescription right on the next best steps is vital, if we are to defeat this pandemic. Is the answer harsh medicine now, with perhaps a better outcome later, or a conservative approach, with the uncertainty that brings in terms of the long term prognosis.
People are taking hard positions, which inevitably leads to conflict and disagreement. Whatever we do now needs to be bold, ambitious, and injected with strong leadership.
Clearly the aim with the Government extension of restrictions to 5 March now is to try and “crush” the virus. Unfortunately, six more weeks and much, much more probably, may also crush some people.
Make no mistake – we are in a war with coronavirus.
The Living with Covid-19 Five Stage Plan now looks like an old copy book and the add-ons and subtractions of various measures we have seen over time, make it look more like an à la carte menu, than a plan people can look to for clear guidance.
There was a feeling in the air this week, that we are running out of ideas and running out of road in the approach to tackling Covid-19. Some people are feeling battle fatigue and are punch drunk with the twists and turns, facts and figures.
In a warzone, that’s often the time when you change generals and allow for fresh eyes on a situation.
Make no mistake – we are in a war with coronavirus. And the length of any war is hard to predict, much less the outcome. We must throw everything at the war effort.
The public is watching developments on vaccination closely. It’s one area that offers some hope for the future.
This week, Minister for Health Stephen Donnelly said that his projection that everyone would be vaccinated by September was not a promise.
He said it was broadly based on when vaccines are authorised and the schedule of delivery. September is still his ‘aspiration’ for when people are vaccinated.
It has also transpired that the target of having 700,000 people vaccinated by the end of March is also in doubt.
The promised daily figures on vaccination have still not materialised and we are coming to the end of January.
At the moment we are getting twice weekly figures and random tweets about how many vaccinations have been done and what is planned. For the public, that is simply not good enough.
In another odd twist late last week, 3,000 vaccinations were removed from the official total of 143,000 on the Covid-19 Data Hub, reducing the total at that time to 140,000.
Apparently the 3,000 were taken off the total as these were second doses. The latest vaccination data is that there have been 147,700 first doses administered and 13,800 second doses.
Just as with case numbers and deaths, daily detailed data is needed on the vaccination programme, so that people can independently judge progress.
The HSE IT system is still being worked on to deliver this information. And a lot of manual recording of vaccination continues. So it looks like it may be some weeks before we get official data published daily on the Covid-19 Data Hub.
The decision to have GPs exclusively deliver vaccination to people over 70 years is also something of a mystery.
The Irish Pharmacy Union says pharmacists have been sidelined in this decision and it makes no clinical sense. Was there an issue of professional rivalry involved here, with GPs marking off their patch of patients and the €60 fee for each full vaccination done?
When I asked the Department of Health the reason behind the decision I was told I should talk to the HSE.
Pharmacists have kept their doors open throughout the pandemic, placing them and their staff on the front line, at risk of contracting coronavirus. They have also plugged the gap created by GPs moving largely wholesale to tele-consultations.
IPU Secretary General Darragh O’Loughlin said that pharmacists had vaccinated over 70s for the flu, every year, for the last decade. And while GPs have been vaccinated against the virus, pharmacists have not.
Someone needs to explain the thinking behind this. Any professional rivalry that might delay vaccination will not go down well with an already very angry public.
The news that dentists will be involved in vaccination is welcome. Indeed, why not have vets too. Any professionals that are capable should be utilised.
When it comes to the national vaccination programme, where does the buck stop? Who is in charge? No one person actually, which adds to the difficulties in terms of accountability.
Technically the political head is the Minister for Health and the Clinical Head is the HSE’s Chief Clinical Officer, Dr Colm Henry.
But then we have the Vaccination Task Force, NPHET, the National Immunisation Advisory Committee and so on and so on. So like the great ‘Yes Minister’ satire sitcom, the person responsible pretty much depends on what question you are asking. That is a recipe for much discontent and confusion for the public.
There was a lot of debate this week about the practicalities and legalities of policing people self-isolating at home. The point being made that gardaí could not go in to people’s houses to check that they are quarantining.
But there is an answer to this if officials are using their time during the pandemic to assess what is in place in other countries. A good friend of mine has explained the system in Australia, where he has family living. There, the police ring people who are supposed to be self-isolating at home on their mobile. They are asked to step outside to the hall door to verify they are at home. The police are parked on the roadside. It’s all quite simple if there is a will to find a way to do it.
There was a view expressed publicly from Government that mandatory quarantine was difficult. In a war, things are always difficult. If Churchill had thought the landings at Normandy too difficult, the most popular first name for boys in Europe could quickly have become Adolf.
Most people are doing their best to honour the public health measures that are needed. There are so few places open it’s hard to break the rules. Any scolding of the public, or assigning blame for the recent rise in cases will backfire badly.
Indeed, most people in this country carry no responsibility for the arrival of new variants of the virus via airports and ports. The decisions around restrictions, or a lack of them at airports and ports, and the monitoring of people coming into the country was not the responsibility of the public.
Likewise, the speediest detection of variants and ensuring those who test positive with them quarantine is not the responsibility of the wider public.
But what we do know, is that the UK variant was allowed to become the dominant one – two-thirds of all cases now involve this variant. The variant was identified in the UK in September. We identified it on Christmas Eve. We know that the South African variant is here now and it’s probably only a matter of time before the Brazillian one is here also.
It is these variants that may drive the length of the current lockdown on longer than expected. People are asking if tougher measures had been taken much earlier last year, in relation to inward travel, including from Northern Ireland, would we be in better control of the impact of variants now? Unfortunately, that horse has bolted.
We have also heard the view that if you tell the public too early that restrictions might be lifted, they will react and drop their guard on public health measures. That is treating people like children and very paternalistic.
Indeed, it harks back to the “doctor knows best” attitude and people “complying” with what has been prescribed. Political leaders work for the people, it’s not the other way around. Citizens have a right to know what is ahead of them and expected of everyone in a health crisis. Anything else, is certainly not an in this together approach.
I don’t think anyone has an issue with any senior Government member who for example may live in Dublin, travelling down the country at the weekend, to be with their family. But likewise, there could be no reason to object to any professional who for example has to work and live in Dublin during the week, going home at a weekend to their wife and family, who may live in Galway. Both cases are essential for the same reasons. Any other approach would bring us into the realm of Animal Farm.
There is much uncertainty about the months ahead. The Government wants the hospital system to recover before making any major decisions on lifting restrictions. It may be that by summer, households will be allowed to meet up in the open air but inter-country travel may not be permitted. It’s also hard to see hospitality opening in any shape or form for a long time, given the gloomy picture presented by Government at this week’s press briefing.
The best advice in a crisis is to tell the truth. Get it all out there as fast as possible. The best communications firms in the world will tell you that. Hide nothing, if you wish to survive. And if you do not know the answers, tell the public that too. This crisis is a high stakes moment for Government. And by extension, all of us too.
People and businesses need to plan. They want to know what the restrictions will be in the foreseeable future and if there are to be restrictions in place long term, for years, rather than months.
What is the new normal going to look like? Knowing this, would allow businesses reorganise, for example pubs to change into restaurants, or move out of the sector completely. Living from one extension of lockdown to another, is not a sustainable position, for either the public or the country. Something will collapse.
The latest information from the Central Statistics Office shows that the overall mortality rate is 18 for every 1,000 confirmed cases of Covid-19 here. This was highest at 77 for every 1,000 cases last April. It was six in December and nine in January.
It will take time to get a clear picture of the scale of excess deaths due to the pandemic, not least because it has not ended yet. The fact that there is no influenza this winter so far and so no deaths from it will also be something to factor into the calculations.
The pandemic has changed people in so many ways.
I was much taken by my colleague Fran McNulty’s news report that sales of chocolate bars, ice-cream and coffee pods are all on the rise, while hairspray, lipstick and razor sales have declined.
And the surge in demand for home baking products has continued.
The sign that so many people are struggling is reflected in the fact that there has been a 30% increase in antidepressants, anti-anxiety medicines and sleeping tablets.
The road back to any kind of normality is paved with huge uncertainty.
There will be wrong turns along the way and we must be able to change direction, if that is what’s needed, to reach our final destination.
When a century passes, between now and the future.
And people look  to understand what coronavirus meant.
Future Irish generations will gaze to the skies, during their own fresh challenges.
And find hope in the same stars, that must guide us now.