It is relatively straightforward to make a statutory instrument under the Health Act 1947 imposing, in varying degrees, local, regional or national lockdowns. By the stroke of a ministerial pen, an economic sector can be closed down, severely restricted, or permitted to trade as normal.
The term “NPHET” means National Public Health Emergency Team. It is there to deal with public health emergencies. We are in an emergency. We have been since March 2020. The State’s reaction to the Covid emergency has gone through a number of phases and a succession of planned levels of response. Looking at how Israel is coping with its emergency (which got much more seriously out of hand than the pandemic in Ireland), we can see that 150,000 Israelis are now being vaccinated daily and that they have already passed the one million vaccination milepost. A number of features deserve note.
Firstly, the prime minister took personal charge of the vaccination programme once vaccines became available. Secondly, Israel has an integrated national health service which has advanced IT files for its citizens. Thirdly, and disgracefully, Israel is making little or no provision for the Palestinian population in the occupied territories or in Gaza.
Whatever the rights and wrongs of what Israel is doing, one thing is clear. They are treating this emergency as an emergency. However, the actual rate of vaccination in Ireland seems to be at a tiny, if well publicised, trickle, compared to what is happening in Israel.
It is strange that the State’s national public health emergency team, while being in a position to advise on lockdown and other reactive steps, does not appear to take such a strong public role in advising the government in relation to the vaccination drive. That appears to be left to the HSE and the Department of Health. I have previously emphasised here that hindsight is 20:20 vision and that it is very easy to pass judgment in retrospect on the State’s performance in combatting Covid.
But in truth, our experts have been confronted with a number of possible scenarios for many months now. One scenario was that the development of a vaccine could take between three and five years, if it happened at all. That scenario was loudly trumpeted by some who wanted to follow the zero Covid strategy. Some of those people predicted a huge death toll in Ireland running to many tens of thousands. Happily, they have been proved wrong.
Another scenario for which any expert advisory group would be expected to prepare was that a vaccine or a number of vaccines would become available by late 2020 or early 2021 (as has happened). That scenario logically required detailed planning for the implementation of a mass vaccination programme. Such planning would have to make contingency arrangements for the sequence of vaccination of different groups within society, the legal issues including indemnity, privacy, proof of vaccination, consent and data protection issues. Some of that is entailed in flu vaccination programmes.
It does not seem that this second scenario has been the subject of serious detailed and advanced planning. There appears to be a “last-minute.com” approach to the reality of mass vaccination in Ireland.
It is not unduly cynical to point out that it is far, far easier to plan for lockdowns, partial or total, than it is to do the grunt work involved in preparing IT, distribution arrangements, personnel training, and the various legal and administrative steps required to achieve what is happening in Israel.
Of course, operating within an EU context both in relation to approval and acquisition of vaccines may complicate the process somewhat. It seems that EU approval is taking a rather leisurely stroll compared to the frantic speed adopted in countries most gravely affected, on a per capita basis (including the UK).
Most people now want those who claim to be expert advisors on a public health emergency to be as publicly involved in firing up the vaccination programme as they appear to have been in closing down the economy. Leo Varadkar is right to ask that the present measures be given a chance to work before further clampdowns are proposed. There are some tentative signs that the infection rate is already declining from that which existed up to the 29th of December. There is no use challenging the Department of Health, the HSE and, in so far as they are different, the personnel of NPHET on why we find ourselves facing an ICU crisis. It’s been staring us collectively in the face since it was reported on in 2009.
An emergency must be treated as an emergency. GK Chesterton famously said: “if a job’s worth doing, it’s worth doing badly”. This is not an acceptance of incompetence; it is a retort to the hesitant, and to perfectionists and procrastinators. It needs to be heeded now.