Alison O'Connor: All this uncertainty would give you a headache. Or maybe it’s Covid...

In some ways, life was easier when it was all black and white. Stay at home. Of course it is better to be out and about and seeing people and being allowed to travel, but the alarming backdrop of rising virus levels and the element of freedom afforded to us — as opposed to us being directed what to do — brings a whole new type of hardness to the situation.

“Finely balanced” is how Health Minister Stephen Donnelly has characterised our current situation. When something is described in such terms, the general response is not to charge at anything. But we’ve also been given our freedom. What exactly is the proper Covid mojo right now?

From what you hear, read and see, the virus is absolutely everywhere currently — city, county, towns, villages, affecting old and young. Indeed the risk of meeting an infected person is higher now than at any time in the pandemic. Sometimes you feel like retreating back into your cocoon but at other times, the thought lands that this has simply been going on forever and you have to start living your life.

The booster vaccine for older people is starting to show dividends at hospital and intensive care level, but case levels are on the rise in all age groups. In the description of one official source, 19- to 24-year-olds are “aflame with positivity”.

As a result of “normal” mixing that is going on, we are set to be awash with all sorts of other viruses, especially among children whose immune systems would not have been taxed during those long periods of lockdown and are now being hit hard.

Our embattled health service faces one hell of a winter when you add to Covid what HSE chief clinical officer Colm Henry described during the week as “the normal viruses resuming normal business”.

In his communiqué on Wednesday, chief medical officer Tony Holohan contextualised his remarks in an empathetic manner by saying a pandemic can be a long and exhausting experience and how we are all tired of this virus.

But the reality is the virus is circulating at too high a level. The previous day he explained we had reported 44,000 cases in the past 14 days and it all represented a significant risk to those who are most vulnerable in our society. So, where stands our sense of solidarity now? Are we operating on behalf of ourselves or thinking of the vulnerable people we know?

He spoke of  “layering all of the public health measures” with which we are all now so familiar, such as washing your hands, wearing a mask on public transport and in other social settings, and trying to meet outdoors, as well as ensuring that indoor spaces are well ventilated.

It all makes sense but where does that sit with nightclub dance floors and large-scale indoors events, such as a glitzy affair I know of that is going on this weekend which is due to have over 400 people in attendance. Is any building with four walls in this country big enough to hold a crowd like that and not result in Covid getting passed from at least some people to some others? But is that just how things are now?

Levels are rising in schools but there is no more contact tracing. Over 6,000 primary school children have tested positive in the past fortnight. Negotiations are ongoing on supplying antigen tests to close contacts. Apparently school authorities do not want anything to do with these tests in terms of keeping them in stock or handing them out to parents. There is the added difficulty of Dr Holohan, having set his face so strongly against antigen tests plus the usual snail’s pace adopted by the Department of Education.

That “layering up” message from Dr Holohan is the key part of a new official campaign due to be launched to encourage us all to #LayerUp #ForUsAll which stresses it is not just one measure, but all things previously mentioned by the CMO such as hand washing, face masks, and the rest. But the fact remains that the message we are getting from the powers that be are somewhat in conflict. As ever, very many people will try and weigh up those conflicts on a daily basis as they go about their business, while others will charge through the gap.

Our society is almost entirely opened up, and this is by Government order and sanctioned by Nphet. As a Government source explained it this week, they are now “advising rather than directing” people and asking the public to rely on their judgement. This is another fine line right here — if things go too far with virus numbers and deaths, the public will turn very angry, very quickly at having been “allowed” to be exposed to Covid like this. No wonder the Government Information Service is carrying out separate research on how to hone the current messaging with regard to public behaviour.

As ever with this pandemic, there is always something out there — almost within our grasp but not quite — this time in the shape of booster vaccines for the general population and vaccines for children under 12.

The European Medicines Agency said last month that a booster dose of the Pfizer vaccine to adults at least six months after the second dose “may be considered”.  It certainly was not a ringing endorsement for these third jabs for people they described as having “normal immune systems”.

It did stun me to learn this week that, of the 507 people who have been treated in intensive care in the last six months, only three of those patients were vaccinated and had no underlying conditions. This is a ringing endorsement of vaccines preventing serious illness.  The National Immunisation Advisory Committee (Niac), which judges these things for us, is, as usual coming under intense pressure to give the general go-ahead to boosters, yet the science is not really fully there yet. 

Plus there is the issue of vaccine equity and the embarrassment of vaccines in countries such as ours while health care staff in poorer countries haven’t even received one jab. And yet. And yet. Just now — with all the Covid craziness seeming to surround us again there are days you think you’d walk the length  of the country if that was what was required to get that booster. It’s all enough to give you a terrible headache.

Then where would you be? It could actually be Covid. Might you require an antigen test? Maybe a PCR one would be better?