theirishtimes--2020-03-26--Coronavirus – the science: How physical distancing works and saves lives

This is a series of regular updates from Irish Times Environment & Science Editor Kevin O ’ Sullivan on scientific initiatives and developments on coronavirus .
Previous editions can be found here .
War on Covid-19 is three-pronged : a longer-term race to produce a vaccine effective in large populations ; generation of treatments ( antivirals ) for deployment in the meantime and use of coronavirus antibodies known as immunoglobulins .
These are proteins produced by plasma cells in the bloodstream and used by the immune system to neutralise pathogens such as viruses .
Presence of antibodies confirms infection , @ @ @ @ @ @ @ a valuable indication of immunity , especially for those working in healthcare .
In addition , antibodies have big potential as a treatment .
Like the global race to produce a vaccine , numerous labs are working on developing quick antibody tests , some of which may even be self-testing kits .
Meanwhile New York health authorities plan to begin collecting plasma from people who have recovered and inject the antibody-rich fluid into patients still fighting the virus in clinical trials .
Known as convalescent plasma , it has been used for centuries @ @ @ @ @ @ @ flu pandemic of 1918 , but not in recent decades .
Some experts say the treatment , though somewhat primitive , might be the best hope for combating coronavirus until more sophisticated therapies are developed , which could take months .
Infusions of convalescent plasma were associated with milder symptoms and shorter hospital stays for some patients during the 2002 SARS outbreak , and initial reports from China suggest it might also be effective in dulling the effects of Covid-19 .
The treatment is not without risks .
There is danger in giving @ @ @ @ @ @ @ or inadvertently transmitting other pathogens in a transfusion , but safety advances in recent decades have made adverse outcomes rare .
Initially , it will be offered to critically ill patients .
Once proven to be safe and effective , it ’ s likely to work best with patients before symptoms become too severe .
The US pharmaceutical Regeneron , which has a large “ industrial operations and product supply facility ” employing 1,000 people in Limerick , has also identified hundreds of antibodies that could treat or prevent coronavirus .
It confirmed @ @ @ @ @ @ @ by mid-April with antibody cocktail therapy , with potential to enter human clinical studies by early summer ” .
“ We don ’ t disclose which products are made where , ” a spokeswoman said – though it ’ s recruiting specialist staff for its Limerick plant .
Longer term antibody tests will also help researchers understand how long immunity to the virus lasts ; a key issue for any future vaccine .
The point of the Covid-19 spear looms ever closer .
That ’ s when it will cause its maximum toll @ @ @ @ @ @ @ curve .
At this stage of the pandemic with cases jumping daily , physical distancing within the community assumes critical importance ; hence the new , scaled-up restrictions with a tightening up on that key measure .
Obviously , it fits with the strategies of wash your hands ; self-isolate if showing symptoms , cough/sneeze into elbow ; and “ test , test , test ” .
Transmission route : Physical distancing is required as Covid-19 spreads mainly from person-to-person , i.e .
– Between people who are in close contact with one @ @ @ @ @ @ @ ; – Through respiratory droplets carried in the air produced when an infected person coughs or sneezes .
These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs .
Justifying the approach : Physical distancing is not a notional precaution , it ’ s a scientifically-justified action based on mathematics , understanding of social patterns and medical knowledge ( epidemiology ) .
It hinges around determining the r0 ( pronounced ‘ r-nought ’ ) value of an infectious disease .
The r0 @ @ @ @ @ @ @ So a typical person who is infected will spread it to 2.5 - between two and three people – during the period they ’ re infectious .
Without controls , a single case would lead to 1,000 cases after four weeks .
The objective is to get that figure down to below one .
At that point the disease stops spreading ; the typical person who is infected isn ’ t passing on the virus to anyone else before they recover .
A complex factoring in to how long the virus remains infectious @ @ @ @ @ @ @ people have physical contact ) , transmission data and immunity/susceptiblity considerations are all part of the r0 computation .
Key actions with Covid-19 : All told with this pandemic , ensuring it has less opportunity to spread to other people , by seeing less of them , and by reducing the chance during an interaction that the disease will pass to you – or from you to another person – are critical community actions .
That ’ s what forces the r0 down in this instance .
So it ’ s back to @ @ @ @ @ @ @ The proof : This is where contact tracing comes into its own , i.e .
determining who an infected person has been in contact with – when they were likely to be infectious – and ensuring all self isolate .
Already Irish actions ( notably physical distancing ) taken so far confirm personal contacts have been reduced from 20 to 5 , and of late tend to be confined to households .
That said , given the current trajectory of cases and deaths , public health specialists say a further 75 per cent @ @ @ @ @ @ @ is forced down .
So it ’ s back to physical distancing in the knowledge it works and saves lives .
– Tell-tale signs : Researchers are confirming the distinct traits of SARS-CoV-2 ( the medical term for the virus ) and key differences with influenza .
It ’ s very stable and does not mutate much , i.e .
alter its genetic mix as it spreads .
In contrast , flu is like a pack of cards ( made up of genetic parts ) that shuffle every year .
So there is @ @ @ @ @ @ @ vaccine , while the annual flu vaccine is the best bet of leading immunologists , virologists and epidemiologists .
– The scale of human decency : Communities are mobilising to help the most vulnerable within their localities .
Action by industry and universities with to the aim of helping those at the healthcare frontline is equally impressive .
DCU ’ s Nano Research Facility is switching operations to make sanitisers , and Trinity ’ s Biomedical Sciences Institute gathered all of its gloves , gowns and face masks and sent them to St @ @ @ @ @ @ @ .
Such actions are replicated across the country and are saving lives .
– Chink of hope on Italian front : There are tiny signs infection rate in Italy is moderating , notwithstanding its continuing , appalling death toll .
These may merely be data blips .
It suggests , none the less , the overall rate of increase is slowing ; as if the pandemic is losing momentum inside a country where it has nowhere to go .
Ireland can not ease its curtailment efforts as rising cases here show no indication @ @ @ @ @ @ @ of Italy .

People stand on designated areas to maintain social distancing as they queue outside a medical store during a government-imposed nationwide lockdown as a preventive measure against coronavirus in Srinagar in India. Photograph: Tauseef Mustafa/AFP via Getty Images
This is a series of regular updates from Irish Times Environment & Science Editor Kevin O'Sullivan on scientific initiatives and developments on coronavirus. Previous editions can be found here.
Playing the antibody card
War on Covid-19 is three-pronged: a longer-term race to produce a vaccine effective in large populations; generation of treatments (antivirals) for deployment in the meantime and use of coronavirus antibodies known as immunoglobulins. These are proteins produced by plasma cells in the bloodstream and used by the immune system to neutralise pathogens such as viruses.
Presence of antibodies confirms infection, so testing for their presence can be a valuable indication of immunity, especially for those working in healthcare.
READ MORE
In addition, antibodies have big potential as a treatment. Like the global race to produce a vaccine, numerous labs are working on developing quick antibody tests, some of which may even be self-testing kits.
Meanwhile New York health authorities plan to begin collecting plasma from people who have recovered and inject the antibody-rich fluid into patients still fighting the virus in clinical trials. Known as convalescent plasma, it has been used for centuries, and was deployed during the horrendous flu pandemic of 1918, but not in recent decades.
Some experts say the treatment, though somewhat primitive, might be the best hope for combating coronavirus until more sophisticated therapies are developed, which could take months.
Infusions of convalescent plasma were associated with milder symptoms and shorter hospital stays for some patients during the 2002 SARS outbreak, and initial reports from China suggest it might also be effective in dulling the effects of Covid-19.
The treatment is not without risks. There is danger in giving a patient the wrong type of blood or inadvertently transmitting other pathogens in a transfusion, but safety advances in recent decades have made adverse outcomes rare. Initially, it will be offered to critically ill patients. Once proven to be safe and effective, it’s likely to work best with patients before symptoms become too severe.
The US pharmaceutical Regeneron, which has a large "industrial operations and product supply facility" employing 1,000 people in Limerick, has also identified hundreds of antibodies that could treat or prevent coronavirus.
It confirmed its “plans to initiate large-scale manufacturing by mid-April with antibody cocktail therapy, with potential to enter human clinical studies by early summer”.
“We don’t disclose which products are made where,” a spokeswoman said – though it’s recruiting specialist staff for its Limerick plant. Longer term antibody tests will also help researchers understand how long immunity to the virus lasts; a key issue for any future vaccine.
The science of physical distancing
The point of the Covid-19 spear looms ever closer. That’s when it will cause its maximum toll – the top of that dreaded cases curve.
At this stage of the pandemic with cases jumping daily, physical distancing within the community assumes critical importance; hence the new, scaled-up restrictions with a tightening up on that key measure.
Obviously, it fits with the strategies of wash your hands; self-isolate if showing symptoms, cough/sneeze into elbow; and “test, test, test”.
Transmission route: Physical distancing is required as Covid-19 spreads mainly from person-to-person, i.e.
– Between people who are in close contact with one another (within about 2 metres);
– Through respiratory droplets carried in the air produced when an infected person coughs or sneezes.
These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
Justifying the approach: Physical distancing is not a notional precaution, it's a scientifically-justified action based on mathematics, understanding of social patterns and medical knowledge (epidemiology). It hinges around determining the r0 (pronounced 'r-nought') value of an infectious disease.
The r0 for Covid-19 is estimated at 2.5. So a typical person who is infected will spread it to 2.5 - between two and three people – during the period they’re infectious. Without controls, a single case would lead to 1,000 cases after four weeks.
The objective is to get that figure down to below one. At that point the disease stops spreading; the typical person who is infected isn’t passing on the virus to anyone else before they recover.
A complex factoring in to how long the virus remains infectious; cultural considerations (extent to which people have physical contact), transmission data and immunity/susceptiblity considerations are all part of the r0 computation.
Key actions with Covid-19: All told with this pandemic, ensuring it has less opportunity to spread to other people, by seeing less of them, and by reducing the chance during an interaction that the disease will pass to you – or from you to another person – are critical community actions. That's what forces the r0 down in this instance. So it's back to the five-step strategy including physical distancing.
The proof: This is where contact tracing comes into its own, i.e. determining who an infected person has been in contact with – when they were likely to be infectious – and ensuring all self isolate.
Already Irish actions (notably physical distancing) taken so far confirm personal contacts have been reduced from 20 to 5, and of late tend to be confined to households.
That said, given the current trajectory of cases and deaths, public health specialists say a further 75 per cent reduction is needed to ensure the curve is forced down. So it’s back to physical distancing in the knowledge it works and saves lives.
Grounds for optimism
– Tell-tale signs: Researchers are confirming the distinct traits of SARS-CoV-2 (the medical term for the virus) and key differences with influenza. It's very stable and does not mutate much, i.e. alter its genetic mix as it spreads. In contrast, flu is like a pack of cards (made up of genetic parts) that shuffle every year. So there is good chance of generating an effective Covid-19 vaccine, while the annual flu vaccine is the best bet of leading immunologists, virologists and epidemiologists.
– The scale of human decency: Communities are mobilising to help the most vulnerable within their localities. Action by industry and universities with to the aim of helping those at the healthcare frontline is equally impressive. DCU's Nano Research Facility is switching operations to make sanitisers, and Trinity's Biomedical Sciences Institute gathered all of its gloves, gowns and face masks and sent them to St James's Hospital up the road. Such actions are replicated across the country and are saving lives.
– Chink of hope on Italian front: There are tiny signs infection rate in Italy is moderating, notwithstanding its continuing, appalling death toll. These may merely be data blips. It suggests, none the less, the overall rate of increase is slowing; as if the pandemic is losing momentum inside a country where it has nowhere to go. Ireland cannot ease its curtailment efforts as rising cases here show no indication yet we can avoid the same fate of Italy.
[ @KOSullivanIT ]


theirishtimes--2020-03-26--Man charged with coughing over PSNI officers and claiming to have Covid-19

A man ( 39 ) is due to appear at Belfast Magistrates ’ Court on Thurday charged in relation to @ @ @ @ @ officers and claiming to have Covid-19 .
The man is charged with common assault and @ @ @ @ @ commit grievous bodily harm .
The charge of common assault relates to a domestic incident @ @ @ @ @ Belfast on Wednesday .
After his arrest the man claimed to have coronavirus and is @ @ @ @ @ over two police officers .

A man allegedly deliberately coughed over PSNI officers and claimed to have Covid-19
A man (39) is due to appear at Belfast Magistrates' Court on Thurday charged in relation to allegedly deliberately coughing over PSNI officers and claiming to have Covid-19.
The man is charged with common assault and two counts of attempting to commit grievous bodily harm.
The charge of common assault relates to a domestic incident at a house in north Belfast on Wednesday.
After his arrest the man claimed to have coronavirus and is alleged to have purposefully coughed over two police officers.


theirishtimes--2020-03-26--Residents block new hotel in Temple Bar over superpub fears

Residents of Temple Bar in Dublin have blocked the development of a new boutique hotel in the city ’ s tourist district which they feared would lead to the creation of another superpub in the area .
An Bord Pleanála has upheld an appeal by the Temple Bar Residents group against the decision of Dublin City Council to grant planning permission for a 12-bedroom hotel at the corner of Merchant ’ s Arch and Temple Bar Square .
The project was promoted by businesswoman , Sandra Doone , whose husband , Thomas , owns the adjoining Merchant ’ s Arch @ @ @ @ @ @ @ the demolition of an existing two storey building , which houses the Irish Pub Shop and several other small commercial units , and the construction of a five-storey building with a retail unit on the ground floor and basement with the hotel on the four upper floors .
However , An Bord Pleanála ruled that the proposed development on grounds of its height relative to surrounding buildings would constitute overdevelopment of the site .
The board concluded it would be “ out of character with the pattern of development in the vicinity ” @ @ @ @ @ @ @ Bar Square because of its height .
“ The subject plot is insufficiently wide to accommodate a building greater than three storeys , ” the board said .
It said the site was not a traditional corner plot where a higher building could create a landmark feature , while the proposed design would have created a vista from the Central Bank down Crown Alley which would be “ visually discordant ” .
In addition , the board said the plans for a single large retail unit at ground floor level to replace a @ @ @ @ @ @ @ s Arch would have a detrimental impact on the vibrancy of the area due to the loss of small-scale commercial units which give Temple Bar its character .
Ms Doone had claimed the existing , under-utilised building was in poor condition and in need of significant refurbishment , while the proposed hotel would “ contribute positively to Temple Bar Square and surrounding environment of the city ” .
She said a use for the building had to be found after An Bord Pleanála had refused planning permission in 2018 for plans which would @ @ @ @ @ @ @ of the Merchant ’ s Arch pub .
Ms Doone claimed she should be commended rather than vilified for opting for a retail use .
However , Temple Bar Residents said the proposed development was a substitute for the previous attempt to extend the Merchant ’ s Arch pub which it claimed would have created a “ superpub ” .
The group said the contention by Ms Noone that the existing building had no architectural merit , given its links to the other application , was “ incredible ” and “ glib ” @ @ @ @ @ @ @ Frank McDonald , claimed the project was “ a Trojan horse for the establishment in time of a fully licensed restaurant ” which was only one step away from converting the entire area into a pub .
He also criticised Dublin City Council for failing to recognise Merchant ’ s Arch ’ s rich urban history and the “ souk of sorts ” in the laneway .
Mr McDonald said the proposed new building would “ stick out like a sore thumb ” in Temple Bar Square .
Residents from the nearby Crampton @ @ @ @ @ @ @ block the sunlight to their windows and balconies as well as causing serious disruption during the construction phase .
An Taisce also opposed the proposed development claiming the demolition of the building could not be justified , while the area was already saturated with guest accommodation .
The heritage group said allowing the hotel would create a strong impetus to look for a licensed use of the building again in the future when there was already an overconcentration of pubs in Temple Bar .
An inspector with An Bord Pleanála said the streetscape @ @ @ @ @ @ @ negatively changed ” by the proposed development which was “ strikingly at odds ” with other buildings in the vicinity .

Temple Bar square in Dublin on St Patrick’s Day, much quieter than normal because of the coronavirus pandemic. Photograph: Niall Carson/PA Wire
Residents of Temple Bar in Dublin have blocked the development of a new boutique hotel in the city’s tourist district which they feared would lead to the creation of another superpub in the area.
An Bord Pleanála has upheld an appeal by the Temple Bar Residents group against the decision of Dublin City Council to grant planning permission for a 12-bedroom hotel at the corner of Merchant’s Arch and Temple Bar Square.
The project was promoted by businesswoman, Sandra Doone, whose husband, Thomas, owns the adjoining Merchant’s Arch pub.
The development would have required the demolition of an existing two storey building, which houses the Irish Pub Shop and several other small commercial units, and the construction of a five-storey building with a retail unit on the ground floor and basement with the hotel on the four upper floors.
READ MORE
However, An Bord Pleanála ruled that the proposed development on grounds of its height relative to surrounding buildings would constitute overdevelopment of the site.
‘Out of character’
The board concluded it would be “out of character with the pattern of development in the vicinity” and would not integrate well into Temple Bar Square because of its height.
“The subject plot is insufficiently wide to accommodate a building greater than three storeys,” the board said.
It said the site was not a traditional corner plot where a higher building could create a landmark feature, while the proposed design would have created a vista from the Central Bank down Crown Alley which would be “visually discordant”.
In addition, the board said the plans for a single large retail unit at ground floor level to replace a number of smaller shops on Merchant’s Arch would have a detrimental impact on the vibrancy of the area due to the loss of small-scale commercial units which give Temple Bar its character.
Ms Doone had claimed the existing, under-utilised building was in poor condition and in need of significant refurbishment, while the proposed hotel would “contribute positively to Temple Bar Square and surrounding environment of the city”.
She said a use for the building had to be found after An Bord Pleanála had refused planning permission in 2018 for plans which would have made its first floor an extension of the Merchant’s Arch pub.
Ms Doone claimed she should be commended rather than vilified for opting for a retail use.
However, Temple Bar Residents said the proposed development was a substitute for the previous attempt to extend the Merchant’s Arch pub which it claimed would have created a “superpub”.
The group said the contention by Ms Noone that the existing building had no architectural merit, given its links to the other application, was “incredible” and “glib”.
The group’s chairman, Frank McDonald, claimed the project was “a Trojan horse for the establishment in time of a fully licensed restaurant” which was only one step away from converting the entire area into a pub.
He also criticised Dublin City Council for failing to recognise Merchant’s Arch’s rich urban history and the “souk of sorts” in the laneway.
‘Like a sore thumb’
Mr McDonald, a former Irish Times environment editor, said the proposed new building would “stick out like a sore thumb” in Temple Bar Square.
Residents from the nearby Crampton Buildings claimed the proposed taller structure would block the sunlight to their windows and balconies as well as causing serious disruption during the construction phase.
An Taisce also opposed the proposed development claiming the demolition of the building could not be justified, while the area was already saturated with guest accommodation.
The heritage group said allowing the hotel would create a strong impetus to look for a licensed use of the building again in the future when there was already an overconcentration of pubs in Temple Bar.
An inspector with An Bord Pleanála said the streetscape of the lane would be “significantly negatively changed” by the proposed development which was “strikingly at odds” with other buildings in the vicinity.


theirishtimes--2020-03-26--Two men found dead after fire in Kells, Co Meath

Two men have been found dead following a fire in Kells , Co. Meath .
In a statement issued this @ @ @ @ @ that members of the force and other emergency services units were called to the scene @ @ @ @ @ house in the town at around 3am this morning .
The men , aged in @ @ @ @ @ were pronounced dead at the scene .
Two other occupants of the house , a @ @ @ @ @ are uninjured .
Gardaí are investigating the circumstances of the incident .

A Garda at the house on Blackthorn Close, Kells, Co Meath, where two men, one from Navan, and one from Kells died in a house fire this morning. Photograph: Colin Keegan/Collins
Two men found dead following a fire in Kells, Co Meathon Thursday morning have been named as Martin Reilly and John Power.
Mr Reilly (51) was from Kells and Mr Power (43) was from Navan, Co Meath.
In a statement the Garda said members of the force and other emergency services units were called to the scene of a fire at a house on Blackthorn Close at about 3am on Thursday.
The men were pronounced dead at the scene. Two other occupants of the house, a male and a female, were uninjured.
READ MORE
Gardaí are investigating the circumstances of the incident although it is understood it is not being treated as suspicious. However, a forensic analysis of the scene is awaited.
vne of the dead men is thought to have been the tenant of the home.
Locals said none of the other people involved are usually resident in the home. Garda sources said the four people had been socialising in the house befor the fire started.
Local man John Tallon who lives in the area he was ‘hugely saddened’ by the death of Mr Reilly, who was known as Biggy.
“Biggy was living here for the last 16 years and everyone knew him. He was extremely well-liked,” he said “He was a brilliant plasterer by trade and if you ever needed a hand with anything, he was always very obliging. We just can’t get over the news.”
Sinn Féin Cllr Eddie Fennessy who is from Navan, said he was in shock at the death of Mr Power.
“I have known John Boy for years. He used to play football with us as kids. He was well-liked and popular and wouldn’t harm anyone,” he said. “Everyone in Clogherboy and the wider community has been hit hard with this news this morning and I extend my sympathies to his family and friends.”
Meath County Council, which owns the house where the fire broke out, said it was awaiting the results of the Garda investigation into the cause of the blaze and extended its sympathies to the families of the deceased.


theirishtimes--2020-03-26--Seeing smaller picture with nanoscale technology in vibration-free space

You are chief technical officer at the DCU Nano Research Facility – what work does it undertake ?
“ It ’ s a custom-built facility that houses lots of different pieces of equipment that researchers can use .
We have 3D-printing facilities , we have electron microscopes , which allows people to see objects at a very high resolution , and we have equipment to examine samples at the chemical and even the atomic level .
Why do the machines need their own building ?
These machines work and make measurements at a tiny scale , so they could be @ @ @ @ @ @ @ or closing doors , or even traffic on a nearby road .
I was involved in helping to design the building to ensure the equipment can work without that kind of interference .
So to minimise vibrations , we have a basement with a special floor for the electron microscopes , and throughout the building we have machines in rooms that are not directly off corridors .
The NRF is also well away from the main road ( Collins Avenue ) , so the traffic won ’ t affect the equipment .
The @ @ @ @ @ @ @ we have lots of power outlets , gas and data points .
What do you do there ?
My job is to make sure that the machines work well , that they are available for people who want to use them and that the researchers who come in are well trained to work with the equipment .
We have a team of technical experts who train researchers so they are proficient with a particular machine , then those researchers can access and book that piece of equipment to use it for their research @ @ @ @ @ @ @ of people in DCU , and also researchers from other universities and Institutes of Technology in Ireland .
We also have customers from companies who want access to the machines , and sometimes we take in samples from researchers or companies and we run the analysis for them .
How did you get into this line of work ?
I studied for a diploma in IT Carlow , then I came to DCU as technical staff in analytical chemistry .
I had meant to go back to Carlow and get a degree , @ @ @ @ @ @ @ in the early 2000s I did a Masters here in instrumental analysis , and in around 2012 I started getting involved in the design of the NRF .
We opened in early 2015 .
What are the challenges of your job ?
I think the challenge is making sure that the machines are all available when they are needed , getting funding to keep them serviced and updated and ensuring that the people who use them have been well trained .
Finally , how do you take a break from the work ?
@ @ @ @ @ @ @ and the sports facilities here at DCU are excellent .
Initially I started going to the gym early in the morning before work to avoid the traffic , and now I typically train twice a day during the week – maybe in the morning and then a gym class or a run lunchtime , or in the evening .
That ’ s my main way to take a break .
”

You are chief technical officer at the DCU Nano Research Facility – what work does it undertake?
“It’s a custom-built facility that houses lots of different pieces of equipment that researchers can use. We have 3D-printing facilities, we have electron microscopes, which allows people to see objects at a very high resolution, and we have equipment to examine samples at the chemical and even the atomic level.
Why do the machines need their own building?
These machines work and make measurements at a tiny scale, so they could be sensitive to vibrations from people walking nearby or closing doors, or even traffic on a nearby road. I was involved in helping to design the building to ensure the equipment can work without that kind of interference.
READ MORE
So to minimise vibrations, we have a basement with a special floor for the electron microscopes, and throughout the building we have machines in rooms that are not directly off corridors.
The NRF is also well away from the main road (Collins Avenue), so the traffic won’t affect the equipment. The building is really well serviced too, we have lots of power outlets, gas and data points.
What do you do there?
My job is to make sure that the machines work well, that they are available for people who want to use them and that the researchers who come in are well trained to work with the equipment.
We have a team of technical experts who train researchers so they are proficient with a particular machine, then those researchers can access and book that piece of equipment to use it for their research.
Who uses the equipment?
Lots of people in DCU, and also researchers from other universities and Institutes of Technology in Ireland. We also have customers from companies who want access to the machines, and sometimes we take in samples from researchers or companies and we run the analysis for them.
How did you get into this line of work?
I studied for a diploma in IT Carlow, then I came to DCU as technical staff in analytical chemistry. I had meant to go back to Carlow and get a degree, but I stayed in DCU. Then in the early 2000s I did a Masters here in instrumental analysis, and in around 2012 I started getting involved in the design of the NRF. We opened in early 2015.
What are the challenges of your job?
I think the challenge is making sure that the machines are all available when they are needed, getting funding to keep them serviced and updated and ensuring that the people who use them have been well trained.
Finally, how do you take a break from the work?
I really enjoy fitness and training, and the sports facilities here at DCU are excellent. Initially I started going to the gym early in the morning before work to avoid the traffic, and now I typically train twice a day during the week – maybe in the morning and then a gym class or a run lunchtime, or in the evening. That’s my main way to take a break.”


theirishtimes--2020-03-26--Elephants to beetles: zoo collections matter for conservation

Prince Tom ’ s record in the European Asian elephant stud book states he died in 1882 , that he killed one person and his skeleton can now be seen in the Zoological Museum at Trinity College Dublin .
The incredible story of Prince Tom ’ s life is barely captured by these bald data points .
As a youngster Prince Tom was gifted to Prince Alfred , son of the British Queen Victoria , and his trip to Dublin Zoo was a long and winding one via Nepal , Sri Lanka , New Zealand and the UK .
His @ @ @ @ @ @ @ pestering by overenthusiastic New Zealand children is far cry from how Asian elephants are kept these days .
Indeed , Dublin Zoo is internationally recognised as a source of expertise in elephant care .
People flock to see animals they would never , or rarely , get a chance to see in the wild .
Zoos have multiple roles in entertainment , education , conservation and research .
The collection of animals that a zoo decides to keep reflects a tension between those different roles .
PhD student Andrew Mooney recently explored how @ @ @ @ @ @ @ zoo keeps in their collection determines how many people visit the zoo and whether this influences the conservation work a zoo supports in the wild .
So if you were playing a zoo-simulation game how should you optimise your zoo collection for maximum visitor attendance and maximum conservation gains ?
The answer is not simple as there are important constraints on the collection a zoo can keep .
If you decide to populate your zoo collection with large animals you will quickly run out of space and will not be able to have @ @ @ @ @ @ @ choose the usual suspects , elephants , giraffes and lions , you will be very similar to other competing zoos .
These trade-offs open the door to alternative collection strategies – zoos with many , small and unusual creatures .
How about a beetle zoo with enormous rhinoceros beetles , glittering jewel beetles , hard-working dung beetles and the charismatic lady beetles ( which are neither bugs nor birds ! )
?
Stud books are kept by animal breeders for animals such as horses and dogs ; they are also kept by zoos @ @ @ @ @ @ @ collections .
The hand-written zoo stud books of days gone by have now become “ big data ” .
Stud book managers share information across institutions , and the data has been compiled into large electronic databases such as Species360 .
Data from more than 470,000 animals from 4,800 species kept in 458 zoos worldwide showed that zoos with many animals , big animals , a higher number of species of mammals in particular , and which are dissimilar to other zoos attract more visitors .
These characteristics of the animals in the @ @ @ @ @ @ @ much as being in a highly populated city location or in a wealthy country .
This information is useful for zoos which rely on visitor numbers for revenue , but does having more visitors translate through to more conservation action in the wild ?
Does a zoo collection optimised for entertainment miss the mark on its conservation role ?
This study showed that the more visitors a zoo gets the higher its contributions to conservation projects in the wild , so it is a win-win for visitors and conservation .
Zoos contribute to @ @ @ @ @ @ @ species within their own walls but also through conservation in the wild , often linked to the species they keep .
The global zoo and aquarium community is reported to be the third largest conservation organisation contributor globally , funded to a large extent by paying visitors .
Strengthening the connection between revenue from visitors and conservation in the wild has the potential to greatly increase the conservation potential of zoos .
Prince Tom ’ s story and the great improvements in animal care in zoos since Victorian times remind us that animal @ @ @ @ @ @ @ modern zoos .
Zoos engage people with animals and this engagement , along with the revenue it generates , can have positive effects for the survival and recovery of animal populations in the wild .
Yvonne Buckley is an ecologist and professor of zoology at Trinity College Dublin

Brothers Gerry and James Creighton with elephants Kirsty and Judy at Dublin Zoo before the animals were transferred to a new home in Neunkirchen Zoo in Germany. Photograph: Dara Mac Dónaill
Prince Tom's record in the European Asian elephant stud book states he died in 1882, that he killed one person and his skeleton can now be seen in the Zoological Museum at Trinity College Dublin. The incredible story of Prince Tom's life is barely captured by these bald data points.
As a youngster Prince Tom was gifted to Prince Alfred, son of the British Queen Victoria, and his trip to Dublin Zoo was a long and winding one via Nepal, Sri Lanka, New Zealand and the UK. His story of alcoholism, poor diet and pestering by overenthusiastic New Zealand children is far cry from how Asian elephants are kept these days. Indeed, Dublin Zoo is internationally recognised as a source of expertise in elephant care.
People flock to see animals they would never, or rarely, get a chance to see in the wild. Zoos have multiple roles in entertainment, education, conservation and research. The collection of animals that a zoo decides to keep reflects a tension between those different roles. PhD student Andrew Mooney recently explored how the numbers and types of animals a zoo keeps in their collection determines how many people visit the zoo and whether this influences the conservation work a zoo supports in the wild.
So if you were playing a zoo-simulation game how should you optimise your zoo collection for maximum visitor attendance and maximum conservation gains? The answer is not simple as there are important constraints on the collection a zoo can keep. If you decide to populate your zoo collection with large animals you will quickly run out of space and will not be able to have very many of them.
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If you choose the usual suspects, elephants, giraffes and lions, you will be very similar to other competing zoos. These trade-offs open the door to alternative collection strategies – zoos with many, small and unusual creatures. How about a beetle zoo with enormous rhinoceros beetles, glittering jewel beetles, hard-working dung beetles and the charismatic lady beetles (which are neither bugs nor birds!)?
Big data
Stud books are kept by animal breeders for animals such as horses and dogs; they are also kept by zoos to document and manage animals in their collections. The hand-written zoo stud books of days gone by have now become "big data". Stud book managers share information across institutions, and the data has been compiled into large electronic databases such as Species360.
Data from more than 470,000 animals from 4,800 species kept in 458 zoos worldwide showed that zoos with many animals, big animals, a higher number of species of mammals in particular, and which are dissimilar to other zoos attract more visitors. These characteristics of the animals in the zoo matter for visitor numbers just as much as being in a highly populated city location or in a wealthy country.
This information is useful for zoos which rely on visitor numbers for revenue, but does having more visitors translate through to more conservation action in the wild? Does a zoo collection optimised for entertainment miss the mark on its conservation role? This study showed that the more visitors a zoo gets the higher its contributions to conservation projects in the wild, so it is a win-win for visitors and conservation.
Zoos contribute to conservation both through their work with threatened species within their own walls but also through conservation in the wild, often linked to the species they keep. The global zoo and aquarium community is reported to be the third largest conservation organisation contributor globally, funded to a large extent by paying visitors. Strengthening the connection between revenue from visitors and conservation in the wild has the potential to greatly increase the conservation potential of zoos.
Prince Tom’s story and the great improvements in animal care in zoos since Victorian times remind us that animal welfare is critical to the success of modern zoos. Zoos engage people with animals and this engagement, along with the revenue it generates, can have positive effects for the survival and recovery of animal populations in the wild.
Yvonne Buckley is an ecologist and professor of zoology at Trinity College Dublin


theirishtimes--2020-03-26--Life in an ICU during Covid-19: ‘There is no hugging someone who is upset’

Personal protective equipment , ie clothing used when treating infectious patients , is a key issue in the coronavirus pandemic .
A shortage of personal protective equipment ( PPE ) in China and Italy greatly contributed to the toll of sickness and death among healthcare workers in those countries .
Understandably , Irish doctors and nurses are concerned there will be an adequate supply of PPE here .
The HSE ’ s current stock of PPE for healthcare workers is “ low ” , according to its chief clinical officer , Dr Colm Henry .
However , it was hoped @ @ @ @ @ @ @ gowns and goggles would arrive from China on Sunday .
The wearing of PPE also imposes an immense burden on staff , equivalent to three times the workload with normal patients , as Dr Suzanne Crowe , an intensive care specialist at Crumlin children ’ s hospital , explains .
Staff have to wear two pairs of gloves – one on top of the other – a full-length gown over a scrub suit , a hat , a tight-fitting mask and a full-face visor worn over the mask to protect themselves adequately from @ @ @ @ @ @ @ is like the mask you ’ d use for sanding the floor , while the visor resembles the face protection you might use if you were welding , ” she says .
For the mask to do its job , the part over the nose has to fit tightly .
“ In order for it to work properly it has to be uncomfortable ; it has to be tight to the face.
” The reason for this elaborate ensemble is to protect staff from Covid-19 patients needing artificial respiration , who have an @ @ @ @ @ @ @ high viral load is concentrated in the patient ’ s nose and airways and is actively shed into droplets which are airborne and may be inhaled by any staff within close proximity.
” As a result a doctor or nurse inserting a breathing tube into a patient , or trying to suction secretions from their airways , is at the highest risk of picking up the virus if unprotected .
“ It gets hot and claustrophobic in there , and then you can be in this gear for up to eight hours .
@ @ @ @ @ @ @ to concentrate on the job in hand , ” says Crowe .
“ Donning ” and “ doffing ” the protective gear is a laborious process that takes 20 minutes before and after use and is best done with a “ buddy ” to ensure maximum protection .
Staff are less inclined to take breaks given the difficulty of removing the gear and are more inclined to stay with the patient , thereby reinforcing the sense of isolation .
“ The aim always is to have the minimum number of people coming into @ @ @ @ @ @ @ of exposure is kept down , ” Crowe says .
The protective gear renders communication between staff , and between staff and the patient , more difficult .
“ It ’ s really difficult to hear each other , ” Crowe says .
Phones and walkie-talkies to aid communication have been trialled during training but they may pose a contamination risk .
Another solution is for staff to use a whiteboard on which to write messages .
Normal ICU staff ratios would see one nurse assigned to each patient ; the ratio of @ @ @ @ @ @ @ where dialysis or an ECMO device is involved .
However , in the current emergency , the staff to patient ratio has moved to 1:2 or even 1:3 , and may worsen as staff go off sick and the crisis deepens .
“ You have this sense of not being able to do the best possible job , ” says Crowe , adding that nurses and doctors are worried about potential “ repercussions ” , and about the risk of infection for staff and their families .
The difficulties don ’ t stop @ @ @ @ @ @ @ for example , can be quite tricky when you ’ re wearing two sets of gloves.You don ’ t have the normal contact with the patient , ” Crowe says .
Crowe worries too about the psychosocial and pastoral aspects of care , given that many of those in ICUs in general are approaching the end of life .
Sedated and asleep much of the time , the patients are now missing out on the human touch , she says .
In the children ’ s hospitals , parents are allowed to visit @ @ @ @ @ @ @ equipment .
“ There ’ s no hugging someone if they ’ re crying and distressed .
It feels very weird .
“ Only the other day , I gave a mum a hug because she was crying so much and afterwards , I went ‘ ugh ’ .
But how could you not do that ?
” A constant concern for staff , she says , is a potential shortage of PPE , and this has led to some hoarding of equipment within departments .
Intensive care specialists are also worried about @ @ @ @ @ @ @ the disease can cause requires large amounts of oxygen , far higher flow rates than with other forms of pneumonia .
Other drugs , for example those used to keep patients deeply comatose , will also be in high demand during the peak of the crisis .
Many severely ill patients with the virus are turned onto their tummy , a process known as proning .
Crowe says that with many adult patients weighing more than 100kg , a big team can be needed to turn the person without disturbing the attached medical @ @ @ @ @ @ @ be needed , each one in full PPE .
On leaving the ICU environment , staff have to assume the entire outer surface of their gear is contaminated so they need help to remove and bin it .
They are instructed that “ hands must be washed in between removal of each piece of clothing – eight times as clothing is removed ” .

Personal protective equipment, ie clothing used when treating infectious patients, is a key issue in the coronavirus pandemic.
A shortage of personal protective equipment (PPE) in China and Italy greatly contributed to the toll of sickness and death among healthcare workers in those countries. Understandably, Irish doctors and nurses are concerned there will be an adequate supply of PPE here.
The HSE's current stock of PPE for healthcare workers is "low", according to its chief clinical officer, Dr Colm Henry. However, it was hoped that a large consignment of masks, gowns and goggles would arrive from China on Sunday.
The wearing of PPE also imposes an immense burden on staff, equivalent to three times the workload with normal patients, as Dr Suzanne Crowe, an intensive care specialist at Crumlin children's hospital, explains.
READ MORE
Staff have to wear two pairs of gloves – one on top of the other – a full-length gown over a scrub suit, a hat, a tight-fitting mask and a full-face visor worn over the mask to protect themselves adequately from the Covid-19 virus.
“The mask is like the mask you’d use for sanding the floor, while the visor resembles the face protection you might use if you were welding,” she says.
For the mask to do its job, the part over the nose has to fit tightly. “In order for it to work properly it has to be uncomfortable; it has to be tight to the face.”
The reason for this elaborate ensemble is to protect staff from Covid-19 patients needing artificial respiration, who have an extremely high viral load.
“This high viral load is concentrated in the patient’s nose and airways and is actively shed into droplets which are airborne and may be inhaled by any staff within close proximity.”
As a result a doctor or nurse inserting a breathing tube into a patient, or trying to suction secretions from their airways, is at the highest risk of picking up the virus if unprotected.
“It gets hot and claustrophobic in there, and then you can be in this gear for up to eight hours. It gets so uncomfortable it gets hard to concentrate on the job in hand,” says Crowe.
Laborious process
“Donning” and “doffing” the protective gear is a laborious process that takes 20 minutes before and after use and is best done with a “buddy” to ensure maximum protection.
Staff are less inclined to take breaks given the difficulty of removing the gear and are more inclined to stay with the patient, thereby reinforcing the sense of isolation.
“The aim always is to have the minimum number of people coming into the isolation room, so the risk of exposure is kept down,” Crowe says.
The protective gear renders communication between staff, and between staff and the patient, more difficult. “It’s really difficult to hear each other,” Crowe says. Phones and walkie-talkies to aid communication have been trialled during training but they may pose a contamination risk.
Another solution is for staff to use a whiteboard on which to write messages.
Normal ICU staff ratios would see one nurse assigned to each patient; the ratio of staff to patients can be even higher where dialysis or an ECMO device is involved.
However, in the current emergency, the staff to patient ratio has moved to 1:2 or even 1:3, and may worsen as staff go off sick and the crisis deepens.
“You have this sense of not being able to do the best possible job,” says Crowe, adding that nurses and doctors are worried about potential “repercussions”, and about the risk of infection for staff and their families.
The difficulties don’t stop there. “Changing a syringe, for example, can be quite tricky when you’re wearing two sets of gloves.You don’t have the normal contact with the patient,” Crowe says.
Pastoral aspects
Crowe worries too about the psychosocial and pastoral aspects of care, given that many of those in ICUs in general are approaching the end of life.
Sedated and asleep much of the time, the patients are now missing out on the human touch, she says. In the children’s hospitals, parents are allowed to visit, but they too must wear protective equipment.
“There’s no hugging someone if they’re crying and distressed. It feels very weird.
“Only the other day, I gave a mum a hug because she was crying so much and afterwards, I went ‘ugh’. But how could you not do that?”
A constant concern for staff, she says, is a potential shortage of PPE, and this has led to some hoarding of equipment within departments.
Intensive care specialists are also worried about oxygen supplies; the viral pneumonia that the disease can cause requires large amounts of oxygen, far higher flow rates than with other forms of pneumonia.
Other drugs, for example those used to keep patients deeply comatose, will also be in high demand during the peak of the crisis.
Many severely ill patients with the virus are turned onto their tummy, a process known as proning. Crowe says that with many adult patients weighing more than 100kg, a big team can be needed to turn the person without disturbing the attached medical equipment. Up to 10 people can be needed, each one in full PPE.
On leaving the ICU environment, staff have to assume the entire outer surface of their gear is contaminated so they need help to remove and bin it. They are instructed that “hands must be washed in between removal of each piece of clothing – eight times as clothing is removed”.


theirishtimes--2020-03-26--Coronavirus: New clinics to be opened by blood donation service

When Patricia Russell gave blood in Limerick last week , she did so in a hotel which was about to close because of coronavirus .
“ I did think , should I go or not , because coronavirus is in everybody ’ s head now , ” she says .
“ You couldn ’ t but think of it .
“ But then you think , what if there was a car accident , or somebody needed blood , and you just do it .
If you ’ re feeling well , and you don ’ t have anything wrong @ @ @ @ @ @ @ Russell , from Meelick , Co Clare , began donating blood after her mother died of cancer in 2013 ; she had received blood transfusions during her treatment .
“ That was what started me donating , ” she explains .
From Monday , the Irish Blood Transfusion Service ( IBTS ) is moving donor clinics to larger venues countrywide so it can put more space between donors to obey social distancing guidelines .
Donors will be asked to make appointments , too : “ In spite of Covid-19 , we still need @ @ @ @ @ @ @ our normal supply , ” said Andy Kelly , IBTS chief executive .
“ Cancer patients , transplant cases , trauma and others with conditions that require ongoing support with blood components rely on blood donors as much as ever.
” “ We are grateful for the support donors have given so far and the blood supply at this time remains good , however the need for blood donations is ongoing and we are now planning for the weeks ahead , ” added Mr Kelly .
The 80 per cent supply need is @ @ @ @ @ @ @ saw demand there fall by about a fifth because of fewer traffic crashes , and less work-related accidents or sports injuries .
The latest restriction to apply to potential blood donors is that they must not show any symptoms of Covid-19 , and must not have travelled outside the island of Ireland within the past 14 days .
Full details for donors can be found at giveblood.ie .
The IBTS had moved to build up stocks ahead of the crisis : “ Obviously , we knew the situation was going to get worse @ @ @ @ @ @ @ the availability of donors.
” Donor numbers , so far , have remained steady .
Contingency plans are in place to ensure clinics can stay open in the event of further travel restrictions , though the IBTS wants donors to be exempted , if that happens .
In Spain , donors were given written permission to leave their homes to donate blood : “ So , we will be asking that that will happen similarly in Ireland so we can maintain blood supply , ” said Mr Kelly .
Northern Ireland has seen @ @ @ @ @ @ @ would be concerned [ that ] it would put donors off coming , ” says Matt Gillespie , supply chain manager with the Northern Ireland Blood Transfusion Service ( NIBTS ) .
“ We are continuing to encourage people to come because we still need donations , ” said Mr Gillespie , adding that Northern Ireland would be able to get emergency supplies from Britain , if that proves necessary .

Donations have fallen in Northern Ireland but there is a contingency to get blood from the NHS in Britain.
When Patricia Russell gave blood in Limerick last week, she did so in a hotel which was about to close because of coronavirus.
“I did think, should I go or not, because coronavirus is in everybody’s head now,” she says. “You couldn’t but think of it.
“But then you think, what if there was a car accident, or somebody needed blood, and you just do it. If you’re feeling well, and you don’t have anything wrong with you, why not?”
Russell, from Meelick, Co Clare, began donating blood after her mother died of cancer in 2013; she had received blood transfusions during her treatment. “That was what started me donating,” she explains.
READ MORE
From Monday, the Irish Blood Transfusion Service (IBTS) is moving donor clinics to larger venues countrywide so it can put more space between donors to obey social distancing guidelines.
Donors will be asked to make appointments, too: "In spite of Covid-19, we still need to collect about 80 per cent of our normal supply," said Andy Kelly, IBTS chief executive.
“Cancer patients, transplant cases, trauma and others with conditions that require ongoing support with blood components rely on blood donors as much as ever.”
“We are grateful for the support donors have given so far and the blood supply at this time remains good, however the need for blood donations is ongoing and we are now planning for the weeks ahead,” added Mr Kelly.
Italian experience
The 80 per cent supply need is based on the Italian experience, which saw demand there fall by about a fifth because of fewer traffic crashes, and less work-related accidents or sports injuries.
The latest restriction to apply to potential blood donors is that they must not show any symptoms of Covid-19, and must not have travelled outside the island of Ireland within the past 14 days. Full details for donors can be found at giveblood.ie.
The IBTS had moved to build up stocks ahead of the crisis: “Obviously, we knew the situation was going to get worse and we might be seriously impacted by the availability of donors.”
Donor numbers, so far, have remained steady. Contingency plans are in place to ensure clinics can stay open in the event of further travel restrictions, though the IBTS wants donors to be exempted, if that happens.
In Spain, donors were given written permission to leave their homes to donate blood: "So, we will be asking that that will happen similarly in Ireland so we can maintain blood supply," said Mr Kelly.
Northern Ireland has seen donations numbers fall slightly: "We would be concerned [that] it would put donors off coming," says Matt Gillespie, supply chain manager with the Northern Ireland Blood Transfusion Service (NIBTS).
“We are continuing to encourage people to come because we still need donations,” said Mr Gillespie, adding that Northern Ireland would be able to get emergency supplies from Britain, if that proves necessary.


theirishtimes--2020-03-26--Coronavirus: Ireland could be quickly overwhelmed by new cases, report warns

Ireland ’ s ability to treat coronavirus patients in intensive care could be the quickest to be overwhelmed in the EU , according to a new report .
The warning from the European Centre for Disease Control ( ECDC ) comes as two more patients with Covid-19 died on Wednesday , bringing to nine the total number of deaths in the Republic from the disease .
The two deaths were of a woman in the east of the country , who had an underlying health condition , and a man , also in the east .
Some 235 new cases @ @ @ @ @ @ @ Health Emergency Team ( NPHET ) , the highest daily total since Ireland recorded its first case almost a month ago .
The total number of cases is now 1,564 .
Ireland ’ s intensive care facilities can cope with just 5.6 people in every 100,000 needing to be hospitalised , the lowest level in Europe , according to the ECDC .
Its estimate is based on a scenario of 18 per cent of hospitalised patients needing ICU care , as happened in Lombardy during Italy ’ s outbreak .
The next-most vulnerable @ @ @ @ @ @ @ can cope with up to 6.7 cases per 100,000 .
The ECDC ’ s modelling is based on official figures for ICU capacity in Ireland , and does not take account of actions taken to increase this capacity in recent weeks .
Asked on Wednesday night about the provision of intensive care facilities , HSE chief clinical officer Dr Colm Henry said “ extensive preparations ” had been made for increasing ICU provision .
Baseline capacity of 220 beds had been increased to about 500 and further capacity was available through the provision @ @ @ @ @ @ @ hospitals , including in private hospitals .
Dr Henry also said personal protective equipment for medical staff would be flown to Ireland from China in 50-60 flights , beginning on Sunday .
The ECDC says that if the pandemic remains on its current course without strong countermeasures and surge capacity enacted , there is a “ high probability ” many EU/EEA countries will experience demands that far exceed currently available ICU capacity .
“ If this trend continues , it is likely that in days or a small number of weeks , prevalence @ @ @ @ @ @ @ be observed in most EU/EEA countries , ” the EU agency warned on Wednesday in its latest update on the pandemic .
NPHET on Wednesday night defended the change in case definition that ruled out sending people with only one symptom of Covid-19 for testing , as previously applied .
GPs around the country reported being inundated with calls from patients seeking clarification or wanting to be reassessed on Wednesday following the change .
Chief medical officer Dr Tony Holohan pointed out that only 6 per cent of tests carried out so far @ @ @ @ @ @ @ Ireland performed a test on everyone who had sought one it would be going beyond what any country in the world has done , he said .
British health officials said a 15-minute test for the virus may be made available through pharmacies and online delivery services .
The UK government said it had bought 3.5 million antibody test kits .
Asked whether Irish authorities might do the same , Dr Holohan said NPHET would like to have a “ reliable ” serological test available but was “ not at this point yet @ @ @ @ @ @ @ Thursday to consider whether Covid-19-specific hospitals should be established during the surge of cases expected in the coming weeks .
Wards and other segregated areas have already been designated in many hospitals but Thursday ’ s meeting will also consider whether to designate some hospitals , particularly in Dublin , for this purpose .
Also on Thursday , legislation allowing a new wage subsidy scheme to come into effect is due before the Dáil .
The scheme to help workers through the pandemic and keep them connected with their employers will involve €410 @ @ @ @ @ @ @ employees over the coming weeks as the Government moves to push cash out as quickly as possible .
This will allow companies to support wages and initially simplify the scheme before the more complex graduated subsidy system from next month .

Chief Medical Officer Dr Tony Holohan says that he does not expect complacency among the public over the lower than expected positive tests numbers for Covid-19. Video: RTÉ
Ireland’s ability to treat coronavirus patients in intensive care could be the quickest to be overwhelmed in the EU, according to a new report.
The warning from the European Centre for Disease Control (ECDC) comes as two more patients with Covid-19 died on Wednesday, bringing to nine the total number of deaths in the Republic from the disease.
The two deaths were of a woman in the east of the country, who had an underlying health condition, and a man, also in the east.
Some 235 new cases were also reported by the National Public Health Emergency Team (NPHET), the highest daily total since Ireland recorded its first case almost a month ago. The total number of cases is now 1,564.
READ MORE
Ireland's intensive care facilities can cope with just 5.6 people in every 100,000 needing to be hospitalised, the lowest level in Europe, according to the ECDC.
Its estimate is based on a scenario of 18 per cent of hospitalised patients needing ICU care, as happened in Lombardy during Italy's outbreak. The next-most vulnerable country is the United Kingdom, which can cope with up to 6.7 cases per 100,000.
Increased capacity
The ECDC’s modelling is based on official figures for ICU capacity in Ireland, and does not take account of actions taken to increase this capacity in recent weeks.
Asked on Wednesday night about the provision of intensive care facilities, HSE chief clinical officer Dr Colm Henry said "extensive preparations" had been made for increasing ICU provision. Baseline capacity of 220 beds had been increased to about 500 and further capacity was available through the provision of "ICU-type" care outside acute hospitals, including in private hospitals.
Dr Henry also said personal protective equipment for medical staff would be flown to Ireland from China in 50-60 flights, beginning on Sunday.
The ECDC says that if the pandemic remains on its current course without strong countermeasures and surge capacity enacted, there is a “high probability” many EU/EEA countries will experience demands that far exceed currently available ICU capacity.
"If this trend continues, it is likely that in days or a small number of weeks, prevalence similar to Hubei province and Italy will be observed in most EU/EEA countries," the EU agency warned on Wednesday in its latest update on the pandemic.
NPHET on Wednesday night defended the change in case definition that ruled out sending people with only one symptom of Covid-19 for testing, as previously applied. GPs around the country reported being inundated with calls from patients seeking clarification or wanting to be reassessed on Wednesday following the change.
Positive
Chief medical officer Dr Tony Holohan pointed out that only 6 per cent of tests carried out so far had come back as positive. If Ireland performed a test on everyone who had sought one it would be going beyond what any country in the world has done, he said.
British health officials said a 15-minute test for the virus may be made available through pharmacies and online delivery services. The UK government said it had bought 3.5 million antibody test kits.
Asked whether Irish authorities might do the same, Dr Holohan said NPHET would like to have a “reliable” serological test available but was “not at this point yet”.
NPHET is to meet on Thursday to consider whether Covid-19-specific hospitals should be established during the surge of cases expected in the coming weeks. Wards and other segregated areas have already been designated in many hospitals but Thursday’s meeting will also consider whether to designate some hospitals, particularly in Dublin, for this purpose.
Also on Thursday, legislation allowing a new wage subsidy scheme to come into effect is due before the Dáil.
The scheme to help workers through the pandemic and keep them connected with their employers will involve €410 being paid a week for all qualifying employees over the coming weeks as the Government moves to push cash out as quickly as possible.
This will allow companies to support wages and initially simplify the scheme before the more complex graduated subsidy system from next month.


theirishtimes--2020-03-26--The science behind the race to develop a coronavirus vaccine

A vaccine for Covid-19 is soon to be injected into healthy volunteers in Seattle , US .
The National Institutes of Health in the US will run these tests with a vaccine made by biotech firm Moderna .
“ This was reputedly prepared and ready for testing in 42 days , which is an incredibly rapid response , ” says Prof Kingston Mills , immunologist at Trinity College Dublin .
“ Under normal circumstances to make a vaccine and have it approved for use could take 10 to 15 years.
” Traditional vaccines are often made from live weakened viruses @ @ @ @ @ @ @ A big advantage with the new vaccine is that it is made from RNA , a simple biomolecule that is easier and faster to synthesise .
The RNA is placed inside a minuscule lipid particle .
RNA is the code that the coronavirus inserts into our cells .
Normally DNA is copied into messenger RNA in our cells , which is the blueprint to make proteins .
The coronavirus hacks into this system to manufacture new coronaviruses .
The RNA inside lipid is injected and gobbled up by patrolling immune cells in our @ @ @ @ @ @ @ pieces of virus protein on their surface to alert and teach other immune cells about the virus .
German company CureVac is also advancing a RNA vaccine for Covid-19 .
CEO Ingmar Hoerr says they will make 10-gram batches of RNA , which is enough for thousands of vaccine doses .
He says with more funding there is nothing to stop them making millions or even billions of doses .
However , there is no RNA vaccine approved for any disease yet .
CureVac had an RNA vaccine for rabies in clinical trial @ @ @ @ @ @ @ coronavirus .
It is expected that drug regulators will fast-forward approval for a pandemic vaccine .
“ It could be ready in 12 to 18 months from now .
That is great if it happens , ” says Prof Mills .
There are also DNA and protein vaccines .
The target proteins are invariably the spikes that give the virus a crown-like appearance under an electron microscope – hence their name coronavirus .
Remarkably , Chinese scientists released the entire RNA sequence of the Covid-19 virus by early January .
Scientists around the @ @ @ @ @ @ @ of all or some of the spike protein to make vaccine .
The spike is what the virus uses to harpoon on to a receptor ( ACE2 ) on cells in our mouth , throat , lungs and gut .
The immune cells and antibodies of a vaccinated person would be expected to spot the spike protein and neutralise the virus .
Moderna ’ s vaccine encodes the entire spike protein .
Prof Robin Shattock at Imperial College London is now testing his own RNA vaccine based on the spike protein in lab @ @ @ @ @ @ @ we hope to do first-in-human studies this summer to see if it induces the right antibody response in people , ” he says .
What will take time is people testing .
“ The science of what will make a good vaccine will happen very fast , ” predicts Prof Michael Farzan at the Scripps Institute in Florida – the scientist who first reported that SARS hooked on to ACE2 receptors in lung cells .
“ The problem is that production , distribution and testing can take a year or more.
” Testing @ @ @ @ @ @ @ sees a small number of healthy adults given the vaccine to ensure it is safe , which may last two months .
The Seattle trial will enrol 45 adults .
Phase II trials test safety in a larger group of people and look for expected effects in the body .
Then comes the big one .
“ The stringent testing is in phase III .
You are normally talking about tens of thousands of people being tested , ” says Prof Mills .
“ They may change the rules when there ’ s @ @ @ @ @ @ @ the hands of the European Medicines Agency in Europe and the Food and Drug Administration in the US to decide if the vaccine can be licensed .
This might be based on more limited safety and efficacy testing than normally required for a new vaccine .
While regulators might speed up decision-making , Prof Mills is adamant they will not bend the rules .
“ They will not regulate a vaccine unless happy it is safe and effective.
” He acknowledges frustration among the public that they can not get a drug such @ @ @ @ @ @ @ “ But if you put something on the market that doesn ’ t work or causes side effects then you lose the confidence of the public , ” says Prof Mills .
“ It has to be tested appropriately.
” Drug trials involve thousands of patients partly because small groups of people may turn out to be at risk of rare side effects , perhaps because of their age , or genetic makeup or underlying health conditions .
On the upside , the SARS-CoV-2 virus is not expected to change much .
It @ @ @ @ @ @ @ a better proof reader ” than other RNA viruses , such as influenza , which tends to make lots of mistakes ( ie mutations ) .
“ It tends to evolve slower than other RNA viruses , ” says Prof Farzan .
“ So we should be in reasonable shape with vaccines based on early versions of the spike protein.
” Flu mutates so much that a new vaccine is needed every winter , and even then it is a best guess as to the dominant strains .
“ I would say HIV @ @ @ @ @ @ @ , and something like this coronavirus is relatively straightforward to develop a vaccine for , ” Prof Farzan adds .
It may even be possible to make a vaccine against many of the coronaviruses in bats that might again jump to people and threaten another pandemic .
Asked if a vaccine for just older people might be feasible , Prof Shattock at Imperial College London says this is unlikely .
It could take longer to show a vaccine is effective in those aged over 65 as their immune response is not as strong @ @ @ @ @ @ @ care givers and medical staff would do a lot to prevent exposure to the more vulnerable.
” Prof Mills does not think that a vaccine will be available by summer .
There may be value to having a vaccine by 2021 .
We don ’ t know if this coronavirus will be seasonal like the flu , meaning that infections drop off during the summer when the weather warms up .
“ If it behaves like the flu then there is risk that it might come back in the autumn , ” Mills @ @ @ @ @ @ @ available for the winter of 2021 .
There are plenty of intense efforts to generate one .
Inovio is a US biotech company developing a DNA vaccine for Covid-19 .
The DNA begets viral RNA and viral proteins .
A group in Australia is developing stable viral protein as parts of its vaccine , and Novavax is working on a protein vaccine .
All are funded by the Coalition for Epidemic Preparedness Innovations ( CEPI ) , which also supports CureVac and a group at Oxford University .
CEPI was established in 2017 @ @ @ @ @ @ @ .
It was funded by governments in Germany , Japan and Norway , as well as the Bill & Melinda Gates Foundation and the Wellcome Trust .
Its sense of emergency about the risk of a global pandemic caused by flu or a novel coronavirus has proven to be entirely justified .

The target proteins for a coronavirus vaccine are the spikes that give the virus its crown-like appearance, hence the name coronavirus. Photograph: Getty Images
A vaccine for Covid-19 is soon to be injected into healthy volunteers in Seattle, US. The National Institutes of Health in the US will run these tests with a vaccine made by biotech firm Moderna.
"This was reputedly prepared and ready for testing in 42 days, which is an incredibly rapid response," says Prof Kingston Mills, immunologist at Trinity College Dublin. "Under normal circumstances to make a vaccine and have it approved for use could take 10 to 15 years."
Traditional vaccines are often made from live weakened viruses or viral proteins manufactured in cells. A big advantage with the new vaccine is that it is made from RNA, a simple biomolecule that is easier and faster to synthesise.
The RNA is placed inside a minuscule lipid particle. RNA is the code that the coronavirus inserts into our cells. Normally DNA is copied into messenger RNA in our cells, which is the blueprint to make proteins. The coronavirus hacks into this system to manufacture new coronaviruses.
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The RNA inside lipid is injected and gobbled up by patrolling immune cells in our bodies. These chop up and stick pieces of virus protein on their surface to alert and teach other immune cells about the virus.
German company CureVac is also advancing a RNA vaccine for Covid-19. CEO Ingmar Hoerr says they will make 10-gram batches of RNA, which is enough for thousands of vaccine doses. He says with more funding there is nothing to stop them making millions or even billions of doses.
However, there is no RNA vaccine approved for any disease yet. CureVac had an RNA vaccine for rabies in clinical trial, but is refocusing now on the coronavirus. It is expected that drug regulators will fast-forward approval for a pandemic vaccine.
“It could be ready in 12 to 18 months from now. That is great if it happens,” says Prof Mills.
Spikes
There are also DNA and protein vaccines. The target proteins are invariably the spikes that give the virus a crown-like appearance under an electron microscope – hence their name coronavirus.
Remarkably, Chinese scientists released the entire RNA sequence of the Covid-19 virus by early January. Scientists around the world then raced to copy the blueprint of all or some of the spike protein to make vaccine.
The spike is what the virus uses to harpoon on to a receptor (ACE2) on cells in our mouth, throat, lungs and gut. The immune cells and antibodies of a vaccinated person would be expected to spot the spike protein and neutralise the virus. Moderna’s vaccine encodes the entire spike protein.
Prof Robin Shattock at Imperial College London is now testing his own RNA vaccine based on the spike protein in lab animals. "With the right funding we hope to do first-in-human studies this summer to see if it induces the right antibody response in people," he says.
What will take time is people testing. "The science of what will make a good vaccine will happen very fast," predicts Prof Michael Farzan at the Scripps Institute in Florida – the scientist who first reported that SARS hooked on to ACE2 receptors in lung cells. "The problem is that production, distribution and testing can take a year or more."
Three steps
Testing happens in three steps. The first sees a small number of healthy adults given the vaccine to ensure it is safe, which may last two months. The Seattle trial will enrol 45 adults. Phase II trials test safety in a larger group of people and look for expected effects in the body.
Then comes the big one. “The stringent testing is in phase III. You are normally talking about tens of thousands of people being tested,” says Prof Mills. “They may change the rules when there’s a pandemic.”
It will be in the hands of the European Medicines Agency in Europe and the Food and Drug Administration in the US to decide if the vaccine can be licensed. This might be based on more limited safety and efficacy testing than normally required for a new vaccine.
While regulators might speed up decision-making, Prof Mills is adamant they will not bend the rules. “They will not regulate a vaccine unless happy it is safe and effective.”
He acknowledges frustration among the public that they cannot get a drug such an an antiviral or a vaccine. “But if you put something on the market that doesn’t work or causes side effects then you lose the confidence of the public,” says Prof Mills. “It has to be tested appropriately.”
Drug trials involve thousands of patients partly because small groups of people may turn out to be at risk of rare side effects, perhaps because of their age, or genetic makeup or underlying health conditions.
On the upside, the SARS-CoV-2 virus is not expected to change much. It has a very large genome and “a better proof reader” than other RNA viruses, such as influenza, which tends to make lots of mistakes (ie mutations).
“It tends to evolve slower than other RNA viruses,” says Prof Farzan. “So we should be in reasonable shape with vaccines based on early versions of the spike protein.”
Flu mutates so much that a new vaccine is needed every winter, and even then it is a best guess as to the dominant strains.
“I would say HIV is the hardest, flu is intermediate, and something like this coronavirus is relatively straightforward to develop a vaccine for,” Prof Farzan adds.
It may even be possible to make a vaccine against many of the coronaviruses in bats that might again jump to people and threaten another pandemic.
Immune response
Asked if a vaccine for just older people might be feasible, Prof Shattock at Imperial College London says this is unlikely. It could take longer to show a vaccine is effective in those aged over 65 as their immune response is not as strong.
“That said, vaccination of care givers and medical staff would do a lot to prevent exposure to the more vulnerable.”
Prof Mills does not think that a vaccine will be available by summer. There may be value to having a vaccine by 2021. We don’t know if this coronavirus will be seasonal like the flu, meaning that infections drop off during the summer when the weather warms up. “If it behaves like the flu then there is risk that it might come back in the autumn,” Mills notes.
There may be a vaccine available for the winter of 2021. There are plenty of intense efforts to generate one.
Inovio is a US biotech company developing a DNA vaccine for Covid-19. The DNA begets viral RNA and viral proteins. A group in Australia is developing stable viral protein as parts of its vaccine, and Novavax is working on a protein vaccine. All are funded by the Coalition for Epidemic Preparedness Innovations (CEPI), which also supports CureVac and a group at Oxford University.
CEPI was established in 2017 to speed vaccine development for new diseases. It was funded by governments in Germany, Japan and Norway, as well as the Bill & Melinda Gates Foundation and the Wellcome Trust. Its sense of emergency about the risk of a global pandemic caused by flu or a novel coronavirus has proven to be entirely justified.


theirishtimes--2020-03-26--On the Covid-19 frontline: ‘We would all love to hide in a corner but none of us will’

Maitiú Ó Faoláin and his wife Triona , who are both GPs , sat down at the kitchen table in the family home in Ashbourne , Co Meath , last week to have the strangest conversation of their married lives .
“ When things started to get worse , I had to sit down with my wife and have a conversation about if one of us was to die from [ coronavirus ] , who would the kids be better off with , ” says Maitiú .
Keenly aware of the risks doctors face during the Covid-19 pandemic , the @ @ @ @ @ @ @ work at the Deerpark Medical Centre , but that Triona would stay at home to mind their children .
“ Kids prefer their mammies , ” he says .
“ It was a very emotional conversation .
To think of leaving the kids without a parent .
.
.
but we knew what we signed up for when we became doctors.
” GPs have dramatically changed work practices since the outbreak began , says Maitiú .
Walk-in clinics have ceased , telephone and video consultations have become the norm and extra care is @ @ @ @ @ @ @ symptoms .
Hospital staff face greater risk of contracting the virus than GPs do , he emphasises .
“ [ Hospital staff ] are petrified .
We are at risk but we are not the highest risk of healthcare workers .
“ We would all love to walk away and hide in a corner but none of us will .
We will serve our community because we love our patients .
We won ’ t leave people wanting.
” Cork GP Dr Nick Flynn , meanwhile , said he and many other doctors @ @ @ @ @ @ @ enough supplies of personal protection equipment ( PPE ) to last until the end of the week , but concerns exist about what happens after .
“ I heard HSE chief executive Paul Reid say that we buy €15 million worth of PPE each year but we are going to spend €214 million on PPE this year and €31 million of that is coming this week and it ’ s being fast-tracked by air freight from China , ” he said .
“ I would be slow to be critical of anyone at @ @ @ @ @ @ @ best , but what doctors need is more clarity about what ’ s coming in and how is it going to be distributed.
” Guarantees about future supplies are needed , too , though they must first go to frontline hospital staff , said Dr Flynn , who runs MyCorkGP , which has four clinics in Cork city and one in the county .
Doctors in A & Es , ICUs and ear , nose and throat wards are most at risk , he says .
“ The international experience shows that those @ @ @ @ @ @ @ are those who are exposed to a lot of virus , what is called high viral load.
” Under the HSE guidelines , each GP is to receive a carton of PPE supplies containing hand gel , 240 surgical masks , two packs of 10 disposable gowns and 100 extended cuff-gloves .
Dr Flynn said he had sourced €5,500 worth of PPE for the 24 clinicians working at his five clinics , which serve some 15,000 patients .

Maitiú Ó Faoláin and his wife Triona, who are both GPs, sat down at the kitchen table in the family home in Ashbourne, Co Meath, last week to have the strangest conversation of their married lives.
“When things started to get worse, I had to sit down with my wife and have a conversation about if one of us was to die from [coronavirus], who would the kids be better off with,” says Maitiú.
Keenly aware of the risks doctors face during the Covid-19 pandemic, the couple decided that Maitiú would continue to work at the Deerpark Medical Centre, but that Triona would stay at home to mind their children.
“Kids prefer their mammies,” he says. “It was a very emotional conversation. To think of leaving the kids without a parent . . . but we knew what we signed up for when we became doctors.”
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GPs have dramatically changed work practices since the outbreak began, says Maitiú. Walk-in clinics have ceased, telephone and video consultations have become the norm and extra care is being taken when treating patients with respiratory symptoms.
Hospital staff face greater risk of contracting the virus than GPs do, he emphasises. “[Hospital staff] are petrified. We are at risk but we are not the highest risk of healthcare workers.
“We would all love to walk away and hide in a corner but none of us will. We will serve our community because we love our patients. We won’t leave people wanting.”
Concerns over supplies
Cork GP Dr Nick Flynn, meanwhile, said he and many other doctors – but not all – currently have enough supplies of personal protection equipment (PPE) to last until the end of the week, but concerns exist about what happens after.
"I heard HSE chief executive Paul Reid say that we buy €15 million worth of PPE each year but we are going to spend €214 million on PPE this year and €31 million of that is coming this week and it's being fast-tracked by air freight from China, " he said.
“I would be slow to be critical of anyone at this time because everyone is doing their best, but what doctors need is more clarity about what’s coming in and how is it going to be distributed.”
Guarantees about future supplies are needed, too, though they must first go to frontline hospital staff, said Dr Flynn, who runs MyCorkGP, which has four clinics in Cork city and one in the county.
Doctors in A&Es, ICUs and ear, nose and throat wards are most at risk, he says.
“The international experience shows that those who do poorly in all of this are those who are exposed to a lot of virus, what is called high viral load.”
Under the HSE guidelines, each GP is to receive a carton of PPE supplies containing hand gel, 240 surgical masks, two packs of 10 disposable gowns and 100 extended cuff-gloves.
Dr Flynn said he had sourced €5,500 worth of PPE for the 24 clinicians working at his five clinics, which serve some 15,000 patients.


theirishtimes--2020-03-26--Coronavirus: Encouraging signs for Ireland in calm before surge

The second raft of measures announced by the Government in an attempt to curb the spread of coronavirus represent a considered and proportionate response to a challenge that is growing by the day .
The measures , set out on Tuesday , will only add to the economic misery already heaped upon citizens by Covid-19 , and have failed to satisfy those voices calling for a complete lockdown of society .
However , the fact that they fall around the centre line of what might have been done does not mean they amount to a fudge .
Throughout this crisis @ @ @ @ @ @ @ consistent and evidence-led approach to the challenge involved .
Where countries on either side of us have flip-flopped and changed tack with astonishing rapidity , the Irish authorities have followed a graduated approach based on the best available international and local advice .
In other countries , some politicians have played politics with the pandemic , but in the State the lead has been taken by scientific experts , with the Government effectively playing a support role that has demanded the provision of large sums of money .
In common with other countries @ @ @ @ @ @ @ way .
There was a failure to clamp down on travel from problem areas , notably Italy , quickly enough .
Ireland also seems to be behind the curve on the provision of personal protective equipment for health staff and on testing .
This was apparent again over the past 24 hours when the criteria for testing were altered again , effectively meaning people with only one Covid-19 symptom will not be tested .
It is hard not to see this as a change designed to cut the demand for testing , which @ @ @ @ @ @ @ the system ’ s ability to provide the service .
It now seems the official approach is the same as that of the World Health Organisation – “ test , test , test ” – but with the rider “ though not just yet ” .
At Tuesday ’ s briefing by the National Public Health Emergency Team , chief medical officer Dr Tony Holohan freely accepted that public health officials had “ cast their net too widely ” when loosening their criteria a fortnight ago .
At the time , the focus @ @ @ @ @ @ @ overseas as a criterion for being tested for the virus .
However , it was the decision to test people with just one symptom that really opened the floodgates .
The resulting 20,000 people a day who sought testing included people with other ailments , including flu , as well as a good proportion of the “ worried well ” .
Lost among the numbers were the real priority cases , such as healthcare workers and , at times , the more severely ill. Now Ireland is adopting the World Health Organisation ( @ @ @ @ @ @ @ which requires two signs – fever and a respiratory symptom such as a cough or breathlessness .
This begs the question why didn ’ t we adopt the WHO rules in the first place ?
There are uncomfortable echoes of the cervical cancer controversy here – where an offer of free repeat smears to the wider population of women ended up clogging up the system and creating months of delay in the screening programme .
In the current situation , too many patients are waiting too long to be tested or too long @ @ @ @ @ @ @ this is only a short-term problem and the backlog will be cleared , as a prelude to wider testing in the population .
Still , in this calm-before-the-surge moment , there are some encouraging signs .
There is widespread adherence to social distancing ; the number of contacts of confirmed cases is dropping ; and the number of diagnosed cases is growing slightly more slowly than expected – though this may be due to the seven-day time lag caused by testing delays .
It is still too early to know whether the measures @ @ @ @ @ @ @ at least the hands on the tiller seem to know where we are headed .

LE Samuel Beckett on Sir John Rogerson’s Quay in use as a coronavirus testing facility: The number of diagnosed cases is growing slightly more slowly than feared. Photograph: Nick Bradshaw
The second raft of measures announced by the Government in an attempt to curb the spread of coronavirus represent a considered and proportionate response to a challenge that is growing by the day.
The measures, set out on Tuesday, will only add to the economic misery already heaped upon citizens by Covid-19, and have failed to satisfy those voices calling for a complete lockdown of society.
However, the fact that they fall around the centre line of what might have been done does not mean they amount to a fudge. Throughout this crisis, Ireland has taken a measured, consistent and evidence-led approach to the challenge involved.
Where countries on either side of us have flip-flopped and changed tack with astonishing rapidity, the Irish authorities have followed a graduated approach based on the best available international and local advice.
READ MORE
In other countries, some politicians have played politics with the pandemic, but in the State the lead has been taken by scientific experts, with the Government effectively playing a support role that has demanded the provision of large sums of money.
Policy mistakes
In common with other countries, Ireland has made mistakes along the way. There was a failure to clamp down on travel from problem areas, notably Italy, quickly enough. Ireland also seems to be behind the curve on the provision of personal protective equipment for health staff and on testing.
This was apparent again over the past 24 hours when the criteria for testing were altered again, effectively meaning people with only one Covid-19 symptom will not be tested.
It is hard not to see this as a change designed to cut the demand for testing, which was running out of all proportion to the system's ability to provide the service. It now seems the official approach is the same as that of the World Health Organisation – "test, test, test" – but with the rider "though not just yet".
At Tuesday's briefing by the National Public Health Emergency Team, chief medical officer Dr Tony Holohan freely accepted that public health officials had "cast their net too widely" when loosening their criteria a fortnight ago.
At the time, the focus was on the removal of travel from overseas as a criterion for being tested for the virus. However, it was the decision to test people with just one symptom that really opened the floodgates.
The resulting 20,000 people a day who sought testing included people with other ailments, including flu, as well as a good proportion of the “worried well”. Lost among the numbers were the real priority cases, such as healthcare workers and, at times, the more severely ill.
Now Ireland is adopting the World Health Organisation (WHO) case definition for Covid-19, which requires two signs – fever and a respiratory symptom such as a cough or breathlessness.
This begs the question why didn’t we adopt the WHO rules in the first place?
Clogged system
There are uncomfortable echoes of the cervical cancer controversy here – where an offer of free repeat smears to the wider population of women ended up clogging up the system and creating months of delay in the screening programme.
In the current situation, too many patients are waiting too long to be tested or too long to get their results. Hopefully, this is only a short-term problem and the backlog will be cleared, as a prelude to wider testing in the population.
Still, in this calm-before-the-surge moment, there are some encouraging signs. There is widespread adherence to social distancing; the number of contacts of confirmed cases is dropping; and the number of diagnosed cases is growing slightly more slowly than expected – though this may be due to the seven-day time lag caused by testing delays.
It is still too early to know whether the measures adopted in Ireland will work, but at least the hands on the tiller seem to know where we are headed.


theirishtimes--2020-03-26--Creches look for clarity on Zappone financial assistance scheme

Creche groups have written to Minister for Children Katherine Zappone seeking further clarity on her bailout of the sector , which will mean the State effectively nationalises the wage bill for creches in exchange for waiving of fees charged to parents for the next three months .
Early Childhood Ireland ( ECI ) has raised several queries with the Department of Children , including whether operators will have a choice about signing the new emergency Covid-19 contract .
They have also asked for clarity on issues concerning holiday pay , maternity leave and how owners who do not pay themselves @ @ @ @ @ @ @ ECI welcomed the proposal , some creche groups have objected to the scheme , according to correspondence seen by The Irish Times .
In a letter to Ms Zappone , the Federation of Early Childhood Providers argued that in the absence of the subsidies , while wages will be covered , significant cash-flow issues will emerge .
“ Your proposal of yesterday will result in services not being able to meet their overheads or fund the payment of staff as we will have considerable cash flow issues .
Your proposal will immediately result @ @ @ @ @ @ @ significant number of staff , running into the tens of thousands , and the closure of a vast number of services nationwide.
” The group said it is “ demanding that the DCYA [ Department of Children and Youth Affairs ] re-instate all existing [ subsidy ] schemes until the end of this crisis ” .
Under a scheme announced by the Government on Tuesday , the department will pay 30 per cent of wages up to a level of €38,000 per year for the next three months , on top of the @ @ @ @ @ @ @ 70 per cent of wages up to this level .
Due to the relatively low average salary in the sector , this will cover the majority of the wage bill across the sector .
However , the department is suspending other subsidies it usually pays to creches during this period and replacing them with this single payment .

Katherine Zappone has been told that her ‘proposal will immediately result in the termination of employment for a significant number of staff’. File photograph: The Irish Times
Creche groups have written to Minister for Children Katherine Zappone seeking further clarity on her bailout of the sector, which will mean the State effectively nationalises the wage bill for creches in exchange for waiving of fees charged to parents for the next three months.
Early Childhood Ireland (ECI) has raised several queries with the Department of Children, including whether operators will have a choice about signing the new emergency Covid-19 contract.
They have also asked for clarity on issues concerning holiday pay, maternity leave and how owners who do not pay themselves a salary will be treated.
While ECI welcomed the proposal, some creche groups have objected to the scheme, according to correspondence seen by The Irish Times. In a letter to Ms Zappone, the Federation of Early Childhood Providers argued that in the absence of the subsidies, while wages will be covered, significant cash-flow issues will emerge.
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“Your proposal of yesterday will result in services not being able to meet their overheads or fund the payment of staff as we will have considerable cash flow issues. Your proposal will immediately result in the termination of employment for a significant number of staff, running into the tens of thousands, and the closure of a vast number of services nationwide.”
Single payment plan
The group said it is “demanding that the DCYA [Department of Children and Youth Affairs] re-instate all existing [subsidy] schemes until the end of this crisis”.
Under a scheme announced by the Government on Tuesday, the department will pay 30 per cent of wages up to a level of €38,000 per year for the next three months, on top of the Government’s wider scheme to cover 70 per cent of wages up to this level.
Due to the relatively low average salary in the sector, this will cover the majority of the wage bill across the sector. However, the department is suspending other subsidies it usually pays to creches during this period and replacing them with this single payment.