theirishtimes--2020-03-16--Coronavirus: Taxi drivers advised to regularly disinfect cars

Taxi drivers are being advised to regularly disinfect their cars and opt for card payments where possible , in a bid to protect themselves and their passengers from coronavirus .
In advice issued by Free Now , the cab-hailing app , the company recommends both drivers and passengers adhere to the HSE guidelines .
Free Now also recommends that passengers touch the inside of the taxi “ as little as possible ” and to avoid touching anyone ’ s hands or phone .
Drivers are advised to clean and disinfect their cars regularly and to avoid touching passengers ’ phones @ @ @ @ @ @ @ on its website , the company said its “ main focus ” is to keep drivers , passengers and employees safe .
“ Drivers can switch to card payment only so that they can avoid touching cash .
We are happy to make this change for any driver who is interested .
Drivers can email Customer Care with the request , ” the statement says .
“ We have also temporarily turned off our Match taxi sharing service.
” Joe Herron , President of the Irish Taxi Drivers ’ Federation , said taxi @ @ @ @ @ @ @ the virus .
“ First of all , it ’ s one of the occupations where you ’ re more vulnerable to get it because you ’ re in a closed area , a vehicle , ” he said .
“ Some drivers are carrying cleaning equipment but it ’ s very hard to get hand sanitiser at the moment , they seem to have all disappeared.
” He added that the pandemic is hitting the sector particularly hard .
“ Most are family men , and lots and lots of them have @ @ @ @ @ @ @ taxi driver , you just don ’ t have any back up as such .
If you don ’ t work , you don ’ t get paid .
People in Amazon and stuff , they were all working from home but we can ’ t do that.
” Alan Cooley , a taxi driver serving Dublin airport , said his fear of contracting coronavirus is severe , but he has no choice but to accept the passengers requesting his services , regardless of where they are travelling from .
“ The drivers @ @ @ @ @ @ @ .
If they don ’ t take the work , they could be waiting at the terminal for hours , ” Mr Cooley said .
“ Because you ’ re self-employed , you ’ re in a precarious position up in Dublin airport .
You have to earn a living .
The people getting into your car , you have to bring them home so you have to make that decision on spec.
” He has begun to wipe down the interiors of his car after every ride , as well as places @ @ @ @ @ @ @ door handles .
“ Every job I have , I wipe down the seats , I wipe down the doors because you ’ re kind of left to your own .
There ’ s no information being sent out to us telling us how to deal with it.
” Despite these actions , he still fears coming into close contact with an individual who has the virus , because that would result in him having to self-isolate for 14 days , giving rise to a loss of income .
He added that the @ @ @ @ @ @ @ dropped substantially ” in recent weeks , meaning fares are fewer and further in between .
“ If you ’ re in Dublin Airport , normally you would wait between half an hour and 40 minutes for a job .
Now you ’ re looking at three hours for a job , ” he said .
“ Even though planes are coming into Dublin airport , and the manifesto is saying they ’ re full , they ’ re not .
You ’ re kind of put under pressure then that you have @ @ @ @ @ @ @ it is .
”

Taxi drivers are being advised to regularly disinfect their cars and opt for card payments where possible, in a bid to protect themselves and their passengers from coronavirus. File Photograph: Alan Betson/The Irish Times
Taxi drivers are calling on the Government to issue a directive on how they can help “ease the burden” being placed on ambulances and emergency services during the coronavirus pandemic.
Vinny Kearns, chief executive of NXT Taxis, said there has been a large decline in normal rides due to coronavirus, and that taxi services could be repurposed to help patients needing to attend medical appointments or for delivering grocery shopping for elderly or at-risk individuals.
“Anything that’s non-essential has really declined, and a lot of our competitors have closed their doors. From an economic point of view, that probably is the best thing for me to do,” Mr Kearns said.
“But we would be delighted to play our part, if we could take the pressure off emergency services. Ambulances could deal with emergencies and we could aid patients getting to essential appointments such as chemo, dialysis, blood transfusions.”
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Mr Kearns has proposed a driver and car be provided exclusively to hospitals, drivers could dress in personal protective equipment and that cars will be cleaned after every ride.
Covid-19 is hitting the taxi sector particularly hard, with most companies and drivers reporting a decline in service users.
Dramatically reduced
Alan Cooley, a taxi driver serving Dublin airport, said the number of people looking for a ride has dramatically reduced over recent weeks.
“The footfall coming through Dublin Airport has dropped substantially. If you’re in Dublin Airport, normally you would wait between half an hour and 40 minutes for a job. Now you’re looking at three hours for a job,” he said.
“Even though planes are coming into Dublin Airport, and the manifesto is saying they’re full, they’re not. You’re kind of put under pressure then that you have to take the job no matter what it is.”
He said he disinfects his car after every ride, but he still feels at risk of contracting the virus while serving people who have just returned from areas with a high level of cases.
“The people getting into your car, you have to bring them home, so you have to make that decision on spec.”
Joe Herron, president of the Irish Taxi Drivers' Federation, said taxi drivers are "particularly vulnerable" to the virus.
“First of all, it’s one of the occupations where you’re more vulnerable to get it because you’re in a closed area, a vehicle,” he said.
He added that the pandemic is hitting the sector particularly hard.
"Most are family men, and lots and lots of them have mortgages, so they need an income. As a taxi driver, you just don't have any back-up as such. People in Amazon and stuff, they were all working from home – but we can't do that."
Free Now, the cab-hailing app, issued advice to its drivers and passengers amid the pandemic.
The company recommends that passengers touch the inside of the taxi “as little as possible”, while drivers should disinfect their cars regularly.
In a statement on its website, the company said drivers can switch to card payment only, and that the company has “temporarily turned off our Match taxi sharing service”.


theirishtimes--2020-03-16--California medical group starts drive-in testing

A medical group in California is to provide drive-in testing at its 92 facilities as demand for coronavirus testing increases .
The Kaiser Permanente medical group is asking patients who believe they have the symptoms of the virus , to email their doctor .
The doctor will then ring or video chat the patient .
If the patient qualifies for testing , they will receive an appointment to attend the nearest Kaiser Hospital for a drive-through testing .
“ We ’ ve set up multiple tents actually outside the hospital , ” said Rebecca O ’ Brien , a sub-specialist @ @ @ @ @ @ @ one of those tents is the drive-through garage .
It ’ s a big tent that a car can drive through.
” She added : “ If the doctors determine that the patient should have a test , and they ’ re well enough , they will get in their car and drive to the drive up .
Without rolling down their window , they will show their Kaiser membership card to the intake people at the drive through.
” The patient is then logged and verified on the system before a practitioner @ @ @ @ @ @ @ dressed in personal protective equipment , to perform the test .
“ Just swab , close up , off you go .
That patient doesn ’ t infect other patients and even if it ’ s not Covid , if it ’ s the flu or something else , you don ’ t want a bunch of people sitting around in the waiting room .
So there ’ s very little room for infection.
” A similar initiative was launched in Cork city late last week at the St Mary ’ s Health @ @ @ @ @ @ @ to use a similar scheme in recent days .
Currently , the at-home testing in Ireland takes about an hour per patient , while the San Francisco hospital can carry out the drive-in test in 30 minute intervals and intend to speed up this time in the coming week , While believed to be an effective method of increasing the volume of testing , Dr O ’ Brien acknowledges that it may not be possible to implement in every healthcare system .
“ We have our own lab , we have our own @ @ @ @ @ @ @ ’ re able to get things done at a much better speed and we ’ re operationally more robust than smaller private practices , ” she added .

A medical group in California is to provide drive-in testing at its 92 facilities as demand for coronavirus testing increases.
The Kaiser Permanente medical group is asking patients who believe they have the symptoms of the virus, to email their doctor.
The doctor will then ring or video chat the patient. If the patient qualifies for testing, they will receive an appointment to attend the nearest Kaiser Hospital for a drive-through testing.
“We’ve set up multiple tents actually outside the hospital,” said Rebecca O’Brien, a sub-specialist with the medical group. “But one of those tents is the drive-through garage. It’s a big tent that a car can drive through.”
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She added: “If the doctors determine that the patient should have a test, and they’re well enough, they will get in their car and drive to the drive up. Without rolling down their window, they will show their Kaiser membership card to the intake people at the drive through.”
The patient is then logged and verified on the system before a practitioner walks up to the vehicle, fully dressed in personal protective equipment, to perform the test.
“Just swab, close up, off you go. That patient doesn’t infect other patients and even if it’s not Covid, if it’s the flu or something else, you don’t want a bunch of people sitting around in the waiting room. So there’s very little room for infection.”
A similar initiative was launched in Cork city late last week at the St Mary's Health Campus and the UK has also begun to use a similar scheme in recent days.
Currently, the at-home testing in Ireland takes about an hour per patient, while the San Francisco hospital can carry out the drive-in test in 30 minute intervals and intend to speed up this time in the coming week,
While believed to be an effective method of increasing the volume of testing, Dr O’Brien acknowledges that it may not be possible to implement in every healthcare system.
“We have our own lab, we have our own pharmacies, we control everything so we’re able to get things done at a much better speed and we’re operationally more robust than smaller private practices,” she added.


theirishtimes--2020-03-16--Simon Coveney: People should ignore social media rumours

Tánaiste Simon Coveney has called on the public to trust the Government and the HSE and to ignore rumours on social media .
He described messages circulating on social media purporting to reveal drastic Government plans as totally irresponsible .
“ I will say this very bluntly to people this morning , be very careful where you get your information from .
“ Yesterday I got dozens of calls from people who thought that the country was going to move into lockdown at 11 o ’ clock this morning because of a totally irresponsible message that was put up initially @ @ @ @ @ @ @ media , so there are all sorts of rumours spreading all around.
” He added : “ We will make decisions based on public health advice , don ’ t pick up information from sources that are not reliable.
” Mr Coveney told Newstalk Breakfast the Government will do everything it can to get the message across about what measures are being taken .
“ We will make decisions as we get advice from public health experts , we don ’ t expect any more dramatic messages immediately .
“ We will try @ @ @ @ @ @ @ be .
We are asking people to work with us .
We need to remind people what this is about .
“ This is about saving lives .
That is the message we need to project every day.
” Meanwhile , Intensive Care Society of Ireland president Dr Catherine Motherway has said a surge in the number of cases of the virus is expected in the next week to 10 days .
“ All we can do is prepare and ask people to obey the rules asked of them , ” Dr Motherway @ @ @ @ @ @ @ “ We will try to save the most lives.
” Hospitals around the country are adding beds and staff , she said .
Such plans have been ongoing in every hospital for the past four to five weeks .
Irish medics have been watching the situation in Italy , she said .
“ It ’ s been very distressing to watch.
” The HSE has purchased new equipment and is sourcing more , she said .
“ We need staff to run them ( ventilators ) , we are reallocating staff .
We @ @ @ @ @ @ @ will have a challenge with staffing .
Everyone is willing to step up to the plate at this difficult time .
“ If we can reduce the surge , it will help us ensure that everybody gets adequate access to the healthcare they need.
” Dr Motherway called on the public to observe social distancing to keep the surge below a manageable level .
“ We want to avoid difficult triage decisions , to protect the more vulnerable members of the population with chronic health conditions and the elderly.
” She urged people @ @ @ @ @ @ @ , yet make sure to observe coughing etiquette and social distancing .
“ There will be challenges , but we will try to save the most lives.
” Separately , Minister for Justice Charlie Flanagan welcomed the response of the vintners to the government ’ s appeal for pubs to close .
He described the decision for all pubs to close as “ an act of solidarity on the part of publicans that was necessary in the circumstances .

Tánaiste Simon Coveney has called on the public to trust the Government and the HSE and to ignore rumours on social media.
He described messages circulating on social media purporting to reveal drastic Government plans as totally irresponsible.
“I will say this very bluntly to people this morning, be very careful where you get your information from.
“Yesterday I got dozens of calls from people who thought that the country was going to move into lockdown at 11 o’clock this morning because of a totally irresponsible message that was put up initially on Whats App and spread across social media, so there are all sorts of rumours spreading all around.”
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He added: “We will make decisions based on public health advice, don’t pick up information from sources that are not reliable.”
Mr Coveney told Newstalk Breakfast the Government will do everything it can to get the message across about what measures are being taken. “We will make decisions as we get advice from public health experts, we don’t expect any more dramatic messages immediately.
“We will try to be as transparent as we can be. We are asking people to work with us. We need to remind people what this is about.
“This is about saving lives. That is the message we need to project every day.”
Meanwhile, Intensive Care Society of Ireland president Dr Catherine Motherway has said a surge in the number of cases of the virus is expected in the next week to 10 days.
"All we can do is prepare and ask people to obey the rules asked of them," Dr Motherway told RTÉ's Morning Ireland. "We will try to save the most lives."
Hospitals around the country are adding beds and staff, she said. Such plans have been ongoing in every hospital for the past four to five weeks.
Irish medics have been watching the situation in Italy, she said. "It's been very distressing to watch."
The HSE has purchased new equipment and is sourcing more, she said. “We need staff to run them (ventilators), we are reallocating staff. We need staff to keep well, we will have a challenge with staffing. Everyone is willing to step up to the plate at this difficult time.
“If we can reduce the surge, it will help us ensure that everybody gets adequate access to the healthcare they need.”
Dr Motherway called on the public to observe social distancing to keep the surge below a manageable level. “We want to avoid difficult triage decisions, to protect the more vulnerable members of the population with chronic health conditions and the elderly.”
She urged people to look in on their elderly neighbours, yet make sure to observe coughing etiquette and social distancing.
“There will be challenges, but we will try to save the most lives.”
Separately, Minister for Justice Charlie Flanagan welcomed the response of the vintners to the government’s appeal for pubs to close.
He described the decision for all pubs to close as “an act of solidarity on the part of publicans that was necessary in the circumstances.


theirishtimes--2020-03-16--Coronavirus: HSE ramps up testing as Covid-19 shutdown intensifies across Europe

Testing for coronavirus will intensify in Ireland from Monday as the number of cases in the State rose to 169 at the weekend and to 214 across the island .
The Government called for the closure of the country ’ s 7,000 pubs from last night until at least March 29th in a further dramatic effort to stem the spread of the disease .
The move was considered essential ahead of the traditionally busy St Patrick ’ s Day bank holiday .
The move leaves 50,000 people in the pub trade out of work overnight in what one industry representative @ @ @ @ @ @ @ jobs in the history of the State ” .
The request to close all pubs , including hotel bars , came as health officials said there were 40 new cases of Covid-19 in the Republic , the highest daily total since the State ’ s first case was confirmed on February 29th .
This has brought the total number of cases in the State to 169 .
Some 25 of the new cases were in the east of the country , nine in the west and six in the south .
There were @ @ @ @ @ @ @ bringing the total in the North to 45 and to 214 overall on the island of Ireland .
The Northern Executive is meeting on Monday to decide whether to escalate its response to the coronavirus emergency .
The North ’ s Department of Health advised people with “ mild symptoms ” such as a new persistent cough and/or fever to stay at home and self-isolate for seven days .
It said in such cases testing would not be required .
An unnamed mother of a child in Co Armagh is threatening legal action @ @ @ @ @ @ @ in Northern Ireland , which unlike in the Republic remain open .
Solicitor Darragh Mackin of Belfast firm Phoenix Law , who is representing the woman , said the departments of education and health in the North have been put on notice of an impending emergency judicial review .
In Europe more than 100 million people are living under lockdown to try to curb the pandemic , as Italy ’ s death toll rose by 368 in just 24 hours .
France , Spain and the Netherlands were the latest to shut down @ @ @ @ @ @ @ to stay at home as the World Health Organisation announced Europe had become the centre of the global outbreak .
Tánaiste Simon Coveney called on Irish tourists in Spain who want to fly home to do so by midnight on Thursday after a plan was agreed with airlines and Spanish authorities .
Mr Coveney , who is also Minister for Foreign Affairs on Sunday held talks with his Spanish counterpart as well as the chief executives of Ryanair and Aer Lingus .
Following the talks Simon Coveney TD said : “ We have @ @ @ @ @ @ @ and Aer Lingus supported by the Spanish government.
” He said Spanish counterparts assured him that Spanish airports remain open and it was not bringing about a flight ban .
America ’ s Center for Disease Control and Prevention ( CDC ) , meanwhile , has recommended that large events and mass gatherings of more than 50 people should be cancelled or postponed for eight weeks , amid fears that coronavirus is spreading in the United States .
In updated guidance issued on Sunday evening , the national health institute cited conferences , @ @ @ @ @ @ @ examples of such gatherings .
Schools , higher education institutes and businesses are not included it said .
The HSE is set to increase testing for coronavirus from Monday , in a bid to meet the rising demand for the procedure .
At the weekend , the health service announced that GPs would be able to order tests through their IT system , and that steps were being made to ensure sufficient testing facilities will be available to meet the rising demand .
Up until this week , testing was carried out at @ @ @ @ @ @ @ Ambulance Service .
However , while at-home tests continue , the HSE is also establishing a number of community testing sites across the country .
These sites will be attendance by referral only , meaning individuals can not simply show up and receive a test .
GPs will from Monday be able to order tests more easily through an electronic process .
“ Members of the public who have normal cold and flu like symptoms or who believe they may have been in contact with Covid-19 are being asked to self-isolate and to @ @ @ @ @ @ @ will then be in a position to triage patients appropriately and order a test where indicated , ” a statement by the HSE said .
Individuals who undergo testing are advised to self-isolate , even prior to receiving the results of the test .
It is understood that these measures will result in a surge of tests being carried out .

Taoiseach Leo Varadkar has warned of an “exponential increase” in confirmed cases of the coronavirus in the coming days.
Taoiseach Leo Varadkar has warned of an "exponential increase" in cases of coronavirus as the confirmed number in the Republic reached 223, and in the North 52, making a total of 275 on the island of Ireland.
The Department of Health confirmed 54 new cases of Covid-19 in the State on Monday night, bringing the total to 223.
It came as Mr Varadkar said he expects a significant increase in positive tests in the coming days and weeks, with some 15,000 expected before the end of the month. He said the number of confirmed cases could rise by 30 per cent a day.
Thirty of the latest cases are in males, 24 in females. Some 41 are associated with the east of the country, 11 are associated with the south and two are associated with the north/west of the country.
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Chief medical officer Dr Tony Holohan and his colleagues shared for the first time projections of case numbers likely to be disclosed in the coming days, as suggested by a statistical model developed by the Department of Health.
The model suggests 78 cases will emerge on St Patrick’s Day, 109 cases on Wednesday, with 355 cases per day by Sunday. That level of infection will require the contact tracing of 40,000 individuals, Dr Holohan said.
Main developments on Monday
The State could activate powers to detain and isolate people suspected of having coronavirus on public health grounds. Photograph: Aidan Crawley/EPA
Testing centres identified
There is an expectation that it will be some days before the system is able to properly respond to a surge in demand for testing, Dr Colm Henry, the chief clinical officer said.
Nineteen new testing centres have been identified and that will rise to 34 by the end of the week. In the meantime, he said people should self isolate if needed; “the test will happen,” he said.
Dr Holohan said the current measures are likely to be extended significantly beyond the current timeframe of March 29th.
He said negotiations are ongoing between doctors’ representative groups and the department on this issue, and praised the work done by GPs as “heroic”.
Mr Varadkar earlier said the rise in numbers of cases “cannot be stopped” and the Government had moved to secure extra ventilators to preserve life.
Legislation to tackle the pandemic will be published on Tuesday.
It was also confirmed on Monday evening that Trinity College Dublin now has eight cases of coronavirus, up from five. The university is asking all students to leave campus accommodation, including international students, because large highly concentrated numbers of students living there will increase chances of rapid transmission.
Deserted streets in Dublin’s Temple Bar after pubs closed to contain coronoavirus. Photograph: Lorraine O’Sullivan/Reuters
The Government has resisted calls to instruct restaurants to close down following a Cabinet committee meeting on the coronavirus, it is understood.
It also emerged on Monday that the HSE is looking at using Croke Park as a temporary “drive-thru” coronavirus testing centre in the coming days, The Irish Times understands.
The HSE has been in contact with the Gaelic Athletic Association (GAA) after the latter offered the use of the 80,000-capacity stadium as a testing centre, as it is not currently being used for sporting events.
Croke Park plan
Local residents in the area surrounding the stadium have received correspondence from Croke Park on Monday about the plan. It is expected the HSE will announce details of it shortly, sources said.
“Following a high-level request from the HSE today and in the national interest, Croke Park is to become a ‘drive-thru’ facility for testing for Covid-19 for designated appointments. This will not be a walk-up service,” the email to locals, seen by The Irish Times, said.
“The stadium layout has been identified as being suitable for facilitating this important service at this time. As soon as we have further information, we will share it with you,” it said.
HSE staff in some Dublin primary care centres have been informed to provide details on how many staff would be required to maintain essential services, to free up other healthcare workers to be temporarily redeployed elsewhere as the health service prepares to significantly ramp up testing for coronavirus, officially known as Covid-19, in the coming days.
Meanwhile, the new online system in Ireland for booking Covid-19 tests has become “overburdened”, leading to outages and forcing the deployment of an alternative email system.
Some general practitioners have also reported long delays in trying to contact the HSE by phone to secure tests.
Up until this week, testing was carried out at people’s homes through the National Ambulance Service. However, while at-home tests continue, the HSE is also establishing a number of community testing sites across the country.
These sites will be attendance by referral only, meaning individuals cannot simply show up and receive a test.
Controlled contractions of virus
The Netherlands will aim to develop immunity to Covid-19 among its population by allowing a large part of its people to contract the virus at a controlled pace, Dutch prime minister Mark Rutte announced in a national address on Monday.
“The reality is that in the near future a large part of the Dutch population will be infected with the virus,” Mr Rutte said. “We can slow down the spread of the virus while building controlled group immunity.”
The idea of developing group immunity to the coronavirus is controversial and the world Health Organization has questioned its basis in evidence.
The EU is proposing a ban on non-essential travel to the region for 30 days in response to coronavirus. European Commission president Ursula von der Leyen tweeted on Monday guidelines were being presented which included a "temporary restriction on non-essential travel to the EU (30 days)".
Germany announced unprecedented plans on Monday to close most shops, limit restaurants' opening hours and ban religious services to try to slow the spread of the coronavirus. The decision took Germany a step closer to a total lockdown similar to those implemented in Italy and Spain.
British prime minister Boris Johnson gave a televised press conference on Monday afternoon emphasising a move away from large groups of people being permitted to gather in the UK.
"We are emphatically moving away from mass gatherings," he said. Such moves "are overwhelmingly worth it to slow the spread of the disease, to save life, minimise suffering, and give our NHS the chance to cope".
British people needed to stop non-essential contact and avoid pubs, theatres and all unnecessary travel, he added. “We need people to start working from home where they possibly can.”
Anti-inflammatory drugs
The HSE has advised any persons diagnosed with Covid-19 to continue taking medication they had been taking previously, unless told not to do so by their doctor, including anti-inflammatories such as ibuprofen or diclofenac.
Responding to what was termed false information about such medication and Covid-19 circulating on social media in the last 24 hours, Dr Colm Henry, chief clinical officer of the HSE advised: “Only take one anti-inflammatory medication at a time. It is okay to take paracetamol and an anti-inflammatory like ibuprofen at the same time.
“There is no evidence to stop any medication at this time.” He advised that if a person has respiratory symptoms, they should not attend a pharmacy in person.


theirishtimes--2020-03-16--Covid-19 patients with best chance of survival to be prioritised

Patients with the best chance of survival are to be prioritised as coronavirus overwhelms the health service , even where families disagree , the Medical Council has told doctors .
“ In making decisions based on the principle of prioritising the use of scarce resources to treat those patients most likely to survive , more lives are likely to be preserved , ” it has said .
This appraisal of the potential benefits a treatment might provide to different patient “ lies within the scope of experienced intensive care medicine doctors , ” the note for doctors on Covid-19 says @ @ @ @ @ @ @ or allied may sometime hold different views ” .
According to the “ important update ” sent to doctors on Sunday , healthcare resources “ may become overwhelmed ” as the impact of the pandemic grows .
Allocation of “ finite ” healthcare resources in a way that is equitable and just “ will present difficult choices ” .
“ Doctors have a duty to use resources prudently and fairly , to produce the most benefits possible for individuals served by those interventions.
” The council says it recognises the difficulties this will @ @ @ @ @ @ @ intensive care , who will have to evaluate patients and identify those with the best chance of recovery .
The council also says “ any site ” designated as a clinical site in the current emergency will be deemed appropriate for doctors to work in , provided it is under the supervision of the nearest hospital or a senior clinician .
It may necessary for doctors to perform duties “ outside their current scope of practice ” during the crisis but all tasks and roles carried out should be within their capabilities and @ @ @ @ @ @ @ doctors have a duty to protect their own health while giving compassionate care to patients .
“ Please remember that amidst the increased workload , longer hours , additional pressure and stress , please take the time to care for yourself .
Take breaks , eat regularly , and get rest .
“ All doctors are on the front line , and the priority for doctors is to self-protect in order to protect and treat others .
A sick doctor becomes a patient , while a healthy doctor can treat and see patients @ @ @ @ @ @ @ our communities .
“ Please remember that during this challenging time the Medical Council stands by your side .
The entire country stands by your side.
” The Medical Council is the professional body for more than 20,000 doctors .

Allocation of “finite” healthcare resources in a way that is equitable and just “will present difficult choices,” the Medical Council told doctors.
Patients with the best chance of survival are to be prioritised as coronavirus overwhelms the health service, even where families disagree, the Medical Council has told doctors.
“In making decisions based on the principle of prioritising the use of scarce resources to treat those patients most likely to survive, more lives are likely to be preserved,” it has said.
This appraisal of the potential benefits a treatment might provide to different patient “lies within the scope of experienced intensive care medicine doctors,” the note for doctors on Covid-19 says.
However, “patients, families or allied may sometime hold different views”.
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According to the “important update” sent to doctors on Sunday, healthcare resources “may become overwhelmed” as the impact of the pandemic grows.
Allocation of “finite” healthcare resources in a way that is equitable and just “will present difficult choices”.
“Doctors have a duty to use resources prudently and fairly, to produce the most benefits possible for individuals served by those interventions.”
Intensive care
The council says it recognises the difficulties this will raise, particularly for those working in intensive care, who will have to evaluate patients and identify those with the best chance of recovery.
The council also says “any site” designated as a clinical site in the current emergency will be deemed appropriate for doctors to work in, provided it is under the supervision of the nearest hospital or a senior clinician.
It may necessary for doctors to perform duties “outside their current scope of practice” during the crisis but all tasks and roles carried out should be within their capabilities and with adequate supervision.
The council says doctors have a duty to protect their own health while giving compassionate care to patients.
“Please remember that amidst the increased workload, longer hours, additional pressure and stress, please take the time to care for yourself. Take breaks, eat regularly, and get rest.
“All doctors are on the front line, and the priority for doctors is to self-protect in order to protect and treat others. A sick doctor becomes a patient, while a healthy doctor can treat and see patients or remotely triage and help patients and our communities.
“Please remember that during this challenging time the Medical Council stands by your side. The entire country stands by your side.”
The Medical Council is the professional body for more than 20,000 doctors.


theirishtimes--2020-03-16--‘I am not going to frequent any hotel, restaurant or cafe in this country’

Last week we wrote a piece in this newspaper which outlined how badly impacted the Irish tourism sector is likely to be as a result of the spread of coronavirus across the country .
We reported the fact that tens of thousands of jobs in tourism were at risk across the country as the number of people from overseas booking holidays in Ireland has dried up to a “ trickle ” , according to hoteliers and industry representatives .
We explained that in a bid to limit losses , some hotels are trying to fill empty rooms and restaurants by @ @ @ @ @ @ @ Since we wrote that piece things have got worse .
Restaurants have had to close – at least temporarily – and hotels have been emptying of both international and domestic visitors .
We are very much in uncharted waters .
A reader called Margaret wasn ’ t buying any of it .
“ I have now decided that for the duration of this ‘ public health crisis ’ I am not going to frequent any hotel , restaurant or cafe in this country , ” she wrote .
She said it had “ @ @ @ @ @ @ @ of picking up the virus but instead is related to a growing sense of annoyance and irritation at that same sector and its complete lack of respect or concern for the public it is trying to attract through its doors ” .
She says that shortly before the new broke of the first case in Ireland at the start of March she visited a Dublin hotel .
“ Less than a metre away , a young lady coughed and sneezed for twenty minutes uninterrupted without once covering her nose or mouth .
When @ @ @ @ @ @ @ picked up her glass and dishes and went on her merry way .
In other words there was absolutely no question of getting a spray or a damp cloth to leave the table nice and clean for the next person.
” Margaret suggested this was “ common practice in dear old Dublin so nothing new there .
I have been on this bandwagon/soapbox for years .
I sent an email to the manager of the hotel and suggested politely that he might like to ‘ up his game ’ in the old hygiene @ @ @ @ @ @ @ coming down the tracks but of course he didn ’ t bother to reply.
” She had more to give out about .
Days later she was in a pub restaurant and sat at a table “ covered in dirty dishes ” .
She went up and asked for the table to be cleaned .
“ The barman came down took the dishes off the table ( with , as my mother used to say , a big puss on him ) and that was it .
He didn ’ t come back @ @ @ @ @ @ @ left at a table that could have had Northern Italians at it ten minutes earlier for all we knew .
The English tourists at the next table also got their meal served at a table that had not been cleaned down .
We didn ’ t enlighten them to that fact .
Again I sent an email to the hostelry and again no response.
” She accused the industry of “ whingeing ” .
“ As I said any reluctance to support the hospitality sector on my part is nothing to do with @ @ @ @ @ @ @ but annoyance at the arrogance of our hospitality sector towards its ‘ bread and butter ’ and its complete unwillingness to let it be seen that it is playing its part in reducing the risks.
” While we believe Margaret has a right to express her views – and the idea that all of us – restaurants , pubs , individuals – have a need to up their game when it comes to hygiene , we think the tourism sector does deserve our support during what is going to be an absolutely horrendous @ @ @ @ @ @ @ brilliant when it comes to cleaning tables but – at least in our experience – things are good in Ireland and are only likely to get better in the days ahead .

The Restaurant Association of Ireland has called on the Government to shutdown all restaurants and cafes to stop the spread of coronavirus. Video: Enda O'Dowd
Last week we wrote a piece in this newspaper which outlined how badly impacted the Irish tourism sector is likely to be as a result of the spread of coronavirus across the country.
We reported the fact that tens of thousands of jobs in tourism were at risk across the country as the number of people from overseas booking holidays in Ireland has dried up to a "trickle", according to hoteliers and industry representatives. We explained that in a bid to limit losses, some hotels are trying to fill empty rooms and restaurants by offering discounted rates to domestic tourists.
Since we wrote that piece things have got worse. Restaurants have had to close – at least temporarily – and hotels have been emptying of both international and domestic visitors. We are very much in uncharted waters.
A reader called Margaret wasn’t buying any of it. “I have now decided that for the duration of this ‘public health crisis’ I am not going to frequent any hotel, restaurant or cafe in this country,” she wrote.
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She said it had “nothing whatsoever to do any irrational fear of picking up the virus but instead is related to a growing sense of annoyance and irritation at that same sector and its complete lack of respect or concern for the public it is trying to attract through its doors”.
She says that shortly before the new broke of the first case in Ireland at the start of March she visited a Dublin hotel. “Less than a metre away, a young lady coughed and sneezed for twenty minutes uninterrupted without once covering her nose or mouth. When she left, the waitress came along picked up her glass and dishes and went on her merry way. In other words there was absolutely no question of getting a spray or a damp cloth to leave the table nice and clean for the next person.”
Margaret suggested this was “common practice in dear old Dublin so nothing new there. I have been on this bandwagon/soapbox for years. I sent an email to the manager of the hotel and suggested politely that he might like to ‘up his game’ in the old hygiene department in light of what might be coming down the tracks but of course he didn’t bother to reply.”
The barman came down took the dishes off the table (with, as my mother used to say, a big puss on him) and that was it"
She had more to give out about.
Days later she was in a pub restaurant and sat at a table “covered in dirty dishes”.
She went up and asked for the table to be cleaned. “The barman came down took the dishes off the table (with, as my mother used to say, a big puss on him) and that was it. He didn’t come back with a cloth and again we were left at a table that could have had Northern Italians at it ten minutes earlier for all we knew. The English tourists at the next table also got their meal served at a table that had not been cleaned down. We didn’t enlighten them to that fact. Again I sent an email to the hostelry and again no response.”
She accused the industry of “whingeing”. “As I said any reluctance to support the hospitality sector on my part is nothing to do with an irrational fear of catching the virus but annoyance at the arrogance of our hospitality sector towards its ‘bread and butter’ and its complete unwillingness to let it be seen that it is playing its part in reducing the risks.”
While we believe Margaret has a right to express her views – and the idea that all of us – restaurants, pubs, individuals – have a need to up their game when it comes to hygiene, we think the tourism sector does deserve our support during what is going to be an absolutely horrendous time. Yes, not everyone is brilliant when it comes to cleaning tables but – at least in our experience – things are good in Ireland and are only likely to get better in the days ahead.


theirishtimes--2020-03-16--Is there any point having health insurance?

A reader called Wesley contacted us in connection with health insurance .
Specifically he wondered what he was paying for .
“ We have health insurance and pay over €3,500 per year for the family ( two adults and two kids ) however we never seen any benefits from having it , ” he says .
“ The only reason we got it was from fear factor , the “ what if we didn ’ t have it and something goes wrong ” combined with me turning 35 and the additional costs they would put on me for never having @ @ @ @ @ @ @ now , when Wesley is 38 and has “ never used or seen the benefit of having health insurance yet I continue to pay for it because of the fear of the great “ what if ” !
We still pay for the doctors and A & E visits and touch wood we haven ’ t had to spend any time in hospitals yet !
” He says members of his family did have to go to A & E about three times in the three years “ and as far as we @ @ @ @ @ @ @ the form to make sure they get extra money from the insurance , but thankfully all trips to the A & E were sorted out on the day and we know we would have gotten the same treatment whether we signed the insurance form or not !
” He concludes by saying that he does not “ believe in insurance , but can see why they are in place .
If I lived in America I would definitely see why having it is necessary but here in Ireland it ’ s a joke @ @ @ @ @ @ @ ) doesn ’ t even have any private beds and by the hospital ’ s own admission to us on a recent A & E visit they said they couldn ’ t give us anything different than a medical card holder or non insured person seeking care ... same beds same doctors same care !
So from 18-35 I managed to save €3,500 per year now I ’ m just giving it to the company for the of mind.
” Wesley makes some good points in asking do we actually need health insurance @ @ @ @ @ @ @ have a heart attack or stroke , are involved in a car accident or have to be rushed into an emergency department suffering from some other ailment then health insurance is of little use .
You will be taken to the nearest public hospital and treated in the public system at no – or at least at very little – cost .
The public system can be excellent in this country and that is largely down to the medical professionals who run it , but it is a long way from perfect .
@ @ @ @ @ @ @ themselves stuck on trollies for days even if they have been paying through the nose for insurance .
However , the reality is that people with health insurance get access to consultants more quickly – even consultants working out of public hospitals if they are allowed see patients privately .
They also get private and semi-private rooms in public hospitals and can avail of treatment in private hospitals , which significantly reduces waiting times for many procedures – both elective and otherwise .
We all know patients in the public system can be @ @ @ @ @ @ @ , before they get to see consultants and people have died as a result of those delays .
That is why many people believe health insurance is essential .
Another reason many view it as essential was contained in a report from the Economic and Social Research Institute which found that wealthier people with private health insurance are more likely to avail of potentially life-saving cancer screening tests in Ireland .
The think-tank study looked at the uptake of breast and prostate cancer testing among middle-aged and older people and said people with @ @ @ @ @ @ @ card were “ significantly less likely to have received a mammogram or prostate screening ” than those with just a medical card .

A reader called Wesley contacted us in connection with health insurance. Specifically he wondered what he was paying for.
“We have health insurance and pay over €3,500 per year for the family (two adults and two kids) however we never seen any benefits from having it,” he says. “The only reason we got it was from fear factor, the “what if we didn’t have it and something goes wrong” combined with me turning 35 and the additional costs they would put on me for never having insurance before!”
Fast forward to now, when Wesley is 38 and has “never used or seen the benefit of having health insurance yet I continue to pay for it because of the fear of the great “what if”! We still pay for the doctors and A&E visits and touch wood we haven’t had to spend any time in hospitals yet!”
He says members of his family did have to go to A&E about three times in the three years “and as far as we could see they get us to sign the form to make sure they get extra money from the insurance, but thankfully all trips to the A&E were sorted out on the day and we know we would have gotten the same treatment whether we signed the insurance form or not!”
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He concludes by saying that he does not "believe in insurance, but can see why they are in place. If I lived in America I would definitely see why having it is necessary but here in Ireland it's a joke – sure Kilkenny (our local hospital) doesn't even have any private beds and by the hospital's own admission to us on a recent A&E visit they said they couldn't give us anything different than a medical card holder or non insured person seeking care ... same beds same doctors same care! So from 18-35 I managed to save €3,500 per year now I'm just giving it to the company for the of mind."
Wesley makes some good points in asking do we actually need health insurance?
If you are unfortunate enough to have a heart attack or stroke, are involved in a car accident or have to be rushed into an emergency department suffering from some other ailment then health insurance is of little use. You will be taken to the nearest public hospital and treated in the public system at no – or at least at very little – cost.
The public system can be excellent in this country and that is largely down to the medical professionals who run it, but it is a long way from perfect. Even with health insurance people can find themselves stuck on trollies for days even if they have been paying through the nose for insurance.
However, the reality is that people with health insurance get access to consultants more quickly – even consultants working out of public hospitals if they are allowed see patients privately. They also get private and semi-private rooms in public hospitals and can avail of treatment in private hospitals, which significantly reduces waiting times for many procedures – both elective and otherwise.
We all know patients in the public system can be left waiting months, if not years, before they get to see consultants and people have died as a result of those delays. That is why many people believe health insurance is essential.
Another reason many view it as essential was contained in a report from the Economic and Social Research Institute which found that wealthier people with private health insurance are more likely to avail of potentially life-saving cancer screening tests in Ireland.
The think-tank study looked at the uptake of breast and prostate cancer testing among middle-aged and older people and said people with neither private health insurance nor a medical card were “significantly less likely to have received a mammogram or prostate screening” than those with just a medical card.


theirishtimes--2020-03-16--Are businesses legally obliged to provide customers with receipts?

“ I live in Belfast and I am not in Dublin too often and less often in Dundrum , ” writes a reader by the name of Eddie .
He was given a gift card for a shopping centre worth €50 a few years ago .
“ Some time passed and I went to Dublin to a niece ’ s birthday party and decided to use the gift card to buy her a present.
” So far so good .
“ When I presented the card and it was scanned , I was told there was no money left on @ @ @ @ @ @ @ used for maintenance fees .
I was asked , ‘ Do I want the card back ?
’ and I said , ‘ No , dump it ’ .
That was my mistake as I now have no proof of what happened , ” he says .
“ Thinking back over the event , I realised that if a bank makes deductions from my account , these transactions are noted on my bank statement .
If I had been able to use the gift card to buy something I would have been given @ @ @ @ @ @ @ the card .
However , I was not given any receipt for the money taken from my card.
” He asks if it is legal for companies to do currency transactions and not issue receipts .
“ I know that you can do nothing for my case but perhaps this insight may help the people with the One4All vouchers.
” Eddie raises a couple of issues here – the issue of maintenance fees and the issue of receipts .
To the last item first .
A retailer does not have to issue a @ @ @ @ @ @ @ Consumer Protection Commission and were told that “ there is no legal obligation under consumer protection law for a business to provide a receipt for the goods you buy .
However , the vast majority of traders will automatically issue receipts to consumers or when requested by a consumer.
” The issue of maintenance fees on gift cards is not new .
New laws governing the gift voucher industry came into force late last year .
They introduced a mandatory five-year expiry limit on all vouchers and clarified other elements of an industry @ @ @ @ @ @ @ euro annually .
An early draft of the Bill had included a provision giving the Minister for Enterprise the power to set fees for the issue and replacement of gift vouchers and for “ inactive balances ” on gift vouchers .
That element of the bill did not make it across the line .
As it stands most gift cards have no maintenance fee for the first 12 months after which about €1.50 is deducted each month .
The only way to avoid the fee as it stands then is to use the @ @ @ @ @ @ @ of little use to our reader at this stage .

"I live in Belfast and I am not in Dublin too often and less often in Dundrum, " writes a reader by the name of Eddie.
He was given a gift card for a shopping centre worth €50 a few years ago. “Some time passed and I went to Dublin to a niece’s birthday party and decided to use the gift card to buy her a present.”
So far so good. “When I presented the card and it was scanned, I was told there was no money left on the card. It had all been used for maintenance fees. I was asked, ‘Do I want the card back?’ and I said, ‘No, dump it’. That was my mistake as I now have no proof of what happened,” he says.
“Thinking back over the event, I realised that if a bank makes deductions from my account, these transactions are noted on my bank statement. If I had been able to use the gift card to buy something I would have been given a receipt acknowledging the cash deduction from the card. However, I was not given any receipt for the money taken from my card.”
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He asks if it is legal for companies to do currency transactions and not issue receipts. “I know that you can do nothing for my case but perhaps this insight may help the people with the One4All vouchers.”
Maintenance fees
Eddie raises a couple of issues here – the issue of maintenance fees and the issue of receipts.
To the last item first.
A retailer does not have to issue a receipt. We contacted the Competition and Consumer Protection Commission and were told that "there is no legal obligation under consumer protection law for a business to provide a receipt for the goods you buy. However, the vast majority of traders will automatically issue receipts to consumers or when requested by a consumer."
The issue of maintenance fees on gift cards is not new.
New laws governing the gift voucher industry came into force late last year. They introduced a mandatory five-year expiry limit on all vouchers and clarified other elements of an industry which is worth hundreds of millions of euro annually. An early draft of the Bill had included a provision giving the Minister for Enterprise the power to set fees for the issue and replacement of gift vouchers and for “inactive balances” on gift vouchers.
That element of the bill did not make it across the line.
As it stands most gift cards have no maintenance fee for the first 12 months after which about €1.50 is deducted each month. The only way to avoid the fee as it stands then is to use the card quickly, something we appreciate is of little use to our reader at this stage.


theirishtimes--2020-03-16--Coronavirus: ‘We can save hundreds; the public can save thousands’

Medics have reacted with alarm at images of people gathering in packed Dublin pubs and flouting the Government ’ s “ social distancing ” guidelines introduced to prevent the spread of coronavirus .
One doctor pointed to the limits of the State ’ s health system to help people who will become critically ill , warning that the public would save many more lives than the country ’ s hospitals if it complied .
“ We can save hundreds and we will save as many as we can , but public engagement will save thousands of lives , ” said @ @ @ @ @ @ @ Care Society and a consultant anaesthesiologist and intensive care physician at University Hospital Limerick .
Dr Motherway said she was upset at the images of people drinking in a packed Temple Bar pub , even though the Government said last week that indoor events of more than 100 people should be cancelled and people should try to distance themselves from others .
Dr Motherway warned the country ’ s hospital system would not be able to cope if Ireland was as badly hit as Italy where there have been 1,800 deaths .
“ @ @ @ @ @ @ @ the surge of critically ill people coming into us if what happens in Italy happens here .
The health service could well be overwhelmed , ” she said .
The Limerick doctor said the hospitals were “ at the back end of the problem ” and the public at the “ front end ” .
There had to be “ significant public buy-in ” to save lives by following the guidelines of maintaining social distancing , washing hands regularly and other simple measures .
“ The public can save a lot more lives @ @ @ @ @ @ @ it down , we will do our best to cope and the less of a surge we have , the better we will be able to cope , ” she said .
“ I don ’ t want to be deciding between patient A and patient B – that is not where I want to be .
I want to be able to treat the patients as they come in.
” The Government ’ s strategy to cope with the outbreak of the Covid-19 infection is to push out and lower the peak @ @ @ @ @ @ @ the health service time .
“ We have been given time by Italy .
We know what is coming .
Italy didn ’ t know what was coming .
They got hit really badly , very quickly , so we should learn from that , ” said Dr Motherway .
The health system has 255 intensive-care unit ( ICU ) beds and the HSE is ramping up capacity , but Dr Michael O ’ Dwyer , head of anaesthesia and critical care at St Vincent ’ s hospital in Dublin , said that @ @ @ @ @ @ @ beds could not cope in a worst-case Covid-19 surge .
“ I don ’ t think there is a health system in the world to scale up to what is a worst-case scenario and provide the sort of ICU needed , ” he said .
Dr Chris Luke , an emergency medicine specialist from Cork , said the scale of the coronavirus pandemic “ hinges completely on population behaviour ” .
The video of the packed pub over the weekend was “ an amazing demonstration of the exact opposite of what social distancing @ @ @ @ @ @ @ three people were infected in that crowd , then the virus was “ now spreading like wildfire ” .
“ It demonstrates exactly how you could best spread the disease through a mixture of fecklessness and recklessness driven by intoxication , ” he said .

The Garda Public Order Unit go through Temple Bar as pubs in that area of Dublin close in ‘interest of public health’ on Sunday. Photograph: Dara Mac Dónaill
Medics have reacted with alarm at images of people gathering in packed Dublin pubs and flouting the Government’s “social distancing” guidelines introduced to prevent the spread of coronavirus.
One doctor pointed to the limits of the State’s health system to help people who will become critically ill, warning that the public would save many more lives than the country’s hospitals if it complied.
"We can save hundreds and we will save as many as we can, but public engagement will save thousands of lives," said Catherine Motherway, president of the Intensive Care Society and a consultant anaesthesiologist and intensive care physician at University Hospital Limerick.
Not far from here, nurses & doctors are working to prepare for the impact of a global pandemic. Everyone is working 24/7. This is an insult to their efforts. There is very clear public health advice. Follow it. All options will be kept under constant review #CoronaVirusUpdates https://t.co/XQvJ7tC13D — Simon Harris TD (@SimonHarrisTD) March 14, 2020
Dr Motherway said she was upset at the images of people drinking in a packed Temple Bar pub, even though the Government said last week that indoor events of more than 100 people should be cancelled and people should try to distance themselves from others.
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Dr Motherway warned the country’s hospital system would not be able to cope if Ireland was as badly hit as Italy where there have been 1,800 deaths.
“We will be unable to cope with the surge of critically ill people coming into us if what happens in Italy happens here. The health service could well be overwhelmed,” she said.
‘Public buy-in’
The Limerick doctor said the hospitals were “at the back end of the problem” and the public at the “front end”. There had to be “significant public buy-in” to save lives by following the guidelines of maintaining social distancing, washing hands regularly and other simple measures.
“The public can save a lot more lives than the hospitals. If they slow it down, we will do our best to cope and the less of a surge we have, the better we will be able to cope,” she said.
“I don’t want to be deciding between patient A and patient B – that is not where I want to be. I want to be able to treat the patients as they come in.”
The Government’s strategy to cope with the outbreak of the Covid-19 infection is to push out and lower the peak of the infections in order to buy the health service time.
“We have been given time by Italy. We know what is coming. Italy didn’t know what was coming. They got hit really badly, very quickly, so we should learn from that,” said Dr Motherway.
ICU capacity
The health system has 255 intensive-care unit (ICU) beds and the HSE is ramping up capacity, but Dr Michael O’Dwyer, head of anaesthesia and critical care at St Vincent’s hospital in Dublin, said that even a properly resourced system of 400-500 beds could not cope in a worst-case Covid-19 surge.
“I don’t think there is a health system in the world to scale up to what is a worst-case scenario and provide the sort of ICU needed,” he said.
Dr Chris Luke, an emergency medicine specialist from Cork, said the scale of the coronavirus pandemic "hinges completely on population behaviour".
The video of the packed pub over the weekend was “an amazing demonstration of the exact opposite of what social distancing is” and that if two or three people were infected in that crowd, then the virus was “now spreading like wildfire”.
“It demonstrates exactly how you could best spread the disease through a mixture of fecklessness and recklessness driven by intoxication,” he said.


theirishtimes--2020-03-16--Coronavirus: People are scared but they want the truth

Facing into some of the hardest weeks this country will ever have experienced , it comes down to this : @ @ @ @ @ of life have to act immediately to save the health and lives of people in @ @ @ @ @ .
Older people too have to modify their activity but most of them already heed @ @ @ @ @ their social interactions as the years have passed .

Widespread testing, isolation and treatment – as much as possible and as quickly as possible – is key to stopping the coronavirus pandemic. Photograph: Alan Betson
Facing into some of the hardest weeks this country will ever have experienced, it comes down to this: people in the first half of life have to act immediately to save the health and lives of people in the second half of life.
Older people too have to modify their activity but most of them already heed health messages and have reduced their social interactions as the years have passed.
The younger among us have to forswear their traditional pleasures – play, sport and gyms, socialising – for a period in order to cease being vectors for a disease that will likely spare them but may sicken and kill many of their parents and grandparents.
Not far from here, nurses & doctors are working to prepare for the impact of a global pandemic. Everyone is working 24/7. This is an insult to their efforts. There is very clear public health advice. Follow it. All options will be kept under constant review #CoronaVirusUpdates https://t.co/XQvJ7tC13D — Simon Harris TD (@SimonHarrisTD) March 14, 2020
Most of them will live on to play and party again. But do they want it on their collective conscience that they spread the virus at a time when health services were overloaded and patients unable to access proper care?
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There’s a story I read for my six-year-old that illustrates the challenge we’re facing – and the price we might pay for our foolishness.
In the legend the emperor of India wants to reward a wily sage who has designed a beautiful new chessboard. The sage says he doesn't want much; just a grain of rice on the first square of the board, double that on the second, and so on.
The emperor is delighted at the bargain he has struck – until his advisers tell him of the terrible mistake he has made. The sage’s reward is growing exponentially, and by the 64th square he has gained enough rice to cover all of India to the depth of one metre. The emperor is destitute, and the sage has taken all.
Substitute the virus for the sage with his grain of rice, and you can see where we are. With the number of cases doubling every few days, it isn’t so much about where we are right now, with our hundred-or-so cases; it’s where we’re headed that matters. We will be destitute, and the virus will have taken all we value, if we do not act.
And where we're headed, unfortunately, is towards an Italian-style meltdown; before the Government announced restrictive measures last Thursday, we were 14 days behind Italy in terms of a massive expansion in cases.
Just because social distancing and schools closures have been introduced does not mean that situation has improved, if the measures are not being followed or if they are not comprehensive enough. The pictures coming out of Temple Bar at the weekend would make you weep.
We won’t be able to say we weren’t warned. As one Italian doctor working though his country’s carnage said this week: “You will not recognise or prepare fast enough for the sudden influx of critically ill patients and they will keep coming.”
"It's coming at an exponential speed; gradually, and then suddenly," said British global health expert Prof Anthony Costello.
Ireland is in the gradual stage, and some are sleepwaking into the crisis. Official figures tell us we have 169 confirmed cases of the disease, but the real number is much higher. By how much we do not know, but it is clear the virus is circulating in the community in parts of the country; perhaps most of it.
By one US estimate, if you’re not diagnosing all cases, one death today means 800 true cases today. This points to the true number of cases here being a multiple of confirmed positive tests.
Yet as World Health Organisation (WHO) boss Dr Tedros Adhanom said on Friday: "You can't fight a virus if you don't know where it is."
We know the virus can spread before people show symptoms. Some people can act as “super-spreaders”; patient 31 in South Korea passed the disease on to thousands of people.
Remember, Italy is worse than Wuhan was at its worst. In Italy, one in eight infected patients have needed intensive care; in China, it was one in 20. The death rate is also much higher.
Remember, too, that Italy has a good healthcare system, better equipped and resourced in many ways than Ireland’s. Back in 2012, it had twice as many critical care beds as Ireland, and that still isn’t enough. We do have a lower proportion of over-65s than Italy, which should help.
We have a crisis but no plan for handling it. We won’t tell people how much of the population will be affected by the virus. We have implemented stringent measures but have only just started the computer modelling that will tell us what impact they will have. We don’t know how many cases are really out there in the population. We have a bottle-neck in testing, which hopefully will be only temporary.
The time for sugar-coating is past, for blandly saying most people will be okay
The WHO talks of stopping the virus, and countries like Taiwan and Singapore seems to have done just that, but our Government talks only of slowing the spread. Is that a failure of ambition, or a recognition that things have gone too far?
It may be the authorities have a national plan, and they know all the answers to the questions raised above. It may be they don’t want to scare people, to induce panic, to instigate more stockpiling.
These are all admirable motives but people are scared anyway. They are also ready for the truth. They know the threat they are facing and they want to know exactly how we are going to fight it.
The time for sugar-coating is past, for blandly saying most people will be okay. True, 80 per cent will suffer only mild or moderate illness, but this category includes patients who get pneumonia.
In Italy, one in 20 patients is their 30s, one in 10 in their 40s and one in seven in their 50s; this is by no means a disease confined to the very old.
Our new measures are a start but, as the WHO's Dr Mike Ryan said last week, the purpose of social distancing is only to "slightly slow down the virus so the your health system can cope".
Social distancing is not a panacea, he pointed out, and it’s not going to stop the pandemic on its own.
The way of achieving this is by rapidly finding possible cases, and by widespread testing, isolation and treatment. As much as possible, as quickly as possible.
There’s a lot to play for: countries that were well prepared and acted fast will have a fatality rate of less than 1 per cent; countries that are not, 3-5 per cent. Our actions over the coming days – whether we close bars and nightclubs, or lock down specific areas – will determine which outcome we get.


theirishtimes--2020-03-16--Crude oil prices have plummeted. Why not prices at the pump?

A man called John contacted us to see if we could “ challenge the consumer rip-off at the pumps ” .
Clearly annoyed , he pointed out that crude oil wholesale prices had declined dramatically in recent days as a result of the spread of coronavirus and a dispute between Saudi Arabia and Russia .
The price of a barrel of oil had fallen over 30 per cent from $ 68 to $ 45 while the euro had strengthened versus the US dollar .
“ Yet the price of diesel per litre at pumps fell maybe 3c or 4c .
@ @ @ @ @ @ @ consumer is being ripped off.
” In fact , by the time we got to read his email , the price of a barrel of Brent Crude was closer to $ 34 a barrel and oil prices had fallen on a scale not seen in a generation .
But despite precipitous declines on international markets , price falls on our forecourts seemed negligible .
This is not the first time wholesale prices and the price we pay at our local garage have been out of whack , and it is hardly surprising that @ @ @ @ @ @ @ companies and accuse them of making easy money .
That is not the actually the case – or at least the only reliable evidence we have would suggest it is not the case .
The only major study into fuel prices in Ireland was carried out by what was then known as the National Consumer Agency almost a decade ago .
It found that Irish petrol companies did not artificially inflate prices .
Figures from other sources , including the AA , have also routinely shown that forecourt fuel prices in Ireland do @ @ @ @ @ @ @ why does it seem like we are being ripped off ?
There are several reasons for that but the main one is tax .
Most of what we pay at the pump is made up of various taxes placed on petrol and diesel .
In fact , if a litre of fuel costs €1.40 , about 90 cent of it goes straight to the taxman .
That means about 50 cent has to be divvied up between the people who get the oil out of the ground , those who refine it and @ @ @ @ @ @ @ well as those who actually sell it to drivers here .
According to multiple sources , retailers here make about 5 cent on each litre of fuel sold .
Another factor is timing .
If a garage buys its stock of petrol and diesel and pays a certain price , it has no real option but to sell it to drivers at a certain price , irrespective of what happens on global markets .
Having said that , with the price of crude oil now at one of the lowest levels in a @ @ @ @ @ @ @ have to fall and fall quickly .
In the past , when crude prices have been hovering at $ 30- $ 40 dollars a barrel , the price of a litre of fuel to consumers should be about €1.20 or so .
And that is the price you should be expecting to see in the days and weeks ahead .

A man called John contacted us to see if we could “challenge the consumer rip-off at the pumps”.
Clearly annoyed, he pointed out that crude oil wholesale prices had declined dramatically in recent days as a result of the spread of coronavirus and a dispute between Saudi Arabia and Russia. The price of a barrel of oil had fallen over 30 per cent from $68 to $45 while the euro had strengthened versus the US dollar. “Yet the price of diesel per litre at pumps fell maybe 3c or 4c. The only logical conclusion is that the consumer is being ripped off.”
In fact, by the time we got to read his email, the price of a barrel of Brent Crude was closer to $34 a barrel and oil prices had fallen on a scale not seen in a generation. But despite precipitous declines on international markets, price falls on our forecourts seemed negligible.
This is not the first time wholesale prices and the price we pay at our local garage have been out of whack, and it is hardly surprising that when it happens many people blame petrol companies and accuse them of making easy money.
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That is not the actually the case – or at least the only reliable evidence we have would suggest it is not the case. The only major study into fuel prices in Ireland was carried out by what was then known as the National Consumer Agency almost a decade ago.
It found that Irish petrol companies did not artificially inflate prices. Figures from other sources, including the AA, have also routinely shown that forecourt fuel prices in Ireland do track international pricing pretty faithfully.
Tax factor
So why does it seem like we are being ripped off? There are several reasons for that but the main one is tax. Most of what we pay at the pump is made up of various taxes placed on petrol and diesel. In fact, if a litre of fuel costs €1.40, about 90 cent of it goes straight to the taxman. That means about 50 cent has to be divvied up between the people who get the oil out of the ground, those who refine it and those who ship it to Ireland as well as those who actually sell it to drivers here. According to multiple sources, retailers here make about 5 cent on each litre of fuel sold.
Another factor is timing. If a garage buys its stock of petrol and diesel and pays a certain price, it has no real option but to sell it to drivers at a certain price, irrespective of what happens on global markets.
Having said that, with the price of crude oil now at one of the lowest levels in a generation, the prices on forecourts will have to fall and fall quickly. In the past, when crude prices have been hovering at $30-$40 dollars a barrel, the price of a litre of fuel to consumers should be about €1.20 or so. And that is the price you should be expecting to see in the days and weeks ahead.


theirishtimes--2020-03-15--Coronavirus: Pubs asked to close in effort to stem outbreak as 40 new cases discovered

The Government has called for the closure of the country ’ s 7,000 pubs from last night until at least March 29th in a further dramatic effort to stem the spread of coronavirus .
The move was considered essential ahead of the traditionally busy St Patrick ’ s Day bank holiday .
The move leaves 50,000 people in the pub trade out of work overnight in what one industry representative said was the “ biggest loss of jobs in the history of the State ” .
The request to close all pubs , including hotel bars , came as health @ @ @ @ @ @ @ of Covid-19 in the Republic , the highest daily total since the State ’ s first case was confirmed on February 29th .
This has brought the total number of cases in the State to 169 .
Some 25 of the new cases were in the east of the country , nine in the west and six in the south .
There were 11 new cases in Northern Ireland , bringing the total in the North to 45 and to 214 overall on the island of Ireland .
The decision to seek the @ @ @ @ @ @ @ Temple Bar pubs in Dublin over the weekend failing to abide by the social distancing guidelines introduced by the Government last week that recommend indoor gatherings not exceed 100 people .
The request to shut bars came after industry representatives told Government officials they could not enforce the guidelines .
“ The social distancing guidelines are completely unworkable in a pub setting , and we have seen regrettably a small number of pubs behave appallingly , ” said Donall O ’ Keeffe , chief executive of the Licensed Vintners Association .
The Government @ @ @ @ @ @ @ public health measure given the reports of reckless behaviour by some members of the public in certain pubs ” .
Mr O ’ Keeffe described it as “ an absolutely traumatic day ” for the trade .
“ There are 7,000 pubs closing with immediate effect , 50,000 jobs gone overnight , ” he said .
“ It ’ s absolutely the right thing to do .
We are doing it in the long-term interest of public health , of our staff and our customers.
” He warned pubs that do not close @ @ @ @ @ @ @ Discussions are ongoing between the industry and Government about arrangements for social welfare payments for affected staff and financial support for the pubs .
Minister for Health Simon Harris said the closures were not an excuse for people to hold so-called Covid-19 parties and urged people not to hold house parties .
“ We need people to show a bit of cop on , and a bit of common sense here .
This is a very , very serious virus , and it has taken the lives of thousands of people across the @ @ @ @ @ @ @ that officials were closely monitoring the situation in restaurants and cafes .
The Government is drafting legislation to deal with the pandemic that could lead to more stringent measures .
Mr Harris confirmed he was considering activating a set of laws which have previously not been used .
Further regulations can be added to the 1948 infectious diseases regulations by the Minister for Health .
These could include the requirement for adults or children to stay home or away from certain places .
Mr Harris said the HSE was being offered the use @ @ @ @ @ @ @ other premises , and he did not expect the Government to need requisitioning powers for extra capacity .
He said Opposition parties would be briefed on Monday .
The Garda and Defence Forces were set to commence a major new operation from Monday morning as part of the State ’ s response to the Covid-19 crisis .
Additional Garda resources are being drafted , with 12-hour shifts being introduced and annual leave restricted .
Gardaí aim to increase high-visibility patrols to provide reassurance to the public .
They are expected to take a @ @ @ @ @ @ @ still arresting violent suspects , in a bid to minimise the risk of people with Covid-19 being brought into stations as prisoners .
Some medical personnel now had the power , under the Health Act 1947 , to compel people to go into isolation if they had Covid-19 or were suspected of having it .
Meanwhile , a member of staff at The Irish Times has tested positive for the coronavirus .
The company ’ s offices in Dublin will be closed for at least 48 hours .
The newspaper and website will @ @ @ @

The Government has called for the closure of the country’s 7,000 pubs from last night until at least March 29th in a further dramatic effort to stem the spread of coronavirus.
The move was considered essential ahead of the traditionally busy St Patrick’s Day bank holiday.
The move leaves 50,000 people in the pub trade out of work overnight in what one industry representative said was the “biggest loss of jobs in the history of the State”.
Temple Bar Company Statement #COVID19 pic.twitter.com/zrd5s5JrRG — Love Temple Bar (@LoveTempleBar) March 15, 2020 Not far from here, nurses & doctors are working to prepare for the impact of a global pandemic. Everyone is working 24/7. This is an insult to their efforts. There is very clear public health advice. Follow it. All options will be kept under constant review #CoronaVirusUpdates https://t.co/XQvJ7tC13D — Simon Harris TD (@SimonHarrisTD) March 14, 2020
The request to close all pubs, including hotel bars, came as health officials said there were 40 new cases of Covid-19 in the Republic, the highest daily total since the State’s first case was confirmed on February 29th. This has brought the total number of cases in the State to 169.
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Some 25 of the new cases were in the east of the country, nine in the west and six in the south. There were 11 new cases in Northern Ireland, bringing the total in the North to 45 and to 214 overall on the island of Ireland.
The decision to seek the closures came after social media videos showed Temple Bar pubs in Dublin over the weekend failing to abide by the social distancing guidelines introduced by the Government last week that recommend indoor gatherings not exceed 100 people. The request to shut bars came after industry representatives told Government officials they could not enforce the guidelines.
"The social distancing guidelines are completely unworkable in a pub setting, and we have seen regrettably a small number of pubs behave appallingly," said Donall O'Keeffe, chief executive of the Licensed Vintners Association.
The Government said the closures were “an essential public health measure given the reports of reckless behaviour by some members of the public in certain pubs”. Mr O’Keeffe described it as “an absolutely traumatic day” for the trade.
“There are 7,000 pubs closing with immediate effect, 50,000 jobs gone overnight, ” he said.
“It’s absolutely the right thing to do. We are doing it in the long-term interest of public health, of our staff and our customers.” He warned pubs that do not close would suffer “irreparable damage”.
Welfare payments
Discussions are ongoing between the industry and Government about arrangements for social welfare payments for affected staff and financial support for the pubs.
Minister for Health Simon Harris said the closures were not an excuse for people to hold so-called Covid-19 parties and urged people not to hold house parties.
“We need people to show a bit of cop on, and a bit of common sense here. This is a very, very serious virus, and it has taken the lives of thousands of people across the globe,” he said, adding that officials were closely monitoring the situation in restaurants and cafes.
The Government is drafting legislation to deal with the pandemic that could lead to more stringent measures. Mr Harris confirmed he was considering activating a set of laws which have previously not been used.
Further regulations can be added to the 1948 infectious diseases regulations by the Minister for Health. These could include the requirement for adults or children to stay home or away from certain places.
Mr Harris said the HSE was being offered the use of private healthcare facilities, hotels and other premises, and he did not expect the Government to need requisitioning powers for extra capacity.
He said Opposition parties would be briefed on Monday.
Patrols
The Garda and Defence Forces were set to commence a major new operation from Monday morning as part of the State's response to the Covid-19 crisis. Additional Garda resources are being drafted, with 12-hour shifts being introduced and annual leave restricted.
Gardaí aim to increase high-visibility patrols to provide reassurance to the public. They are expected to take a selective approach to making arrests, while still arresting violent suspects, in a bid to minimise the risk of people with Covid-19 being brought into stations as prisoners.
Some medical personnel now had the power, under the Health Act 1947, to compel people to go into isolation if they had Covid-19 or were suspected of having it.
Meanwhile, a member of staff at The Irish Times has tested positive for the coronavirus. The company’s offices in Dublin will be closed for at least 48 hours. The newspaper and website will continue to operate.


theirishtimes--2020-03-16--Another 54 new cases of coronavirus confirmed on Monday

The Department of Health confirmed another 54 new cases of Covid-19 in the State on Monday night , bringing the total to 223 .
Thirty of the cases are in males , 24 in females .
Some 41 are associated with the east of the country , 11 are associated with the south and two are associated with the north/west of the country .
The chief medical officer Dr Tony Holohan and his colleagues shared for the first time projections of case numbers likely to be disclosed in the coming days , as suggested by a statistical model developed by @ @ @ @ @ @ @ suggests that there will be 78 cases on Tuesday , 109 cases on Wednesday , and 355 cases per day by Sunday .
That level of infection will require the contact tracing of 40,000 individuals , Dr Holohan said .
It came as the total number of cases in Trinity College Dublin rose to eight , and the university announced wide-ranging measures to limit the spread of the virus on-campus .
These included instructions that students resident on campus must leave .
Those with a home in Ireland must leave by 8pm on @ @ @ @ @ @ @ overseas by 5pm on Wednesday .
The Department released some aggregate patient data , which showed that one-third of cases are aged between 25 and 44 years .
However , more data on patients and case severity , or how sick people are with the disease , is not ready for publication .
A more in-depth report on this data , as well as county-level breakdowns of cases , is expected this week .
Dr Holohan , asked about Ireland ’ s level of fatalities – two from 223 diagnosed so far – @ @ @ @ @ @ @ dataset too small to “ draw any comfort ” about how deadly the disease was proving here .
He said Ireland will see deaths increasing , as other countries have seen .
The Department also shared survey data from research it had undertaken , which showed good compliance with and knowledge of key measures such as hand-washing ( 90 per cent ) and knowledge of key issues such as the most common symptoms ( 84 per cent ) .
There is an expectation that it will be some days before the system is @ @ @ @ @ @ @ in demand for testing , Dr Colm Henry , the chief clinical officer , said .
Nineteen new testing centres have been identified and that will rise to 34 by the end of the week .
A significant shipment of testing kits will arrive on Thursday , which is expected to help testing teams .
In the meantime , he said people should self-isolate if needed .
“ The test will happen , ” he said .
Strong advice against ringing 999 , 112 or out-of-hours services in an effort to arrange a @ @ @ @ @ @ @ that the current measures to delay the spread of the virus are now likely to be extended significantly beyond the current timeframe of March 29th .
“ We are expecting the current situation to last for a significant period of time ; it ’ s difficult to put a period of time on it beyond that.
” Dr Holohan said that the department does not want to see “ financial barriers in the way of people who are seeking help and guidance from GPs ” .
He said negotiations are ongoing between doctors @ @ @ @ @ @ @ this issue , and praised the work done by GPs as “ heroic ” .
He would not go into further detail .
Asked about widespread suggestions that the State would , or should , go into a so-called “ lockdown ” , Dr Holohan said it would be easy for him to recommend widespread closures of facilities and public transport , but “ while that might reduce transmission of the virus , it would be a very disproportionate measure ” .
“ [ A ] full-scale lockdown .
.
.
forcibly stopping @ @ @ @ @ @ @ disproportionate response at this point.
” Dr Holohan emphasised that the department ’ s advice against mass gatherings of 100 people or more did not apply to supermarket settings .

Dr Colm Henry, the HSE’s chief clinical officer, and Dr Tony Holohan, chief medical officer at the Department of Health, at the latest briefing on the Covid-19 virus. Photograph: Nick Bradshaw for The Irish Times
The Department of Health confirmed another 54 new cases of Covid-19 in the State on Monday night, bringing the total to 223.
Thirty of the cases are in males, 24 in females. Some 41 are associated with the east of the country, 11 are associated with the south and two are associated with the north/west of the country.
The chief medical officer Dr Tony Holohan and his colleagues shared for the first time projections of case numbers likely to be disclosed in the coming days, as suggested by a statistical model developed by the Department of Health.
The model suggests that there will be 78 cases on Tuesday, 109 cases on Wednesday, and 355 cases per day by Sunday. That level of infection will require the contact tracing of 40,000 individuals, Dr Holohan said.
READ MORE
It came as the total number of cases in Trinity College Dublin rose to eight, and the university announced wide-ranging measures to limit the spread of the virus on-campus. These included instructions that students resident on campus must leave. Those with a home in Ireland must leave by 8pm on Tuesday, and those with a home overseas by 5pm on Wednesday.
The Department released some aggregate patient data, which showed that one-third of cases are aged between 25 and 44 years. However, more data on patients and case severity, or how sick people are with the disease, is not ready for publication. A more in-depth report on this data, as well as county-level breakdowns of cases, is expected this week.
Fatalities
Dr Holohan, asked about Ireland’s level of fatalities – two from 223 diagnosed so far – said it was too soon and the dataset too small to “draw any comfort” about how deadly the disease was proving here. He said Ireland will see deaths increasing, as other countries have seen.
The Department also shared survey data from research it had undertaken, which showed good compliance with and knowledge of key measures such as hand-washing (90 per cent) and knowledge of key issues such as the most common symptoms (84 per cent).
There is an expectation that it will be some days before the system is able to properly respond to a surge in demand for testing, Dr Colm Henry, the chief clinical officer, said. Nineteen new testing centres have been identified and that will rise to 34 by the end of the week. A significant shipment of testing kits will arrive on Thursday, which is expected to help testing teams.
In the meantime, he said people should self-isolate if needed. “The test will happen,” he said. Strong advice against ringing 999, 112 or out-of-hours services in an effort to arrange a test was reiterated.
Extended
Dr Holohan indicated that the current measures to delay the spread of the virus are now likely to be extended significantly beyond the current timeframe of March 29th. “We are expecting the current situation to last for a significant period of time; it’s difficult to put a period of time on it beyond that.”
Dr Holohan said that the department does not want to see “financial barriers in the way of people who are seeking help and guidance from GPs”. He said negotiations are ongoing between doctors’ representatives groups and the department on this issue, and praised the work done by GPs as “heroic”. He would not go into further detail.
Asked about widespread suggestions that the State would, or should, go into a so-called “lockdown”, Dr Holohan said it would be easy for him to recommend widespread closures of facilities and public transport, but “while that might reduce transmission of the virus, it would be a very disproportionate measure”.
“[A] full-scale lockdown . . . forcibly stopping movement, we think would be a disproportionate response at this point.”
Dr Holohan emphasised that the department’s advice against mass gatherings of 100 people or more did not apply to supermarket settings.