The Covid-19 vaccination programme is not expected to lead to population immunity and won't lead to society returning to normal soon, according to a Stormont briefing paper.
A paper presented to the Executive by Health Minister Robin Swann said there is “robust evidence that the first dose reduces the risk of clinical disease by 70 to 90% within 14 to 21 days”, but there isn't evidence on whether the vaccine reduces transmission rates in asymptomatic people.
While jabs will protect the most vulnerable quickly, ministers were told that experts do not expect “that the vaccine programme will lead to 'population immunity' and the return of normal life in the near future”.
Here are the top five points from the paper, which shed further light on the current situation in Northern Ireland and provide an insight into the rationale behind some of the decisions made by the Executive.
The Health Minister told the Executive there is “robust evidence that the first dose reduces the risk of clinical disease by 70 to 90% within 14 to 21 days” but there isn’t evidence on whether vaccination reduces transmission rates in people who are asymptomatic.
It continues: “It is therefore not possible at this stage, to estimate the impact on wider community transmission even when more of the population are vaccinated.
“Our vaccination programme will protect the most vulnerable in our community most quickly against the severe outcomes of disease.
“However, it is not expected by vaccine and public health experts that the vaccine programme will lead to ‘population immunity’ and the return of normal life in the near future.
“It will be some time before we see a reduction of the wider health service pressures.
“In broader terms, a key issue is also whether Covid-19 vaccines will be able to protect against infection or disease from these new variants.
“Work to evaluate the real-world effectiveness of the vaccines is under way in Northern Ireland.”
The figures reinforce in alarming detail the precarious position as Northern Ireland begins to lift restrictions.
Looking back at case rates in mid-September last year, the briefing paper describes them as “a cause for concern”.
It then provides a table which highlights that Northern Ireland is in a worse position now than in September, with the seven-day incidence rate in most council areas in March at least double the seven-day incidence rate in September.
For example, on September 14 in Ards and North Down, the seven-day rate per 100,000 of the population was 20.5 — this rose to 72.7 on March 12.
In Mid and East Antrim, the seven-day case rate per 100,000 of the population on September was 25.9 and was 74.3 on March 12.
HEALTH SERVICE CAPACITY
The document outlines the current situation in Northern Ireland hospitals — again highlighting the need to proceed with caution.
“The ICU position remains a concern,” it warns.
“The standard funded provision is for 72 ICU beds. Any ICU beds open above this level requires the deployment of staff from elsewhere.”
According to the paper, there were 91 patients in critical care beds on March 10, of which 29 had Covid-19.
This is down from the peak of 74 critically ill Covid-19 patients on January 25.
However, Mr Swann warned that “the number of patients requiring treatment in critical care remains high” and explained that this will continue to impact on the ability of the health service to carry out elective operations in the coming weeks.
IMPACT OF LOCKDOWN
The document outlines the many harmful effects of lockdown on the population, noting that they are likely to be “increasing health inequalities”.
Among the concerns raised by Mr Swann was “increased harmful alcohol consumption, more snacking and poor diets, and increased sedentary behaviour”.
He also warned “emerging evidence suggests that the disease burden from conditions such as mental ill-health is rising, as well as there being a measurable increase in cases of domestic violence”.
Levels of loneliness and social isolation are also a concern, he said.
The paper also refers to a reduction in the amount of time people have spent engaging in outdoor activities during the winter months, with 44% of the Northern Ireland population spending less time taking part in outdoor recreation in November and December last year than over the same period in 2019.
The document also states that it “is likely to take time for the full effect” of the lockdown to become clear but that the Department of Health is monitoring the emerging evidence.
TIMING OF RELAXATIONS
In the briefing to his Executive colleagues, Mr Swann said that the ongoing hospital pressures, levels of community transmission, threat of new variants and partial vaccination coverage, he has concluded that “broadly the current restrictions and requirements remain a necessary and proportionate response to the epidemic at this point in time”.
However, he said he was content to propose or support a number of careful changes, subject to a return to classroom teaching after Easter.
The document states this position is supported by the chief medical officer and deputy chief scientific advisor.
Mr Swann proposed that initial relaxations should be aimed at encouraging people to spend time outdoors.
He further states he has received advice that easing some restrictions will “offer the wider public renewed hope” and help encourage people to adhere to other important restrictions.
The document goes on to warn that “Easter remains a real source of risk of households gathering, hence proposed amendments for more intense relaxations would not come into effect until after Easter and only subject to final ratification after the Easter weekend.”