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Coronavirus can only be fought on an all-Ireland basis

Andy Pollak

The 2001 foot-and-mouth disease outbreak showed that effective cross-border co-operation can add up to more than the sum of its parts, argues Andy Pollak


Professor Ian Young, chief scientific advisor to the Department of Health, with First Minister Arlene Foster and Deputy First Minister Michelle O’Neill

Professor Ian Young, chief scientific advisor to the Department of Health, with First Minister Arlene Foster and Deputy First Minister Michelle O’Neill

Photo by Kelvin Boyes / Press E

Professor Ian Young, chief scientific advisor to the Department of Health, with First Minister Arlene Foster and Deputy First Minister Michelle O’Neill

After a teleconference meeting on Tuesday between the Tanaiste, Simon Coveney, Secretary of State Brandon Lewis, Arlene Foster, Michelle O'Neill and the two health ministers, it was announced that the chief medical officers in Belfast and Dublin would sign a memorandum of understanding to formalise cross-border cooperation to combat Covid-19 later in the week.

The previous day, one of Britain's leading public health experts, Dr Gabriel Scally, who is originally from Northern Ireland, called in the Irish Times for the Northern Ireland Executive to "decouple themselves" from the British Government's approach to tackling Covid-19 and "with every possible urgency, harmonise their strategies and actions" with those of the Irish government.

He said that, in this coronavirus pandemic, Ireland's geographical advantage as an offshore island, able to control movement to and from the island, "is being squandered by the adoption of very different approaches to dealing with the disease".

He pointed out that the Republic is attempting to limit the spread of, and thus terminate, the outbreak as rapidly as possible through widespread and intensive community testing and contact tracing, a practice which was abandoned in Northern Ireland on March 13.

Testing here, as in the rest of the UK, is now largely reserved for hospital in-patients and health service staff.

The result is that, while the aim in the south is to reach 100,000 tests per week by the end of April (although they are currently lagging behind that target), the north's goal is under 8,000 tests.

Dr Scally warned that, without common restrictions on travel to and from the island, there was a real possibility of another mass outbreak in the future: "Two different approaches to testing and contact tracing are just not compatible with achieving the level of control needed to win the battle."

He also pointed to the absurdity of the Irish government strongly advising people in Lifford in Co Donegal to self-isolate for a minimum of 14 days, while, a stone's throw away in Strabane, the Government advice is isolation for only seven days.

The Republic's top expert on international health, Professor Sam McConkey, of the Royal College of Surgeons in Ireland, was on RTE radio and UTV on Monday calling for similar all-island measures.

He repeated that the pandemic would not stop at the much-crossed Irish border and called for "a joined-up, unified approach" in areas like the provision of personal protection equipment and diagnostic reagents, staff exchanges and the cross-border care of patients.

There is a precedent here in animal health.

In the spring of 2001, foot-and-mouth disease, which had originated in an abattoir in Essex and quickly spread throughout Britain, was detected in sheep on a farm in south Armagh. Four more cases were detected in Louth, Tyrone (two) and north Antrim.

However, both departments of agriculture, in Dublin and Belfast, moved quickly to ban the import of animals and animal products from Britain.

Within a couple of months, the spread of the disease had been prevented by determined cross-border action by the two departments and their agents.

In a follow-up study by the Centre for Cross Border Studies, senior civil servants and farming representatives from both jurisdictions agreed that high levels of cross-border co-operation had played a significant role in containing it to the four infected areas.

There are also important precedents for successful cross-border co-operation in human health.

The Co-operation and Working Together network of health professionals in the border region, now nearly 30 years old, has shown what can be achieved when health administrators, doctors, nurses and other health workers work together to achieve better services and reduced waiting times in areas such as cardiology, radiotherapy and ear, nose and throat.

An all-island paediatric heart surgery service in Crumlin Hospital in Dublin has significantly reduced the need for Northern Irish children to be sent to Britain.

A senior Northern Ireland civil servant told me a few years ago that health had been a major missed opportunity for north-south inter-governmental co-operation.

He went on: "Neither health service is in good shape, but some rationalisation could have been done together.

"The cross-border justification could have been used - 'This has to happen on a cross-border basis, otherwise it won't happen at all'."

In 2012 a study for the two departments of health concluded: "Through working together to address major health issues, significant additional benefits to the population of each jurisdiction can be achieved which could not be achieved by each system working in isolation."

Another important new factor is that the Irish government has moved to bring the 19 private hospitals in the south under public control for the duration of the present crisis, so that we now have two public systems on the island for the first time.

This makes effective cross-border co-operation between the two health services to combat this external threat much more do-able.

At a Press conference after the announcement of the imminent cross-border memorandum of understanding, it was obvious that Arlene Foster and Michelle O'Neill were still disagreeing over the level of testing needed.

We will have to wait and see how significant this memorandum will be, given continuing disagreements in the Executive along 'Britain is right' versus 'Ireland is right' lines.

The vehicle for bringing the northern and southern administrative systems together has been there for the past 20 years and more: the civil servants from both jurisdictions working together in the North South Ministerial Council in Armagh.

Let us hope the two governments - and the Northern Ireland Executive, in particular - have the wisdom to scale up that secretariat to work jointly to combat this pandemic.

As Dr Scally and Professor McConkey have stressed, it makes enormous sense to work as one island to keep the effects of this death-dealing plague to an absolute minimum in order to gain precious time for the development of an effective vaccine.

I believe now is the time for Arlene Foster, in particular, to show brave leadership. For the sake of the health and wellbeing of the people of Northern Ireland - and Ireland as a whole - I hope she is able to break out of her unionist straitjacket, admit that the British Government's current strategy is inadequate and ally Northern Ireland with the superior strategy, based on widespread testing and tracing, which has been adopted by the Irish government, the World Health Organisation and the EU's European Centre for Disease Prevention and Control.

Andy Pollak was the founding director of the Centre for Cross Border Studies in Armagh

Belfast Telegraph