1. Strategy: We desperately need a sustainable strategic plan for dealing with Covid-19 which sets out what needs to be done to suppress the virus to the lowest possible level, and to keep it there.
This should be based on the available international evidence of what works, expert advice on how it can be achieved, and a clear and balanced assessment of risks and benefits.
A collective effort is required both to combat the virus and to organise the staged reactivation of society. In particular, achieving the suppression of the virus would provide the stability and reassurance needed for businesses whose resilience is now wafer thin.
2. Communications: Clear and consistent public health messaging is essential.
The Northern Ireland Executive must act to restore trust and confidence as a matter of urgency. It must reinstate regular, if not daily, briefings by ministers and officials, which include uncensored questions from the public and journalists.
In a time of crisis, it is crucial that the government are honest with the public and treat them with respect.
The public must be treated as equal partners in this global emergency and those leading the response must not act to suppress critical views but rather respect and listen carefully to opinions based on properly informed insight and expertise.
3. Data: Easily accessible, understandable and usable information on Covid-19 is crucial in a public health emergency.
High quality, reliable, robust data is a prerequisite for trust and confidence in politics.
Northern Ireland’s Covid-19 dashboard is complex and not fit for purpose.
The public need to be reassured that decisions have been made based on the appreciation and understanding of evidence and the public cannot obtain that reassurance if the full range of data from official sources is missing or obscured from their view.
4. External Review: The Northern Ireland Executive must demonstrate that it is capable of learning from what has happened to-date and that they are informed by international best practice and guidance.
To what extent have we learnt from our mistakes?
As a matter of priority, the Executive should immediately invite a small group of external experts to undertake a rapid review of the response of the Northern Ireland Executive to the pandemic and provide, if necessary, recommendations in public to the Assembly.
A further such review should be scheduled for not more than six months’ time.
5. FTTIS: We cannot control Covid-19 without having a proper Find, Test, Trace, Isolate, and Support system.
The Northern Ireland system is under-resourced and rudimentary.
For example, it does not operate to international guidelines in that it doesn’t test close contacts.
To ensure effectiveness, people should be properly supported when they need to isolate.
That should not just be limited to financial aid or assistance with accommodation if needed, but should also include emotional and practical help delivered by the community and voluntary sector.
6. Support: There needs to be a comprehensive, responsive economic support package for businesses and employers to mitigate the harm caused to the economy.
This involves using all of the levers at the disposal of the devolved government.
7. Vaccination: Given the abject failure of attempts so far to control the virus there is an urgent need for ambitious goals to roll out the vaccination and change the course of the coronavirus pandemic. We must ensure the distribution and uptake is as efficient, effective and equitable as possible.
Suggestions that vaccine is being given to non-patient facing health service staff and that general practices are not being treated equally can only undermine public trust. An immediate, smoothly run and accessible around the clock vaccination programme should be accompanied by a large-scale information campaign to build public confidence and support.
8. Co-ordination: Despite repeated acknowledgement that the virus does not recognise borders and the disease does not discriminate, cross border co-ordination has been extraordinarily limited.
Significant differences in regulations, restrictions, data collection and messaging pose practical challenges, cause confusion and are completely illogical on an island the size of Ireland.
This is not a constitutional issue, a nationalist or unionist issue, an orange or green issue, it is a global emergency which is costing lives and ravaging generations of loved ones.
It is not too late to develop an integrated and effective approach across the island.
9. Importation: There is no point in working hard to suppress the virus and save lives if it is still so easy for new cases to be imported via our ports and airports across the island of Ireland.
The current system of self-isolation does not work.
It should be replaced immediately as part of an agreement with the Republic of Ireland with a system of ‘managed isolation’ as operated successfully in many other islands of various sizes and populations across the world.
10. Health services: The normal functioning of health services has been dramatically and detrimentally impeded by the pandemic.
There is an enormous catch-up task ahead.
There are the routine things such as immunisations and screening that need to be caught up on, in addition to a very substantial backlog of people who have health concerns but have been unable to get the assistance or investigations or treatment that they need during the pandemic.
Deirdre Heenan is Professor of Social Policy at Ulster University, and Senior Associate with the Nuffield Trust London and Professor Gabriel Scally is a Public Health Physician, President of Epidemiology and Public Health at Royal Society of Medicine and member of Independent Sage