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[00:00:08]

Hello and welcome to The Stand with Eamon Dunphy. The stand is proudly supported by Tesco at Tesco, our exclusive house for over sixty fives. Family carers and extremely medically vulnerable customers are every weekday, Monday to Friday, up to nine a.m. Health care and emergency services have priority access at all other times now, more than ever, every little helps. Now we have a problem in this country with the covid-19 pandemic, and there is no consensus about how we can best defend ourselves from this virus.

[00:00:52]

And the political consensus that did exist for a while appears to have broken down after a very robust cabinet and long cabinet meeting on Monday in which we understand from sources that Michel Martin only about clashed. And we got some new measures which are imposed on people. They're very strange. They're quite contradictory in places. And there is a lot of confusion around. There's also disagreement between physicians and scientists and people who are familiar with the medical side of this equation.

[00:01:34]

There is, of course, the business and economic side as well. We're joined now by Thomas Ryan Thomas is associate professor in the School of Biochemistry and Immunology at Trinity College and also in their Institute of Neuroscience. And Thomas has been for to stand a very, very valuable contributor and very accurate in his assessment of where we are at any given time over the past two months or so to us. And thank you very much for joining us again. There is widespread confusion about the effectiveness and indeed even the details of the measures the government announced after the meeting and the cabinet meeting on Monday.

[00:02:25]

What we are clear about now is that they didn't adopt all of method's proposals and some kind of compromise was attempted. What's your response to the new measures that apply from Monday?

[00:02:46]

Well, first of all, I have to say that I completely respect any short term measures that our public health professionals, through leadership and Nevitt, prescribe for the population. I've been very critical of overall strategy and or lack of strategy and how we need to manage the pandemic going forward. And I think that involves a large degree of leadership from government because there are different choices to be made and that leadership has to be advised with public health expertise. But but it really is our political decisions, legitimate political decisions for the long term, for the wellbeing of the population.

[00:03:32]

But when it's a day to day situation or a week to week situation, that's where we sometimes have to put in reactionary measures. We have to react to what's going on. And in those circumstances, I think we need to completely follow the short term advice of our our public health officials, because they're the ones who are have their finger on the pulse. They have privileged access to the data, the modelling. And it's their main it's their main form of expertise.

[00:04:05]

I mean, I'm a scientist and I'm an independent observer of what's going on. I'm not a public health professional. And when it comes to the acute measures that we need to put in place to keep things from spinning out of control, I think it's necessary to place our trust and confidence in those people at the same time. At the same time, it's clear that there is a lot of contradictions between the different measures that are being put in place.

[00:04:34]

This seems to be the case. Even if the government would have taken its advice at face value. But also there seems to have been some negotiation within cabinet for which of these measures would be employed. And and for and in what and in what scope that is worrying. I, I agree with all of my health and scientific colleagues who seem to have the view, which I do, that the government should not be watering these things down in order to make them more competitive for the public.

[00:05:06]

That's not how it works. The government's job is to sell it to the public, absolutely. But this is not the way to do it. You certainly don't want a situation where benefits are putting things on so the government can take it off. You know, you don't want that kind of a situation evolving. So but regarding the measures themselves, some of them seem contradictory. I can see that. But that can be for good reason. Now, we know that, for example, outdoor sporting events, from a spectator perspective, if there's enough spacing between you and there's not shouting that they're they should be relatively safe because most transmission occurs indoors.

[00:05:46]

We can't have a stadium full or half full. But but having having 50 to 100 people socially distance at a soccer match, that shouldn't in principle be a big problem for what we know about the virus. But let's say they have evidence of transmission in Ireland under those conditions that we haven't seen yet. So we have to trust them. We have to trust that they made that decision for a reason. I don't think it was done just for perception's.

[00:06:11]

Then there are other issues about the contradictions between what's OK in schools versus what's OK in the workplace. And we discussed last time even about the risk of transmission in schools. Children transmit the virus 50 percent as much as adults as the population. Teenagers transmitted just as much as adults. So why are schools and workplaces being treated slightly differently? And then here the reality is that from a population perspective, everything is contributing, everything is contributing. There's no one magic bullet.

[00:06:44]

And the government do have to make legitimate political decisions about what at what time needs to take priority. And that's OK. I mean, even though it seems contradictory, I think that's OK. But my concern just to sum up, is not so much the contradictory nature of these of these measures, which which may be legitimate. I don't know. I'm not a public health expert. And so I defer to the intuition, knowledge and experience of our public health experts.

[00:07:16]

But my concern is that this is not going to be enough.

[00:07:20]

Now, nobody would envy the government the task they face. They have to try to reconcile two hugely important aspects of life, public health and the economy. I think you would you agree that the reconciling those two things is very difficult to the point of being almost impossible. Would you agree with that? No, I don't agree that it's impossible to reconcile those almost impossible.

[00:08:03]

I quite agree nothing is impossible if you see the outlines of it. However, they are subject to our democratic process where they can be lobbied and they must take account of the businesses, the jobs of their constituents. So they have not just a single task in their minds, they have two tasks to reconcile. Two different imperatives. Absolutely.

[00:08:34]

The government have many tasks and it's an unenviable job. I don't accept this narrative that currently in the media everything is about public health and there are very few economic voices that's been said by a number of commentators in the past few weeks. The reality is that the what we're calling the economic voices, which are lobbying groups and special interest groups, they don't need to always have a very loud voice in the media. They have direct access to, yes. Many of the components of government and the infrastructure around it, whereas most of us who are contributing to the conversation from a scientific or medical perspective have no such really direct access.

[00:09:19]

I mean, we can we can offer information and ideas, but we have no mechanism of political pressure. And this is why I think journalists are so important at this point in our in our history. Really. Yes. But the reality is that and many people have made this point before that health and the economy are the same thing in this respect and that public health is necessary for a vibrant economy and a vibrant economy is necessary for public health. So people who are very strong on the lobbying side, people who want us to simply open up and to get on with things, their view is that if the economy suffers, public health will suffer.

[00:09:59]

And they're absolutely right about that. At the same time, if public health is really allowed to suffer in a strong and acute way because of the virus, then the economy will suffer and more and more evidence has been provided for this. And and there's studies that have been done in the United States that have indicated, and I'm not an economist, but have indicated that the virus and the health damage to the virus has been more damaging to the economy than lockdown was.

[00:10:29]

Yes, and I'm not advocating for a lockdown. I don't think lockdown is a good thing. I think we need to find a way around this, because if we really do have a good strategy for dealing with covid-19, then we shouldn't need a lot of restrictions. Yes.

[00:10:43]

And back in June, when the infections were in single digits many days and into July and and the death rate was falling and the infection rate may be six or seven certain certain days, you were telling us understand that because we weren't imposing the right measures and disciplines, that this was a false sense of security and that we were being lulled into complacency. And unless and you are right, we are now in a position to Mars where last Saturday there were 200 new infections.

[00:11:30]

On Tuesday, there were 195 new infections, and yesterday there were 54 new infections.

[00:11:39]

So we're in trouble at this point.

[00:11:42]

Would you agree? Yes, I think everyone agrees with us now, you're you're part of a group called Zero covid Ireland, a group that believes that we can achieve what Taiwan, South Korea, New Zealand achieved. And I want to quote you the opening sentence from a piece in the Irish Times this morning by Jack Lambert, who's a professor of medicine and infectious diseases at the Batter Hospital and the School of Medicine. His opening sentence is Elimination of coronavirus in Ireland is a fantasy.

[00:12:19]

It is a dream that will not be achieved in the immediate future. And he goes on then to say effectively and and he quotes Dr Michael Ryan from the World Health Organization as also saying elimination of the virus is not a realistic plan. And he goes on to suggest, I suppose, that we just get on with it the best we can and not go for any absolute solutions.

[00:12:52]

Yes. So I associated with a group of scientists and physicians in Ireland that have been pushing for zero covid strategy that we think the best way of dealing with Korona virus in Ireland is to eliminate it from community transmission in a way that had been achieved in New Zealand. It's not perfect. We can talk about that. It has almost been achieved in South Korea and it had been achieved in Iceland and very much arguably in Taiwan. A common feature is islands are a good place for getting early elimination of this virus.

[00:13:28]

Now, regarding Dr Jack Lumber's who I really can't overstate that I have immense respect for, particularly because of the positions he's taken during this pandemic. I agree with half of his opening sentence in that elimination of covid-19 in Ireland is a is a dream, but I think it's an achievable dream. Yes. And I think it's the best possible outcome for the population. And I don't think that we have had an honest discussion about this. Yes. In Ireland.

[00:14:02]

So part of the narrative now, not just from from Jack, but from other people, is that we need to move away from this. But we were never really moving towards it in the first place. Yes. And the zero covid idea has been treated as a sort of a fringe idea by by the Irish media to a large extent and by the government. The reality is it's a very centrist position and I think it's a very sensible position provided you're willing to you're willing to do it.

[00:14:32]

And I don't think there's been a serious debate about what it would entail, but not just about what it would entail, but what the end result would be and how those two things, both what we have to do to get it and what the result, what the prize would be like, how those compare with the alternatives. And once we have those things on the table, then we can discuss whether or not this is achievable, whether or not this can be done, and whether or not people want it to be done.

[00:15:04]

And I don't think that a handful of experts or journalists or politicians can preemptively make this decision for the population. Nor do I think that they can legitimately shut down this conversation before we've had it. Yes.

[00:15:21]

And I mean, the lobbyists for businesses, particularly in the hospitality area, tourism and the travel area as well, they don't have a problem getting their concerns aired and that and they are to some extent, they set the agenda for our government. And what you want, I assume, is that the views that you hold are also on the on the agenda and are on the table, as you put it, that you want them on the agenda, you want them seriously discussed and debated.

[00:16:04]

And that surely is the role of the media in this crisis.

[00:16:09]

Yes, I think so. And I think that these options may be more palatable, even beneficial to most people who are coming at this. From an economic perspective, I think that many of the lobby groups who are representing, for example, the hospitality sector, the tourism sector, don't quite represent the real views of their membership. And I do think that a lot of people who are working on the ground, small business owners, et cetera, can see that the best long term situation until we have a widely available vaccine is to be able to operate at 100 percent capacity.

[00:16:42]

Yes, and this. And also, of course, to avoid further lockdowns, which is a looming threat to us right now, as we learned this morning. So this is where another false dichotomy has emerged in the past month or so of public conversation. We have gone from having health versus the economy, which I think a lot of people see now, that health versus the economy is a false dichotomy, though it still comes up. Yes, health and the economy are on the same side.

[00:17:09]

Now, there's a new false dichotomy that has emerged and it's about are we opening up or are we closing down? And this has been misattributed to different strategies. So for some reason, it has entered a lot of people's consciousness that living with the virus, a lot of people say we have to live with the virus because they say elimination is not possible, have created this sort of narrative that living with the virus means opening up fully. It does not.

[00:17:43]

Yes, living with the virus means living with restrictions. That's a fact. And this is what we're struggling with now, where we're reaching out and finding the limits of how much we can live with the virus. And it's not looking very good at the moment, is it? No, it's not. And this is the kind of thing that we're going to be living with if we if we choose the virus, hopefully it can get better because our test face isolation infrastructure is completely failing, as we've seen.

[00:18:11]

This is predictable since May. It feels like we have been asleep since over the summer. We've wasted opportunities here and everyone agrees. Everyone who wants to go for suppression or everyone who wants to go for elimination, everyone agrees this is a crucial tool in our arsenal that has not been developed and that's partly or largely even responsible for the current situation. But even if that gets up to scratch and starts to contain the virus in the community, we are still going to be living with significant restrictions.

[00:18:44]

That's what living with the virus means. And if we take this approach, which we can do, and there's various levels of quality in doing it, I mean, the South Korean approach is not elimination, but it's very heavy suppression that will still put limitations on our economy and limitations on our social life and limitations on our education. And we need to level with the public that that is the reality we will be choosing to face in a best case scenario for the next one to two years.

[00:19:12]

If we go with suppression, if we go with living with the virus, we go with elimination. We need to be honest that that means opening up. If you succeed in achieving elimination, does it mean closing down? It means opening up. Elimination is not about reducing the death rate to zero. It does that. That's a bonus. Elimination is about opening up the economy to one hundred percent levels. It's about opening up society to one hundred percent.

[00:19:37]

That's why we want elimination is may or may not require restrictions for a short period of time to achieve it. But nobody wants we can discuss that. But nobody wants to persist in lockdown. There is none of us who are advocating for a zero covid Island who want to live under lockdown or even any kind of restrictions indefinitely. The reason we want to go for zero covid Island is precisely the opposite of that. Yes. So we because we want to live without restrictions.

[00:20:10]

Now, can you confirm to us that for a period of time in June, early July, that we were down to a single digit infection's per day and that we were managing fine? I remember you telling me that this is fine. Now, we really need to take our courage in our hands and do the last bit, which is stay with lockdown down, stay with what we're doing. We can now eliminate that, eliminate this. And the time period you talked about then was four weeks.

[00:20:54]

Or so. At that point, we started opening up again, and we are where we are now, in trouble as exactly as you predicted.

[00:21:05]

Yes, I mean, we were we were very close to elimination. To be fair, the last mile is one of the hardest. So it it's not just a case of had we kept our existing locked down, as it was for a few weeks, that it would have led to elimination. It might have if we had had travel restrictions, proper travel restrictions into the country. But also, I think we need to be more active and I think we need a regional approach.

[00:21:35]

I know people don't like regional approaches because county boundaries are not entirely fair. So you need to have more sensible regions. But I think it is possible to hunt out the virus. We did lose our major opportunity. Our major opportunity was then in the summer, but we still have the choice. And I hope that we can still make that choice proactively, because, again, what I'm concerned about is, given what we heard about today, that sources have told journalists that and fish are very worried that if if cases continue to rise, that we may end up in full lockdown again and if we end up in full lockdown again, which would be incredibly tragic because we would be essentially going back to March, April, then we can start the conversation again, because then we're back in square one and then it can be well, given that we have to have a future, if we were in that situation, I really hope we don't ever in that situation.

[00:22:40]

But if we do, then we can have a conversation also about, well, do we want to do it properly this time? Do we want to go all the way? But I that's not what I'm advocating for. Now, what I'm saying is that we can still proactively engineer elimination of the virus before anything like that happens. And obviously, we need to change what we're doing. Now, regarding the case numbers in midsummer, yeah, we were in single digits for a while, but as many people have pointed out, we've never really had a perfect testing surveillance system based on the case fatality rates in Ireland.

[00:23:14]

It looks like we've only been ever really detecting a third of the active cases in the community. So even when we were in single digits, we probably were in double digits. And even now there are probably a lot more cases going around the island than we're aware of, which is worrying. And that's partly because our testing situation has slowed down and this also affects our perception of how the virus is moving. There's been a lot of comments recently, for example, not to not to go in too much of a tangent, but on the issue of travel, it's been very good.

[00:23:46]

I think that people have voted with their feet and decided to stay in Ireland. And of course, not a lot of people are traveling internationally. And it's not because of government restrictions. It's because now is not a great time to travel. So we haven't had a lot of incoming travel into Ireland, but the travel that has come in has not been properly regulated, not being properly quarantined now we're told, and we can see it in the data that comes from the Department of Health and the Hajazi.

[00:24:10]

There's very few travel related cases of covid-19 in Ireland, but that doesn't mean there's very few travel related cases. That just means we're not detecting them. Yes, which is not surprising because people who travel, they travel with an agenda. It's business, it's tourism, it's personal. And they may not know the rules. They may not have a GP. They may not want to report their symptoms. And if they have mild symptoms, so you're less likely to detect primary cases of travel related transmission.

[00:24:42]

And if a traveler, whether they're Irish or an Irish expatriate visiting Ireland or an Irish tourist going to another country and coming back, or a foreign national visiting Ireland, if they come in and they spread it to 10 people, that's not classified as travel related transmission. That would be classified as community related transmission or unknown transmission. So so we don't know we don't know what the effect of travel has been, but surely it's having an effect.

[00:25:13]

Now, I want to ask you about method, which is the task force advising the government. The scientists are not represented, you and your colleagues are not represented on Nevitt, surely that is a mistake because your input is so important and your knowledge is deep and wide from across the world. Why are there no scientists on Nevitt? Why is your voice and the voices of your colleagues not represented on the body that is advising the government, even though you were asked and did give a submission to the Iraqis at covid committee?

[00:26:08]

Well, obviously, I think scientists have an essential role to play in the management of any country's response to this pandemic. One of the reasons the United States of America, which is obviously the world's leading scientific country, is. Partly functional despite its current president, is because it has the Center for Disease Control and the Center for Disease Control also draws on academic scientists across America for for information and for input. At these times in Ireland, the scientific community is not represented on NPR.

[00:26:47]

And so the types of scientists that you hear in the media quite a lot over the past few months, which represent a very small subset of Ireland's scientific community, we really have a strong scientific community in Ireland. It's a cliche, but we do publish, we do punch above our weight in terms of our scientific output are not represented on. This is partly for historical reasons and it is a public health body and it preexisted the pandemic. And it's it's it's been put in the position to take control of the situation.

[00:27:27]

It's partly because it's started with a caretaker government. I think there were partly political reasons for it that certain politicians may not have wanted to take responsibility for this issue because we've had health controversies in the past when when that happens. And it wanted to be delegated to to medics. Yes. So these are historical reasons. Now, the reality is that you need an advisory panel that is scientific or that is a combination of of scientific and medical perspectives, because scientists and medics are very different types of professionals.

[00:28:05]

And if you look at the British equivalent of Nafiz, which is the scientific advisory, which is sage, they were criticized by the right, by members of the World Health Organisation early in the pandemic because they were over 60 percent civil servants and only only 40 percent, I think, are 50 50 in terms of independent experts. Now, what do we mean by an independent expert? By an independent expert? We mean two things. One, a person who is not employed by the government or by the civil service directly, so someone who is autonomous so they can't be influenced by government policy.

[00:28:48]

And secondly, that they are an active expert in their field. So they're there working at the cutting edge of a particular type of expertise. And all of us have very narrow expertise. We talk broadly about things when we're talking with the media. But but we all focus on very specific things. So you need many experts at the table. Now, when you look at nefesh, nefesh, the main committee is basically composed almost ninety five percent of officials who are in the employment of the Department of Health and the Health Service executive.

[00:29:28]

Now, many of them are doctors in the sense that they are doctors of medicine, but they are full time professional public health officials or civil servants that are working in the apparatus of state. So therefore, they are not they are not independent by any means. And also they are not necessarily active experts researching their field. So if you want to take an example, one of the most eminent experts in Ireland is Professor Luke O'Neill. Yes. Who is a world leading immunologist.

[00:30:02]

And that means that immunologists around the world know who he is. If he goes to Australia, if he goes to America, if he goes to Japan, all the immunologists there know who he is, even if they've never met him. Yes. And he has direct access to all of those networks, a. Like Lionel Messi. I don't know who that is. I come on to Barcelona, though, it is a respected and highly respected.

[00:30:35]

Exactly, exactly. Yes, science is is very international and it to be being a being a successful scientist means that you have to compete at an international level. Now, that is how how we can look at these things. So what you want is a diversity of experts who were working at the cutting edge. You need diverse types of expertise and and you need them to be of a high calibre. And we have that in Ireland. But currently it's not really feeding into in any way into into an effort.

[00:31:14]

Now, NFF has advantages to it. And and I want to state those two here very clearly. The weakness of the British approach was that their top committee had very few and at one point no public health experts, which was a huge mistake. So we're actually really strong on the public health expertise side, which is really important because they're the ones doing the mechanics of dealing with outbreaks and the day to day restrictions, as we were talking about earlier.

[00:31:44]

So there are strengths in method. Absolutely. And I think that everyone there is is doing an immensely difficult job under very challenging situations. But what I am saying is just that it's not a very comprehensive body. Now, people will say that enough. It has an expert advisory group and it does have an expert advisory group. The expert advisory group, however, is not stocked with scientists either. It is stocked primarily with consultants, physicians, medics.

[00:32:17]

Again, not one or two of them would be classified as as as active research scientists, too. But mostly they are they are medical professionals. And though they are not mostly in the direct employment of the agency or the Department of Health, it's still a small country and the medical community is very much tied up with each other. So the degree of independence of opinion and independence of thought is not clear. Groupthink? Yes. And then the expert advisory group has a subsidiary group which is called I think it's called the Research Subcommittee of the Expert Advisory Group, which is chaired by a physician and has 10 people on it.

[00:33:06]

Of those 10 people and six people are, last time I checked, are civil servants and four people are classified as researchers in the minority, and two of which are active researchers. One of them is the chief scientific adviser who I think should be on an equal footing with the chief medical officer. Yes, but but is but is relegated that subcommittee and that subcommittee set up further subcommittees in March where the scientific community in Ireland tried to have more input into what was going on, but it wasn't well received.

[00:33:45]

A lot of this is documented. So in general, it's been there's there's a different culture of doing things from from medical perspective and from a scientific perspective. And generally speaking, you know, scientists should not be in control of the day to day of how things are done because scientists should be there for helping with information strategy and for planning, funding things. What's going to work, what's not going to work. I think this would have made a difference for how we manage facemasks.

[00:34:17]

I think it would make a difference for how we manage asymptomatic transmission. I think our entire testing, tracing infrastructure would have been much more efficacious and well designed if it had more scientific input. But the day to day of how we manage this, of course, is the domain of of melee of medics and of our public health experts. But I think it would also have been valuable and still could be valuable to bring in the private sector. And we discussed this in the past.

[00:34:44]

And yes, if you have the private sector infrastructure and thinking and mentality and resources and networks, that that would be a great way of doing testing, a great way of doing contact tracing in a way that would be probably more efficient than what has been carried out by the NHS and of course, the NHS. You're going to be dealing with their primary role role, which is providing health care with the backlogs that have been created. So there's there's room for division of labour there.

[00:35:16]

And I think it requires government to say to its to its infrastructure. Which means the civil service, which means the Department of Health, which means the agency and other departments and agencies, if necessary, to say that just because we're not getting it done doesn't mean it can't be done. Yes. And we have the expertise and knowledge in Ireland and we have the resources and the manpower and the will to do everything the way we need to be doing it.

[00:35:47]

But it may not exist within the civil service or it may not exist within the agency, but people want to get involved. And I think that for cultural reasons, that didn't happen. And I think that that's something that needs to be looked at in the future.

[00:36:06]

A final question, Thomas. We have introduced some new measures this week. They're not going to help, are they? And the Irish Times and it's really the leading article today makes a remarkable statement here. Some young people need to cop themselves on The Irish Times says, and they don't usually use such blunt language in a letter. And alongside that observation on the editorial page, a lady from Canberra and McDonough says the next covid age specific strategy is obvious.

[00:36:48]

No restrictions for people aged over 70, some restrictions for people aged between 35 and 70, and a total lockdown for people aged under 35 years. Now, her point, I think, from my own observation, is well made. And I put this to you finally. The messaging, the propaganda, the signals. From the very beginning of this pandemic. Have been that it's the older people and people with underlying health conditions who are at risk of dying.

[00:37:28]

That for young people it is not something that is desperately serious and in many cases can be relatively mild.

[00:37:38]

Therefore, and we see a situation now where 67 percent of the infections yesterday were in people under forty five. Eighty five percent of the two hundred on Saturday were under forty five. In other words, that cohort of people are not feeling the heat. They're not feeling the need to be responsible. And that is a massive contributory factor to the numbers we're seeing now.

[00:38:07]

I'm very much against any kind of Age-Related stratification for how we deal with covid-19. If you look at the really successful countries like South Korea, like time, they didn't engage in feeling of of particular groups because they had two strategies that worked for everyone. You control the virus by controlling the spread in the population of 20 to 50 euros because they're the major spreaders of this virus in practice. Yes. Young people, I don't know if you like, we're giving we're giving very young people a very hard time in this.

[00:38:40]

I know there are lots of anecdotal cases of teenagers behaving badly. There are also cases of 20 and 30 year olds doing so. But we're about to put twenty five or 30 of them in a room together for six to eight hours a day. Yes. So when you're concerned about young people spreading the virus, I'm not going to blame the individual behaviour of young people there. It's it's we have to manage the school situation and this is going to be a major challenge.

[00:39:06]

But regarding the overall strategy, it so one of the measures that came out and I share everyone's skepticism, I don't feel like the measures that have been imposed. It's hard to disagree with most of them. I know they've been inconsistently employed, but it's hard to disagree with them given the situation we're in. We do need more restrictions. So I support them in that respect. But there's one which is involves shielding of people over 70. Now, shielding is is a euphemism for restrictions of the old.

[00:39:41]

Yeah. So when we were all under lockdown, we were all shielding. But now we're talking about shielding older people. And a lot of people think this is a good idea. And a lot of people think this is a very sensible idea. And in many respects it is. So it's it's about protecting the more vulnerable, which means older people and people with pre-existing conditions. There's problems with it, though. The problem is that, first of all, it's it's unhealthy for older people to be isolated as it is for everyone.

[00:40:09]

It's it's bad for people's physical health and it's bad for people's mental health. The other thing is that we know it doesn't work. And this is really important to remember. It doesn't work. And that means two things. Number one, it doesn't work from an epidemiological perspective. I'm not an epidemiologist, but I know that the studies that have models, the effects of non pharmaceutical interventions on managing covid-19 in the population have shown that shielding has a very small effect on the overall population, which shouldn't be surprising because most of the virus is transmitted by middle aged people.

[00:40:46]

So if you shield old people, the overall population, it doesn't it doesn't reduce the transmission of the virus very much so. It's so shielding of old people is not going to reduce the transmission in the population. The other reason it doesn't work is that it doesn't you can't really shield them. It just doesn't work. And we've learned about this not just in the nursing homes, but in the general community, that countries that have engaged in shielding like the United States, like Ireland, unfortunately, like the United Kingdom and like Sweden, they haven't been able to do it because what happens is if the virus goes to high levels in the population, which which can be encouraged with the shielding perspective, because middle aged people and younger people can be can be fooled into behaving in a more relaxed way if they think older people are being shielded, that it eventually gets into the older population anyway, because shielded people need to interact with the real world and particularly people who live in multigenerational families or who don't live alone or who are financially challenged or who need to interact with other people will get the virus if at some point if if it's swimming around in the population.

[00:41:58]

So so shielding is never really going to be effective at protecting most of the vulnerable population. In reality, however, of course, it is sensible if you're a vulnerable individual to shield yourself. If you can, you can afford to. When there are a lot of cases going around because it may not protect the population, but of course it may protect yourself at some cost, at the cost of your isolation, at the cost of not doing whatever else you would be doing at that point in time.

[00:42:34]

So the point about that is that it's not a preventative measure. Shielding is very much a reactive measure to deal when you have a surge coming. But of course, Rolling Glen knows this. Yeah. So this is push as part of the recommendations that in itself is is a cause for some concern.

[00:42:56]

OK, Thomas, we're very grateful to you for joining us on the stand. Thomas Ryan is associate professor at the School of Biochemistry and Immunology at Trinity College and also part of the neuroscience team there.

[00:43:13]

We're very grateful to Thomas, to you for listening and of course, to test cold responses. That's all we have time for now. We'll talk to you soon.