The coronavirus pandemic challenges us in new ways and our lives may never be the same, as RTÉ Health correspondent Fergal Bowers explains.

In a pub quiz, in the distant future – and if pubs are actually open by then – a question may be asked; Who was Cillian De Gascun?
Contestants might wonder, was he a Holy Roman Emperor, the lead singer in a rock band, or a key part of the national battle against the dreaded coronavirus.
The Covid-19 emergency has made household names of many medical and scientific scholars. It has revealed to the country, the vital work of public health doctors. Their role has remained largely a secret for decades, perhaps under-appreciated and down the pecking order of health service priorities.
The health service has seen many reports over the years. One that may not immediately come to mind is the Hickey Report, into community medicine and public health. It charted the future, way back in 1990. The report made sweeping recommendations on an overhaul of the surveillance of population health and control of communicable diseases, as well as putting those doctors who worked in the area on a new professional status.
Dr Cillian De Gascun
Not all of what was proposed happened. But it did recommend the establishment of a National Virus Reference Laboratory, which of course is now headed by Dr Cillian De Gascun.
The report back then also noted how Ireland still relied on overseas laboratories for help with tests. That was 30 years ago and in recent weeks we have needed to rely again on laboratory assistance from Germany, welcome as it is.
People will also be familiar with the ongoing need to rely on testing in America for CervicalCheck. So our lack of self-sufficiency in these matters comes to the fore again.
Covid-19 has also brought other individuals to greater public prominence – like Dr Tony Holohan, although he was already quite well-known in relation to the CervicalCheck crisis.
Add to that list Professor Philip Nolan, who would be a valuable partner in a pub quiz for epidemiologists. Plus Dr Colm Henry, HSE chief Paul Reid and Paul Connors, the Health Service Executive national head of communications, who the public have gotten to know via the weekly HSE briefings broadcast live on RTÉ News Now. His army training no doubt ensures that the briefing starts on time and that it has focus.
Professor Philip Nolan
Coronavirus has also threatened to drag some prominent individuals and corporate empires down. We can see the financial implications in the world of aviation, for business magnates and the like. And the potential job losses for employees are horrendous, with Aer Lingus and some of the meat industry in the spotlight in recent days. It’s heartbreaking.
Covid-19 is like an unwelcome visitor to your home. Someone who knocks on your door, at an unexpected hour, when you had other plans. Someone who well-overstays their time and leaves a big mess behind too. Such visitors may also bring with them unwelcome gifts, in the form of inconvenient truths. We are living with the enemy.
It challenges us in new ways and our lives may never be the same.
For over 1,000 people here, the virus has resulted in death and devastation for their families and friends left behind. The healing will be long and difficult. Full memorial or remembrance services can not be held for the foreseeable future, which adds to the pain.
As a result of coronavirus, we will probably never be the same as individuals, or as a society and our priorities are being redefined. It is testing what human nature is capable of. Each day there is the potential to be exposed to a fatal risk. Many of the things that matter now, held little sway before Covid-19.
Some of the changes are nice – a new generation of people have turned their hands to baking; families watch TV together again; more books are being read; the number of people out exercising within the ground rules appears to have increased. There may yet be a strange dividend of sorts from Covid-19.
We are all in changed places, some in new work places, others without work, some in new relationship places and facing fresh challenges. It’s unlikely that these changes will be short-lived as Covid-19 will be with us for some time. We may be facing significant long term change for society and our lives. For the world. Processing this all mentally will take time.
As Chief Medical Officer, Dr Tony Holohan said late last week, the virus will lead to a new way of living. From a political perspective, the virus has come at an unusual time for Ireland too, just after the relatively recent General Election. The current Government is faced with managing a country, a society and an economy – and not just a health service, a health system which itself is almost unrecognisably changed.
This past week has seen tentative signs for some optimism.
Dr Tony Holohan
The spread of Covid-19 has been reduced, although we are not there yet. Where exactly “there” is, is also a bit unclear. The number of admissions to hospitals each day is around 30-40 patients. It’s still too high. Thankfully the number of people in intensive care units is reducing and at the time of writing it was 106 patients. Our thoughts are with each one of those patients in intensive care and their loved ones, at this worrying time.
Outside of hospitals and nursing homes, the spread of the virus is reduced. Experts put the reinfection rate at between 0.5 and 0.8 and today there is much more data on which to base some predictions. Those figures also suggest that if we had not acted in the way we did, there would be 5,000 deaths by today. Many lives have been saved.
Despite all the positive indicators, the Chief Medical Officer has said that Ireland is not in a place where there is a case to be made to lift restrictions. It’s an unwelcome truth.
The events that have occurred in some nursing homes have also raised difficult questions, yet to be fully answered. We must bear in mind that it is difficult to combat a pandemic and these are extraordinary times.
When the events in nursing homes are reviewed, some of the important aspects will be how individual homes acted, the statutory oversight of homes by the Health Information and Quality Authority and the timing and detail of various guidance, on the prevention and management of Covid-19, issued to homes by the HSE.
Over 60% of deaths have been in nursing homes. Under HIQA standards, nursing homes must have infection control programmes to include proper hand hygiene and isolation by staff and residents, who test positive for Covid-19. Nursing homes also have medical practitioners attached, who along with out-of-hours GP services, usually provide care and assessment and their part in assessing ill residents will also be evaluated.
We must not forget that nursing home care is primarily nurse led and they have major expertise, built up over many years, in dealing with outbreaks of influenza for example. The staff are also close to residents and mental, emotional and physical strain of recent weeks has been difficult for them too. Each day at work, nursing staff and other health care workers may face a clear and present danger of contracting the virus.
We have seen some comparisons of Ireland with other countries, in our performance in terms of cases, deaths and other factors. These types of comparisons are fraught with dangers. This kind of data is so dependent on openness and honesty by each country and on what exactly is being tested – is it just hospital cases, or those in the community also, for example.
Also are deaths liked to Covid-19 and probable deaths being counted – they are in Ireland. There is a world of a difference between the number of swabs taken for example and tests actually done and the results back with patients.
Likewise people should exercise caution pointing to some countries where restrictions are being lifted. It’s just too early to say what exactly is happening in this regard in Sweden, Denmark, Austria and Germany, for example. But experts are watching closely.
We must always remember that this virus has only been public for four months. The peer-reviewed academic papers have not been done yet. Even here, we have not seen the full data set for the projections and observations being made via the National Public Health Emergency Team. Late last week, we were told that at some point the data will be submitted for publication.
Of course, some of the data is widely available on the websites of the Health Protection Surveillance Centre, the HSE, the Department of Health, the WHO and the European Centre for Disease Prevention and Control. In terms of what is available, there is so much more now than even a few weeks ago and that is valuable, in terms of informing public discourse.
There are some hopeful signs about developing good antibody tests. But even here, it is important to have large, independent clinical trials, to be sure these are the best tests possible, at this time. There are big commercial interests in the coronavirus epidemic too, so let’s not lose sight of that in the understandable clamour for hope. Ditto for a vaccine.
We would also benefit from getting as much data as possible in real time, so we know the exact number of cases, deaths and admissions more or less for each day. Overall there must be statistical rigour, if anything is to be drawn from the data and used towards national health and societal policy.
I have been writing this week about what we have all found ourselves in strange, uncomfortable and very unexpected places. As I’m sure is the case with most people, if you had asked me for my thoughts last New Year’s Eve, as to what 2020 was to bring, it most certainly could not have been this.
I also could never have imagined that in recent weeks, with the help of a wonderful team of people, I would be associated with a charity song, in aid of Age Action Ireland and the Irish Red Cross and its fund, supporting older people affected by Covid-19. Using social distancing, recording the voices of adults and children in different parts of Ireland, we put together a version of ‘On Horseback’, originally written by Mike Oldfield in 1975.
Mike Oldfield circulated a link to our version of the song via his private Facebook page last weekend. That was unexpected and certainly helped. We also had the support of Uniflu to cover costs of production for what was a complex project. And it means that all monies raised by the download of the song will go to the charity.
All this week, it was in the top 10 of digital downloads in Ireland – at one point even ahead of a Rolling Stones’ new release. It’s all down to the generosity of Irish people. So on behalf of everyone involved with ‘’ thank you to all who have supported the project so far.
There have been some other significant developments in the last week. The case definition for the virus changed to widen the scope of testing which is due to reach 100,000 a week after 18 May. People need to have just one of three key symptoms – sudden onset of either fever, cough or shortness of breath – with a sign of acute respiratory illness coming on. Patients must also be within a list of priority groups. That case definition for testing may be extended further, removing the need to be in a priority group, if the capacity of the system to test is there.
Testing is important as a key to helping unlock some of the restrictions. The danger with issuing a schedule of how restrictions might be lifted, is that of “anticipatory reaction”. It means that if people see one restriction being lifted, they may view it as okay to drop their guard in another area. That could prove fatal, literally.
There are differing views as to whether restrictions could be lifted on a regional basis. For example, keeping strong restrictions in the Dublin and other regions where there are significant case numbers but relaxing some restrictions in other parts of the country. While this will be considered by NPHET, nothing is expected soon in relation to a variety of regional approaches and there would be dangers in moving in that direction.
It’s just over two month since we had the first confirmed case here. Now the beginning of May has arrived.
At this time, by tradition in parts of Europe, sprigs of Lilly of the Valley, are offered to loved ones and friends, for good luck. We will all need some luck, in the weeks and months ahead.
The ever present danger posed by coronavirus, means that some of our old ways must be cast aside – like last year’s turf.
The month of May offers us a welcome, before the brightness of summer.
A time to reflect on the new reality, our changed ways of living and on fresh beginnings.