It was a less ebullient Health Minister and his chief medical adviser who came to brief the health committee on Wednesday of this week.

The minister began by observing that more men were dying than women from the virus but the department were optimistic about progress. R, as calculated by Prof Young was between 0.7 and 0.8, though it was difficult to calculate when there is not enough testing. He stated that some were making their  own interpretation of statistics and epidemiology but that the two Irish CMOs would compare Covid and missing cases.

Department of Health policy, he said, was now Test, Trace and Isolate.

Since 22 April PHA had been involved in a 7 week pilot of contact tracing. On 18 May there had been 36 cases and 35 were followed up (It was pointed out that tests needed to be done to find the cases).

Asked how many contact tracers there were the minister said that there was a room in Linenhall Street and there might be 10-20 contact tracers within. PHA were developing a job description. 

CMO stated that ICU was now in a low stage critical care mode. The Minister said Health and Social Care (is that NHS?) would have to be rebuilt and that waiting lists would go from awful to frightening.

Chief Social Worker Sean Holland (05 Mar) and CMO (23 April) had referred to capacity (but had they read what was going on in Italy and Spain) and ventilators (no mention of 68% success of ECMO at the Royal Brompton) which CMO had said ECMO was too specialised for Belfast, but not for Dublin! (With 4% of 900 cases and 68% success, 24 lives could have been ECMO).

It was said that the situation could have been worse but it was hard to imagine it.

The CMO went on about footfall and that no one knew in January but he had Wales CMO Dame Deidre Hine’s Report on H1N1 and may have had sight of the unpublished Exercise Cygnius Report which he had referred to when confronted early in the pandemic.

He said it was not known that it was highly infectious but did health officials not read the reports from China, WHO, South Korea, Singapore. Italy and Spain?

Alex Easton (DUP) asked about closed wards in Ulster Hospital Dundonald and Lagan Valley Hospital and how many care home residents had been admitted to hospital for further management.  CMO stated that it would take a while to get that information from the Trusts (even with electronic patient administration systems?)

Colin McGrath (SDLP) asked about death statistics and said he could not believe that CMO was from a health service which was not sure of what people had died from.

He asked if many of the excess deaths were really Covid-19?

Gerry Carroll  (PBP) who said he was not a ‘hurler on the ditch’  asked about patterns of behaviour and correlations with care home deaths from Covid-19? He stated that there had been patterns of neglect.

How many RQIA inspections had there been and when and why did CMO advise them to stop inspecting care homes, he asked.

The Minister and Chief Medical Officer referred to "pieces of work" being carried out and the committee were keen to know more of the pieces.

Pat Sheehan SF came back to contact tracing. Returning to the GAA (after remembering the passing of his fellow-St Gall's Club stalwart Gerry Higgins),  he said he played the ball and not the man.

There was a long exchange about contract tracing but it seemed that testing was vital to find the cases and this should have begun on 01 January.

The difficulties of fancy Apps versus reliable methods of test, trace and isolate were contrasted. Alan Chambers (UUP) surprisingly said that the focus had been too much on hospitals. 

Chair Colm Gildernew was keen on a rapid exchange of information given the pace of the pandemic and administered a rap on the knuckles for the Department of Health. He listed a series of documents which had not been received as promised in a timely fashion. The Committee were far from happy with the DoH and, undoubtedly, will provide valuable testimony to any inquiry.

Dr Michael Donnelly MB, BCh, BAO is a clinical epidemiologist.