Can the Covid-19 review provide the answers?
by Fergal Bowers, https://www.facebook.com/rtenews/ · RTE.ieThe Covid-19 world public health emergency officially ended at the start of May 2023, with a declaration from the World Health Organization.
Most of the restrictions that had been in place in Ireland were lifted well over a year earlier, at the start of 2022.
At this point, the memories of it all make it seem like a very long time ago, another country even.
But it only started four years ago and the impacts were devastating.
Some of the after-effects continue to this day, including Long Covid and vaccination programmes to protect the most vulnerable.
The plan for the review had been expected to go to the Cabinet much earlier this year, but there were big challenges in securing an independent chairperson and that caused a delay.
What has been announced this week is an evaluation. It is unclear how much, if any, of the proceedings will be in public, or broadcast.
Given the impact of Covid-19 - the number of people infected and the scale of deaths - it left no family untouched.
For that reason, every citizen will have some interest in this assessment of Ireland’s strategy and approach.
So, transparency and maximum participation will be key.
No legal power
This will not be a statutory public tribunal of Inquiry with legal powers.
It is not a private Commission of Investigation either.
There will be no power to compel the attendance of witnesses, in public or private, or the production of documents, including text messages and emails.
The Government will of course expect all public servants to co-operate with the proceedings, which will be led by Professor Anne Scott, and supported by a team of multi-disciplinary experts who have yet to be identified, confirmed and appointed.
So, everything is still not in place.
For some time now, the Government departments, such as the Department of Health, have already prepared their submissions for assessment.
Ms Scott, the person leading this review, is a Professor Emerita, University of Galway.
She is also a nurse and holds a particular interest in the philosophy and ethics of healthcare.
She is also a highly regarded expert.
Her final report is due to go to the Taoiseach within 18 months, which may be a quite ambitious timeframe.
Opposition parties, patient campaigners and others are very unhappy with the nature of this evaluation.
Sinn Féin Leader Mary Lou McDonald described the review as coming very late in the day before a general election and noted it would have no legal powers.
She also said it was weak and cannot establish all of the important facts the public deserve to know.
The Government has been anxious for some time to avoid a combative, legalistic, costly, blame game process.
Inquires in other countries
Those who support the evaluation approach point to the UK Covid inquiry, a statutory inquiry which has taken place in public for years.
The chairperson for the UK Inquiry was announced in December 2021 and the inquiry continues, with a battery of top lawyers participating.
Other countries have tried different approaches and have long completed their own investigations.
Taoiseach Simon Harris points to the non-statutory Scally Review, which examined the CervicalCheck crisis and provided answers.
There was wide recognition that it was successful, not least amongst the victims.
Mr Harris also acknowledged it was important for the forthcoming probe to establish what went well and what did not go well.
Former CEO of the Health Service Executive Paul Reid, who was at the helm of the health service during the pandemic, has said previously that the system got around 70% of things right.
If that proves to be correct, there will be significant interest in hearing about the other 30%.
For the HSE, there will be questions about its capacity to deal with patients with the disease, especially the ICU capacity in place.
A new virus
We must not forget that Covid-19 was a new virus and there was no cure, or real treatment when it arrived and swept the world.
There were also no vaccines at the time. In modern times, the world had never seen anything quite like it.
There was no playbook to guide people.
There was also a lot of fear, including among health staff about how to deal with it.
We had the telling line from Dr Mike Ryan, of the World Health Organization, that the greatest error is not to move fast in the face of these health threats.
Speed trumps perfection, he stated.
The Terms of Reference for the evaluation here will mean different things to different people.
The task is to establish a factual account of the overall strategy and approach of the whole of the Government response.
The breath of issues that may or may not come under scrutiny is enormous.
Nursing homes
The response to pressures on nursing homes and the level of deaths in the facilities is a major issue.
Families have questions about why patients in hospital were not tested and were discharged to nursing homes, only to have the virus spread.
Majella Beattie, Chief Executive of Care Champions, has said that nursing home residents often could not get admission to hospitals themselves because of fears about Covid-19, while other patients did.
She said this week the concern is that during the pandemic, the State left private nursing homes to their own devices.
Worse, there were claims at the time that the HSE was poaching nursing staff from homes and did not make sufficient personal protective equipment available to these facilities, due to the pressures the HSE was facing.
Care Champions want accountability for what they say were systemic failures, before, during and after the pandemic.
They support the call for an independent people’s inquiry.
Families will want closure over the loss of loved ones and their questions fully answered.
If this does not occur, it may leave a wave of anger.
The evaluation has no legal powers and so, it is hard to see how it can attribute any blame or point fingers at identifiable people.
If this is the case, it may only be able to identify systems failures.
The degree it will examine the relationship between the Government and the National Public Health Emergency Team (NPHET) is unknown.
The evaluation has been charged with examining the structures and processes of the Cabinet committees and NEPHET.
Follow the science
People will want to know to what degree Ireland was guided by the science in dealing with Covid-19 and what that science was for lockdowns, stay at home rules, the modelling of projected cases and deaths, and asking older people to 'cocoon'.
During the pandemic, wet pubs that did not serve food and could not open.
Those that did serve food were allowed open, if they served a substantial meal that cost at least €9 a person.
What was the basis for this rule and who came up with it?
In Britain, it is estimated that they experienced over 200,000 excess deaths due to the way the pandemic was handled in the early stages.
A few studies have suggested a low level of excess deaths in Ireland and this will be an important fact to establish.
In June, a Society of Actuaries in Ireland report estimated 1,100 excess deaths during the pandemic years.
Earlier this year, an OECD Working Paper suggested no excess deaths, although these were preliminary findings.
The vaccination campaign, despite problems, is regarded as one of the big successes and undoubtedly saved lives.
Time will tell if people give the evaluation of Ireland’s response to the pandemic the benefit of the doubt and let it do its work.
There is also the unknown composition of the next the Government after the forthcoming general election and whether a new administration might want to change the nature of this important review.
Certainly, Ms Scott and her team have an unenviable but critical task.