Policy responses for Ireland - HSRM

Ireland


Policy responses for Ireland

1.2 Physical distancing

Update 10 May 2021: ‘Time to feel hopeful and to start planning our summer’ says the CMO

On 6 May 2021, Dr Tony Holohan, Chief Medical Officer in the Dept of Health said ‘it is time to feel hopeful and to start planning our summer… We have worked so hard to reduce the spread of this disease. More than 30% of adults have now been vaccinated with one dose of COVID-19 vaccine in Ireland.’ Dr Holohan was speaking in advance of the further lifting of restrictions. He encouraged people to continue to ‘minimise the incidence of COVID-19 throughout May and June. Prioritise being outside and avoid crowds’.

On 10 May, there is further easing of restrictions, described by Tánaiste Leo Varadkar as ‘a day of freedom’. From 10 May 2021, people can travel freely across Ireland, meet their friends and family again and attend religious services. 12,000 businesses are set to reopen this week and 100,000 people will go back to work.
In the last week in May, a new Government National Economic Plan will be published. It is expected that some of the sectors hardest hit by the pandemic will be targeted, including hospitality and tourism. Government also has to make hard decisions about the phasing out or continuing of other pandemic financial supports.

Sources:

https://covid19ireland-geohive.hub.arcgis.com/ 

https://www.irishtimes.com/news/ireland/irish-news/time-to-be-hopeful-and-start-planning-our-summer-says-holohan-1.4557210 

https://www.rte.ie/news/2021/0510/1217960-reopening-reaction-coronavirus/ 

Update 29 April 2021: Major phased easing of restrictions announced, beginning in early May

On 29 April 2021, the Taoiseach Micheál Martin, in a televised address to the nation, announced the lifting a large number of COVID-19 restrictions. The announcements were based on advice from the National Public Health Emergency Team (NPHET). The reopening will take place in stages, beginning in early May. At the end of May, the Government will assess whether the reopening should continue in June. Restrictions will be lifted on travel, personal services, retail, outdoor socialising and religious services. Speaking on 30 April 2021, health minister Stephen Donnelly said the previous Government  five level plan is useful architecture but the levels can be largely discounted in favour of focusing on new measures announced. He also said that the NPHET could recommend an “emergency brake” on reopening but ‘ultimately the pulling of any such brake is a decision by Government’.

On 04 May 2021, all construction sites will be able to reopen. From 10 May, the phased resumption of non-essential retail will begin, starting with click and collect, where items can be pre-ordered and then collected from the store. Hairdressers and other personal services will reopen with a booked appointment. Cultural institutions such as museums, galleries and libraries will reopen. Capacity on public transport will increase to 50% of normal loads.
In-person religious services will resume with some limitations. For funerals and weddings up to 50 mourners or guests are permitted at a service. For weddings, six people are allowed at the reception indoors, or 15 outdoors, and this will rise to 25 people indoors in June. Organised outdoor gatherings can also take place with a maximum attendance of 15 people. Outdoor training will resume for adults in pods of maximum 15 people.

On 10 May 2021, the intercounty travel ban will be lifted. Households will be able to meet outdoors, with a maximum of three households or six people. Limits on outdoor visits will not count for children under twelve. Fully vaccinated people can also meet indoors with other fully vaccinated people as long as there are no more than three households present. Grandparents who have been vaccinated will also be able to meet indoors with grandchildren.

Those who have been vaccinated will be among a select group permitted to meet indoors in groups of three households from 10 May 2021. The timing of this will likely depend on which vaccine was received. Those who have received both doses of Pfizer can meet indoors around one week after their second dose. This will be two weeks for those who have received both shots of their Moderna vaccine. For those who have received Johnson & Johnson, they can meet two weeks after receiving their single shot. For those who have received AstraZeneca they can meet four weeks after their first dose which is a major boost for that group given what can be a wide gap between the first and second dose.

On 17 May 2021, the rest of non-essential retail is set to return, including many shops which have been closed for several months. On 02 June 2021, it is currently planned that before the June bank holiday in the first weekend in June, domestic tourism will begin with hotels, bed and breakfasts, hostels and guesthouses allowed to re-open. Indoor dining and leisure facilities will be allowed for residents only.

On 07 June 2021, it is planned that outdoor services will return for restaurants and bars. No distinction will be drawn between pubs that serve food and pubs that do not, so all pubs that have outdoor facilities can reopen, some for the first time in more than 400 days. Previously when restrictions were eased only pubs which served food and where the customer ordered a substantial meal costing at least €9, had been allowed to reopen.

On 07 June 2021, gyms and swimming pools will also reopen. Outdoor sports matches will resume but no crowds will be allowed. The number of guests attending a wedding reception will increase to 25. Indoor visits in private households will resume with one other household permitted to attend. Furthermore, the Government said it is preparing for the safe return of cinemas and theatres sometime in June subject to public health advice.
In July, indoor dining may resume but no date has been set. The Government has said that once it reaches a critical mass of vaccinations, it will give consideration to resuming indoor hospitality in restaurants, bars, nightclubs and casinos. The Government will also give consideration to indoor matches and exercise classes, mass gatherings and international travel
Tánaiste Leo Varadkar said that thousands of businesses would reopen and hundreds of thousands of people would be able to return to work. He said many of the business and employee supports would remain in place ‘at least until the end of June.’ Mr Varadkar added that it was likely to be September before people were allowed to return to their offices, as he said that would be when a ‘critical mass’ of people was vaccinated.

Minister for Arts and Sports Catherine Martin said that the Government would prepare proposals for the holding of a limited number of pilot large events for sport and music, including indoor events, though she declined to be drawn on when the events would take place.

Sources:

https://www.gov.ie/en/speech/d1879-speech-by-the-taoiseach-micheal-martin-announcing-new-public-health-measures-coming-into-place-in-may/  

https://www.gov.ie/en/press-release/62fef-statement-from-catherine-martin-td-minister-for-tourism-culture-arts-gaeltacht-sport-and-media-at-government-press-conference/  

https://www.gov.ie/en/press-release/0bd80-new-public-health-measures-announced-the-path-ahead/ 

https://www.irishtimes.com/news/politics/phased-reopening-to-begin-next-week-as-vaccination-plan-moves-to-over-50s-1.4551692    

https://www.irishtimes.com/news/politics/explainer-what-are-the-reopening-plans-and-key-dates-for-exiting-lockdown-1.4551007  

Update 15 April 2021: Tánaiste Leo Varadkar confident that Ireland is ‘on track’ to ease restrictions as part of a phased reopening this summer

On the basis of the recent Pfizer announcement to supply Ireland with 545,000 extra vaccines, Tánaiste Leo Varadkar said that ‘we’re on track, both to ease restrictions as planned from fourth of May and to have over 80% of people receiving their first vaccine by the end of June’.

Speaking on RTÉ's Morning Ireland, he added that there are encouraging signs as cases are stable and falling, the reproductive 'r' number is currently estimated to be below one and all children are now back in school.

According to Mr Varadkar, government will develop a reopening plan for the months of May, June and July: ‘what we’re planning is allowing more outdoor activities and a planned reopening of retail and personal services which includes hairdressers’. However, he clarified that while a staggered lifting of measures looks set to begin next month ‘things can go wrong and it does depend on four things – vaccines, variants, case numbers and the state of our hospitals’. It is expected that this will be published before the end of April 2021.

From 4 May 2021, the following are all under consideration (subject to the prevailing public health situation):

  • Full reopening of construction activity;
  • Phased return of non-essential retail commencing with click and collect and outdoor retail (garden centres, nurseries etc.);
  • Recommencement of personal services on a staggered basis;
  • Reopening of museums, galleries and libraries; and
  • Recommencement of religious services on a staggered basis.

Sources:

https://www.rte.ie/news/coronavirus/2021/0415/1209997-covid-ireland/

https://www.rte.ie/radio/radioplayer/html5/#/radio1/21939309

https://www.gov.ie/en/publication/35bb8-covid-19-sectoral-guidance/

Update 30 March 2021: Slight easing of COVID-19 restrictions commencing

On 30 March 2021, the Irish government announced plans to introduce changes to the current level 5 lockdown. Starting the same day, restrictions were eased for those who have received their full course of COVID-19 vaccination. Two vaccinated individuals may now meet indoors as long as they have received their second dose at least two weeks prior.

Further slight easing of restrictions will commence on Monday 12 April after the Easter holiday with the following changes:
  • Full return to school for all children in primary and secondary school.
  • The 5km travel restriction will be eased so people can travel within their full county or up to 20km from their home across a county boundary.
  • Outdoor socialising involving two households will be allowed in public places but not people’s gardens.
  • Construction industry can recommence work.

As of 19 April 2021, high-level sports training can resume if approved by Sport Ireland.

As of 26 April 2021, non-contact sport such as golf and tennis can resume and training for other sports and dance will be allowed in pods of 15 for children under 18 if taking place outside. The maximum attendance at funerals will increase from 10 to 25.  Zoos, wildlife parks and heritage sites will reopen.

In May 2021, consideration will be given to allowing museums and galleries to open along with a phased return of non-essential retail, starting with click-and-collect, and hair and other grooming services. Recommencement of regular religious services on a staggered basis is also being considered.

In June 2021, consideration will be given to the reopening of hotels and B&Bs.

Sources:

https://www.gov.ie/en/speech/6d7c3-speech-by-the-taoiseach-micheal-martin-announcing-new-public-health-measures-coming-into-place-on-april-12/ 

https://www.gov.ie/en/collection/ba4aa0-letters-from-the-cmo-to-the-minister-for-health/#2021 

https://www.irishtimes.com/news/politics/covid-19-vaccines-overhaul-sparks-anger-as-government-agrees-to-begin-easing-restrictions-from-mid-april-1.4523777

Update 11 March 2021: New visitation guidance for nursing homes

New Visitation Guidance for Nursing Homes was published on 11 March 2021 by the Health Protection Surveillance Centre in the HSE which will come into effect from 22 March. The guidance incorporates learning from the positive impact of the vaccine rollout nationally and internationally and expands the scope of visiting on general critical and compassionate grounds. It also refines the guidance across Levels 1 to 5 in the government’s plan - COVID-19 Resilience and Recovery 2021 - The Path Ahead. This includes increased visiting at Levels 3, 4 and 5, subject to risk assessment and no open outbreak.

Under the guidance from 22 March 2021:
  • residents may be facilitated to receive two visits per week on general compassionate grounds. This will be possible following two weeks after full vaccination of approximately 8 out of 10 of all residents and healthcare workers in the nursing home. This is an increase from the current guidance where one visit per resident is facilitated every two weeks.
  • there is no requirement to limit visits to less than one hour.
A range of specific critical and compassionate circumstances where visiting will be facilitated are outlined. These include:
  • A resident expresses a strong sense of need to see someone
  • When there is an exceptionally important life event for the resident (for example death of a spouse or birthday)
  • When the visitor may not have another opportunity to visit for many months or years, for example because they are leaving the country
  • Circumstances in which end of life is imminent.
 
Source:
https://www.gov.ie/en/press-release/2b3d8-minister-for-health-and-minister-for-mental-health-and-older-people-welcome-new-visitation-guidance-for-nursing-homes/ 

Update 24 February 2021: The Path Ahead – new COVID-19 Government framework published

On 24 February 2021 the Taoiseach Micheál Martin announced that the country would remain in level 5 lockdown until 5 April as he launched the Irish Government’s new plan for the next phase of life under COVID-19 named ‘COVID-19 Resilience and Recovery 2021: The Path Ahead’. The plan details the Government’s strategy for reopening certain important sectors such as childcare and education while remaining vigilant in the face of infection rates which are slow to reduce and dominated by the highly infectious B117 variant of the virus, which now accounts for 90 % of all cases in Ireland.

The plan reflects the precarious situation the country finds itself in as Deputy Chief Medical Officer Ronan Glynn wrote in a letter to the Minister for Health Stephen Donnelly TD on 18 February: ‘Ireland continues to experience a very concerning and precarious epidemiological situation. Incidence is falling but the rate of decline has slowed and daily case counts remain very high’.

‘The Path Ahead’ consequently sets out the reopening of only education and childcare while most other aspects of non-essential communal life and commerce remain restricted in line with level 5 lockdown restrictions. Important milestones in the plan include:

 • A phased return to in-person education for children by date:
  a. March 1 2021: Primary students up to second class and students in their final year (6th year) of secondary school will return
  b. 15 March 2021: Primary students 3-6 class and 5th year secondary school students return
  c. 12 April: all remaining secondary school students return
 • Phased resumption of childcare
  a. 8 March: Early Childhood Care and Education programme resume operation
  b. 29 March: all other early learning and childcare services resume operation
 • Non-essential travel remains restricted to a 5 km radius of a person’s home
 • Anyone able to, should continue to work from home
 • The Employment Wage Subsidy Scheme, the Pandemic Unemployment Payment and the COVID-19 Enhanced Illness benefit have each been extended until 30 June 2021.

Sources:

https://www.gov.ie/en/publication/c4876-covid-19-resilience-and-recovery-2021-the-path-ahead/

https://assets.gov.ie/124558/5ebbef54-d238-4fc5-8997-45f5b9fbe2d9.pdf

Update 12 February 2021: COVID-19 situation improves but restrictions will remain in place for months

Speaking on Morning Ireland on 11 February 2021, Taoiseach Micheál Martin said that there may be a high level of restrictions until April. Deputy Chief Medical Officer Ronan Glynn told the bi-weekly press briefing of the National Public Health Emergency Team (NPHET) later on the same day that much progress has been made. He said ‘We are cautiously optimistic about the epidemiological situation across the country. This positive momentum has been achieved through the dedication of people across the country in recent weeks. However, incidence and mortality rates are still very high, and the significant risk of community transmission of the virus remains, especially for those most vulnerable to COVID-19 infection. It is of vital importance that people continue to stay at home and to work from home where at all possible’. He pointed out how there were as many new cases of COVID-19 in the last week as there was in any week in 2020 and encouraged people to keep their contacts low and to continue to work from home.

While case numbers are down the decline in numbers testing positive has slowed down reflecting the decision to start testing asymptomatic close contacts in the last week. On 12 February 2021, Ireland’s national incidence rate is 299.6 cases per 100,000 of the population using the Health Protection Surveillance Centre 14-day rolling average compared to 397.1 a week ago and 621.9 the week previous. HSE Chief Clinical Officer Dr Colm Henry said that the 14-day has more than halved from the preceding 14 days, when it was 766. This represents ‘the greatest, most rapid fall’ in 14-day incidence rates in Europe, albeit from a high level.

At the NPHET briefing, Professor Philip Nolan, Chair of the NPHET Irish Epidemiological Modelling Advisory Group, said: ‘we are back in the containment phase of this pandemic. However, the positivity rates among household contacts are quite high, close to 30%’. He outlined many positive indicators of the disease included the numbers in hospital and CIU and the deaths rate is slowly falling. He said the r-number is estimated at between 0.6 and 0.8 but cautioned that everyone continue to adhere to the public health guidance and restrictions due to the infectious nature of the virus in the community.

Sources:

https://www.gov.ie/en/press-release/331d8-statement-from-the-national-public-health-emergency-team-thursday-11-february/ 

https://www.rte.ie/news/coronavirus/2021/0211/1196616-five-things/

Update 26 January 2021: Level 5 restrictions extended until 5 March alongside new travel regulations and enforcement

Speaking at a press conference following Tuesday’s Cabinet meeting, Taoiseach Micheál Martin announced the extension of Level 5 Covid-19 restrictions until at least 5 March 2021. The extension was announced in order to give time to reduce the pressure on hospitals and ICUs.

Mr Martin outlined new travel restrictions and further Garda (policing) powers to enforce them. The full implications of some of the proposed regulations are not clear but plans include:
  • Maintaining Level 5 restrictions limiting internal travel within the State to 5 km from an individual’s home.
  • Garda check points will be set up 5 km from the border with Northern Ireland in an effort to reduce unnecessary travel.
  • Incoming travellers will face a legal requirement to self-isolate after arrival with criminal sanctions for breaches. Prior, the advice has been for arrivals to self-isolate but without a legal basis.
  • Travellers arriving in Ireland without a negative PCR test will also face a fine of up to €2,500, up to six months’ imprisonment. Returning holidaymakers will face increased fines.
  • Authorities in the Republic and Northern Ireland have agreed to share some data in relation to passengers for the purposes of curbing the spread of the virus on both sides of the jurisdiction.
  • A temporary travel-ban on visa-free short-term travel from Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Peru, Suriname, and Uruguay as well as South Africa.

Meanwhile, renewed calls from public health academics and opposition politicians for a ‘Zero-COVID’ strategy have been rejected by members of the National Public Health Emergency Team (NPHET) as impractical and risky.

NPHET members have said that promoting Zero-COVID is the same as making ‘false promises’ that an end to lockdown can be achieved soon through virus elimination. Chief Medical Officer Dr Tony Holohan said that zero-Covid is unrealistic in the Irish context of being a small economy which depends on its links with Europe. He said it would be unrealistic to seal the border to stop movement and that it is more reasonable to maintain the current policy of reducing community transmission along with focusing on getting people vaccinated as quickly as possible.

Sources:

https://www.gov.ie/en/press-release/e2374-extension-of-level-5-restrictions-and-introduction-of-measures-for-international-travel/

https://www.irishtimes.com/news/ireland/irish-news/level-5-extended-until-march-5th-while-officials-consider-ban-on-all-non-essential-travel-into-state-1.4468043

https://www.irishtimes.com/news/ireland/irish-news/visa-free-travel-banned-from-most-south-american-countries-and-south-africa-1.4470082?

https://www.irishtimes.com/news/health/it-is-an-utterly-false-promise-nphet-rejects-zero-covid-strategy-as-impractical-and-risky-1.4470532

Update 6 January 2021: Stricter level five measures introduced for January

Government announced further restrictions to level five on 6 January 2021 with immediate effect except where stated and to run until the end of January when they will be reviewed. All schools are to remain closed except for final year students and those with special and complex needs. Childcare is closed with the exception of children of essential workers and vulnerable children. Construction sites are to close on 8 January. Only essential retail will remain open, click and collect will no longer be permitted. Until 9 January, there is no travel into Ireland from Great Britain or South Africa. From 9 January, all travelers from those locations must have a negative PCR COVID-19 test result within 72 hours prior to arrival.

https://www.gov.ie/en/publication/2dc71-level-5/ 

Update 30 December 2020: Ireland placed on full level five restrictions

In an address to the nation, Taoiseach Micheál Martin announced that the government agreed that Ireland needed to enter Level five as set out in the Plan for Living with COVID-19. It came into effect at midnight and are due to remain in place until midnight on 31 January 2021.

The government made this decision based on substantial deterioration of Ireland’s epidemiological profile and NPHET’s advice.
The primary message is in order to stop the spread of the virus everybody should stay at home, with the exception of essential purposes. The government further agreed that the ban on air travel and passenger travel on ferries from the UK will be extended to 6 January. As a similar new strain has been identified in South Africa, this ban will also apply to South Africa until 6 January.
Measures introduced included:
  • no visitors are permitted in private homes/gardens (except for essential family reasons such as providing care to children, elderly or vulnerable people, or as part of a support bubble)
  • no social/family gatherings should take place in other settings
  • people may meet with people from one other household in outdoor settings when taking exercise
  • weddings planned up to and including 2 January may proceed as planned, up to a maximum of 25 guests. Weddings from 3 January may proceed, but with a maximum of 6 guests
  • funerals may have up to 10 mourners
  • people are required to stay at home except for travel for work, education or other essential purposes, and will be permitted to take exercise within 5km of home;
  • people away from their place of residence on 31 December will be permitted to return to their place of residence
  • all retail, other than essential retail must close from close of business on 31 December
  • all non-essential services remain closed, click and collect services will be available
  • everyone is to work from home unless essential for work which is an essential health, social care or other essential service and cannot be done from home
  • early learning and childcare services open with protective measures
  • schools open from 11 January with further review on precise situation in advance of that date
  • higher, further and adult education should remain primarily online.

https://www.gov.ie/en/press-release/066ce-ireland-placed-on-full-level-5-restrictions-of-the-plan-for-living-with-covid-19/ 

Update 22 December 2020: Ireland placed on level five restrictions with a number of specific adjustments

On 22 December, the Taoiseach announced that from midnight on 24 December until 12 January, Level five restrictions will apply nationally, with a number of specific adjustments to Level 5 and certain transitional arrangements will apply during the Christmas period. This is in response to the rapid increase in COVID-19 case numbers over recent days, the nature of social interaction likely to take place over the Christmas involving mixing between younger and older people and the risk that this could lead to a wave of infection with a higher risk age profile.

Restrictions include:
  • non-essential retail may remain open, retail sector is requested to defer January sales;
  • gyms, leisure centres and swimming pools may remain open for individual training only;
  • outdoor golf and tennis are permitted. Participants should be from a maximum of two households;
  • hotels may only open for essential non-social and non-tourist purposes except for guests who already have a booking and are due to check in up to and including 26 December;
  • you must remain within your county (as opposed to within 5km of your home) apart from travel for work, education or other essential purposes;
  • non-contact training in pods of up to 15 may take place outdoors;
  • no matches/events should take place except for professional and elite sports and horse racing and greyhound racing behind closed doors

Specific transitional arrangements for the Christmas period are:
From 3pm on 24 December:
  • restaurants and pubs operating as restaurants will close
  • hotels may provide food and bar services to guests only after that point

For those who are part of a support bubble, the bubble counts as one household. Up to and including 26 December:
  • visits from up to 2 other households will be permitted
Up to and including 31 December:
  • visits from one other household will be permitted
From 1 January:
  • no visitors are permitted in private homes/gardens (except for essential family reasons such as providing care to children, elderly or vulnerable people, or as part of a support bubble)
  • Travel outside your county will continue to be permitted up to and including 26 December. Those away from their place of residence after that period will be permitted to return to their place of residence.

Christmas religious services may take place, but will move online after 25 December when places of worship may remain open for private prayer. Weddings can have up to 25 guests. From 3 January, weddings can have up to 6 guests.

The government has also agreed that the current restrictions on travel from Britain to Ireland should remain in place until at least 31 December, but kept under constant review in the light of unfolding information and circumstances.

https://www.gov.ie/en/press-release/a1f21-ireland-placed-on-level-5-restrictions-of-the-plan-for-living-with-covid-19-with-a-number-of-specific-adjustments/ 

Update 30 November 2020: Restrictions on Visitors to Nursing and Care Homes to Be Eased

From the 7 December restrictions on visitors to long term residential care facilities (including nursing homes) will be eased. The guidelines published by the Health Protection Surveillance Centre (HSPC) on 30 November detail the measures to be implemented at the five levels of the Government framework for COVID-19. The guidance states ‘to promote wellbeing up to one visit by one person per week should be facilitated on compassionate grounds for those residents who wish to receive visitors when at levels . . . 3 and 4,’. At level 5 one visit by one person every two weeks would be permitted. In some disability settings, one visit by one person per week may still be permitted under level 5.

Sources:

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/residentialcarefacilities/Guidance%20on%20visits%20to%20RCF.pdf 

https://www.irishtimes.com/news/social-affairs/restrictions-on-nursing-home-visits-will-ease-from-next-week-1.4423862

Update 27 November 2020:  Ireland to relax measures from 1 December as cases are the lowest in Europe

In an address to the nation on the evening of 27 November, after six weeks of lock-down measures, Taoiseach Micheál Martin announced the relaxation of measures with effect from 1 December, with further relaxation of measures to come into effect on 18 December for three weeks.

The easing of restrictions came as the National Public Health Emergency Team (NPHET) reported the 14-day incidence rate at 93.7 per 100,000 population. This is the first time in two months that the Irish rate went below 100 per 100,000.

From 1 December, people are advised to continue not to mix with any other households outside of their support bubble. In outdoor settings away from one’s home or garden, up to six people from a maximum of two households can meet while maintaining strict physical distancing. No organised indoor gatherings should take place with exclusions for business, training, conferences, theatres, cinemas or other arts events, where the environments are controlled and protective measures are in place. Controlled outdoor gatherings of up to 15 people can take place. Libraries, museums, galleries can open. Gyms, leisure centres and swimming pools can open for individual use only. A maximum of 50 people can attend places of worship with the cap of 25 remaining on funerals and weddings.

From Friday 4 December, restaurants and pubs operating as restaurants (serving a substantial meal) can open for indoor dining with additional restrictions, including a requirement for meals to be prepared on site, inside the premises, with a maximum of six people per table. Wet pubs (those that do not serve food) can only provide delivery and take-away services. All retail shops and shopping centres and all services such as hairdressers, beauticians, barbers and opticians can open with strict adherence to guidance on protective measures.

It is still recommended that everyone work from home unless absolutely necessary to attend in person. Higher and adult education is to remain primarily online. Domestic and foreign ravel is advised only for essential purposes. Public transport capacity is limited to 50%.

There is a change in policy on face coverings which are now advised in crowded workplaces, places of worship and in busy or crowded indoor and outdoor spaces where.

From 18 December, social and family gatherings where people can mix with a maximum of two other households are allowed. In outdoor settings away from your home or garden, a maximum of three households can meet while maintaining strict physical distancing. Guidance issued by the government includes a safe Christmas checklist, advice on safe shopping, safe visiting and dining out in cafés and restaurants and safe Christmas day.

The measures announced deviate from some of the public health advice issued by NPHET. In a 36-page letter to the health minister, dated 26 November 2020, Dr Tony Holohan detailed how Ireland’s early imposition of level five restrictions means that we are now top of the European league table in terms of our low numbers of cases with COVID-19. Despite the progress, NPHET warns that if restrictions are now ‘a third wave of disease will ensure much more quickly and with greater mortality than the second’ and recommended ‘a cautious approach’ to easing of measures as the ‘epidemiological situation remains fragile’ recommending the need to prioritize and make choices about discretionary social contacts. NPHET recommended that the hospitality sector remain closed for another eight weeks but allowing limited contact between households. The government decision chose the opposite with opening up restaurants and pubs from early December. Government stressed how they had to take account of the public health advice and weigh it up against social and economic impacts. The decision to ease restrictions was made by a cabinet decisions which was informed by a five-hour meeting of the cabinet sub-committee on cCOVID-19 and the Senior Officials Group. The decisions were informed by data gathered by the Central Statistics Office and private consultancy EY as well as that provided by NPHET.
Speaking on national radio on 29 November Minister for Health Stephen Donnelly said that the Government were expecting the level of cases to rise from the second week in December, and that a rapid rise could lead to further measures being introduced in January.

Sources:
https://www.gov.ie/en/publication/ad569-level-3/ 

https://www.gov.ie/en/publication/e3b9e-safe-christmas/ 

https://www.gov.ie/en/collection/ba4aa0-letters-from-the-cmo-to-the-minister-for-health/#november 

https://www.irishtimes.com/news/ireland/irish-news/government-may-yet-face-hardest-call-on-covid-19-restrictions-1.4423006 

Update 22 October 2020: Ireland moves to highest level of COVID-19 restrictions

In a letter dated 15 October to the Minister for Health, the National Public Health Emergency Team (NPHET) recommended to government, for the second time in October, move the whole country to level 5 (the highest level) in the five-level COVID-19 management framework. In this letter, the Chief Medical Officer says that applying stricter measures will serve to supress the virus with the goal of:
  • Preventing disruption of non-COVID health and social care services
  • Protecting medically and socially vulnerable people
  • Averting disruption to childcare and education.

In response, on the evening of Monday 19 October, the Taoiseach announced that the nation would indeed move to level 5 restrictions for a period of six weeks with the goal of significantly reducing the spread of the virus and to enable the celebration of Christmas to happen in a safer manner with a semblance of normality.
Level five rules include:
  • Everyone should stay home as much as possible and should work from home unless providing an essential service for which their physical presence is required
  • Outdoor exercise is permitted only within a radius of 5km of one’s home
  • No visits to other people’s homes or gardens allowed
  • Meeting with one other household in an outdoor setting which is not a home or garden is allowed
  • Individuals who live alone or are parenting alone, can form a support bubble with one other household
  • No social/family gatherings should take place, except for weddings (with up to 25 guests) and funerals (with up to 25 mourners)
  • No organised indoor or outdoor events
  • Essential retail and services will remain open
  • Bars, cafes, restaurants and wet pubs may provide take-away and delivery services only. Wet pubs in Dublin remain closed
  • Hotels, guesthouses and B&Bs may remain open, but only to support provision of essential services
  • Museums, galleries and other cultural attractions will remain closed
  • Libraries will be available for online services only
  • Outdoor playgrounds, play areas and parks will remain open with protective measures
  • Visits to Long Term Residential Care facilities are suspended with the exception of visits required for critical and compassionate circumstances
  • Travel outside of 5km is allowed for
   o Travel to and from essential work
   o To attend medical appointments, and to collect medicines and health other products
   o For vital family reasons such as providing care to family members
   o To attend a wedding or funeral
   o For farming
   o To visit a grave

Sources:

https://assets.gov.ie/93272/2c5f1621-4233-47d8-adce-96e9b9b2ffc1.pdf

https://www.gov.ie/en/publication/2dc71-level-5/


Update 14 October 2020: Level 4 restrictions placed on counties Donegal, Monaghan and Cavan and ban on household visits nationally as primary source of infection

The decision was made by the Government to move counties Donegal, Monaghan and Cavan to Level 4 restrictions with an effect from midnight on 15th of October until the 10th of November. The decision was based on high 14-day incidence rates which were 571 per 100,000 for Cavan, 360 for Donegal and 353 for Monaghan, compared to 190 nationally and in the light of the very high incidence rates in Northern Ireland.

Under Level 4 no visitors to private homes are permitted, non-essential retail closes and non-essential workers are to work from home. Schools will remain open in the impacted counties, and people can travel for work, education and essential purposes only.
The Government also announced a ban on visits to private households and gardens for the rest of the country currently at Level 3. The only visitors allowed will be those providing care for children, elderly and vulnerable people. People will be allowed to meet in groups of up to six from up to two households in outdoor settings, including for exercise and dining, provided that they adhere to social distancing rules. Sports teams which were allowed to play behind closed door under Level 3 up to this point will not be permitted to train unless social distancing is maintained.

The decision was made based on the consistent data over a number of weeks which demonstrates that majority of infection clusters originated from private households.

Sources:

https://www.irishtimes.com/news/health/nationwide-ban-on-home-visits-imposed-while-cavan-monaghan-donegal-moved-to-level-4-1.4380616 

https://www.thejournal.ie/outbreas-ireland-hpsc-5234010-Oct2020/


Update 1 October 2020: New visitation guidance for nursing homes published

The Health Service Executive and the Health Protection Surveillance Centre have published new COVID-19 Guidance on visitations to Long Term Residential Care Facilities to support long-term residential services, including nursing homes, in planning and facilitating visiting arrangements for their residents across all levels of restrictions (from Level 1 to 5), in cased of outbreaks or clusters being identified taking into account compassionate and critical circumstances. The document emphasises the importance of balancing protective public health measures with the protection of mental health and wellbeing of vulnerable residents as well as those who visit them.

The document outlines how continued social interaction for residents can be provided safely at each level. It urges the long-term residential facilities to plan for alternative visiting and communication arrangements, such as “window visiting” (where a person stands outside and speaks to a person at safe distance through an open window) or virtual visiting (through telephone or video-link), in case where visiting may need to be restricted or suspended for the protection of residents and staff.

Sources:

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/vulnerablegroupsguidance/Guidance%20on%20visitations%20to%20LTRCF.pdf

https://www.gov.ie/en/press-release/56463-minister-for-mental-health-and-older-people-welcomes-the-publication-of-new-visitation-guidance-for-nursing-homes/

Update  1 October 2020: Further restrictions considered following latest figures and changing patterns of infection severity

On 1 October, the National Public Health Emergency Team (NPHET) recommended country-wide restrictions based on the nationally increasing number of COVID-19 cases and clusters associated with people socialising. Current Level 3 restrictions in Dublin and Donegal, where home visitors are limited to a maximum of six people from a single household, and people meeting at restaurants can only meet with one other household, are to be applied nationally. Apart from those restrictions, counties currently at Level 2 will not move to full Level 3 restrictions. However, the public health officials expressed concerns about increase in cases in Cork, Galway, Roscommon and Monaghan.

More than 4,500 cases of COVID-19 have been confirmed nationally over the last two weeks. The acting chief medical officer, Dr Ronan Glynn have expressed the concern over the changing pattern of severity and impact of COVID-19 infections. Currently, 120 people with COVID-19 are hospitalised compared to 36 hospitalised on 1 September and eight on 1 August. Twenty people are in critical care. There were 32 deaths in September compared with four reported in August. The most recent national 14-day average is at 96.92 per 100,000 compared with 88.26 reported on Monday and 33.12 at the beginning of September. There has been a sharp rise in cases among 19-24 years as the colleges reopened last week, and concerns about the rise of cases among those over 65 years old. However, the numbers among school aged children are low and stable.

Sources:

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/surveillance/covid-1914-dayepidemiologyreports/

https://www.rte.ie/news/2020/1001/1168634-nphet-update-covid/

Update 25 September 2020: Level 3 restrictions placed on county Donegal

Due to a six-fold increase in the rates of COVID-19 in Donegal over a two-week period in mid-September, level 3 restrictions come into effect in Donegal at midnight on 25 September 2020 (https://www.gov.ie/en/publication/f9a0c-donegal-is-at-level-3/).

This means no social or family gatherings should take place, with exemptions for weddings and funerals. People can have a maximum of six visitors from one other household in their home or garden. No organised indoor gatherings should take place. Organised outdoor gatherings can have a maximum of 15 people.

People living in Donegal must not leave Donegal to travel either domestically or internationally, with the exception of those who must travel for work, education and other essential purposes such as caring. People living outside of Donegal should not travel to Donegal, with the exception of those who must travel for work, education and other essential purposes. People working in Donegal are asked to work from home unless absolutely necessary.

Schools, Early Learning and Childcare services will remain open. Adult and Higher Education Institutions should remain open, but are asked to review protective measures and take steps to limit congregation as much as possible. People are asked to walk or cycle where possible so that public transport is available for use by essential workers and for essential work only.

Update 18 September 2020: New restrictive measures introduced in Dublin

On the evening of 18 September, Taoiseach Micheál Martin announced that the entire county of Dublin is to be on Level three of the Framework for Restrictive Measures with effect of midnight. He said the action is based current public health advice in response to the deteriorating situation of the virus in Dublin over the past number of weeks. The rest of the Ireland remains at Level two.
Dublin will stay at Level three for a period of at least three weeks until Friday 9 October. The priority is to keep schools and early learning and childcare services open and minimise disruption in the work force. Level three means a maximum of six people from one other household can visit another home and no social or family gatherings should take place in other settings. No organised indoor gatherings should take place and for organised outdoors gatherings, no more than 15 people can be there.

Sports training is only allowed for non-contact training with a maximum of 15 people. Matches cannot take place and gyms can open only for individual training. Religious services are to move online, while places of worship remain open for private prayer. Up to 25 people can attend weddings and funerals. All museums, galleries and other cultural attractions are to close, libraries will be available for e-services and call and collect. Restaurants and cafes (including bars/pubs serving food) may remain open for take-away and delivery and outdoor dining to a maximum of 15 people.  Nightclubs, discos and casinos will remain closed. Hotels, guesthouses and B&Bs may remain open, but with services limited to residents.

Everyone in Dublin is advised to work from home unless absolutely necessary to attend in person and to stay in the county of Dublin apart from work, education and other essential purposes, if appropriate. Schools and creches are open with protective measures. Further, higher and adult education to escalate all appropriate protective measures and limit congregation as far as possible.
All visits to nursing homes are suspended, aside from critical and compassionate circumstances.

Source:

https://www.gov.ie/en/publication/cf1f3-special-measures-in-place-for-dublin/

Update 10 September: Tighter restrictions on household visitors in Dublin to be recommended by NPHET

On 10 September, it was reported that the National Public Health Emergency Team (NPHET) would recommend introducing additional restrictions on visits to private households in the capital. This is based on the data indicating that around half of all new infections in Dublin is transmitted through private households (https://www.irishtimes.com/news/health/coronavirus-people-told-to-change-behaviour-amid-fears-dublin-cases-could-double-every-two-weeks-1.4350918). As the cases in the capital increase at a 5% a day, there are concerns that Dublin will double the number of infections every 14 days. The tighter visitor restrictions would mean only six visitors, from two other households (instead of three currently) are allowed. This follows a similar announcement on 9 September by the chief medical officer, Dr Ronan Glynn, urging the public in Dublin to limit the number of social contacts through limiting household visitors and family gatherings.

While NPHET is tasked with making recommendations, it is up to the Irish government to decide whether these are put in place. The actual restrictions are to be announced next week, following the cabinet’s meeting on Tuesday, 15 September.

The 14-day incidence of COVID-19 infections in Dublin has increased in the second week in September to 70.8 cases per 100,000 compared to 53.2 a week ago (https://www.rte.ie/news/coronavirus/2020/0910/1164299-nphet-meeting/). The data comes from the daily 14-day Epidemiology Reports published by the Health Protection Surveillance Centre (HPSC), a data arm of Irish Health Service Executive, which began to publish them at the beginning of September (https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/surveillance/covid-1914-dayepidemiologyreports/).

Update 8 September 2020: Pubs to reopen amid growing concerns over rising COVID-19 infections

On the 8 September, the government announced the decision to reopen Irish “wet” pubs – which is the term given to pubs which do not serve food - on the 21 September (https://www.irishtimes.com/news/politics/cabinet-decides-all-pubs-can-open-from-september-21st-1.4349607). This is a fourth proposed opening date for pubs and the government has confirmed there will be no further delays.

Public health experts expressed their surprise with the timing of the government’s decision to reopen the pubs (https://www.irishtimes.com/news/health/covid-19-health-experts-surprised-at-decision-to-reopen-pubs-1.4349859). It comes at the time of growing concerns over rising infections as well as of reopening schools and the higher education sector. The experts argued that this will make it difficult to “disentangle trends” and access the effects of each sector opening on the rise of infections.

However, some experts, including Professor Sam McConkey from the Royal College of Surgeons in Ireland consider the reopening is reasonable provided there are strict regulations in place. These would include social distancing measures such as having an outside areas or groups of six or less people, more than two metres apart, as well as people sitting down, limited number of households mixing together, table service only, people wearing masks unless seated.
Any further restrictions on pubs being open are to be part of general restrictions on businesses, dependent on the increasing levels of infections regionally, and not part of a national approach aimed solely at pubs.

The Irish pubs are considered “an important part of the fabric of Irish society”, yet they have been subjected to what has been termed the longest lockdown in Europe. 3,500 pubs remained closed since March, with approximately 25,000 employees affected ((https://www.irishtimes.com/news/health/europe-s-longest-lockdown-irish-wet-pubs-set-to-reopen-on-september-21st-1.4349053). Trade unions and representative bodies for pubs, the Licensed Vintners Association and the Vintners Federation of Ireland, have welcomed the decision.

Update 28 August 2020: Decision to open pubs deferred as schools reopen

A decision to open pubs currently not serving food has been deferred for another two weeks due to high rates of community transmission of the virus. At the press briefing on 27 August Dr John Cuddihy, Director, Health Protection Surveillance Centre, HSE said; ‘We are identifying outbreaks in a number of different settings such as private homes, workplaces and social settings. Congregated settings are ideal environments for this disease to spread between people. We all must avoid such congregations if we are going to break the chains of transmission of the virus’ (https://www.gov.ie/en/press-release/f4b2d-statement-from-the-national-public-health-emergency-team-thursday-27-august/).

Meanwhile, about a million students and 100,000 teachers and staff are returning to primary and secondary schools during the last week of August and first week of September (https://www.gov.ie/en/campaigns/a128d-back-to-school/?referrer=http://www.gov.ie/returntoschool/). With a goal of all students returning full time, schools have undertaken massive work to organise classrooms and the whole school environment with social distancing and infection control in mind. The Department of Education has published advice for families and students for how to manage the process of going back to school and what to do in the case where a child is ill (see https://www.education.ie/en/Press-Events/Press-Releases/2020-press-releases/PR20-08-14.html and https://www.education.ie/en/Press-Events/Press-Releases/2020-press-releases/PR20-08-21.html).

Update 20 August 2020: Increased alignment between North and South in relation to numbers allowed to gather

There has been an increase in the numbers of people in Northern Ireland testing positive for COVID-19 with the R-number estimated at 1.3 on 20 August 2020. In a statement from the Northern Irish health minister Robin Swann on the same day, he outlined the tightening of restrictions on indoor and outdoor gatherings reducing the numbers at indoor events from 10 to six and for those outside to 15 with effect of 22 August (https://www.health-ni.gov.uk/news/minister-announces-tightening-restrictions). This will align Northern Ireland with Ireland in this regard.

Update 21 August 2020: Confusion caused by mixed messages from Government as COVID-19 cases remain high

On 21 August, the localised lock-downs introduced two weeks ago in Kildare, Laois and Offaly were lifted in Laois and Offlay but were continued in Kildare for another two weeks (https://www.gov.ie/en/press-release/5f683-statement-from-the-national-public-health-emergency-team-friday-21-august/). 

At the Department of Health COVID-19 briefing on 20 August 2020, Professor Philip Nolan, Chair of the Irish Epidemiological Modelling Advisory Group, said ‘the R-number is at or above 1.2’ (https://www.gov.ie/en/press-release/f501e-statement-from-the-national-public-health-emergency-team-thursday-20-august/). He specified two specific concerns firstly, the number of new cases per day remains high and secondly, the changing pattern from large outbreaks in specific settings to much smaller outbreaks distributed across the country.

Speaking at a press briefing following a prolonged cabinet meeting on 18 August, Taoiseach Micheál Martin announced the tightening of key restrictions for the next three and a half weeks to 13 September 2020 (https://www.gov.ie/en/speech/e1067-statement-by-an-taoiseach-announcing-new-public-health-measures-which-will-last-until-13-september/). The new restrictions with effect from 18 August mean that the Phase Four of the Reopening plan has been postponed again. At the government briefing, Micheál Martin said the government agreed to finalise and publish a Roadmap for Resilience and Recovery before 13 September 2020.

The measures introduced on 18 August are due to run til 13 September. They include
• No more than six people should gather indoors and no more than 15 should gather outdoors and people should continue to practice distancing and wear masks if in closed spaces.
• All businesses should continue to facilitate remote working where possible.
• Restaurants and cafes, including pubs operating as restaurants, can remain open but with mandatory restrictions on closing times of 11.30 pm (this was previously 11pm).
• Sport events and matches are to revert to “behind closed doors” with strict avoidance of social gatherings before and after events
• Indoor and outdoor training should follow the 6 indoor and 15 outdoor guidance
• Public transport should be avoided where possible
• In private transport, the wearing of facemasks is advised where households are mixed.

Following these announcements there was confusion in relation to whether people should or had to continue to work from home, how many can attend cultural events or outdoor sporting events, whether it is safe to go on public transport (https://www.irishtimes.com/business/economy/do-the-latest-covid-19-restrictions-mean-your-office-will-stay-shut-1.4334864).

In a social media message released on 19 August, Dr Ronan Glynn, acting chief medical officer said new measures are being introduced because new cases are much higher than they were a few weeks ago (https://twitter.com/i/status/1296140781821071360). He specified how there has been on average 96 new cases a day over the last two weeks, the 14-day incidence is over 20 per 100,000 and how Ireland has the third fastest upward growth rate in Europe. There are increasing numbers of cases and clusters in families and households. Dr Glynn explained that the new measures were focused on all children being able to safely return to school.

Update 14 August 2020: Public Health officials urge focus on three national priorities after local restrictions put in place in three counties
 
Following lock-down measures introduced in three counties on 7 August due to high numbers of cases in those counties, residents in Kildare, Laois and Offaly were advised not to travel outside their county and to only move within their own county for essential work, family or caring duties (https://www.gov.ie/en/publication/7b237-special-advice-for-those-living-in-kildare-laois-and-offaly-friday-7-august-2020/). The restrictions resulted in the closure of many services and businesses that are not considered essential, with everyone who can work from home advised to do so. Education, childcare, retail outlets and hairdressers remain open while all indoor gatherings are limited to a maximum of 6 people from no more than three households and outdoor gatherings to a maximum of 15 people. The measures are planned to remain in place until 21 August as substantial testing and tracing is taking place to contain the outbreaks.

In the daily update on 13 August 2020, Dr Ronan Glynn, Acting Chief Medical Officer, Department of Health, said; ‘We expected that this week the daily figures we report would rise and fall. NPHET is closely monitoring all trends, patterns and changes in the data, including not just case numbers but locations, age groups, and sources of transmission. We are asking those in Kildare, Laois and Offaly to hold firm and stay with us in the measures introduced last weekend. As today’s figures show, cases are also occurring in several other counties around the country. This is still about a united, whole of country approach. The only way we can effectively suppress COVID-19 across Ireland in the long term is if we act together to protect each other’ (https://www.gov.ie/en/press-release/2658d-statement-from-the-national-public-health-emergency-team-thursday-13-august/).

With the number of new COVID-19 cases going up over recent weeks, the National Public Health Emergency team is asking people to redouble their COVID-19 prevention efforts such as avoiding crowds, keeping 2 metres distance, handwashing, wearing face coverings and using the COVID Tracker App.  On 11 August, Dr Ronan Glynn said the focus as a society must be on three national priorities - protecting public health and the most vulnerable, the resumption of non-COVID health services and the reopening of schools (https://www.gov.ie/en/press-release/b9560-statement-from-the-national-public-health-emergency-team-tuesday-11-august/). The public has a significant role in ensuring the success of these three through their actions.

Update 12 August 2020:  Government considers colour codes to replace phased re-opening plan as part of long term COVID-19 response

The Irish government is considering introducing colour codes to replace the current phased re-opening plan in recognition that COVID-19 will be with us for the foreseeable future. In an interview on Morning Ireland on 12 August, Minister for Health, Stephen Donnelly TD, said the phases were about providing timeframes whereas the colour codes are a warning system on where ‘we are at on any given day’ similar to weather warnings where people know to take precautions as needed depending on threat levels (https://www.rte.ie/radio1/morning-ireland/programmes/2020/0812/1158692-morning-ireland-wednesday-12-august-2020/?clipid=103469879#103469879). The Department of Health said the colour coding system is part of a framework being developed by NPHET which envisages four phases of the response in which indicators for escalation, objectives, and priority actions are outlined.

Yellow is the lowest risk level where people are expected to take normal precautions. Minister Donnelly said this is where most of the country is at in the second week in August. Orange represents a higher risk level with local outbreaks that might lead to areas being locked down such as is currently the case in three counties in Ireland. Red is the highest risk level and would indicate that nation-wide outbreaks are ongoing and that similar measures to those imposed at the beginning of the pandemic would be reintroduced. Blue status is where the virus has been successfully suppressed in the community through a vaccine or some other kind or medical breakthrough.

Update 7 August 2020: Increased cases of COVID-19, r-number at 1.8 and phase 4 delayed again

At a press briefing held by the acting Chief Medical Officer, Dr Ronan Glynn, on 6 August 2020, the increased numbers of people testing positive for COVID-19 were highlighted with specific concerns in relation to high numbers in three counties (Kildare, Laois and Offaly). During the last two weeks, almost half of the all the cases in Ireland occurred in these three counties. Dr Glynn urged residents in these counties to be extra vigilant to stop the further spread of COVID-19.

The rate of incidence of the disease nationally during the last two weeks was 9.85 per 100,000. The median age was 31 year with 75% occurring in people under the age of 45. 32% were healthcare workers. The high number of new cases include clusters in meat packing factories and Direct Provision Centres (where asylum seekers are accommodated).

At this press briefing Prof Philip Nolan, the chair of the National Public Health Emergency Team (NPHET) epidemiological modelling advisory group said ‘We have seen a significant increase in the incidence of COVID-19 over the past week. The reproduction number for the virus is now estimated to be 1.8. A reproduction number of almost 2 is a serious concern, and although we have not yet seen a significant increase in community transmission, there is a significant risk this could develop over the coming days and weeks, emphasising the need for each of us to be extremely cautious that we do not contribute to the transmission of the virus’ (https://www.gov.ie/en/press-release/4d259-statement-from-the-national-public-health-emergency-team-thursday-6-august/). 

As of 6 August 2020, there has been a total of 1,768 deaths from COVID-19 in Ireland, while the number of COVID-19 cases is 26,372.
At a government press briefing after a meeting of cabinet on 4 August, the Taoiseach Micheál Martin confirmed that Ireland would delay moving to phase four of the reopening plan due to the increased numbers of cases over the last two weeks (https://www.gov.ie/en/speech/8c24a-speech-by-an-taoiseach-micheal-martin-post-cabinet-briefing-4-august-2020/). He also confirmed that the reopening of pubs, hotel bars and nightclubs would not go ahead on 10 August as planned.

The government decision not to go ahead with phase four means that the maximum size of crowds gathering outdoors will stay at 200 and at 50 for indoors and that the evidence will be reviewed again in three weeks' time.

At the same press briefing the health minister, Stephen Donnelly said that public health advice and public safety was driving the government decision.
 
Government also confirmed that face coverings would be mandatory in all retail settings from 10 August (https://www.rte.ie/news/business/2020/0715/1153527-mandate-calls-for-masks-to-be-mandatory/). The following countries have been dropped from Ireland’s ‘green List’ of countries - Malta, Cyprus, Gibraltar, San Marino and Monaco.

Update 29 July 2020: Visiting guidelines for nursing homes

The Health Protection Surveillance Centre (HPSC) published updated guidelines for visitors to residential care centres including nursing homes, acute mental health facilities and community housing units for people with disabilities.

Minister of State for Mental Health and Older People, Mary Butler TD said ‘I’ve listened to the views of many families and I recognise that the impact of COVID-19 on society in general and especially those living in nursing homes has been considerable. We must remember that residential settings are people’s homes as well as places where health and social care are provided’ (https://www.gov.ie/en/press-release/dc892-minister-for-mental-health-and-older-people-welcomes-the-latest-visiting-guidance-for-nursing-homes/).

The requirement to nominate a maximum of two visitors has been removed. An unlimited number of nominated visitors is now allowed but with the recommended number of visitors at any one time limited to two with some flexibility particularly in the case of child visitors with appropriate supervision (https://www.irishtimes.com/news/social-affairs/nursing-homes-no-longer-restricting-visitor-numbers-under-new-guidelines-1.4316611). Previous guidelines requested that children not visit facilities.

Outdoor visiting is recommended where appropriate. Facilities are asked to schedule visits to avoid heavy footfall in a facility at any time. Visitors should be asked if they have experience COVID-19 symptoms or been in close contact with an infected person. Visitors are required to sign in, to perform hand hygiene upon arrival, to wear face coverings, and to practice physical distancing from others in the facility (https://www.rte.ie/news/2020/0729/1156301-nursing-homes-covid-visits/).

Update 15 July 2020: Final phase of lifting restrictions is delayed as R-number is over 1, face coverings to become mandatory in indoor settings

At a press briefing on 15 July 2020 the Taoiseach Micheál Martin announced a government decision to delay moving to phase four of the roadmap to reopen the country (https://www.pscp.tv/w/cd4FszFBbWp6T0dEZGRZRWV8MU93R1dMRGpQd3BKURL_dGboGKVPO4fz3I9aJh_Q6dFFrm8pZ8VzW5FKCnm3?t=7s). The country was due to move to the fourth and final phase of the roadmap to lift coronavirus lockdown restrictions on Monday 20 July 2020. As a result, only pubs currently open and serving food will be permitted to serve the public. The final phase is now scheduled for 10 August 2020.

The government also decided that the wearing of face coverings will be made mandatory in retail outlets and the current advice against non-essential overseas travel is to remain in place. Following concern over large house parties, no more than ten people can gather in private homes (https://www.irishtimes.com/news/health/covid-19-ten-person-limit-put-on-house-gatherings-as-pubs-to-stay-shut-until-august-10th-1.4305203).

In its daily press statement on 15 July, the acting chief medical officer Dr Ronan Glynn said the R-rate is now above 1. The R-number measures the number of infections each new case causes; a measure above one is an indication that infections are on the rise. Dr Glynn said the virus only needed ‘the smallest window of opportunity to become a major problem again’ and therefore the National Public Health Emergency Team (NPHET) are recommending a “cautious” approach (https://www.gov.ie/en/press-release/4e2a1-statement-from-the-national-public-health-emergency-team-wednesday-15-july/).

10 July 2020: New regulation for the mandatory wearing of face coverings on public transport

Minister for Health, Stephen Donnelly T) signed the Health Act 1947 (Section 31A – Temporary Restrictions) (Covid-19) (Face Coverings on Public Transport) Regulations 2020 for the mandatory wearing of face covering on public transport on 10 July 2020.
 
The regulations provide that, from 13 July 2020, members of the public shall not, without reasonable excuse, travel by public transport without wearing a face covering.
 
Reasonable excuse includes where a person
  • cannot put one on, wear or remove a face covering because of any physical or mental illness, impairment or disability or without severe distress
  • needs to communicate with another person who has difficulties communicating
  • removes the face covering to provide emergency assistance or to provide care or assistance to a vulnerable person
  • removes the face covering to take medication. 
 
The Regulations do not apply to children under the age of 13.
 
Where a passenger is not wearing a face covering, a relevant person under the Regulations may request the passenger to wear a face covering, refuse the passenger entry to the public transport vehicle, or may request the passenger to alight from the vehicle.  A passenger must comply with these requests or with a refusal of entry. Failure to comply is an offence.
 
More guidance on the appropriate use of face coverings is available https://www.gov.ie/en/publication/aac74c-guidance-on-safe-use-of-face-coverings/

Update 25 June 2020: Government confirms further opening up as numbers of new cases remains low alongside the introduction of mandatory face coverings on public transport

At a press briefing by the Taoiseach Leo Varadkar on 25 June 2020 Government it was confirmed that Phase 3 of the Roadmap for Reopening Business and Society would proceed on Monday 29 June 2020 (https://merrionstreet.ie/en/News-Room/News/Government_confirms_that_it_is_safe_to_proceed_to_Phase_3_of_the_Roadmap_for_Reopening_Business_and_Society.html).

It was also announced that face coverings are to become mandatory on public transport and that personal responsibility more important than ever as country reopens.
A wide range of businesses and services can now open or recommence from Monday including:
  • Adult education facilities, crèches, pre-schools, summer camps and youth clubs
  • Museums, galleries, theatres, cinemas and other cultural outlets
  • Religious buildings and places of worship
  • Wellbeing services like massage therapy, chiropractors, hairdressers and beauty salons
• Driving schools and driving testing
• The hospitality sector including cafes and restaurants, pubs and hotel bars serving food, hotels and holiday parks

Up to 50 people can gather indoors and up to 200 outdoors, providing social distancing and public health advice is adhered to. Phase 4 is expected to commence on 20 July 2020, subject to Government approval. At that point pubs, bars, hotel bars and casinos may reopen, with the number of people permitted at outdoor gatherings rising to 500, and 100 indoors.

At the government press briefing, Dr Tony Holohan, Chief Medical Officer, Department of Health, noted that the number of daily reported deaths has been in single digits since 28 May 2020. This brings the death toll from the disease in the State to 1,727 and the total number of known cases of infection to 25,405 (https://covid19ireland-geohive.hub.arcgis.com/).

Dr Holohan said: that the National Public Health Emergency Team ‘noted today that over a third of new cases in the past 14 days are under 35 years of age. It also noted a number of EU countries reported an increase in new cases. 7% of cases notified in Ireland over the past fortnight have been associated with travel. NPHET expressed a clear view that overseas travel poses a risk to importation of the disease and to further transmission in Ireland’ (https://www.gov.ie/en/press-release/da0ef-statement-from-the-national-public-health-emergency-team-thursday-25-june/).

-----------------------------------------------------------------------------

Update 19th June 2020: Phase 3 of re-opening Ireland: accelerated relaxation of restrictions from 29 June 2020

On 19 June, due to low levels of virus transmission, Irish government approved a revised version Roadmap for Reopening Society and Business which accelerates the easing of restrictions with effect from 29 June. The National Public Health Emergency Team recommended the speeding up of measure so that from 29 June, as part of Phase 3, the following services may reopen:
  • Museums, theatres, cinemas, and concert halls and of places of worship
  • Leisure facilities, gyms
  • Hairdressers and barber shops, beauty and tattooing services as well as wellbeing services (e.g. massage, acupuncture therapies) may reopen
  • Childcare facilities and all indoor and outdoor amenities for children, summer camps can go ahead
  • Cafes, restaurants, pubs and hotels, hostels and holiday parks
  • All sporting activities can recommence but with a limited number of spectators present
  • Social gatherings will be limited to 50 people indoors and 200 outdoors.

All of the above activities have to be compliant with public health guidance and work protocols. This will be monitored by State agencies.
The following public health advice was issued:
  • People are asked to maintain social distancing and to consider a risk of undertaking an activity based on distance, type of activity, time spent on it and its environment;
  • Face coverings are advised when using public transport, in retail outlets and in other public areas when social distancing is difficult;
  • People are encouraged to walk or cycle if possible and use public transport for essential journeys only;
  • Those who can work from home are advised to continue to do so;
  • People can travel anywhere in Ireland but any non-essential overseas travel should be avoided. Those coming from overseas are expected to self-isolate for 14 days;
  • Those over 70 or medically vulnerable are advised to stay at home as much as possible and exercise particular caution in public areas.

The final phase, Phase 4, will commence on 20 July and any remaining restrictions will be re-opened, or resumption will be considered for review.

Sources:

https://www.gov.ie/en/collection/ba4aa0-letters-from-the-cmo-to-the-minister-for-health/

https://www.gov.ie/en/news/58bc8b-taoiseach-announces-roadmap-for-reopening-society-and-business-and-u/?referrer=http://www.gov.ie/roadmap/ 

https://www.gov.ie/en/press-release/143e6-government-approves-revised-roadmap-for-reopening-society-and-business/ 

-----------------------------------------------------------------------------

Update 15th June 2020: Nursing Homes open up to visitors

Starting on 15 June 2020, people living in residential care facilities including nursing homes are allowed visits from their loved ones (https://www.gov.ie/en/publication/e5be7-daily-briefing-on-the-governments-response-to-covid-19-monday-15-june-2020/). Each resident is allowed two named visitors but only one can visit at a time. Each facility has rules in place tailored to their service and physical environment and their experience of COVID-19 which visitors must adhere to (https://www2.hse.ie/conditions/coronavirus/visiting-nursing-homes-and-residential-care-facilities.html#:~:text=Each%20resident%20can%20have%20two,leave%20at%20the%20agreed%20times). These can include calling ahead to book a time to visit, limiting visits to certain durations, wearing a facemask and protective apron, and handwashing. 

Nursing home staff will be working with family members of residents to find the right balance of as “normal” an experience as possible while ensuring the ongoing safety of everyone in the facility.

-----------------------------------------------------------------------------

Update 12th June 2020: Researchers advocate a policy of COVID-19 suppression

On 8 June, a group of Irish researchers published an open letter, urging the two governments on the island of Ireland to rethink their long-term mitigation approach to the COVID-19 crisis. They urged the governments to resist the pressure to “go back to normal as soon as possible” and reassess lockdown measures rather than aim to remove them (https://crushthecurve.ie/).

The researchers argued for tougher short-term measures and adoption of a coordinated all-island “policy of suppression” (https://www.irishtimes.com/news/health/covid-19-letter-signed-by-irish-researchers-seeks-policy-rethink-1.4273936). They argued that this could eliminate the virus within weeks rather than months. This would involve wearing masks in public when social distancing is not possible, “a vigilant test/trace/isolate infrastructure”, as well as testing travellers to Ireland. While researchers acknowledged the costs of imposing further lockdown, they also argued that the “real costs” of living with the virus “for the foreseeable future” far exceed the costs of stricter short-term measures. According to them this represents “the most scientifically sound strategy in terms of public health and economics alike”. The researchers referred to successes of South Korea, New Zealand, Australia, Austria, Greece, China, Iceland in halting the virus but agreed each country needs tailored response.

Amongst signatories of the letter are specialists in public health, infectious disease, virology, immunology, and respiratory and intensive care consultants, many of whom have worked on the frontline during the pandemic.

When Chief Medical Officer, Dr Tony Holohan was asked about the open letter at the Department of Health on the day of its publication, Holohan said that the public health leadership has been clear from the beginning that the priority was to “minimise the number of cases to as low as it can possibly go”. He said that Covid-19 couldn’t be eliminated in the same fashion that illnesses such as polio could be. He added that the public health leadership felt “it’s the right time to ease restrictions” and the situation would be monitored closely going forward.

-----------------------------------------------------------------------------
Update 8 June 2020: Ireland enters into Phase 2 and eases up on restrictions

On 6 June Taoiseach Leo Varadkar addressed the nation and announced that phase 2 would go head on 8 June and some further restrictions would be brought forward (https://www.gov.ie/en/publication/7ae99f-easing-the-covid-19-restrictions-on-june-8-phase-2/).

From 8 June there are five key messages in addition to observing the public health guidance, continuing to limit where you go and limit the number of people you meet. These are
  • Stay Local: You may travel within your own county, or up to 20 kilometres from your home if crossing county boundaries.
  • Meeting other people: You may meet up to 6 people from outside your household both indoors and outdoors for social gatherings. Organised outdoor exercise, sporting, cultural or social activities of up to 15 people may take place.
  • Shops: All retail is reopening. Shop locally, shop safely and support businesses in your community.
  • Work from home: It is more important than ever to work from home where possible.
  • Transport: Walk or cycle if you can. Only use public transport if you absolutely need to. Public transport capacity is limited because of social distancing requirements.
Other guidance is given under the following headings:

Community health:
  • It is recommended that face coverings be worn in public places, such as shops, and on public transport.
  • You may meet up to six people from outside your household both indoors and outdoors for social gatherings.
  • Organised outdoor exercise, sporting, cultural or social activities of up to 15 people may take place.
  • If you are over 70 years or medically vulnerable, be extra vigilant.
  • Up to 25 immediate family and close friends may attend funeral services.

Children:
  • Outdoor summer camps may operate for primary school children.
  • Playgrounds and commercially-serviced outdoor amenities may reopen.

Economic activity and work:
  • The Return to Work Safely Protocol is the operative guide for employers and employees.
  • Working from home must continue wherever possible.
  • Marts may reopen where social distancing and hygiene can be maintained.

Retail, services and commercial activity:
  • All retail outlets may reopen. Opening times and modes of operation may vary. Please co-operate with store staff and abide by systems put in place for your safety.

Cultural, sporting and social:
  • Groups of up to 15, including trainers and coaches, may return to non-contact outdoor training activity (but not matches) while maintaining social distancing at all times.
  • Public libraries can reopen.
  • Behind-closed-door horse and greyhound racing can commence.

Transport and travel:
Public transport
  • Social distancing means that overall capacity remains extremely restricted. Use public transport only for essential journeys.
  • Wearing a face covering is recommended.
  • Avoid peak-time travel.
  • Walk or cycle if possible.
International travel
  • All non-essential overseas travel to and from Ireland should be avoided.
  • Passengers arriving from outside the island of Ireland are expected to self-isolate for 14 days.
  • Passengers will also have to complete a form showing where they will self-isolate.

Advice for those over 70 years or medically vulnerable:

If you are over 70 years or medically vulnerable, please use your judgement to decide how best to apply the following public health guidance:
  • stay at home as much as possible
  • you may welcome small numbers of people to your home, but maintain social distancing
  • for shopping, please use the times specially allocated by retailers
  • if you are visiting someone who is over 70 years or medically vulnerable, please be extra vigilant.

During his address, Varadkar explained how the roadmap to reopen the country will be accelerated and the plan is now be shortened from five to four phases. Originally, there was a five-stage plan running until 10 August. As a result of the 5 June announcement, the final stage is now on 20 July.

Contrary to public health advice, the government announced that shopping malls can open on 15 June on the basis that they take measures to ensure that people do not congregate and that people could go beyond the 20km limit as long as they are within their own county.

Hotels, restaurants, hostels and museums can reopen from 29 June 2020. Places of worship will resume services with precautions. Pubs and bars can open on 29 June also but they must serve operate as if they are restaurants.

In the letter from the Chief Medical officer to the health minister on 4 June 2020, Tony Holohan stated that ‘it is impossible to predict with certainty what the future trajectory of the COVID-19 disease will be in Ireland. Consequently, it is not possible to provide assurance that it is safe to reduce the public health social distancing measures and stricter measures may have to be reintroduced if a strong upsurge of infection were to occur at some point in the future’ (https://www.gov.ie/en/collection/ba4aa0-letters-from-the-cmo-to-the-minister-for-health/).

-----------------------------------------------------------------------------

Update 2 June 2020: Government encourage citizens to keep travel and physical distancing guidelines as well as good hygiene measures in advance of phase 2 lifting on 8 June 2020

Government has encouraged citizens to keep travel and physical distancing guidelines as well as good hygiene measures in advance of phase 2 lifting on 8 June 2020. Speaking at the government press conference on 2 June 2020, a government spokeswoman said ‘We know it has been tough, however, as we approach the end of Phase 1 of the Roadmap, we can see that the efforts everyone has made are continuing to benefit our communities. Hopefully, that gives us a very good chance of moving to Phase 2 as scheduled, if we can keep it up for a few more days’ (https://www.gov.ie/en/publication/263f6-daily-briefing-on-the-governments-response-to-covid-19-tuesday-2-may-2020/).

Phase two is due begin on 8th June 2020. If this goes ahead, the 5km restriction on movement will be increased to 20km but people will be advised to make only necessary journeys. Those over 70 and those considered vulnerable will be allowed visitors by a small number of people for a short period of time. Up to four people may visit another household for a short period while maintaining social distancing.
---------------------------------------------------------------------------

Update 18 May 2020: Phase 1 of re-opening Ireland began on 18 May 2020

Phase 1 of re-opening Ireland began on 18 May 2020. During Phase 1, people can leave their home for a wider range of reasons and can meet in small groups outdoors. It is recommended that:
  • social distancing should be maintained at all times
  • limit your contact with others when out and about
  • distance yourself at least 2 metres away from other people, especially those who might be unwell
  • avoid crowded areas. If an area looks busy, go somewhere else or return at a quieter time
  • wear a face covering in some situations where social distancing is not possible, for example in shops or on busy public transport. Wearing cloth face coverings may help prevent people who do not know they have the virus from spreading it to others

https://www.gov.ie/en/publication/ad5dd0-easing-the-covid-19-restrictions-on-may-18-phase-1/.

---------------------------------------------------------------------------
Update 18 May 2020: Reopening from 18th May to go ahead

At a press briefing on 15 May 2020, the Taoiseach Leo Varadkar confirmed that measures planned to begin to lift COVID-19 restrictions on 18 May 2020 will go ahead. On 18 May 2020, new guidelines will come into place as part of Phase 1 of the government's roadmap for reopening society and business. Under these guidelines people can leave their home for a wider range of reasons including the following five reasons:
  1. To go to work, if your place of work is open and you cannot work from home;
  2. To shop for items you need;
  3. To exercise within 5km of your home;
  4. For medical reasons or to care for others;
  5. To meet friends or family outside, within 5km of your home, in groups of no more than four and will be able to meet in small groups outdoors.

Social distancing guidelines are to be maintained at all times during this Phase. Everyone is advised to:
  • wash your hands well with and often to avoid contamination;
  • cover your mouth and nose with a tissue or bent elbow when coughing or sneezing, and discard of used tissue safely;
  • limit your contact with others when out and about;
  • distance yourself at least 2 metres away from other people, especially those who might be unwell;
  • avoid crowded areas. If an area looks busy, go somewhere else or return at a quieter time

For the first time, advice is given regarding face covering. The advice is to ‘wear a face covering in some situations where social distancing is not possible, for example in shops or on busy public transport. Wearing of cloth face coverings may help prevent people who do not know they have the virus from spreading it to others. Guidance on safe use of face coverings can be accessed here: https://www.gov.ie/en/publication/aac74c-guidance-on-safe-use-of-face-coverings/’.

At the press briefing, the Taoiseach said that the Government was advising people to wear face coverings on public transport and in crowded places indoors, but this will not be a legal requirement. The Chief Medical Officer, Dr Tony Holohan warned that face coverings did not provide ‘some kind of magic shields against the disease’.
According to phase one of the Government’s roadmap for reopening, garden centres, farmers’ markets, opticians, motor and bicycle repair shops, phone repair shops will open on Monday. Outdoor workers in construction can return including gardeners and those working in allotments.

See here for more details on the public health measures in place from 18 May: https://www.gov.ie/en/publication/cf9b0d-new-public-health-measures-effective-now-to-prevent-further-spread-o/


---------------------------------------------------------------------------
Update 1st May 2020: Ireland to reopen after 18 May while some restrictions will be eased from 5 May

Ireland is to reopen after 18 May while some restrictions will be eased from 5 May. 

The Taoiseach, Leo Varadkar, made an address to the Irish people at 18.30 on 1 May 2020. Many of the restrictions in place until 5 May are to remain but some measures have been eased from 5 May. These include:
  • A relaxing of cocooning measures for people over 70, who will be able to go outside their homes if they avoid all contact with other people.
  • The 2km limit in place for exercise will be extended to 5km if they avoid all contact with other people
  • Schools to stay closed until September

He outlined changes from 18 May which include
  • Outdoor workers including construction will return to work
  • DIY, garden and hardware stores to reopen
  • Some sporting activities in small groups will be allowed
  • Small groups of family and friends will be permitted to meet in the open
  • Many regular health services will resume operating.

In his address, the Taoiseach outlined a road map for how to reopen Irish society and the economy. The stages will be three weeks apart starting on 18 May (https://www.gov.ie/en/news/e5e599-government-publishes-roadmap-to-ease-covid-19-restrictions-and-reope/#phase-2). Varadkar made clear that Ireland can only move from one stage to the next if we keep the virus under control. He said Ireland will begin to reopen on the 18 May but until there is a vaccine or effective treatment, there will be a long-term need for physical distancing. Cabinet will meet again on 2 May to discuss how to restart businesses. Cafes and restaurants will reopen on 29 June and pubs will reopen on 10 August if progress continues to be made. The Taoiseach warned that the phased re-opening the country would be reversed, if the rate of the infection increases significantly as the lockdown is eased.

The government will regularly assess the following criteria as we seek to keep the level of transmission low while gradually restarting our economy:
  • the latest data regarding the progression of the disease
  • the capacity of the health service
  • the capacity of the testing and tracing system
  • the measures in place to protect vulnerable groups
  • an assessment of the impact of excess morbidity and mortality as a consequence of the restrictions

On 27/02/2020, a Northern Irish woman who travelled through Dublin Airport was the first confirmed case on the island. On 29/02/2020, the first confirmed case in the Republic of Ireland was reported in a teenager returning from a ski holiday in northern Italy. The teenager was placed in isolation in a Dublin hospital. The school which he attended was shut down for two weeks on 01/03/2020, but this was a precautionary measure to reduce the risk of transmission among students and no other schools were affected by the closure at that time.

Guidance on mass gatherings was discussed at a NPHET meeting on 03/03/2020. In the minutes of the meeting it was recorded that the approach and risk assessment towards mass gatherings was ‘informed by ECDC and WHO documents. The protocol / algorithm for implementation should now be finalised. It was noted that the risks applying to travellers for geographical regions is in the current context and this may alter depending on the spread of COVID-19. It was acknowledged that the situation is rapidly evolving, and changes may inform advice on mass gatherings and large events.’  Actions emerging from this meeting were the Department of Health publishing Guidance on Mass Gatherings and the HSE developing a protocol for the implementation of the Guidance on Mass Guidance.
 
On 12th March 2020, Ireland moved into the delay phase of the outbreak and the Taoiseach (Prime Minister) along with the Tánaiste (Deputy Prime minister), health and finance ministers gave an address to the nation on coronavirus announcing restrictions on mass gatherings (of more than 100 people if located indoors and more than 500 people if located outdoors), the closure of museums, galleries and tourism sites, creches, schools and colleges and encouraging all those who can to work from home. Since then there have been three more addresses to the nation by the Taoiseach on 17th, 24th and 27th March as well as daily press briefings available on TV and radio on the range of government-wide measures announcing the cross-government approach to coronavirus.

On 15 March, the Government asked all public houses in Ireland to shut their doors from Sunday night in light of the coronavirus. It followed discussions with the Licenced Vintners Association (LVA) and the Vintners Federation of Ireland (VFI). The Government asked all public houses and bars, including hotel bars, to close until at least March 29th. The LVA and VFI outlined ‘the real difficulty’ in implementing the guidelines on social distancing in a public house setting, as ‘pubs are specifically designed to promote social interaction’. The Government also called on all members of the public not to organise or participate in any parties in private houses or other venues which would put other peoples’ health at risk. The Health (Preservation and Protection and other Emergency Measures in the Public Interest) Act 2020 was signed into law by the President of Ireland on Friday, 20 March. This Act empowers the Minister for Health to prohibit and restrict the holding of certain events, and to close certain premises, for example public houses.

From midnight on 27/03/2020, stay at home measures were introduced for the whole population and cocooning measures were introduced for everybody over 70 and those who are extremely medically vulnerable to COVID-19. Under the ‘stay at home’ measures, everybody is urged not to leave their homes, with strict guidelines for people to stay at home from midnight on 27/03/202. The only times people can leave their homes are:
   • to travel to or from work if they are providing an essential service. A list of essential retail outlets is available at:  https://www.gov.ie/en/publication/625292-updated-list-of-essential-retail-outlets-27th-march-2020/
   • to shop for food
   • to collect medical prescriptions and medical supplies and attend medical appointments
   • to carry out vital services like caring (including family carers)
   • for brief individual exercise - within 2 kilometres of your house. You can bring children but must keep 2 metres away from others for social distancing.
   • for farming.
   • The main rule is to STAY AT HOME.

Cocooning is a measure to protect those over 70 years or those extremely medically vulnerable by minimising interaction between them and others. This means that these people should not leave their homes. Even within their homes should minimise all non-essential contact with other members of their household. This is to protect those who are at very high risk of severe illness from COVID-19 from coming into contact with the virus. The main cocooning measures are:
   1.       Strictly avoid contact with someone who is displaying symptoms of COVID-19. These symptoms include high temperature and/or new and continuous cough.
   2.       Do not leave your house.
   3.       Do not attend any gatherings. This includes gatherings of friends and families in private spaces for example family homes, weddings and religious services.
   4.       Do not go out for shopping and, when arranging food or medication deliveries, these should be left at the door to minimise contact.
   5.       Keep in touch using remote technology such as phone, internet, and social media.
   6.       Do use telephone or online services to contact your GP or other essential services.
   7.       Ensure you keep phones/devices charged, and have credit on your phone so that you can stay connected.

The extremely medically vulnerable are listed as follows
   • people aged 70 years or over
   • solid organ transplant recipients
   • people with specific cancers
       (a) people with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
       (b) people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
       (c) people having immunotherapy or other continuing antibody treatments for cancer
       (d) people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
       (e) people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
  • people with severe respiratory conditions including cystic fibrosis, severe asthma and severe COPD
  • people with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)
  • people on immunosuppression therapies sufficient to significantly increase risk of infection
  • women who are pregnant with significant heart disease, congenital or acquired.

As of 05 April 2020, there was no ‘lock down’ in place in Ireland, although a quarantine is in place with everybody being asked to stay within a 2 km radius of their own home and to only go out for essential healthcare appointments, exercise and visiting an older or vulnerable relative.

On 7 April 2020, The Minister for Health, Simon Harris, signed the Health Act 1947 (Section 31A-Temporary Restrictions)(Covid-19) Regulations on 7 April 2020 (https://www.gov.ie/en/news/e9d120-minister-for-health-simon-harris-signs-regulations-to-give-an-garda-/). These are new regulations to widen the power of the Gardaí (Irish police force). The regulations underpin the measures announced by the Taoiseach on 27 March 2020 requiring people to stay at home and not to gather in public. The Gardaí have been given these powers on an exceptional basis. They are to be used for exceptional cases. The Gardaí will continue what they have been doing to date, where the approach has been to engage, educate and encourage people to abide by government and public health measures in relation to COVID-19. Enforcement has and will continue to be a last resort and used sparingly (https://www.gov.ie/en/publication/0a93b6-daily-briefing-on-the-governments-response-to-covid-19-monday-8-apri/).

At the government press briefing on the 10 April, Liz Canavan, Deputy Secretary General in the Department of An Taoiseach, made it clear that any restrictions on movement (the 2 kilometre rule) do not apply to a person trying to avoid risk of harm or seeking to access essential services. She pointed out that frontline support services are still available, that An Garda Síochána (the police) is prioritising response to domestic abuse and other services like the Courts and the Legal Aid Board are ready to offer support where needed. There was also an appeal for people to stay at home over the Easter bank holiday weekend (https://www.gov.ie/en/publication/37d6f7-daily-briefing-on-the-governments-response-to-covid-19-friday-10-apr/).

On 10 April 2020, the Taoiseach made his fourth direct address to the nation in relation to COVID-19. In the address the extension of the restrictions announced two weeks previously were announced for a further three weeks, meaning they will be remain in place until Tuesday May 5th (https://www.gov.ie/en/speech/a7249f-speech-by-the-taoiseach-with-update-on-latest-covid-19-public-health/). These recommendations were made on the advice of the National Public Health Emergency Team.

When questioned on when the restrictions may be lifted, the health minister Simon Harris said "To consider lifting restrictions, the growth rate of the virus, which is now just below 10 per cent, needs to fall below 5 per cent; and that the average number of people in intensive care units being treated for Covid-19 needs to drop to near 100 from a current level of about 150" (https://www.irishtimes.com/news/ireland/irish-news/coronavirus-government-will-ease-restrictions-on-trial-basis-when-spread-is-curbed-1.4227430).

Key source:

Government of Ireland. Previous updates on COVID-19 (Coronavirus): https://www.gov.ie/en/publication/ce3fe8-previous-updates-on-covid-19-coronavirus/