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