1.4 Monitoring and surveillance
Update 22 October 2020: Health experts warn population of 100% higher risk of contracting COVID-19 now than at the end of June
At a public briefing on Thursday 22 October, members of the National Public Health Emergency Team (NPHET) made a direct appeal to the Irish population to take precautions to avoid contracting COVID-19.
The Chief Medical Officer, Dr Tony Holohan said ‘we are now in level 5 because the disease is at very serious levels in our country and posing a significant risk to public health’ and urged everyone who does not perform essential work to stay at home.
Deputy Chief Medical Officer, Dr Heather Burns underscored the serious risk of contracting the virus by pointing out that the 14-day incidence was at 3 per 100,000 at the end of June while was on 22 October, 302 per 100,000 population. She said ‘the risk of being exposed to COVID-19 is now 100 times greater than it was 4 months ago’.
Professor Philip Nolan, Chair of the NPHET Irish Epidemiological Modelling Advisory Group, said that the reproduction number currently is 1.3 -1.4 nationally. He said ‘the goal now is to suppress transmission of the virus and bring our case numbers to manageable levels. If we work hard together to get the reproduction number to 0.5, we should succeed in reducing cases to below 100 a day in six weeks time.’
Update 19 September 2020: New local COVID-19 data hub launched
On 19 September, health minister Stephen Donnelly announced that a new data set has gone live on the COVID-19 Data Hub, with case information now available at a Local Electoral Area level across Ireland.
Minister Donnelly said: “I understand that people really want to know more detailed information about this virus, how it is affecting their communities, and those around the country as a whole. The COVID-19 Data Hub now offers regularly updated Local Electoral Area data in order to fulfil this very real desire that is out there for transparency around this virus and its impact. Transparency is a key cornerstone of Ireland’s response to this pandemic. At this crucial time, it matters more than ever.”
The data hub is a collaboration between the Department of Health, the Ordnance Survey Ireland, the All-Island Research Observatory, the Health Protection Surveillance Centre, the Health Service Executive, and the Central Statistics Office.
Update 20 August 2020: Results of seroprevalence study estimates 1.7% national prevalence of COVID-19
On 20 August, the HSE published the results of the ‘Study to Investigate COVID-19 Infection in People Living in Ireland (SCOPI): A national seroprevalence study, June-July 2020’. This was the first seroprevalence study in Ireland. The research measured antibodies to SARS-CoV-2 virus, which are an indication of past infection with COVID-19. The study found a prevalence of infection of 0.6% in Sligo and 3.1% in Dublin. Based on these results, it is estimated that the national prevalence rate is 1.7%.
The research recruited people from counties with the highest and lowest levels of COVID-19. A representative sample of 1,733 people aged 12 to 69 years in Sligo and Dublin participated in the study The study found no statistical differences in prevalence between age group or between males and females. Using the prevalence data from this study, the HPSC estimates that that 59,500 people in Ireland in the age group 12 to 69 years had been infected with SARS-CoV-2 up to mid-July; three times more than that detected via surveillance of notified cases.
Dr Derval Igoe, the lead investigator on the research said that the low prevalence found in Ireland reflects similar studies in Italy and Spain although it is a bit lower than there (https://www.pscp.tv/w/1MnxndaAPaMGO). The study design is based on a protocol developed by the World Health Organization (https://apps.who.int/iris/bitstream/handle/10665/332188/WHO-2019-nCoV-Seroepidemiology-2020.2-eng.pdf?sequence=1&isAllowed=y). The full report of the results is available at: www.hse.ie/scopi
Update 3 August 2020: Frontline workers (drivers, carers, housekeeping and in security and process plants) are particularly vulnerable to COVID-19
Research entitled 'Differences in risk of severe outcomes from COVID-19 across occupations in Ireland’ published by the Economic and Social Research Institute (ESRI) identified the occupations in Ireland that have highest vulnerability to more severe illness from COVID-19 due to workers’ underlying characteristics (https://www.esri.ie/news/some-essential-workers-particularly-vulnerable-to-covid-19). Using data from the Healthy Ireland Survey and Labour Force Survey, the study compares workers across three risk dimensions: COVID-19-vulnerable chronic illness rates (eg chronic heart disease, chronic respiratory disease, diabetes), older age, and living in a deprived area. These three factors have been linked to worse health outcomes including more severe illness, hospitalisation, and mortality from COVID-19.
Update 31 July 2020: Concerning rise in COVID-19 cases recorded
The highest number of COVID-19 cases in one day since late May were recorded on 30 July (https://www.gov.ie/en/press-release/c662d-statement-from-the-national-public-health-emergency-team-thursday-30th-july/). Acting chief medical officer Dr Ronan Glynn said the 85 new cases left officials ‘very concerned’ and he is calling on the public to double down on COVID prevention basics including avoiding large crowds, practising physical distancing, wearing face coverings and washing hands regularly (https://www.irishtimes.com/news/health/coronavirus-health-officials-very-concerned-after-highest-number-of-cases-since-may-reported-1.4318139).
A portion of the new cases are associated with known clusters in a factory, in two migrant accommodation centres and in several construction sites. Dr Glynn said these clusters might explain the spike or they may be a sign of something more significant (https://www.irishtimes.com/news/health/one-death-and-85-new-cases-in-state-shows-how-quickly-covid-19-can-re-emerge-1.4318011). The National Public Health Emergency Team (NPHET) will be monitoring the situation closely over the coming days.
Dr Glynn said on 31 July that he hopes that we are seeing evidence of Ireland’s contact tracing system working well: ‘We know over the past weeks there have been a number of clusters and what we hope is the numbers yesterday reflect the rapid testing of those clusters and the identification and isolation of those within those clusters’ (https://www.rte.ie/news/coronavirus/2020/0731/1156599-coronavirus-ireland/).
Phase 4 of Ireland’s easing of restrictions, having already been delayed once, is due to commence on 10 August including the reopening of pubs. NPHET will make its recommendation to the Government and the Cabinet is due to meet on Tuesday 4 August to make a decision on the matter.
Update 24 July 2020: Reproduction rate falling again
After the delaying the fourth phase of Ireland’s post-Covid reopening plan due the reproduction rate of Covid-19 rising to above 1 (between 1.2 and 1.8) last week, the R-rate has now again come down. Health Minister Mr Stephen Donnelly TD said that best estimate is that the ‘R’ number has come down over the last ten days and is currently between 0.7 and 1.4 (https://www.irishtimes.com/news/politics/oireachtas/coronavirus-donnelly-says-r-rate-has-fallen-but-warns-ireland-will-see-second-surge-1.4312682).
In a statement in the Irish lower house of parliament, the Dáil, Mr Donnelly told TDs that public health experts believe that the ‘stabilisation is linked to renewed efforts from the public from around two weeks ago'.
The decision of whether to commence with phase four, now due to happen on 10 August, will depend on the situation at that time. Data and evidence will be continually reviewed in the interim to support the decision.
Minister Donnelly also said that plans are being made to ensure that the health service is prepared to face a second wave of Coronavirus in winter, saying that: 'public health officials are warning there would be a second surge here based on how they see the disease work around the world, but the hope was that any surge would be low and localised’ (https://www.rte.ie/news/2020/0724/1155330-coronavirus/).
Update 9 July 2020: Rise in cases of COVID-19 in younger people, facemasks recommended for all healthcare settings while R-number is now above 1
At the press briefing following a meeting of the National Public Health Emergency Team (NPHET) on 9 July Dr. Ronan Glynn, Acting Chief Medical Officer, Department of Health, said that of the 23 confirmed cases ‘15 are directly or indirectly related to travel. NPHET today reiterates that all non-essential travel overseas should be avoided’ (https://www.gov.ie/en/press-release/8f1f2-statement-from-the-national-public-health-emergency-team-thursday-9-july/). All new cases of Covid-19 reported on 9 June 2020 were in people aged under 44, and 77% were among under 25 years of age. Of the 140 cases that tested positive in the last week, the median age was 34 years, compared to a median of 83 years for all cases that have occurred in the last four months (https://covid19ireland-geohive.hub.arcgis.com/).
At the briefing, Dr Glynn said that as of today, NPHET has recommended that all visitors to healthcare settings including hospitals, GP practices and pharmacies, should wear face coverings.
Professor Philip Nolan, Chair of the NPHET Irish Epidemiological Modelling Advisory Group, said; spoke about the increase in the number of reported cases over the last 2 weeks and said this is now reflected in ‘the R-number is now at or above 1’. Prof Nolan reiterated that ‘there is an immediate need for all of us to take care and caution in our decisions and actions’.
Update 3 July 2020: New report examines excess deaths during pandemic
The Health Information and Quality Authority (HIQA) published a report on 3 July 2020 examining the number of excess deaths that occurred during the current COVID-19 epidemic. According to HIQA, the report ‘assesses the number of deaths that occurred in Ireland from 11 March 2020 to 16 June 2020, relative to the expected number of deaths, using data from the death notices website RIP.ie. It also examines whether the reported COVID-19 death figures provides an accurate estimate of excess deaths during the epidemic’ (https://www.hiqa.ie/reports-and-publications/health-technology-assessment/analysis-excess-all-cause-mortality-ireland).
Speaking on the publication of the report HIQA’s Chief Scientist, Dr Conor Teljeur, said: ‘there is clear evidence of excess deaths occurring since the first reported death due to COVID-19 in Ireland. There were about 1,100 to 1,200 more deaths than we would expect based on historical patterns; a 13% increase between 11 March to 16 June. However, the number of excess deaths is substantially less than the reported 1,709 COVID-19-related deaths over the same period’. They have forwarded their work for consideration and to inform the work of the National Public Health Emergency Team.
Update 2 July 2020: New figures reveal at least 79 patients have died after contracting Covid-19 in hospital
New figures released in a parliamentary question to Green Party TD Ossian Smyth by the HSE say that 265 patients contracted Covid-19 while being treated in hospital for other conditions (https://www.irishtimes.com/news/ireland/irish-news/at-least-79-patients-died-after-getting-covid-19-in-hospital-1.4294389). The figures do not include infections that occurred in other residential settings such as nursing homes. The HSE says notifications are not complete as there are further hospital-acquired cases of the virus not included in its figures. The data compiled by the HSE’s Health Protection Surveillance Centre found that up to 23 June 2020, 3,285 hospitalised patients were confirmed with Covid-19. One in five of the hospitalised patients died.
Update 15th June 2020: HSE launches Study to Investigate COVID-19 Infection in People Living in Ireland (SCOPI)
On 15 June 2020 a new study to investigate the extent of COVID-19 infection in Ireland was launched (http://www.hse.ie/scopi ). A representative sample of more than 5,000 people are being invited to participate in the Study to Investigate COVID-19 Infection in People Living in Ireland (SCOPI) (https://www.hse.ie/eng/services/news/media/pressrel/hse-launches-study-to-investigate-covid-19-infection-in-people-living-in-ireland-scopi-.html). Participants will be from counties Dublin and Sligo, selected as sample locations because they represent areas of the country with higher and lower known levels of infection respectively. The seroprevalence study will measure exposure to COVID-19 infection in the population using an antibody blood test. The intention is to repeat the antibody research in other areas of the country over the coming year.
Those who consent to take part in the study will be asked to complete a short questionnaire by phone followed later by a blood test for antibodies. Participants will be provided with their individual results and those who are found to have antibodies for COVID-19 will be asked to take part in a follow-up study. This will include further questions relating to COVID -19 symptoms and involve three further blood tests over a 12-month period.
Serological tests measure the antibody response in an individual. Antibodies to COVID-19 are produced over several weeks after infection with the virus. The presence of antibodies indicates that a person was infected with the COVID-19 virus, irrespective of whether the individual had severe or mild disease, or even asymptomatic infection. Tests will add to the scientific understanding of how long antibodies last and what protection they may provide against any new COVID-19 infection.
The study design is based on a protocol developed by the World Health Organization (https://apps.who.int/iris/bitstream/handle/10665/332188/WHO-2019-nCoV-Seroepidemiology-2020.2-eng.pdf?sequence=1&isAllowed=y). Initial results are expected in late August and will enable HPSC to estimate the level or prevalence of infection of COVID-19 in the population across different age groups.
The case definition for confirmed and probable cases of COVID-19 used in Ireland is based upon the European Centre for Disease Prevention and Control (ECDC) definition. At the NPHET meeting of 03/03/2020, it was noted that ‘differences continue between the ECDC and the UK approaches. A number of potential options in relation to updating the Irish case definition were discussed, noting possible variance to the UK definition. The group agreed to maintain the current case definition in use in Ireland at this time (ECDC definition before update) and to keep this under ongoing review’.
The case definition has changed as the status of the disease has changed during the crisis. On 12 March, the case definition was updated to ‘symptoms of new onset fever of 38 degrees or more, or chills or symptoms of respiratory tract infections including cough to be considered when assessing the requirement for testing’.
As of 26/03/2020, the HPSC define the COVID-19 interim definition as
• Clinical criteria
A patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease e.g., cough, shortness of breath)
A patient with any acute respiratory illness AND having been in contact with a confirmed or probable COVID-19 case in the last 14 days prior to symptom onset
A patient with severe acute respiratory illness (fever and at least one sign/symptom of respiratory disease e.g., cough, shortness of breath AND requiring hospitalization) AND in the absence of an alternative diagnosis that fully explains the clinical presentation.
• Case classification
Case meets the clinical criteria of a suspect case above (and no alternative diagnosis, microbiological or non-infectious, has been found).
A suspect case for whom testing for the COVID-19 virus is inconclusive
A suspect case for whom testing could not be performed for any reason.
A person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms.
At the NPHET meeting of 10/03/2020 it was agreed that the HSE and DOH would work together to increase public health capacity for contact tracing and surveillance. Minutes from the meeting recorded that ‘there was a discussion in relation to the capacity in HSE Public Health given the contact tracing and surveillance requirements generated by the increase in the number of cases. HSE advised that they are seeking to increase capacity in these services. Increased administrative staff have been put in place to assist Public Health departments, and it is expected that the impact of this will be seen shortly. Other possible approaches were identified, including staff redeployment. It was noted with thanks that HIQA have offered assistance and are working with the HSE to see how best this could be done. It was agreed that public health capacity for contact tracing and surveillance is an immediate priority and should be addressed as such. This should also be included in the action plan under preparation.’
The HSE increased capacity from 36 contact tracers in early March to 1,400 contact tracers by 2/04/2020 with plans to further increase the number of contact tracers if and as required, with other public servants being trained in contact tracing.
On 31 March, the National Public Health Emergency Team made the following recommendations in relation to contact tracing:
• to focus contact tracing on suspect cases within prioritised groups. The HPSC to update guidance to GPs and contact tracing teams
• contact tracing to encompass the period from 48 hours prior to the onset of symptoms given the risk of asymptomatic transmission
• in response to infections in long term residential care (nursing homes, disability and mental health) and homecare settings NPHET will work with the HSE to identify a number of measures which can be taken to strengthen support to staff and providers of nursing home care.
16 April 2020: The coroner in Dublin, where the majority of covid-19 related deaths are occurring has warned that not all Covid-19 deaths are being reported as required by law. The Dublin Coroner, Dr Myra Cullinane “has written to medical staff in hospitals and other locations who are responsible for completing death certificates saying they must comply with the requirement to report “any death in the context of proven or suspected” Covid-19 to her office (https://www.irishtimes.com/news/health/some-covid-19-deaths-are-not-being-reported-coroner-warns-1.4229935?localLinksEnabled=false+warns+medical+staff+of+legal+requirement+to+record+all+Covid-19+deaths). This comes amid concern over possible under-reporting of deaths from the virus, particularly outside hospitals.
16 April 2020: Modelling data on COVID-19 in Ireland was presented at the Department of Health press briefing on Thursday 16 April 2020 by Professor Philip Nolan, Chair of NPHET Epidemiological Modelling Advisory Group. Professor Nolan said: “Our model today is showing four reproductive numbers, illustrating the different stages of the disease in Ireland over the past 6 weeks. “We now estimate our R0 to be between 0.7 and 1.0, which means current restrictions are successfully suppressing the disease” (https://www.gov.ie/en/publication/ea86cc-covid-19-modelling-data-thursday-16-april-2020/).
20 April 2020: Ireland reported its highest numbers of COVID-19 deaths on 20 April 2020 with 77 deaths, bringing the total number of deaths to 687. The daily press briefing CMO reported 401 additional cases confirmed in Ireland, bringing a total of 15,652 confirmed cases of COVID-19 in Ireland to date. There is a time lag in death reporting by health authorities, however trends over the last week show that the rate of increase in death and the number of new cases is reducing (https://www.gov.ie/en/press-release/b02c86-statement-from-the-national-public-health-emergency-team-monday-20-a/).
24 April 2020: The estimated community transmission rate of COVID-19 is now below 1. On 2 April, Professor Philip Nolan, Chair of NPHET Epidemiological Modelling Advisory Group, said that the R number ‘is between 0.5 and 0.8. For the population at large, the growth rate is at zero and the transmission of the virus is effectively suppressed. This success emphasises how vital it is to remain vigilant in our behaviours. If the R number moves above one, we are no longer in control of the disease” (https://www.gov.ie/en/publication/a950be-covid-19-modelling-data-thursday-23-april-2020/).
29 April 2020: Findings from a Mortality Census of Long-term Residential Care Facilities was presented at the Department of Health press briefing on Wednesday 29 April 2020. This found that between 1 January and 19 April 2020, of the 3,368 nursing homes’ deaths, 616 were COVID related (https://www.gov.ie/en/publication/868ad8-mortality-census-of-long-term-residential-care-facilities-1-january-/).
Speaking at their presentation, Dr Kathleen MacLellan who chairs the NPHET sub-group on vulnerable people said:
"Ireland remains one of the few countries globally who has collected and officially reported data from long term residential care settings from the start of the pandemic. From the end of March we have seen an increase in deaths in this sector that can be attributed to COVID-19. As we continue to collect and report mortality data coming from this sector we will have a greater understanding of the behaviour of the disease in this setting and it will help us to inform public health actions and clinical care.”
Monitoring and surveillance of cases and deaths include long-term care facilities but not home care. There has been specific efforts to test all staff and residents in long term care facilities since the week of 20 April 2020. Daily updates from the National Public Health Emergency Team and from the Department of An Taoiseach (Prime minister) specifically mentions the nursing home sector since mid-April.
13 May 2020: The Health Information and Quality Authority (HIQA) published four summaries of academic research and evidence to support the National Public Health Emergency Team’s (NPHET’s) response to COVID-19 (https://www.hiqa.ie/hiqa-news-updates/hiqa-publishes-four-evidence-summaries-support-national-response-covid-19). One of the summaries examined the spread of the virus by children. HIQA’s Deputy CEO and Director of Health Technology Assessment, Dr Máirín Ryan, said: ‘While the evidence is limited, it appears that children are not substantially contributing to the spread of COVID-19 in their household or in schools. One study suggests that while there is high transmission of COVID-19 among adults aged 25 years or older, transmission is lower in younger people particularly in those under 14 years of age’. Another HIQA summary found that there remains a lack of clear evidence as to whether long-term immunity is possible from SARS-CoV-2 (the virus that causes COVID-19) (https://www.hiqanews.com/evidence-summaries-to-support-the-national-public-health-emergency-team/).
14 May 2020: The daily briefing of the National Public Health Emergency Team revealed a spike in cases on 14 May 2020. New cases of COVID-19 which had stayed below the 300 new cases per day for the first two weeks in May and some days as low as 107 spiked on the 14 May (https://geohive.maps.arcgis.com/apps/opsdashboard/index.html#/29dc1fec79164c179d18d8e53df82e96). The Chief Medical Officer told the briefing that ‘223 of the confirmed cases reported today are historical cases which have been managed clinically but only recently notified to the HPSC’. A COVID-19 is an infectious disease, it is mandatory that all new cases are reported to the Health Protection Surveillance Centre (https://www.gov.ie/en/news/7e0924-latest-updates-on-covid-19-coronavirus/#the-latest-news-as-of-6pm-on-thursday-14-may-2020). It emerged that the cases were staff in one of the country’s largest hospitals. The hospital said it reports daily on positive cases of COVID-19 as it is an infectious disease. There is currently a review taking place to understand why the cases reported were not captured in the national data (https://www.rte.ie/news/coronavirus/2020/0515/1138612-covid19-coronavirus-tests/).
On 21 May, technical notes which has guided the work of the Irish Epidemiological Modelling Advisory Group (IEMAG) was published. The IEMAG was formed on 11 March 2020 to provide statistical and mathematical modelling support and advice to the Chief Medical Officer and the National Public Health Emergency Team (NPHET). The remit of IEMAG includes:
• gathering evidence and monitoring the epidemiological characteristics of the COVID19 outbreak in Ireland and the pandemic internationally; and
• developing epidemiological models to forecast the COVID-19 outbreak in the Republic
of Ireland, monitoring the impact of public health interventions, and modelling probable scenarios for numbers of new cases of COVID-19 over time.
After requests from politicians at the first COVID 19 parliamentary committee meeting last week, the IEMAG published a set of technical notes. In its cover letter, it noted these are ‘to inform other scientists, epidemiologists, statisticians and mathematicians of our approach, and to help refine and enhance our techniques and models. These notes are of necessity technical in nature’.
At the NPHET briefing on 21 May, Professor Philip Nolan, who leads the COVID-19 modelling said that his “best guess” is that around one per cent of the population had been exposed to COVID-19, although the figure could be as high as five per cent. ‘For every hundred people out there, there’s at least 95 who have never been exposed to this virus, if we start to transmit it because of the way we act, there is no protection against the virus’ (https://www.gov.ie/en/publication/dc5711-irish-epidemiology-modelling-advisory-group-to-nphet-technical-notes/).
On 25 May, the daily COVID-19 briefing by the Chief Medical Officer reported no COVID-related deaths reported in the previous 24 hours (https://www.gov.ie/en/publication/20f2e0-updates-on-covid-19-coronavirus-since-january-2020). As of 11am, Monday 25 May the HPSC has been notified of 59 confirmed cases of COVID-19. There is now a total of 24,698 confirmed cases of COVID-19 in Ireland.
Speaking at the press briefing, Dr Tony Holohan, Chief Medical Officer, Department of Health, said: ‘The number of new cases and reported deaths over the past week indicates that we have suppressed COVID-19 as a country. It has taken strict measures to achieve this. It will take another week to see any effect on disease incidence that might arise from the easing of measures in Phase 1.’
The Irish Central Statistics Office published its first in a new series of information bulletins that aims to provide insights on those who have either died or contracted COVID-19 by using data from the Computerised Infectious Disease Reporting (CIDR) provided to the CSO by the Health Protection Surveillance Centre (https://www.cso.ie/en/releasesandpublications/br/b-cdc/covid-19deathsandcases/). This report outlines that
• Over 65s account for almost 92% of confirmed deaths
• This older age group also accounted for more than 26% of all confirmed cases of the virus
• Further analysis found that 14% of all confirmed cases are people aged 80+, despite only making up 3% of the population.
• In almost 88% of deaths there was an underlying condition, the median age of these deaths was 83, the same as that for all deaths. This compares to the median age of 48 for all those with a confirmed case of the virus.
The data, which is based on the date of death, shows that there were 1,287 confirmed and 231 suspected deaths due to COVID-19 in since the first recorded death on 11 March up to the week ending 15 May 2020. There were 23,900 confirmed cases since the first recorded case on 28 February 2020. The peak number of confirmed cases and highest amount of deaths occurred during the week ending 17 April 2020.
More men have died from COVID -19 than women (670 deaths compared to 617) even though more women were diagnosed as a confirmed case than men (13,694 women compared to 10,170 men).
Almost 65% of all cases occurred within the 25 and 64 age group, 94 of whom have died. Despite making up 33% of the population only 9% of confirmed cases are in the 0-24 age group but this percentage has been rising since early April.
28 May 2020: At the daily press briefing, the Department of Health published a ‘Comparison of Mortality Rates between Ireland and other countries in EU and internationally’ (https://www.gov.ie/pdf/?file=https://assets.gov.ie/75031/2c4aee04-baca-4b12-90a0-e999621b82e5.pdf#page=null). The report states ‘Despite this difference in incidence rates, which can be attributed to a higher testing strategy in Ireland, Ireland has substantially lower reported mortality rates than the UK countries. In addition, Irish mortality figures include confirmed and probable cases in all settings, whereas figures from England and Wales include only laboratory confirmed.’
The report points out the difficulties in comparing mortality data across countries due to differences in testing, mortality case definition, demography, geography and a range of other factors. In this report, it states that ‘the Health Protection Surveillance Centre (HPSC) data as of midnight 19/05/20 indicates that 80% of all notified deaths from COVID-19 occurred in the over 75-year age groups. Deaths in nursing homes (850 cases) represented 54% of total deaths (1576 cases) in Ireland on that date.’
On the day of the publication of this report, there were nine people reported who died with COVID-19 totalling 1,639 COVID-19 related deaths in Ireland up and a total of 24,841 confirmed cases of COVID-19 in Ireland to 27 May (https://www.gov.ie/en/press-release/d823e-statement-from-the-national-public-health-emergency-team-thursday-28-may/).
Health Protection Surveillance Centre. COVID-19 interim case definition: https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/casedefinitions/ (Date last updated: 29/03/2020)
Press releases, Agendas and minutes of the meetings of the National Public Health Emergency Team: https://www.gov.ie/en/collection/691330-national-public-health-emergency-team-covid-19-coronavirus/