Northern Ireland ventures into ‘uncharted waters’ as new Covid-19 restrictions come into place

Like many in Northern Ireland, Michael McNamara is at a loss to explain where it all went wrong. “I’ve got no idea,” he says from inside his carpet shop along Belfast’s Ormeau Road. A short pause for thought follows before he sighs and shrugs. “We seemed to dodge a bullet during the first peak, but now it’s moving in the wrong direction. Who knows why.”

By all accounts, the country emerged from the initial wave of the pandemic relatively unscathed. Analysis in April showed that Northern Ireland had the lowest recorded mortality rate across the UK – a trend that seemingly continued into the later stages of spring, with roughly 500 deaths from the disease reported by the government in early May.

The nation’s early success in suppressing Covid-19 stemmed from the decision to shut down before the virus had been largely seeded throughout the population, explains Helen Dolk, a professor of epidemiology at Ulster University. “During the first wave, Northern Ireland was behind London in its epidemic curve and therefore locked down relatively earlier which saved lives,” she tells The Independent.

Claire Hanna, a Social Democratic and Labour Party MP for Belfast South, suggests that “all the things we complain about” equally helped in slowing the tide before lockdown was implemented.

“We don’t have major transport links, so there weren’t six planes a week coming in from Italy,” she tells The Independent. “Rurality – a lot of people live in isolated circumstances. Poor public transport. You couldn't go on the tube and infect five people for example. Because we stopped before all the little fires were all over the place, we got by during the first wave.”

But the outlook for Northern Ireland has since changed. Stormont’s health department has now recorded 25,177 cases in total – nearly half of which have been reported since the turn of the month. Although more testing is being carried out, figures in September showed that the positivity rate is up to 3.7 per cent from 0.5 per cent in July.

Deaths remain low for now, while health minister Robin Swann has assured the nation that improvements in treatments mean less hospitalised patients are likely to die, but there’s no doubt that Northern Ireland stands at a crossroads. All metrics currently point to a difficult winter.

Of mounting concern is the city of Derry and Strabane council area. Here, the seven-day infection rate is at 870 cases per 100,000 people – one of the highest in Europe. The rising numbers are naturally taking their toll on Altnagelvin Area Hospital, the largest in the northwest of Northern Ireland.

According to Western Health and Social Care Trust, which is responsible for the running of Altnagelvin, the number of patients needing admission is almost doubling every three to four days.

“The continued increase in community transmission is impacting significantly on our hospitals,” a spokesperson for the trust told The Independent. “This is a very worrying time for us and if the rate of infection continues locally we will have some very difficult decisions to make in the coming days around what services we can continue to offer.”

The trust added that an increase in community transmission across Derry has also had a “knock-on effect” on staffing levels, depriving the hospital of many nurses and doctors who have been forced to self-isolate due to testing positive or potential exposure.

One nurse at Altnagelvin said she and her colleagues were fearful of “what it is to come” due to the region’s soaring rates. “Covid has left everybody nervous,” she tells The Independent. “We’re all really nervous about going home to our own families.”

She insisted that the crisis had brought her team closer together – “We always have each other’s back, I’ve never felt on my own” – but said that the morale of the hospital as a whole had changed. “You don’t see a lot of people about the hospital,” she says. “You don’t leave your ward anymore really.

“This is uncharted waters for us. We’ve never been through anything like this before. Nobody knows where we’re going to end up. It is concerning the amount of people who have Covid now. I just hope with the guidelines set in place it does start to come down.”

As for what’s driving the surging transmission rates in Derry, experts have pointed to the town’s high levels of deprivation. “Socio-economic conditions are going to be a factor,” Ivan Perry, a professor of public health at University College Cork, tells The Independent.

He reels off a number of qualities unique to the area and other low-income regions in Northern Ireland. “High density and low quality of housing. A high proportion of the population feel the need to go to work when they're not ready. And if they’re living in houses where it's not easy to isolate. The virus thrives in the conditions of poverty and social marginalisation that all diseases thrive in.”

Claire meanwhile argues that the relatively low impact of the first wave fostered a false sense of security throughout the wider population. “It made people a little complacent,” she says. “But it’s hard to know how faithfully people have been following the rules.”

As for what comes next, officials are hopeful that the new restrictions – which will notably see pubs and restaurants close for one month, along with schools for two weeks – will prove effective in reducing the R rate and slowing the number of people being admitted to hospitals.

But there’s a danger that the country could find itself caught in a disruptive cycle of rules and regulations that don’t ever go far enough in combating the virus, says David McCann, a deputy editor at Northern Ireland’s largest current affairs blog.

“We're kind of chasing our tails at the moment,” he tells The Independent. “We're on this treadmill which we can’t seem to get off. These new measures should bring the R number down, but if cases rock up again in November then we’ll just be back to where we are now.”

The short-sighted nature of the strategy has been criticised by many academics and health experts, who have called on the government to return to its “zero-Covid” policy. “The only goal that makes sense is to persist until elimination of community transmission is reached,” says Prof Dolk. “Four weeks will not be enough to reach this goal. If we persist longer, as countries such as Australia have done, we can look forward to reopening our economy without constant braking.”

Others have warned that the “circuit-breaker” will all be for nothing if the government doesn’t fix the country’s Test and Trace system. With a work-force of 151 contact tracers, the service has capacity to deal with 300 positive cases a day, according to government analysis. Yet, daily infections throughout October have repeatedly approached the 1,000 mark, prompting one Sinn Fein politician to describe the service as “useful as a chocolate fireguard”.

“Once cases are at that number, your test and trace is completely overwhelmed,” says Prof Perry. “We know these systems aren’t brilliant. They're overly centralised and there’s issues with staff.” He adds that it’s vital authorities use the next month to beef up the service and prepare Northern Ireland for the next stage of the pandemic.

In the meantime, the wider public have little choice but to do what is asked of them and persevere. More lives will undoubtedly be lost, businesses forced to close and families upturned. But even in the face of such adversity, the people of Northern Ireland are refusing to throw in the towel.

“We’re such a close community, the whole of Derry cares,” says the Altnagelvin nurse. “If one person needs something, nobody could say we don’t pull together – because we do. As long as that sticks and stays, and we continue to support each other, and the nurses and doctors of our community, we’ll get through it and be on the other side soon.”