Experts looking at why Cavan has highest rate of Coronavirus

Public health officials are investigating why County Cavan has the highest rate of infection of Coronavirus per capita in Ireland, having overtaken Dublin in the past week.
There are now 832.3 confirmed cases of Coronavirus in the county per 100,000 of population. It equates to 634 COVID-19 positive cases in real terms.
At yesterday's evening's press briefing at the Department of Health, the situation was address by Dr Colm Henry, HSE chief clinical officer and Dr Tony Holohan, chief medical officer. They dismissed speculation that Cavan's proximity to the Border with Northern Ireland is a factor – pointing instead to other variables.
Dr Henry: “Some people talk about it [Cavan] being a Border county but it doesn't corrolate with other Border counties. There was an outbreak in the hospital there [Cavan General]. There was an outbreak in some residential care facilities there and some congregated settings. 
“So there were certain outbreaks there that led to much bigger numbers and a bigger impact on what is a smaller populated county. It doesn't appear to be directly related to the fact it is a Border county.”

'Most serious of outbreaks'
Pressed on whether healthcare facilities were prepared for the outbreak, Dr Henry said: “Certainly, the biggest challenge to date was in the hospital, which is under the governance of the RCSI Group, who have been robust in their response in terms of their public health intervention and in terms of the protection of patients and staff.
“But, like any outbreak in a healthcare setting, it was very challenging and presented huge risks to patients and staff. Based on my engagement with them and my understanding from their actions, they had a very robust and very early intervention to that most serious of outbreaks, which was in the Cavan Monaghan General Hospital in Cavan Town.”

'Great caution'
Asked for his opinion on the topic as to why the rate in County Cavan is so high, Dr Holohan played down the significance of what he said were 'crude figures' and said it did not necessarily mean a great risk of infection in the Breffni county.
“There are some variations in terms of the challenge that existed in the hospital, the numbers of cases might have arisen from that. Ultimately these are crude rates so it's just the number of cases per 100,000 of population and comparisons of those always have to be taken with great caution.
“You will see apparent variations, that may not be real variations in terms of the risk of the disease. You have to take into account whether there were variations in the level of testing in those populations and so on and whether any other variations arose.”

Clusters
Dr Holohan also suggested that clusters may be impacting on the rates in Cavan.
“So this particular pattern may well be explained by that [clusters] but it's something that we need to look at - as to whether we see significant or important enough regional variations in this that suggest that there needs to be some sort of regionalised response. So we will consider that on an ongoing basis. We don't think there has been any indication or circumstance yet that would justify such an approach,” he said.

 

'Very seriously'

County Monaghan, meanwhile, despite being the last county in Ireland to officially record a Coronavirus case, is now in third place nationally, after Cavan and Dublin, in terms of the rate of infection. It has 632.1 cases per 100,000 of population (total of 388 cases).
Commenting on the high infection rates in Cavan and Monaghan this week, Minister Heather Humphreys told the Celt: “I was speaking with senior officials from the HSE this morning, who have assured me that they are taking the issue very seriously. They have also confirmed that they are investigating why there has been an increase in transmission rates in the Border region as a matter of urgency."
She continued: "There has been a suggestion that the higher figures might be linked to a spillover of infections coming from the North. However, I’d like to be very clear that this is unlikely to be the case. An Garda Siochána have also confirmed that they have seen no activity around the Border that they would be concerned about. Overall people are following the public health advice and I don’t think it’s fair to be creating divisions during this difficult time."
Minister Humphreys said that public health officials will continue to investigate the issue. "In the meantime, the best thing we can do is to continue to follow the advice of the chief medical officer,” she urged.

 

All-island approach needed
Aontú Councillor Sarah O’Reilly has expressed shock and concern over the high incidence rates and the effect being had on communities in Cavan and Monaghan.
She's calling for an all-Ireland approach to tackling Covid-19 and had previously highlighted the potential threat to Border counties should an all-Ireland approach fail to be adopted.
She said: “Ultimately, there is no one reason for the high rates of infection in Cavan and Monaghan, but certainly there is much that could have been done to prevent the high incidence rates of Covid-19 in these counties.”
Cllr O’Reilly is also urging people to follow the guidelines of the chief medical officer and adhere to the restrictions.
“Furthermore, the Irish government must step up and ensure that any resources required by frontline services in Cavan and Monaghan are met to help tackle the particular prevalence of the threat in these counties,” said the Aontú councillor.

Figures

The county by county figures are valid as of midnight, April 27, the latest time for which confirmed case numbers are available.
The data relating to infection rates is contained in a report 'Epidemiology of COVID-19 in Ireland' prepared by the Health Protection Surveillance Centre (HPSC) and it is up to date as of April 29. Those figures are based on the 2016 Census of Population.

The infection rate in Dublin, the county with the largest number of confirmed cases in Ireland, meanwhile, is 723.7 cases per 100K of population. That translates to a total of 9,751 cases.
Cavan is the only county to exceed the 800-mark for the rate of infection per 100K.
As of 1pm yesterday (Thursday), there were 20,253 positive cases of Coronavirus nationwide, and the death toll was 1,190.