It's hard to overstate how bad the situation is in Ireland right now.

We had 6,110 new covid cases confirmed today, in a population of 4.9m people.

If we scale that up to the population of the US (328.2 million), the equivalent would be over 400,000 new cases in Ireland today.
By comparison: US had over 200,000 new cases of covid yesterday & just under 300,000 new cases the day before. US data is noisy, with testing lags & undercounting.

But even so: by official stats, Ireland had at least a 1/3 more new cases per capita today than the US.
Our Chief Medical Officer, Tony Holohan ( @CMOIreland), has said that 'Right now the underlying level of disease is higher than the first wave'.

Our graph of new cases shows that fairly dramatically.

Growth of new cases is vertical.
It's almost impossible to get our heads around what that means.

Some comparators:
- 20% of all covid cases in Ireland were reported in the *last week* alone
- New cases today (one day!) greater than those in June, July, August combined

(thanks to @higginsdavidw & @shanedbergin)
The WHO recommends that test positivity is kept below 5% over 14 days, so as to be able to properly track cases in the community.

Go above that? You're essentially flying blind.

Ireland's test positivity is now 25.27%., x 5 times the recommendation.

https://covid19.shanehastings.eu/api/swabs/ 
Some international comparisons.

Our 7-day test positivity is 20.1%.

Los Angeles, one of the hot spots of covid transmission in the US, has a 7-day test positivity of 18.4%.

Ireland's 7-day test positivity is higher than LA.
Another comparator: Ireland has had more new cases of covid in ONE DAY than the entire caseload of New Zealand and Taiwan, combined, over the entire pandemic. https://twitter.com/NoonanJoe/status/1346174335556456449
What changed?

It's tempting to point to new UK variant, which is certainly circulating here. However, recent sampling suggest that the new variant is only responsible for 10% of new cases in Ireland (so far).

It doesn't seem to be driving the new surge. https://twitter.com/CillianDeGascun/status/1345139326863224838
So what happened?

In a word: Christmas.

In more words: we left lockdown at the beginning of December. The Irish government opened shops - but also opened pubs, restaurants and cafés in December. People could meet indoors, without masks, to eat & drink. https://twitter.com/Orla_Hegarty/status/1346199324225626113
In doing this, the Irish government overruled the advice of their own pandemic response team, NPHET.
In a letter dated 26 Nov 2020, @CMOIreland advised AGAINST opening hospitality due to the risk of super-spreading events and - in bold type - *particularly* against opening BOTH household visits AND hospitality.

The Irish government ignored this advice.

https://assets.gov.ie/99265/1c5ba10e-465d-4494-b7fb-f4c50bbb96fc.pdf
By the time Christmas came, we now know that cases were already hitting 2000 per day.

By 23 December.

(Massive thanks to @andrewflood for this observation) https://twitter.com/andrewflood/status/1346199731912007685
Add in household visits over Christmas & the results are explosive.

@President_MU confirmed that cases are now growing at 10-13% *per day*. Nolan said growth is at the 'high end' of that estimate.

At only 10% growth, 6,110 cases becomes almost 12,000 cases per day in 1 week.
. @dylanhmorris told @zeynep for her most recent piece that 'exponentials are so cruel that noone wants to look them in the eye.'

Ireland is showing the proof of that right now.
Hopefully, an immediate lockdown will arrest this trend and we will never get to that number.

However, we're already locked into the terrible mathematics of this pandemic.

Of the people who are *already infected*, some will need hospitalisation and ICU beds. And some will die.
Across the ocean, @trvrb calculated the case fatality rate (CFR) in the US - that is, the % of people diagnosed with covid who ultimately die of the disease.

He found that, on average, covid victims died 22 days after their diagnosis. Just over 3 weeks. https://twitter.com/trvrb/status/1326404864843390976
Put differently (& to paraphrase @edyong209):

Some people who contracted the virus on Christmas Day will have developed symptoms by New Year's Day, be in hospital by mid-January, and in the mortuary before the end of the month.

22 days.
How many people?

According to Trevor, the CFR in the US is about 1.8%.

In Ireland, our CFR since June has been lower - about 1.07%. That is, just over 1% of the people diagnosed with covid in Ireland since June ultimately died of the disease.
If we apply @trvrb's heartbreaking heuristic, of the 6110 people who were officially confirmed with covid in Ireland today, 110 of them could die in around 22 days.

Or, using Ireland's more optimistic track record of 1.07%, 61 of them may die before the end of the month.
And by the same calculation, of the approximately 38,000 people who contracted covid in Ireland over the last 22 days, 380 may die.
God, this is horrifying to type out.
But here we get to the crux of it – an echo of all the painful graphs and projections we made last March.

This is the best case scenario.

Because when we imagine 380 people dying – 380 families, 380 funerals, the unspeakable grief – we imagine a *functioning health service*.
And currently, NPHET predicts 1500-2000 people in hospital by mid-January, and 200-400 people in ICU beds.

We're a small country with an under-funded health system.

We only have about 287 staffed ICU beds. In total.
How do you fit 400 people into 287 ICU beds?
How do you fit 2500 sick people into 600 hospital beds?

You don't.

And so the death rate - inexorably, terribly - climbs higher again.
There is a race here: between the virus, with its heart-rending statistics of death, and the vaccine.

If high-risk groups are vaccinated, the death rate falls - potentially by up to 90%. But this won't help you if you're already infected. https://twitter.com/laoneill111/status/1346264283676602369
And so we will stay home. We will do everything we can to crush this curve and avert as much of this horror as we can. We are a small country, and highly networked, yes, but that can play in our favour, too.

We know each other.
We want to protect each other.
We will stay home.

We will hold to hope.

And we will wait for vaccines.
And while we do so, we can hold our government to account. We can make sure that they listen to public health advice, and listen to us.

We can hold the line.
We can fight this virus, together.
And we can live to see another, better Christmas next year.
You can follow @laineydoyle.
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