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A pandemic… What are the odds?

By Fintan Moore - 02nd Mar 2020

Fintan Moore ponders the new Government’s potential responses if COVID-19 hits Ireland hard

bhe phrase ‘China Crisis’ used to just refer to a synth-pop British band from back in the dim and distant 1980s, although they have shown remarkable longevity and are still touring. In a much more worrying display of longevity, the outbreak of Coronavirus, aka COVID-19, has expanded from being a localised Chinese crisis to something much bigger — and it’s also still touring. At time of writing, the Italian authorities are struggling to contain it, so by the time you read this, it seems likely that other countries in Europe will also be affected. It has not officially been declared a pandemic yet, but that seems to be just a matter of time. 

We’ve been assured by the HSE and the Department of Health that there are plans in place that will be rolled-out if and when people in Ireland start coming down with the virus. I don’t like to scaremonger, but these are two organisations that can’t really point to a track record of excellence when it comes to planning. Unlike with the stock market, sometimes ‘past performance’ is a good indicator of future gains, or in this case, losses. In fairness to them, even a well-organised and fully-resourced health service would struggle to contain a disease such as this, which has a long incubation period, various transmission possibilities, and apparently some carriers who are symptomless.

So, in a very plausible worst-case scenario, the Irish health service will be unable to contain the spread of COVID-19, and hospitals will be swamped. Patients will be advised to stay at home and be treated by their families. For most of these people, they will suffer nothing worse than a flu-like illness, but pharmacies can expect a steady footfall of these patients and their families. We will be well and truly in the firing-line on this one. So how bad might it be? 

In a much more worrying display of longevity, the outbreak of coronavirus, aka COVID-19, has expanded from being a localised Chinese crisis to something much bigger — and [like the group China Crisis], it’s also still touring

There is obviously the great unknown variable, which is how transmissible the disease might be from pharmacy customers to pharmacists and pharmacy staff. However, the approximate average mortality rate for people who contract the virus seems to be about 2 per cent, but apparently the available data is too low to give a correct percentage. Sadly, the increase in data is occurring, so that figure will become more accurate. What might be vaguely ‘reassuring’ for some of us is the breakdown in fatality rate by age. For people aged 10-to-49, the rate ranges from 0.2 per cent to 0.4 per cent. The rate for those aged 50-to-69 jumps to a range of 1.3 per cent to 3.6 per cent. So even if by some freak circumstance every pharmacist of a working age in the country became infected, we would still only lose a handful of us. I’m not trying to be glib or callous, but if we do hit this particular iceberg, then we will need to be hard-headed and pragmatic.

Primary Errors

The recent General Election that saw Sinn Féin support surge to unprecedented levels has all the usual political correspondents trying to unravel what the people were thinking. It seems that housing and health were the main reasons for voters floating to the ‘dark side’, but exit polls show up some anomalies — for example, contrary to what you might expect, tax cuts are desired by a higher percentage of Sinn Féin voters than Fine Gael voters. Go figure.

In relation to the desire of the public for better health services, some commentators have been blindly trotting out the old fallacy about the need for ‘more primary care centres’, without any critical thinking being applied. There is no evidence that the existing primary centres built in the last 20 years have actually improved health outcomes in their areas. The financial model used has the HSE as ‘the pig that pays the rent’ by taking enough space to generate a profit for the developer. The vast majority of these centres add no extra services to what existed before they were built. Politicians like them because they get a photo-op cutting the ribbon but in reality, they are simply a vehicle for taxpayers’ money to be paid in perpetuity to private companies. Maybe a left-leaning Government might contain the right people to start questioning this model. 

Not to be Sniffed At

Anecdotally, it would appear that the country is awash in cocaine, despite the potential addiction and health risks. Matt Cooper recently expressed his bemusement at the guys he knows in their 50s who are overweight and unhealthy, yet still take cocaine — maybe the Drug Squad should infiltrate the Today FM Christmas party. Personally, I’ve no interest in the stuff, but tend to be agnostic about what other people choose to do for kicks — mountaineering and motorbike riding are pretty risky, but nobody’s trying to prohibit them. However, cocaine use is funding the most vicious criminal gangs the country has ever seen. There is no ‘Fair Trade’ cocaine, so exploitation and violence exist at every level on the supply chain. Even people who wouldn’t dream of wearing real fur don’t mind snorting it, so perhaps there should be a more severe sentencing policy for possession of cocaine for personal use to deter people from dabbling. To be effective, a policy like this would need to be country-wide and well publicised, rather than the current haphazard situation, with widely-varying policies applied by individual judges. The status quo is a lottery in which otherwise blameless people caught in the wrong place at the wrong time and sentenced by the wrong judge can be unfairly hit with a sentence that has repercussions out of all proportion to the misdemeanour involved.

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