Ireland's pandemic review: Six years on from Covid, the real lessons have yet to be learned

by · TheJournal.ie

THE SECOND PHASE of the evaluation of Ireland’s response to the pandemic finished last week. Listening to excerpts on the radio from expert witnesses triggered nasty flashbacks. Back to those frightening days when no one knew what was happening.

In healthcare, we worried about how we would contain infection and ration resources – if it came to it. But most of all, there was the terror of bringing the illness home. Parenting alone, I remember feeling deeply conflicted and scared about my competing obligations to patients, and my duty to stay healthy for my children.

Healthcare workers had no childcare as schools were closed, but we had to show up and take on extra responsibilities. I was in a ‘bubble’ with my sister and her family, shuttling my children back and forth. Thousands of essential and emergency workers did the same for months.

Home life was a challenge for everyone, from those stuck in temporary accommodation to older people isolated in nursing homes. Some people tried to homeschool and keep down a job, others suffered worsening mental health, addiction and relationship breakdown. Domestic violence reporting soared. Teenagers and children socially regressed.

Among many things, the pandemic was a profoundly emotional and human experience. With the recent praise from epidemiologists, sociologists and public health specialists for Ireland’s response to the pandemic, there was acknowledgement to the evaluation panel that lessons have not been learned from some of the failures.

Professor Steve Thomas, an expert on public health from Trinity College Dublin, issued a warning that waiting lists and healthcare staff morale need to be tackled. Without addressing delays in treatment, another pandemic would provoke a similar public health response, as there remains a fundamental lack of healthcare capacity.

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Chair of the panel, Professor Anne Scott, concluded that people were trying to do their best under difficult circumstances. It is here that staff morale plays a vital, but often unnoticed, role.

Slow to look back

One of the reasons why some believe that we have not learned enough is that our assessment of Ireland’s performance is occurring six years after the event. Australia, Canada and New Zealand have all reviewed and reported several years ago on their recommendations for pandemic preparedness.

Established in 2022, the UK inquiry published its second sobering report recently. While acknowledging the scale of the challenge that Covid-19 presented to all governments, it exposed a failure to treat the impact on vulnerable people, the elderly and children seriously enough; to provide clear and compassionate public health messaging; and to support people as they emerged from lockdown.

Are the evaluation findings in Ireland likely to be different? Interestingly, the public consultation with 7,000 respondents already reveals two areas where a huge impact was felt: mental health and relationships and social connections. People understood that not all decisions would be correct, but more than anything else, they struggled to manage the psychological effects of isolation.

It turns out that it’s not only the morale of emergency and healthcare workers that requires attention, but also public morale.

Focusing on how the experience made us feel could give us solid direction on how to repair and build towards greater cohesion and readiness for another global shock. If the emotional and psychological effects of isolation were the key learnings from the evaluation panel, we ought to take different decisions the next time.

Learning lessons

Our feelings shape our decisions more profoundly than we often realise. Emotions influence the economy through consumer sentiment, market endorsement and voter turnout. Since the pandemic, there have been troubling events like the O’Connell Street riots, which demonstrate the knife-edge of emotion and tolerance that society balances on.

We share the psychological impact of isolation as it has filtered into public life in the form of distrust, anger and cynicism, although each of us experienced the pandemic differently.

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The pandemic brought our human frailty so close that many people found meaning in their lives, while others found even less. Many of these difficult negative emotions have not been acknowledged sufficiently, and hang in the air today.

Apart from the pandemic public consultation, we have done little to shine a light on common values, emotions and aspirations. Shared values of courage, hope and solidarity are hidden within the public consultation. Stories of retired healthcare workers doing testing and vaccinations, of international medical students working in teams to turn patients in the ICU, of hospice home visits, and of organ donations and transplants, which continued against the odds.

The final report of the evaluation panel will no doubt comment on the logistics of preparing for another pandemic in future. We are late to the lessons to be learned, most of which are already published internationally.

I hope the delay means we can focus much more on decisions which respect our humanity, our emotions and our psychological need for companionship.

Dr Suzanne Crowe is a consultant in paediatric medicine and is President of the Irish Medical Council.

 

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