I'll show how the situation in France and Spain has developed over the last while.

The patterns are remarkably consistent.

They begin with young people driving case loads and more slowly it begins to impact the elderly. It should concern us all here.

This is a graph showing clusters by week in France.

From the end of week 27 (July 5th) to the end of week 31 (August 2nd), you see a steady rise in cases associated with clusters (This graph was produced on Day 1 of Week 35 so ignore the drop-off).

Throughout that slow rise period, it was mostly young people contracting Covid19 and it was not leading to increased hospital admission or death among the elderly.

There's a "But..." coming.

Now look at this - it's clusters associated with French nursing homes.

They initially avoided all of the new infection in younger people but look what you see happening weeks later (by end of August) - 200 cases per week in nursing homes, a full 10 times more than early July.

What happened is this:

-Young people contracting Covid19
-Elderly people initially being unaffected as they were protecting themselves (and being protected in nursing homes.)
-As more and more young people got it, it became harder for elderly people to avoid it.

This picture is mirrored in Spain.

Look at hospital admissions per week in the over 60-years-old:

Aug 6th-12th: 639
Aug 13th-19th: 882
Aug 20th-26th: 1,102

The past week was on pace for 1,600. Hospital admissions have nearly trebled in elderly people since early August.

The issue is intuitively simple.

Elderly people have a smaller number of close contacts, who tend to be family members.

When cases rise across society, it becomes harder for family members to avoid it and harder to avoid passing it on.

That's in the home environment.

Elderly people in a nursing home environment become more vulnerable too, because both staff and visitors are more likely to have the virus when community infection is rampant.

Masks, washing hands, PPE are only mitigation measures, not prevention measures.

Essentially, all of these cases make it very hard for elderly people to avoid it.

What starts off as mostly young people, gradually starts to impact the elderly.

This is already happening here in Ireland, at a lower level than France or Spain. https://www.rte.ie/news/2020/0903/1162903-nphet-meeting-virus-spreads/

Nursing homes in Ireland had been effectively Covid-free for the last 2 months, with fewer than 25 cases in 60 days.

International experience tells us this can't be sustained when infection increases in the community, because the virus will sneak back into those settings.

The best way to reduce the risk facing the elderly this winter is for us all to refocus on the basics that got us into a good position.

Repetitive hand washing, wearing masks, and probably most relevantly, by reducing our close contacts down a little bit more.

Lets say in the past week, you had 8 close contacts. Aim for 1 fewer this week, if possible.

It's only a reduction of 1 person, which on an individual level doesn't make much difference.

But if 5 million people do it - interact with 1 fewer person - it makes a huge difference.