Dáil Éireann Debate, Wednesday - 22 July 2020
229. Deputy Róisín Shortall asked the Minister for Health his views on the testing strategy; and his further views on whether a greater number of potential asymptomatic carriers should be tested when there is spare testing capacity in the system. [17590/20]
View answerA robust, real-time process of testing, isolation and contact tracing is central to our public health strategy for containing and slowing the spread of COVID-19, as advocated by WHO, European Commission and ECDC. The HSE has developed a comprehensive, reliable and responsive testing and tracing operation which has standing capacity to undertake 15,000 tests per day/100,000 tests per week. Significant effort has also been made to ensure quick turnaround times. As of 20 July, 567,819 tests have been carried out with an 5.1% positivity rate overall. 50,860 tests have been completed in the last 7 days.
It is important to note that the recommendation in relation to 15,000 tests a day/100,000 tests a week was always in relation to the level of capacity that should be available on a continuous basis in case it is needed and was never intended as an activity target that should be met on a regular basis. While we are in a positive position of not needing this full capacity at present, it is critical that we have it available to us when it is needed. The testing and contact tracing operational and resource model has been designed to flex up and down as needed to match an increase in demand, it has been stressed tested at higher activity levels and is capable of responding quickly to changes in demand.
COVID-19 testing demand is influenced by a range of factors including prevalence of the virus, the case definition and overall testing strategy, and testing activity levels will fluctuate as these factors change as we have already seen over the last four months.
While prevalence is low at present, Ireland is currently pursuing a very robust testing strategy under the guidance of NPHET. The case definition is very broad, with a low threshold for referral in place in line with the ECDC guidance. There are also a number of targeted testing programmes in place which are aimed at potential asymptomatic carriers and populations/settings that are most vulnerable to the virus. This includes testing of all close contacts, weekly testing of nursing home staff and pre-testing of incoming hospital patients.
Close contacts are now being tested twice and contacted on a daily basis to monitor symptom development. Very few countries are proactively testing asymptomatic contacts in this manner. The vast majority of close contacts tested so far were asymptomatic. Data for 19 May - 12 July shows that of contacts with first test results confirmed, the overall positivity rate was 8%. Within that group, the positivity rate for symptomatic contacts was 16%, whilst it was 6% for asymptomatic contacts.
All staff in nursing homes are being tested weekly over the course of 4 weeks, at which point the programme will be reviewed. This programme is in recognition of the vulnerability of nursing homes to this virus and builds on the mass testing programme carried out in April/May.
Finally, the HSE has developed guidance for the management of planned hospital admissions for non-COVID care which sets out advisory testing strategies for hospital patients, both inpatient and daycase.
NPHET will continue to consider how best to target testing capacity. Our testing strategy will continue to evolve and will be based on emerging evidence, public health risk assessments and will continue to be directed by Public Health advice.
