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Contact tracers to begin asking community transmission cases about visits to pubs and restaurants

Currently around one in four cases are identified as community transmission.

Image: Shutterstock

THE ACTING CMO has said contact tracers are to start asking people who test positive for Covid-19 and who are believed to be community transmission cases about their visits to bars or restaurants in the period before their positive result.

After the National Public Health Emergency Team’s (NPHET) recent recommendation that bars and restaurants in Dublin stop serving customers indoors there were calls for officials to provide concrete evidence that transmission had been linked to these settings.

At the Oireachtas Covid-19 committee today, Microbiologist Professor Kirsten Schaffer said she was concerned that information about where cases originate is not available.

“I rang Public Health Ireland yesterday to inform myself more and to find out what the situation is at the moment. Currently, when a person is diagnosed with Covid-19, Public Health Ireland will ask them about the contacts they had in the preceding 48 hours. It will not ask where the individual thinks they have acquired the infection.

“It does not ask whether they have been to a restaurant or attended a house party. It does not have that information and neither do I.

However, it is crucial that we start trying to collect such information so we can show the data and use it to state the reasons why, for example, house parties with more than ten people attending are forbidden, and if it happens, then the Garda will be called and the house parties will be shut down.

“We need some data to argue with, and currently it is not there. I know from Germany, because such data is collected there, that increasing rates there are strongly associated with house parties and family gatherings, where people congregate and do not adhere to social distancing rules.”

At this evening’s Department of Health press conference, Acting Chief Medical Officer Dr Ronan Glynn said plans are now being put in place to ensure this kind of questioning is included in the contact tracing system. 

“This is an issue that many countries have faced and the majority of countries would not retrospectively contact trace every case because it’s an enormous workload and would significantly lengthen the process,” he said.

“But it needs to be done in at least a proportion of cases and there are plans being put in place to do that.”

Dr Glynn said this would be done in cases characterised as community transmission, where there is not an obvious link to another case. Currently around one in four cases are identified as community transmission.

He said there is clear evidence that certain environments are higher risk, such as indoor and poorly ventilated areas as well as settings in which people come together indoors for a prolonged period of time.

“And let’s be honest where people come together, consume alcohol and drop their guard, that increases risk,” he said.

“We’ve a situation tonight where we’ve almost 100 people in hospital, 16 in critical care units. Our doctors and nurses around the country are very concerned about the potential impact this is going to have on the provision of non-Covid healthcare.

“The last thing we want to see is this impacting again on our cancer services and all the other services that need to go on on a daily basis.

“We have choices to make. In that context we have to protect our priorities and at the moment unfortunately certain elements of our social lives are less important than others and we have to be honest with people about that.”

This evening Dr Una Fallon, director of public health, HSE Midlands, gave a number of examples she and her colleagues had come across as part of their work on complex contact tracing cases, many with large numbers involved.

In one case a factory worker who had minor symptoms asked a friend to give them a lift to a sporting event. At this event there were “lots of close contacts” and this resulted in two further cases – the friend who gave the lift and one other.

From those two cases, there were a further 19 cases, mainly linked to work and from those 19 cases a further five.

Dr Fallon said there were other outbreaks linked to family events such as funerals or communions.

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“People may adhere to the guidance for the service but where there may be a meal afterwards with a number of tables, even though you’d have six to a table there would be association between the tables and co-mingling.”

In another case a sibling of a confirmed case went to a house party when they should have been restricting their movements and Dr Fallon said the “end point of that was more than 20 new cases”.

“The message is just because you know people and you’re out with them doesn’t mean you should drop your guard.”

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