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No plans to change current testing regime, but contact screening to be reduced in longer-term

A paper drawn up for NPHET suggested children under 13 with mild symptoms should no longer be tested.

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Updated Sep 13th 2021, 1:58 PM

THE HSE HAS said there are no current plans to change the existing testing regime, despite an internal discussion paper suggesting those with mild symptoms may be able to forego a test. 

However, close contact testing will likely be scaled back in the future if the pandemic recedes to an epidemic.

A paper, released to a number of publications under the Freedom of Information Act, was drawn up for the National Public Health Emergency Team (NPHET) in July this year, but public health officials have not yet advised that these actions be taken.

The paper proposed to discourage the testing of mildly symptomatic children under the age of 13 and to remove the requirement for vaccinated adults to get a test, even if they have mild symptoms.

Speaking to RTÉ, HSE Chief Clinical Officer Dr Colm Henry said there are “no plans at the moment to change the testing regime or indications”.

“Yes, there was a discussion paper put in because we’re now examining a totally different scenario than the one we had a year ago,” he said.

A year ago we were dealing with a novel virus against which none of us had immunity and for which there was no vaccination in sight, and which presented a considerable threat to older, vulnerable people  and to the stability of healthcare systems.

He said the availability of a highly effective vaccine had given the HSE choices.

“What we’re doing now is imagining the transition from a pandemic stage to an endemic stage, where this disease is no longer considered exceptional, but part of a profile of other seasonal viruses.”

Dr Henry said changes to the testing regime would be made based on factors such as the case numbers, the positivity rate, the impact on hospitals and the impact on vulnerable groups. He said a move to an ‘endemic stage’ would mean more focused testing in outbreak settings or in people who are symptomatically ill. 

National Lead for Testing and Tracing Niamh O’Beirne said the HSE does expect there will be a change to the testing policy “in due course” when the pandemic eases.

Right now, we have the same testing capacity and the same approach as we’ve had for the last period of the pandemic, but we do know that as it changes to an endemic stage – we’re not there yet – but when that does happen, there will be a point in time where you do scale back testing because the threat from the virus has faded and it’s no longer appropriate to restrict the movements of so many people if they’re close contacts.”

Speaking to RTÉ’s Morning Ireland today, Leo Varadkar said that while he had seen reports, he has not seen advice from NPHET on the proposal.

“Speaking as a doctor, it does make sense to me,” he said. “Because of the vaccination programme Covid is now a virus we can live with.”

Varadkar said managing the virus in the future will be similar to the way in which flu has been managed and the current testing capacity will not be necessary.

The proposal paper also suggested that fully vaccinated close contacts would no longer have to be tested, a policy that has been introduced since the paper was written in July. 

In a statement, the Department of Health said the public health response to Covid-19 is kept under ongoing review, including approaches to testing, contact tracing, outbreak management, surveillance and sequencing.

“This review will inform the development of a future public health response strategy and approach for the coming months.”

NPHET is meeting today and is expected to discuss the current requirements for children who are close contacts of a positive case to isolate for 14 days. There are around 12,000 pupils absent from school as a result.

O’Beirne, speaking on the News at One, said that the HSE deals with around 1,200 students each day who are close contacts, which adds up over the course of the isolation period.

Overall, Covid-19 testing at the weekend was up by 17% compared to the previous weekend, with 30,000 people tested.

School pupils are being tested at “about three times the level of any other age group”.

“You get other viruses that circulate when children return to school and parents would like children to come forward for testing to know whether they have Covid or whether they have another virus, so that is also starting to drive the amount of testing that’s going on,” O’Beirne said.

If a school is waiting to hear the outcome of a public health risk assessment, the advice is that children should continue to attend in the interim if they do not have Covid-19 symptoms, she said.

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“The level of risk is very low if the children in the classroom are asymptomatic. The important thing on the side of the parent is not stand anyone to school who’s symptomatic,” O’Beirne said.

“If the classroom doesn’t have children who have symptoms, the advice from public health is to wait until you have your public health risk assessment so that you don’t risk taking too many children out of the school day and then to work then to get them back in.”

With reporting by Lauren Boland

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