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Explainer: What's the latest advice about Covid-19 symptoms and when should you seek a test?

Hrere’s another look at Ireland’s testing system and how it works.

Image: Shutterstock/Horth Rasur

COVID-19 TESTING IS back in the headlines, following a significant rise in the number of cases in Ireland in recent weeks.

There was no shortage of confusion around testing during the first few months of the pandemic, when the eligibility for testing changed multiple times and many people wondered whether they were still able to get tested.

Multiple issues with the system over the course of the first few months were eventually ironed out, as the government supercharged Ireland’s capacity to carry out testing by the beginning of the summer.

But some issues have arisen again as we face into the winter months. With that in mind, we’re revisiting the testing system and how it all works.

What are the latest problems? What do plans for ‘serial’ testing in meat factories and Direct Provision centres entail? And how do you know whether you need a test and what should you do to get one?

Here we take a look.

How should I know if I need to go for a test?

Anyone who has one of the main symptoms is being asked to contact their GP, who will assess whether they should be referred to have a sample taken.

The symptoms are:

  • Fever (a temperature above 38 degrees Celsius)
  • Any kind of cough – not just a dry one
  • Shortness of breath
  • Loss or change to your sense of smell or taste

On top of this, those who are close contacts of a confirmed case should also present for testing even if you don’t have symptoms.

If you are a close contact, you will be phoned by the HSE’s contact tracing team, who will arrange a test for you.

As soon as you show symptoms, you should begin to self-isolate and those living with you should restrict their movements.

What happens then?

Those who phone their GP will be assessed over the phone. The HSE is urging those who think they may have the virus not to go to a GP surgery, pharmacy or hospital. 

The test and assessment should be free of charge, including out-of-hours services. Those who don’t have a GP, are advised that any GP can arrange a test.

If a GP decides that a person does not need to be tested, they will still be asked to stay home and self-isolate for 14 days and people in their household will have to restrict their movements.

How does testing work?

If a GP decides that you do need to be tested, they will arrange one.

Test appointments are confirmed by text message, which include details on where a person should go and when.

Each person will be sent to be tested a community test centre or in their home, where healthcare workers take a swab from their nose or throat, as well as phone numbers to inform patients about their results.

Those results are sent to a person by text message. Most people are expected to get their test results back within 3 days.

After being tested, patients are urged to keep self-isolating before they get their result.

How do I self-isolate?

Put simply, self-isolation means staying indoors and avoiding contact with other people. It’s best to behave as if you have the virus, even if you don’t have symptoms.

Don’t go outside. Don’t go to school, or work, or anywhere else in public – and don’t use public transport.

Don’t invite people to your home and if if you live with other people, don’t share things like cutlery and cups, and keep away from them as much as you can, and try leave your room as little as possible.

If you have to go into a room with other people in it, try to keep 2 metres apart from them and wear a face covering or face mask.

If possible, you should also get someone to leave your food on a tray at your bedroom door. You should leave this outside when you’re done, and have whoever collects it clean it immediately with soap and hot water.

If you need food or supplies, friends, family or delivery drivers can drop them off – but make sure they leave them outside, or if they have to come inside, don’t be in the same room as them.

HSE advice also states you should keep an eye on your symptoms, and call emergency services (112 or 999) if they get so bad that you have difficulty breathing or your cough gets worse. 

Do I qualify for ‘blanket testing’?

Plans announced by the government last week means that thousands of workers at meat processing plants across the country are set to be tested on a regular basis.

The blanket testing aims to identify cases of the virus in the factories as early as possible to protect workers, their families, and the wider community.

Some workers at meat processing factories are known to live in Direct Provision centres. Plans to test residents in centres also aim to prevent clusters there.

It’s not quite known who is going to pay for these systems of blanket testing yet, or exactly how often the tests will take place. But it’s hoped that implementing them will limit the ability of the virus to circulate in the wider community.

What are the latest problems?

Simply put, the testing system wasn’t adequately prepared to scale up so quickly in response to the spread of the virus in recent weeks.

At the height of the pandemic, the government pledged to be able to carry out 15,000 tests a day. This capacity was never reached, and the scale of testing naturally eased off as new cases dwindled during the summer months.

But as those cases rose again, the testing system struggled to cope, because testing facilities and contact tracing centres had been closed.

Although some of these have now re-opened, the result has been slower turnaround times for testing and tracing – which is important, because the longer it takes to identify positive cases and possible contacts, the more the virus has a chance to spread.

Figures from the HSE on Tuesday showed that the median time from referral for a Covid-19 test to the completion of contact tracing is now 2.83 days – but some patients say they’re waiting longer than that.

The issue isn’t helped by some patients’ long lists of contacts.

Yesterday, Mary Codd, Associate Professor of Epidemiology and Health Statistics at UCD and head of the university’s contact tracing centre said it was seeing contact lists of between 10 and 30 people in some patients.

What are the government saying?

On Tuesday, the HSE told TheJournal.ie that there was no backlog in the contact tracing process.

But there has since been political acknowledgement that the system isn’t coping as well as it should be.

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Also speaking on RTÉ radio yesterday, Minister for Transport Eamon Ryan acknowledged that the rise in cases has “led to a certain delay in turnaround”.

“I think the system was caught off guard with the speed of it,” he said, adding that turnaround times for testing and contact tracing are “not good enough”.

He also said that that it was difficult to get officials to carry out contact tracing, but this was later disputed by Codd.

She explained that the contact tracing system has been in operation all along, albeit at a scaled back level because it was not required.

“All along there has been an escalation plan,” she told Drivetime on RTÉ Radio One.

“There are now five centres that are fully operational across the country. So while it needed to be scaled back up, to say that it was caught off guard is not quite accurate.”

Codd added that the UCD contact tracing centre was called into action on Friday 7 August, and was “fully operational” 36 hours later.

Health Minister Stephen Donnelly noted the HSE did around 42,000 to 52,000 tests last week and now had the capacity to carry out ‘serial’ testing in meat processing plants, Direct Provision centres and nursing homes.

He acknowledged there were some “outliers” whose time from referral to the completion of contact tracing was not adequate.

“It is absolutely fair to say, we saw a very quick spike over the period of 48 hours,” he explained.

“The testing tracing teams have to go from 20 positive tests today to about 150 positive tests a day, and there was a lag.”

But he said he was happy that the health service was identifying gaps in the system, adding that the Department of Health and HSE were attempting to stop such a lag happening again.

For its part, the HSE has said it will continue to add capacity to the contact tracing capacity to meet ongoing demand, so hopefully the wait will ease off in coming days and weeks.

So can I still get a test?

To be clear: the lag in the median turnaround time doesn’t mean the system is under massive strain. It’s more that things aren’t quite where the government wants them to be.

Donnelly also said yesterday that he stood over a demand made while in opposition that the time from referral to testing should be below three days.

None of this means you can’t get a test. If you think you need one, you should contact your GP and self-isolate.

This week, the government tightened restrictions at what it said was a “critical moment” for the country in its battle with Covid-19.

Professor Philip Nolan, chair of the NPHET Irish Epidemiological Modelling Advisory Group and current president of Maynooth University, talked us through the reasoning behind these restrictions and what the government means.

Check it out here:

Source: The Explainer/SoundCloud

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