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Holohan 'still strongly recommends against' antigen tests for general public: Key points from the weekly NPHET briefing

A round-up of NPHET’s press briefing at the Department of Health this afternoon.

Chief Medical Officer Dr Tony Holohan
Chief Medical Officer Dr Tony Holohan
Image: Leah Farrell via RollingNews.ie

PUBLIC HEALTH OFFICIALS today announced a further 425 new cases of Covid-19 in Ireland, with four more deaths confirmed.

This now brings the total number of Covid-19 cases in Ireland to 254,870, with the death toll from Covid-19 at 4,941.

This afternoon’s briefing was led by Chief Medical Officer Dr Tony Holohan, who was joined by Deputy Chief Medical Officer Dr Ronan Glynn, chair of NPHET’s epidemiological modelling advisory group Professor Philip Nolan, Cillian de Gascun, medical virologist and director of the National Virus Reference Laboratory, and Dr Abigail Collins, HSE consultant in public health medicine. 

Here’s what was discussed: 

Antigen tests

  • NPHET continues to “strongly recommend” against the use of antigen testing among the general public. 

The tests that are used by health professionals in Ireland are PCR tests. But recently antigen tests – which are rapid Covid-19 tests – went on sale in Lidl.

Antigen tests (which are the same as the ‘lateral flow’ tests you might have read about in relation to the UK) give a result quicker than a PCR test, but the accuracy levels are exactly not the same.

“The use of antigen tests by the general public, applying those tests themselves … is still something that we strongly recommend against, and we’re still clear on that,” Dr Holohan said. 

“You cannot rely on a negative result. In effect, a negative result does not tell you anything,” he said. 

“We’re concerned that people will take these tests themselves, get a negative result and conclude, and it might be perhaps even reasonable for them to conclude but it’s wrong, that it’s ok for them to go into somebody else’s house to a gathering or to an event that maybe otherwise wouldn’t be safe,” Dr Holohan added. 

“That’s the exact kind of situation that we’re concerned about.” 

Meanwhile, Health Minister Stephen Donnelly said on Tuesday that a tweet sent by Professor Philip Nolan comparing antigen tests to snake oil was an unhelpful comment.

Responding to a tweet by supermarket chain Lidl, which was advertising the sale of its new antigen tests alongside barbecue goods such as sausages, Nolan said: 

“Can I get some snake oil with that? It makes for a great salad dressing with a pinch of salt and something acerbic. Stay safe when socialising outdoors over the next few weeks. Small numbers, distance, masks. These antigen tests will not keep you safe.”

When asked whether he regrets making the snake oil comment, Nolan responded: “[Antigen testing] has its place, it’s not recommended in terms of self administration of tests from wherever they might be purchased.”

Unlike PCR, antigen tests work more effectively if a person is symptomatic but are not as effective at identifying pre-symptomatic cases. 

An antigen test won’t confirm if a person without symptoms has Covid-19 as these tests rely on a high viral load to identify presence of Covid-19. 

According to the HSE, antigen tests are about 80% accurate if a person is symptomatic but only about 50%-60% accurate if a person has no symptoms and self-administers an antigen test.

If a person is symptomatic and receives a negative antigen test result the advice is that they should also get a PCR test, which can also detect early infection in a person. 

The Department of Health advice is clear on this – it does not currently advise the use of antigen tests by the general public, according to a spokesperson. 

Furthermore, if a person gets an antigen test from a private company and tests positive this will not be automatically reported to the HSE and, if it is indeed a “true positive” result, close contacts will not be informed and could spread Covid-19 to others, the spokesperson added. 

There is also a risk with antigen tests that a person could receive a false positive or a false negative which could have implications for the person and others around them, they said. 

The official advice remains that if a person develops symptoms they should self-isolate and contact their GP who will arrange a free PCR test. 

Travel

  • The greater the progress that can be made in terms of vaccinations, the greater the likelihood there will be to a return to foreign travel, Dr Holohan said. 

Last week, the EU’s executive branch proposed the easing of restrictions on travel to the 27-member bloc as vaccination campaigns gather speed.

Travel to the EU is currently extremely limited, except for a handful of countries with low infection rates. But with the summer season looming, the European Commission hopes the new recommendations will help dramatically expand that list.

EU officials believe vaccination campaigns will soon be “a game changer” in the fight against Covid-19, especially within the bloc and the border-free Schengen zone.

Speaking about the prospect of foreign travel going forward, Dr Holohan said that “the greater progress we can make in terms of getting vaccinations rolled out … the greater the likelihood there is going to be for us safely returning to those activities … including foreign travel”. 

“It’s going to become a reality for people who’ve been vaccinated,” Dr Holohan said. 

Calling on people to continue to sign up for vaccination, Dr Holohan said: “The more we can get our vaccination rates up, the greater our expectation can be around the early and safe return of some measures, including foreign travel.” 

Face coverings

  • Use of face coverings for fully vaccinated people is something that will be subject to review, Dr Holohan said. 

Yesterday, US President Joe Biden said that Americans vaccinated against Covid-19 no longer need to wear face coverings outdoors when there is no crowd. 

He was speaking shortly after the Centers for Disease Control, the top government health agency, notified fully vaccinated Americans that they can go mask-free most of the time outdoors.

“If you are fully vaccinated, you can start doing many things that you had stopped doing because of the pandemic,” the CDC said in a statement.

Masks are still considered necessary for vaccinated people if they are at concerts, parades or large sporting events, even when outdoors, the CDC said.

When asked whether NPHET will issue similar advice, Dr Holohan said: “So I’m not saying to you we’re actively considering that specific thing but the measures that have to be taken at a societal level, and at an individual level, are dependent on the risk profile of a disease.”

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The Chief Medical Officer added: “We’ll be looking at all of those things over the course of the next number of weeks.”

“Some of the measures that are in place around basic protections, and particularly things like face coverings and physical distancing … these kind of things are things that would be subject to review,” he said. 

Variants

  • Public health officials are not ruling out local restrictions to tackle the Indian variant of Covid-19. 

In the UK, the variant has been attributed to a fresh spike in cases, with a range of measures including local lockdowns and targeted vaccination under consideration to halt the spread.

It was confirmed at the briefing today that 41 cases of the Indian variant, B1617.2, have been detected in Ireland.

The briefing heard that he Indian variant is likely to be more transmissible than the UK variant.

Asked if outbreaks here could lead to localised restrictions, Dr Holohan said: “When we’ve had the need to, in the past, take specific measures against specific variants, we’ve done that.

“Some of the arrangements are in place in terms of travel are a perfect example of that.”

He added: “There has been a significant increase in community transmission in the UK.”

Chairman of Nphet’s Coronavirus Expert Advisory Group, Dr Cillian De Gascun explained that there are two strains of the Indian variant, B1617.1 and B1617.2.

There have been 20 confirmed cases of the B1617.1  strain and 41 cases of the B1617.2 strain.

He said: “B1617.2 is the one that we’re more concerned about at the moment, based on the experience in India and in the UK.

“Indeed, the fact that it has gotten to 41 in Ireland over the last couple of weeks would be a concern for us as well.”

He added: “I don’t think will be unreasonable to implement public health measures on a basis to allow us to seek more information, whether that’s enhance testing or enhanced contact tracing.”

However, he stressed that this is a hypothetical situation at the moment.


Source: The Explainer/SoundCloud

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