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Chief Medical Officer Dr Tony Holohan is to give advice to government around rule changes for close contacts.
covid rules

Govt advised to scrap confirmatory PCR tests for those with positive antigens

Changes in Covid isolation rules to be discussed by Cabinet tomorrow.

LAST UPDATE | 11 Jan 2022

HEALTH MINISTER STEPHEN Donnelly has said people who test positive on an antigen test won’t need a confirmatory PCR test under changes to be considered by Cabinet tomorrow. 

Public health advice to government this evening has also recommended that the isolation period for close contacts that have no symptoms and have received their booster jab should be scrapped. 

Donnelly said he also received advice from the Chief Medical Officer Dr Tony Holohan that all isolation periods for those with symptoms and are testing positive will be brought to seven days across the board.

Impact on HSE

Speaking on RTÉ’s Prime Time, HSE Chief Operating Officer, Anne O’Connor said that changing rules on self-isolation would help reduce the number of healthcare staff who are out due to self-isolation.

O’Connor said that it is estimated that there are over 17,000 healthcare workers out due to Covid-19, whether that is due to a positive test or self-isolation as a close contact.

She said that that number could drop by over half if the new rules are accepted by Cabinet.

“We would envisage that would drop the number by more than half,” said O’Connor.

“We would estimate that at least half of that number are people who are at home, isolating by virtue of being close contacts who are asymptomatic.

“We would see a very significant impact.”

O’Connor added that the number of HSE staff who are absent is spread across the entire healthcare system, and not just within the hospital system.

In particular, O’Connor highlighted residential services and day services as some healthcare operations that have faced significant staffing issues due to Covid-19.

“We know that there are day services that haven’t been able to reopen since Christmas, purely because of staffing,” said O’Connor.

PCR changes

Speaking to Newstalk’s Hard Shoulder, the health minister said the recommendation that confirmatory a PCR test would be removed for those testing positive on antigen is “very positive”.

“It makes it easier for people, they don’t have to go and get a second test, and it frees up some of the pressure on the PCR system as well because obviously we want people to be able to get those PCR tests as quickly as possible. So that’s the first main major change,” he said. 

People will be able to log their positive antigen test on a new online system which will be  integrated into the contact tracing system, said the minister. 

HSE Chief Executive, Paul Reid, said that the new system would be finalised this week.

This “may well lead to an apparent increase in the reported numbers”, he said, when asked if we can expect to see a big surge in the case numbers that are notified daily as antigen and PCR tests will now be the combined daily figures. 

“We really want to try and ease the burden on people,” he said, adding that the government is “very aware of how difficult” it is for people and their employers to deal with close contacts that have to isolate despite not having any symptoms.

He also said that the current system for receiving antigen tests for free from the HSE would be expanded to provide more tests on a weekly basis.

“We’re currently sending out about 350,000 of these a week and we’re looking to increase it to about half a million a week, and they are all currently provided for free,” said the health minister, speaking on RTÉ’s Six One.

Donnelly said that he would be recommending to Cabinet that higher grade masks, including disposable surgical masks and FFP2 masks, be worn by those who are labelled as close contacts.

However, Donnelly said that the government would not be moving to either make the more expensive FFP2 masks free or subsidised.

If approved by Cabinet, he said the requirement for close contacts to isolate would go completely, but that people will still be told to take regular antigen testing for several days.

The new measures, if approved, will come into force very soon, he added. 

“We will be moving on this quickly,” he said.

Sinn Féin’s health spokesperson David Cullinane said if government proceeds with scrapping PCR confirmatory tests for those that test positive on antigen they should make them freely available.

“The cost of antigen testing is considerable for many families,” he said.

Earlier today, Tánaiste Leo Varadkar said that lifting hospitality restrictions will be done on a phased basis.

Current restrictions on pubs and restaurants, which include an 8pm closing time, are due to be in place until at least 30 January.

Speaking on both RTE News and Newstalk this afternoon, Varadkar said the government will be in a position to ease restrictions in February, but warned that the Omicron wave is “still unfolding”.

“I certainly wouldn’t do it in one fell swoop,” said Varadkar. The Tánaiste said government will only move to reduce restrictions when it is confident that the country is over the hump of infections.

While he said they are seeing a record numbers of cases, that’s not translating into hospital ICU admissions and deaths in the way it did in previous waves.

“That is very reassuring. But it’s not yet time to drop our guard. This is still unfolding. It probably hasn’t peaked,” he said, adding that government expects the wave to peak through the course of January.

Varadkar explained that there are around 90 people in ICU at the moment with the virus, while the number was 130 a few weeks ago. 

Doctors on the ground are telling government that about 25% or 30% of those in hospital are “incidental” whereby it could be somebody who has gone into hospital with a burst appendix but who also has Covid in the nose. 

However, Varadkar said he would still like to see the hospital numbers falling ” before we’re in a position to ease restrictions”.

Less than two weeks ago the CMO said in a statement:

“In the last 24 hours, 148 people with COVID-19 were either admitted to hospital or received a “detected” test result while in hospital. Hospitalisations at this level are not sustainable and are having a significant impact on our health service.

“It is important to note that these admission figures are increasingly likely to be driven by the surge in Omicron infection which now accounts for over 90% of PCR confirmed cases in Ireland. Over 90% of people in hospital and intensive care with COVID-19 are there for the management of COVID-19; less than 5% of those in hospital or intensive care have ‘incidental’ (asymptomatic, non-infectious) disease.”

When asked about discrepancy between NPHET’s figures and the evidence doctors on the ground are reporting to government, the health minister confirmed there is an issue with the data.

“It’s something that’s been looked into. The HSE are going a big piece of work on this at the moment and they’re looking at exactly this.

“So you have people who… they’re not being treated for Covid, they have no symptoms of Covid, but they have tested positive – they show up in the figures of a thousand plus that we are currently reporting.

“There’s another group who maybe being treated for Covid, but it’s not the primary reason they’re in and the Covid isn’t particularly dangerous for them. We want to know who they are as well.

“And then there’s the there’s the final group who really are quite ill with Covid, they’re being actively treated for Covid, and some of them you know could end up in a much worse situation, and could end up in critical care. There has been a discrepancy… in some of the data that NPHET has looked at and really there is a piece of work between the Department of Health and the HSE,” said Donnelly.

There is “ground for optimism”, said Varadkar, who added that the evidence is now clear that the Omicron variant is less severe and does not translate into mortality in the same way as previous waves.

Speaking about the months ahead, he said there should be a “summer of freedom” this year. 

Ireland must keep up the pace with our European counterparts in terms of reopening in the summer months, he said.

“Certainly view is that when it comes to using the restrictions across the spring and summer, we shouldn’t be outliers. We should keep pace with the reopening that we see across Europe and I wouldn’t like this to be the third summer in which Ireland has strict rules,” he said. 

Varadkar said he will be “pushing for a rapid reopening over spring and summer, but only if it is safe to do so”.

On the issue of scrapping isolation periods for close contacts with no symptoms, he said:

“There does come a point sometimes with public health advice, you have to get the balance right and sometimes, advice and regulations can do more harm than good. That’s why I think that they should be eased. But we’re very much relying on the CMO to make sure that we do it in a way that is safe and doesn’t cause the virus to spread more rapidly. 

“What I’d anticipate is they’ll probably make some recommendations around people who are fully vaccinated and boosted and that’ll be in line with what the ECDC has recommended at the weekend.”

Additional reporting by Tadgh McNally

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