Antigen testing has part to play in pilot events, say experts

Thursday’s Iveagh Gardens concert experiment in Dublin could pave the way to larger outdoor festivals but health experts have re-emphasised the need to add antigen testing to the mix.

Whether any transmission occurred at the event will not be known for some time but there is a belief that a more detailed understanding of human behaviour, a key aspect of how viruses spread, is possible to ascertain from such gatherings.

The National Concert Hall hosted concert, in which singers James Vincent McMorrow and Sorcha Richardson performed to 500 people was billed as "the first of many pilot events to take place outdoors this summer".

A number of “control measures” were in place including staggered access times, socially distanced queuing systems, hygiene stations, enhanced cleaning regimes and socially distanced “standing pods” for attendees. However, many in the health field believe such events offer more nuanced opportunities.

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Beaumont Hospital infectious diseases specialist Dr Eoghan de Barra, believes that there would be significant benefits derived from antigen testing concert-goers as they arrive. He suggests technology could also be employed to study human interaction and behaviour in finer detail.

The rapid testing approach has proven divisive in the medical and scientific communities. Some feel it offers a valuable additional tool; others that it threatens to instil misplaced confidence given the relative unreliability of results compared to PCR lab tests.

Dr de Barra believes behavioural analysis could be used to see how people’s interaction changes, or not, as a result of such testing, possibly through movement technology of the kind used in rugby matches.

“That’s what science should be about. There should be experimentation in all available medical opportunities, not excluding something,” he said of the antigen debate.

“Maybe they are not the answer but like anything else in science you have to ask the question and do it in an experimental way.”

Kingston Mills, Professor of Experimental Immunology at Trinity College Dublin (TCD), also believes Thursday's concert, as well as Leinster's Friday night rugby fixture, are perfect opportunities to add antigen testing to other safety regimes.

“This is one of the first mass gatherings, small mass gatherings, and the suggestion that we made was that pilot studies be done in various settings to assess the benefits,” he said, referring to the Ferguson Report, produced by an expert group including Prof Mills, which examined the use of rapid testing.

Among a long list of recommendations for targeted pilots, it suggested the tests be used among participants and spectators, notably at sporting events “to enable a more widespread safe return”.

Sam McConkey, a professor of infectious diseases at the Royal College of Surgeons in Ireland, said that while he understood both sides of the antigen debate, he believed Thursday's concert was a good omen for what might be possible later this summer.

Notably, he said, large concerts and festivals of the Slane Castle or Marlay Park variety could be aspired to, if on a greatly reduced capacity level.

“I think it’s the first step in rebuilding confidence in doing these large scale events that we love and enjoy, yet it’s not just opening up everything in a free-for-all,” he said.

“But I think it will take one or two [weeks], about ten days until we see whether any instances of Sars-2 transmission [occurred] at the event.”

Crucially, Prof McConkey said, sector specific working groups could be established to examine how to safely re-establish events at various levels, from small pubs to large outdoor concerts.

“I think that’s what we should try to aim for…what about a Marlay Park in September that’s only one third full, or 10,000 people in venues that take 50,000?”