The HSE has warned about the limits of Covid-19 testing as a measure to control or measure transmission during the Omicron surge of infections, even with plans to increase testing capacity.

As new data indicated almost half of tests coming back as positive, the HSE’s lead of testing and tracing said there were plans to increase capacity to be able to distribute up to 300,000 antigen tests per week from next week, up from 100,000.

However, given the scale of infection, Damien McCallion said testing systems would “have limits”, with pressure on the system leading to longer waiting times.

Hospital Report

“Those are huge numbers and clearly every testing system is going to have limits, and if the disease is as widespread as it would appear it is at the moment, then the public health guidelines become more important than testing as a control measure,” he said.

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HSE chief clinical officer Dr Colm Henry said “as we approach this level of disease, the power of testing to identify all cases followed by the triggering of public health actions diminishes,” he said. “While testing remains important, its value as a control mechanism across the whole population is reduced and the focus shifts to individual actions people must take to reduce transmission.”

The level of positivity was described by one source as “keel-over territory” – officials believe many thousands of infections are going undiagnosed, as 6,735 new cases were confirmed on Monday. Testing appointments were unavailable in every county on Monday afternoon.

Flights cancelled

Separately, Aer Lingus cancelled some European flights as Covid curbs continued to disrupt travellers’ plans.

Outright bans on some travellers, and demands that passengers show negative test results to enter many countries, hit Christmas holiday plans this year.

Dr Henry said there were currently 1,126 beds free in the hospital system to deal with an anticipated post-Christmas influx of Covid.

While this would be in line with a non-Covid year, he said the health service was “awaiting with apprehension and trepidation the conversion rates [from cases of the Omicron variant to hospitalisations] in other countries and trends in our own”.

A senior Government source said they were encouraged by hospitalisation data from South Africa, Denmark, Norway and the US, while GPs here reported preliminary indications that those infected with Omicron were not falling as ill as in previous waves. Dr Denis McCauley, chairman of the GP committee of the Irish Medical Organisation (IMO) said “the evidence on the ground is we are not seeing an awful lot of very sick people, which is great, and long may it last,” he said.

Coalition sources believe there will not be a rerun of last year’s wave of deaths and pressure on hospitals. However, senior health sources indicated further public health restrictions remained in the balance as the scale of the wave of infection could cancel out any reduced severity associated with Omicron infection.

Further measures

There is concern among public health officials, but not surprise, at the path infection is taking. It is believed further interventions that may be considered could include limiting the number of households that can meet together indoors.

A clear pattern in the data is not expected for about a week, with uneven reporting patterns over the holiday period further distorted by delayed presentations and seasonal variations in hospital admission patterns.

Public health officials are monitoring outbreak numbers, hospital-associated infections and admissions among other early indicators in the testing system. Sources indicated that a rapid deterioration in one or more metrics this week could indicate serious difficulty.

Sinn Féin health spokesman David Cullinane said a prolonged absence of testing slots would be “problematic”, while his Labour Party counterpart Duncan Smith said it was clear capacity was “majorly stretched”.

“We need to look for more capacity to get us through January.”