Community Covid testing and tracing times raise concerns

Median Covid-19 testing and tracing times for positive cases in the community are in excess of three days, new figures show.

The figures, which relate to those outside the acute hospital system who have contracted the virus, have raised concerns among experts, who say they cast doubt on the State’s ability to stamp out clusters of infection.

Data released by the Health Service Executive (HSE) show that the median end-to-end turnaround time for community cases where Covid is detected is 3.5 days. This has come down from 3.9 days in the last seven days.

Experts recommend that the entire process should take no more than three days, and ideally closer to two days.

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The end-to-end figure relates to the time taken from a GP referral for testing to the completion of contact tracing and the referral of a person’s close contacts for testing.

The figure for community testing does not include fast-track hospital tests, which are often processed in on-site laboratories, and therefore have a significantly faster turnaround time. For example, in a hospital setting, the median time taken from swabbing for a sample is 16 hours, and the time to complete all contact tracing is one day.

‘Complex pathway’

A HSE spokeswoman said community testing is “a much more complex testing pathway than a testing pathway in an acute setting”. After a positive test, three calls take place – to inform a person of their status, to gather their contacts and then to call close contacts.

Contact tracing is, the HSE said, “an incredibly complex process”. It said the contact tracing process is fraught with challenges, including people not picking up their phones, which means a team is in place to source numbers and addresses. “Clearly, these can extend turnaround times.”

“Furthermore, as the country has continued to open up, individuals are increasing the numbers of those who they are in social contact with, meaning the close contacts are increasing,” the HSE said. At present there are five close contacts on average per person.

However, experts said they were concerned by the turnaround times for community testing, and the risk that slower turnaround times would impact on the HSE’s capacity to limit outbreaks.

“It’s the community outbreaks we’ve been struggling with; unless we get rapid results and rapid tracing we won’t be able to prevent the ongoing explosion,” said Prof Sam McConkey, head of the department of international health and tropical medicine at the Royal College of Surgeons.

Chain of transmission

Dr Tomás Ryan of the school of biochemistry and immunology at Trinity College Dublin, who has been a staunch critic of the State’s testing system, said there is a greater need to trace those in the community quickly as they may not be aware of their status.

“The reason we are interested in the end-to-end process is because we want to identify and isolate people who are presymptomatic or asymptomatic and spreading the virus,” he said.

Testing and tracing is seen as a key tool to break chains of virus transmission and facilitate some return of normal social and economic activities. The State has invested tens of millions to create a contact tracing system from scratch since the pandemic hit Ireland, and turnaround times have come down significantly since spring.

However, concerns remain over the capacity of the system. On Thursday, HSE chief executive Paul Reid said the impact of schools reopening had created a “significant challenge on the daily lab testing because we are reaching capacity”.

A spokeswoman for the HSE said there had been a “significant increase in close contact work due to schools reopening”.

Labour Party leader and health spokesman Alan Kelly said testing efficiency is “absolutely critical”. “We need to ensure that we resource the HSE to be able to bring down the times, as the quicker we can identify and isolate those infected in community settings, the quicker we will get on top of this.”

He also called for a common reporting standard on testing to be created “that everyone follows across the board”.