Serial testing for Covid-19 in nursing homes is to be phased out as vaccination has “virtually eliminated” deaths from the disease in the facilities and has significantly reduced infections.
Health Service Executive chief clinical officer Colm Henry informed operators of the decision in a letter yesterday. Serial testing will also be phased out in long-term residential facilities that meet certain criteria, excluding acute mental health centres.
Nursing homes have been one of the settings hardest-hit by Covid-19 infection and mortality during the pandemic, with more than 1,500 related deaths.
However, as vaccination numbers rise, groups representing the sector said the “time is right” to move away from the serial testing of staff, which has formed the core of the programme.
State chief medical officer Tony Holohan on Friday said deaths had been “virtually eliminated” in nursing homes.
Ahead of a significant easing of restrictions from Monday, he said the incidence of the disease was broadly static and the numbers requiring Covid-19 treatment in hospitals continued to fall. Four deaths and 434 new cases were reported yesterday.
Nursing Homes Ireland chief executive Tadhg Daly said ending serial testing was a “prudent move” but he warned that the situation must be monitored closely. The HSE letter outlined that there would be a phased approach to easing out serial testing in care facilities, following advice from local public health teams.
It will occur where 80 per cent of residents and staff are fully vaccinated, where no cases were detected in the last serial-testing round, and there is no open outbreak in the facility in the last 28 days.
With the HSE exploring ways to encourage younger people to get tested, the move should free up capacity in the wider system.
The move comes against a backdrop of optimism in Government about the pandemic, with the National Public Health Emergency Team not meeting this week for one of the first times since the pandemic began.
But senior public health sources cautioned there was some way to go until there was full vaccine protection across the population, and that any further unlocking of society was dependent on the rollout.
Dr Holohan expressed scepticism about rapid antigen testing, arguing that consumers should not buy kits in supermarkets due to the “real risk” of false results providing reassurance to people planning to mix. Senior medical sources echoed this view, saying there is limited enthusiasm for the tests across many healthcare settings.
Advice has been sought from the National Immunisation Advisory Committee on the use of AstraZeneca and Janssen vaccines in people under 50, said Dr Holohan. While existing advice permits such use in some circumstances, the Government is hopeful wider use in younger cohorts would avoid the wastage of tens of thousands of vaccines. The advice is expected in the coming days.
The Government, meanwhile, is understood to be wary of plans to waive patents on Covid-19 vaccines. Sources argued such a move could take time and that other approaches may get vaccines to developing countries quicker.
Relaxing patent rules
The Biden administration in the US has backed plans to relax patent rules, although some European countries have been more guarded. The issue was to be discussed at an EU leaders’ dinner in Porto last night.
Plans for a certificate system that would allow vaccinated people to travel in the bloc during the pandemic were also due to be discussed. It would also permit more travel into Schengen-zone countries from outside the EU. Ireland is to monitor the latter development and assess whether alignment is possible, said sources.
On the waiver issue, the Department of Enterprise said the US statement was “significant”, but that negotiations would take some time as the issues are complex.
A spokesman said Ireland would engage with the EU, which is responsible for international trade, on its position for upcoming discussions on the issue. It said there may be “existing flexibilities” within trade agreements governing intellectual property which can address issues raised by those advocating a waiver.
“The EU position is that manufacturing capacity, access to raw materials and distribution networks are the main obstacles that need to be overcome in the supply of vaccines,” said the spokesman. Use of voluntary licensing arrangements may be used to increase manufacturing capacity “by disseminating the technology and know-how of those who developed the vaccines”, he added.