Covid: 1,154 more cases as Hiqa advises caution on antigen tests

No change to mask rules for schools as Hiqa says it is ‘premature’ to consider removing requirements

Antigen tests are cheaper and faster than the standard PCR tests for detecting Covid-19, but Irish public health officials have repeatedly questioned their accuracy and utility in the pandemic. Photograph: Laura Hutton/The Irish Times

Antigen tests are cheaper and faster than the standard PCR tests for detecting Covid-19, but Irish public health officials have repeatedly questioned their accuracy and utility in the pandemic. Photograph: Laura Hutton/The Irish Times

 

Antigen testing for Covid-19 should not be used to replace existing ways of mitigating the spread of the virus, the State’s health watchdog has advised.

There is “uncertainty” about the effectiveness of rapid antigen tests in screening people without symptoms, and their widespread use has significant resource implications, according to the Health Information and Quality Authority (Hiqa).

Hiqa, in its latest published advice to Government, has also recommended the current minimum age for mask-wearing in the community - currently, 12 years in schools - should be not be reduced.

The advice came as a further 1,154 confirmed cases of Covid-19 were reported in the State.

As of 8am on Monday, 297 Covid-19 patients were hospitalised, of which 63 were in ICU, the Department of Health said.

The five-day moving average is 1,327.

Antigen tests are cheaper and faster than the standard PCR tests for detecting Covid-19, but Irish public health officials have repeatedly questioned their accuracy and utility in the pandemic. Hiqa’s latest advice echoes the reservations of the National Public Health Emergency Team about their use outside limited circumstances.

“Based on the current evidence, there is uncertainty regarding the effectiveness of rapid antigen testing for screening of asymptomatic individuals with the aim of limiting transmission of SARS-CoV-2,” the advice states.

“There are also significant resource, implementation, regulatory, ethical and social considerations associated with the widespread use of rapid antigen detection tests in asymptomatic populations.”

Hiqa says the tests may have a role in limiting transmission in certain circumstances, but only as an additional public health measure, rather than a replacement for known mitigation measures.

“A negative antigen test in an asymptomatic person should not be viewed as a ‘green light’ to engage in activities that would be otherwise considered as high risk for transmission,” according to Hiqa chief scientist, Conor Teljeur.

“Also, the introduction of routine and widespread rapid antigen testing in asymptomatic populations would require a significant investment. Any decision to use them for screening in asymptomatic populations should consider a variety of factors, including the prevalence of Covid- 19, the proportion of the population who have adequate immunity and the vulnerability of the population involved.”

Masks

In relation to masks, Dr Teljeur said national and international evidence suggests when existing mitigation measures - such as physical distancing, hand hygiene, increased ventilation and not attending with symptoms - are fully implemented, schools become “low risk environments”.

“As there are currently high rates of infection in the community, we encourage parents and children to continue to observe public health guidance before, during and after school activities. We also recommend that anyone who has the opportunity to avail of the Covid-19 vaccine does so.”

Five countries - England, Denmark, Norway, Sweden and Switzerland - have either completely or mostly removed masking requirements for all students, with Northern Ireland set to follow suit shortly.

Though it was outside the scope of this advice, members of the Covid-19 expert advisory group which discussed the latest Hiqa findings agreed it was “premature” to consider revising the current requirement for second-level students to wear masks.

And although the group did consider the potential use of masks by fifth and sixth class pupils, the consensus was for no change to existing rules.

In Northern Ireland, there were a further five deaths of patients who had tested positive for Covid-19, while 1,020 more cases of the virus were reported. There were 379 Covid-19 patients in hospital in Northern Ireland, with 33 in intensive care.