Covid-19: Self isolation and testing rules to change as 19,290 new cases reported

Up to 500,000 people likely to have been infected last week, says Dr Tony Holohan

The 14-day incidence last week hit its highest level in the pandemic, at 4,450 cases per 100,000 people, but Tony Holohan’s estimate is even higher at it takes account of testing constraints and undetected infections. Photograph: T Narayan/Bloomberg

The 14-day incidence last week hit its highest level in the pandemic, at 4,450 cases per 100,000 people, but Tony Holohan’s estimate is even higher at it takes account of testing constraints and undetected infections. Photograph: T Narayan/Bloomberg

 

Up to 500,000 Irish people were likely to have been infected with Covid-19 last week, according to a January 6th letter from chief medical officer Dr Tony Holohan to Minister for Health Stephen Donnelly.

The likely prevalence of active infection was 5.7-9.6 per cent, equivalent to between one in 10 and one in 20 of the population, Dr Holohan told Mr Donnelly in the same letter.

Its contents emerged as 19,290 new cases of the virus were confirmed on Tuesday. As of 8am Tuesday morning, there were 1,062 patients in the country’s hospitals with 92 of those in ICU.

In spite of the continued high case numbers Mr Donnelly has said that people who have received a positive Covid-19 antigen test result will no longer need to receive a confirmatory PCR test.

Up until now a positive antigen result required people to get a PCR test to confirm the positive result, but the change will free up space in the testing system.

Mr Donnelly later clarified that the change only applied to those aged up to 39 who are not health care workers. Beyond that, for people who are symptomatic, the advice was to still get a PCR test, he told RTE Six One News.

Mr Donnelly also confirmed he plans to brings plans to Cabinet that will remove the five day isolation period for close contacts of confirmed cases, if the individual has been given their Covid-19 booster.

Mr Donnelly told Newstalk FM that he received the recommendations on Tuesday afternoon in a new letter dated January 11th from Dr Holohan.

Close contacts who have not received a booster and have been in contact with a confirmed Covid-19 case, will now have to isolate for seven days.

For those who have actually tested positive themselves, the isolation period will now be reduced from 10 days to seven for everyone. Previously it was seven days for people who had a booster, and ten for people who did not.

In addition, any person who has not received a booster shot, but who has had Covid-19 in the last three months will not have to restrict their movements for five days if they are a close contact of a confirmed case.

‘Major impact’

This is set to have a major impact as a huge number of people will now not need to restrict their movements if they are deemed to be close contacts in the coming weeks.

“The recommendation is that the confirmatory PCR test would be removed. I think that’s very positive. It makes it easier for people, they don’t have to go and get a second test, and it frees up some of the pressure on the PCR system as well because obviously we want people to be able to get those PCR tests as quickly as possible. So that’s the first main major change,” Mr Donnelly said.

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“The second one which I think will be welcomed as well is the isolation period: so if you get your test and you test positive, currently, for those who are boosted the recommendation is they isolate for seven days and unboosted for 10 days. The recommendation is that it just becomes seven days for everybody.”

On the removal the five day restriction of movement for close contacts, he said: “I think this is the one that will affect most people. If you have boosted immunity, currently, you’re asked to restrict your movements for five days. That requirement would go completely, so no restricted movement if you have boosted immunity. Now, the recommendation is still obviously that there is regular antigen testing for several days. During that period people would also wear the higher grade masks.

“And also if you don’t have boosted immunity, the time that you’re going to restrict your movements was 10 days. The recommendation is that would move down to seven days and obviously you still do the regular tests and where the higher grade masks.

Anne O’Connor, chief operations officer of the HSE, said the new rule changes could more than halve the 17,000 employees currently out of work due to Covid infection or being close contacts.

“We would envisage that really close contacts who are asymptomatic - and that’s the really important thing, we are not talking about people who are Covid positive coming to work - but people who have no symptoms who are close contacts, so it would make a huge difference to us,” she told RTE’s Prime Time programme on Tuesday.

However, Anthony Staines, professor of health systems at Dublin City University (DCU), said it was too soon to relax the health restrictions.

“It could make the peak wider and that means more sick people, that means more hospitalisations. Unfortunately it means more deaths, it means more long Covid,” he said, also on Prime Time.

“We have been having conversations about safety in schools since last August. If you think about the speed at which this decision has been made compared to the speed at which no decision has been made about schools, I think that raises some questions the Government needs to answer.”

Highest incidence rate

The 14-day incidence rate for the virus last week hit its highest level in the pandemic, at 4,450 cases per 100,000 people, but Dr Holohan’s estimate is even higher at it takes account of testing constraints and undetected infections.

Covid-19 cases in hospital are growing at about 7 per cent per day, Dr Holohan says in the letter sent to Mr Donnelly on January 6th.

Incidence is high across all age groups and is higher than at any time in the pandemic in all but the oldest age groups, he says. Test positivity has also increased in those aged 65 years and older in recent weeks.

Relaying new guidance from the National Public Health Emergency Team (Nphet), Dr Holohan advises that all types of masks, including cloth masks, can significantly reduce transmission if they are properly constructed, well fitted and appropriately worn.

“Medical grade and respirator masks, if properly worn, offer greater protection than cloth masks; anyone who wishes to wear a medical grade or respirator mask instead of a cloth mask should do so, so long as whichever mask they choose is well-fitting and worn properly.”

People who are over 60 or are medically vulnerable, who are currently advised to wear a medical mask in confined spaces, “may prefer to wear a respirator mask,” Nphet now advises.

Officials also say “ideally” a respirator or medical-grade mask, and not a cloth mask, should be worn by anyone: with a confirmed diagnosis during their infectious period; with symptoms; who is a household contact of a confirmed case; or who is visiting a healthcare setting or visiting those who are vulnerable to Covid-19.

Dr Holohan says Nphet will prepare a report before its next meeting (next week) that will allow for a better understanding of the severity of Omicron, the impact of vaccination and boosters and other “important measures” of the impact of Covid-19 on the health system.

“While the current situation is dynamic and there are still a number of important uncertainties, we have the benefit of a year’s data on Covid-19 vaccines, and it is timely to reassess our strategic priorities for Covid-19 immunisation in the near and medium term.”

Test and trace capacity

According to the letter, the test and trace system is now operating at surge capacity and under “severe pressure”. However, the number of deaths and ICU admissions linked to Covid-19 remains stable.

Dr Holohan says the recent increase in incidence and hospitalisation has not “as yet” translated into increased critical care admissions or deaths. Potential contributory factors including the age profile of recent cases, the protection conferred by immunity from vaccines and infection and the “lower intrinsic virulence” of Omicron compared with previous variants.

The number of hospital-acquired infections continues to be of concern, according to Dr Holohan, with 36 recorded in the week to December 26th last.

There has been a significant increase in confirmed cases among hospital staff; 704 in the week to December 26th.

Some 80.5 per cent of reported antigen test results are currently confirmed through PCR testing.

In early January 96 per cent of new Covid-19 cases were due to the Omicron variant, according to the letter, and 718 cases of Omicron have been confirmed through whole genome sequencing.

So far this winter, 37 flu cases have been notified, while notifications of RSV dropped by 75 per cent at the end of 2021.

Dr Holohan says 49 per cent of those in hospital are fully vaccinated, as are 40 per cent of those in ICU.

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