Reliability of Covid antigen tests seen as key issue as reopening continues

Government’s chief science adviser backs use of rapid tests to complement other health measures

Ministers and the three party leaders favour rolling out the use of antigen tests to help with the reopening of many sectors of commercial and social life. Photograph: Getty

Ministers and the three party leaders favour rolling out the use of antigen tests to help with the reopening of many sectors of commercial and social life. Photograph: Getty

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Significant differences have emerged between Ministers and public health officials over the use of antigen testing during the reopening of business and social life.

Senior members of the National Public Health Emergency Team (Nphet), including chief medical officer Dr Tony Holohan and modelling chief Prof Philip Nolan, have advised caution on the use of antigen tests in recent days.

However, Ministers and the leaders of the three coalition parties are strongly in favour of rolling out the use of such tests to help with the reopening of many sectors of commercial and social life, including sports and cultural events and, in the autumn, colleges and universities.

Antigen tests are fast and can be self-administered, but have a higher rate of error than the PCR tests that are widely used by health authorities to test for the disease.

Dr Holohan and Prof Nolan have in recent days warned that these tests are not reliable enough to be taken as evidence that someone does not have Covid-19.

However, the tests were backed by a report compiled by a team of scientists and experts led by the Government’s chief science adviser, Prof Mark Ferguson, which said they could be used to complement other health measures and as a way of finding non-symptomatic cases.

Several Ministers are in favour of the use of the tests to facilitate reopening, and there is understood to be impatience in Government Buildings on the issue.

Total doses distributed to Ireland Total doses administered in Ireland
8,557,330 7,049,574

However, Dr Holohan again stressed his objections on Monday when he told RTÉ Radio the risk was that a negative test “might falsely reassure you.. For every two cases of the disease where an antigen test is done, it will miss it in one of these cases. We can’t have people behaving as if they don’t have the disease when they do.”

Dr Holohan said it was not a question of trust in the public; it was the fact that the test did not give “a reliable enough” result.

However, Minister for Health Stephen Donnelly in a statement issued to The Irish Times on Monday night strongly backed the use of the tests.

“I believe rapid testing has a role to play in our fight against Covid-19,” he said.

“The expert report recommends that different Government departments and agencies establish pilots or feasibility studies in their respective sectors. Several of my Cabinet colleagues are now actively producing plans for their own sectors.

“I am also establishing a rapid test knowledge group to ensure that information on validated tests and sampling can be readily accessed. There are divergent expert views on rapid testing, and it is important to deploy these tests in a way that maximises the potential benefits.”

Insiders

Tensions between Government and the public health officials have been evident to insiders for some time.

On Monday night a representative for small businesses accused public health officials of being “glib, flippant and scientifically ignorant” over their criticisms of rapid antigen tests to detect Covid-19.

The Department of Health should ascertain why some members of Nphet have an animus against antigen testing “in the face of overwhelming scientific evidence”, according to Isme, the Irish small and medium enterprise association.

The department should also consider how reliable Nphet advice is when it is “so demonstrably wrong” on the issue, according to chief executive Neil McDonnell in a letter to Mr Donnelly.

Citing the advice of international health bodies, Mr McDonnell said if Nphet “is privy to scientific advice at variance with the guidance from these agencies, it should publish it immediately”.