Oireachtas Joint and Select Committees

Thursday, 11 June 2020

Special Committee on Covid-19 Response

World Health Organization: Public Health Advice

Dr. David Nabarro:

Those are tough ones. I checked with Dr. Michael Ryan, an Irishman who is the head of the WHO health emergencies programme, this morning because I knew I would be asked to express an absolute position on 2 m versus 1 m. Dr. Ryan reminded me that these are fundamentally statements of risk. First, the context of how much virus is around must be taken into context. Second, the location of the person needs to be considered. Is it closed or open? We believe this virus is much more easily transmitted in closed locations. Third, it is really important to recognise there is certainly still a risk of getting Covid if somebody is 1 m away from someone coughing in front of them, but that risk is 70% less than if the two people are really close. At 2 m the risk is down to about 85% less or even 90% less. Each time 1 m is added the risk is reduced.

In the end choices need to be made. How much risk of continued Covid infection is one prepared to tolerate? That is a position taken by the national government and it will be taken on the basis of multiple factors. We all know that maintaining the 2 m has economic and social costs. I am not prepared to say it is absolutely 1 m or 2 m, but I am prepared to say that there is a considerable reduction risk with 1 m and a much greater reduction risk with 2 m.

The Deputy asked if someone who has had Covid is immune from getting it again. We do not know. I wish I could answer the question "Yes" or "No". I have family members who have had Covid. I wish I could tell them they do not need to take precautions because they will not be infected again, but I am afraid we just do not know yet.

The Deputy asked about hydroxychloroquine. The clinical trials are under way. I think the Deputy will know that the WHO trial on hydroxychloroquine was stopped for a period after a publication in The Lancetand another one in The Union Journal of Medicine, stating that hydroxychloroquine increased the risk. Then after a review of these two papers, it was decided the trial should go ahead. We do not have the answer on the efficacy of hydroxychloroquine either in prevention or in treatment of Covid.

The Deputy asked if home testing kits will be available. There is absolutely no doubt that in the coming weeks and months, there will be far greater availability of serology tests that tell whether people have antibodies against this virus and that will enable people to know whether they have had the disease. It will not tell them whether they are immune. We anticipate much wider availability. We do not know what the cost will be. So far only a small number of the kit manufacturers have had their kit tested to ensure they are reliable. I do not think we are anywhere near having home testing for the virus, which would be the most useful one to have. If there was one thing I would love to appear as if a miracle, it would be a reliable home testing kit for virus that could just be done by taking a swab, putting it on some kind of stick and looking at the result.

That is not anywhere near production yet, as far as I know.

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