Dr. Colm Henry:

I thank the Chairman and members for the invitation. I am joined by my colleagues: Mr. Damien McCallion, HSE national director; Ms Niamh O'Beirne, national lead for testing and tracing; and Dr. Cillian De Gascun, consultant virologist in UCD and director of the National Virus Reference Laboratory.

As requested by the committee, we submitted a detailed document on testing and tracing for Covid-19. I will, therefore, use this opening statement to make some summary comments.

Since the onset of the Covid-19 pandemic, the HSE has worked tirelessly to build a robust testing and tracing infrastructure with the aim of monitoring and reducing the transmission rate of Covid-19 in order to protect public health. It is important to acknowledge the extent of what has been achieved as part of this response. To date, we have developed a testing system that has enabled us to complete over 400,000 tests. Our World in Data ranks Ireland sixth in the number of tests per head of population within the EU and the UK.

There have been many complexities to the infrastructure that have needed to be considered and overcome. Carrying out polymerase chain reaction, PCR, testing for Covid-19 has proved challenging at times. The process involves more than simply taking swabs; there are multiple layers to the process that impact the end result. In order to take swabs, we had to set up 48 test centres. The first of these opened on 16 March. Within ten days, more than 40 were open. We then had to consider how we would increase laboratory capacity to meet the expected demand. We then had to ensure we could increase our ability to contact-trace to a larger scale than had ever been performed in the country to date. We also built new IT systems to enable us to track and trace individual results through the process. To do all this, we had to redeploy staff from other areas of the HSE and other public sector bodies, set up centres to support our public health departments and build a system from scratch to enable the service to function. This had to be done while responding to the ongoing pandemic, something that has been described in the initial response as equivalent to building the aeroplane while flying it. It has been well publicised that we had issues with testing in the early stages, with delays in testing and the return of test results, much of this connected with global issues with the supply of test kits and reagents, our local lab capacity and a broad initial case definition. The case definition changed as knowledge of the virus and its characteristics increased. This required close work with the primary care community to respond to changes in case definition and referring for testing accordingly.

We have striven to overcome these challenges to build a more robust system capable of meeting demand today with flexibility into the future for any potential surges. Despite early issues, we have strengthened our capability to protect the nation's response to Covid-19. Since 18 May we have the capacity to deliver 100,000 tests per week across our end-to-end testing infrastructure, from referral through to contact tracing. We have reduced our turnaround times significantly, with swabbing appointments being mostly same day or next, laboratories completing testing in one day and contact tracing also completing in one day. In order to meet the need to trace contacts on a large scale, a contact management programme has been in operation since March. It operates a three-call process to efficiently contact-trace a confirmed case and also conducts acts of surveillance for 14 days from contact with a confirmed case. We are one of the few countries to offer automatic testing for contacts of confirmed cases. This has been in place since May. We are ensuring that we remain agile in our approach, driving continuous improvement and striving to be as proactive as possible in our response. Week on week we make changes that increase efficiency. We still face some challenges, however, including anticipating the ongoing number of tests which will be carried out per week.

Referrals from GPs have fallen recently in line with reduced disease prevalence, and positivity rates have fallen from a peak of 25% to 0.5%. As a result of demand, our available capacity has been lower in recent weeks. We must keep in mind, however, that as the country begins to open we may see a demand for increased capacity once again, and we need to be ready.

The current testing and tracing service was put in place in order to meet the immediate requirements of the Covid-19 crisis. The design of a new model that will operate for the next 18 or more months has commenced. This critical project will run over the summer months, with a target implementation date in late August. It will focus on building a fit-for-purpose and sustainable testing service that will deliver short turnaround times, maintain long-term capacity and effective contact tracing and be flexible for any future surges that may come.

I sincerely thank everyone who has played a part in developing the current testing and tracing operational model, which has enabled us to protect public health to date. We are most grateful for the support of the GP community, which has worked with us since the outset in a very collegiate, practical and productive way. Testing and tracing, along with other public measures such as social distancing and good hand hygiene, will play a big part in all our lives until a vaccine for Covid-19 has been developed and delivered. We will be happy to address any questions members may have.