Dr. Siobhán Kennelly:

The Deputy is correct. As we are well aware, the knowledge around asymptomatic transmission was not there. It was around 25 March that the European Centre for Disease Prevention and Control, ECDC, first highlighted the possibility of asymptomatic transmission. It was well into April before that was actually confirmed as a real route of transmission. Most of our guidance at the time was not based on knowledge or understanding of that particular aspect. As it became more understood, the focus on testing was re-emphasised.

However, our guidance did change, particularly around mid-March and emphasised the need for the isolation of patients for a 14-day period after they transferred out. The key around what came through in the ministerial expert report is that we do not know in terms of the people who did transfer out with Covid at which point in time in their hospital journey they had Covid. We do not know whether it was pre-existing coming into hospital or picked up subsequently in a nursing home because our systems do not allow for information to be communicated in that way.

It was clear to us in the context of testing and the nursing home outbreaks. This is why 14-day isolation is mandated. It is a difficult issue for many residents when they are being transferred because it is quite an onerous piece. It is important to emphasise that we do not over-rely on testing as part of the transfer function for these patients.