Ms Niamh O'Beirne:

I thank the Chairman and the members of the committee for the invitation to attend the meeting to discuss testing and tracing. Joining me today are Dr. Kevin Kelleher, assistant national director of public health, and Mr. Damien McCallion, national director of emergency management.

Since the onset of the Covid-19 pandemic, the HSE has worked tirelessly to build a robust testing and tracing infrastructure. It is important to acknowledge the extent of what has been achieved. To date, we have established a system that has enabled us to complete more than 1.54 million tests, identify 58,000 detected cases and complete more than one quarter of a million contact tracing calls. Last week, we processed more than 115,000 tests, exceeding the capacity set out by 15%.

We all know that caution is required when making international comparisons, but as for how our testing numbers compare against those of our European neighbours, as reported by the European Centre for Disease Prevention and Control, ECDC, we are ranked second among countries with a population of more than 2 million of the 28 European countries that the ECDC reports on. We are outranked only by Denmark. In addition, many countries do not test close contacts as a routine, such as the UK, the Netherlands and most recently Belgium, while some countries such as Germany, specifically in the Berlin region, Switzerland and the Netherlands have requested people to trace their own close contacts.

We remain agile in our approach when responding to the Covid-19 pandemic and have driven continual improvement within our systems and processes. We have focused on turnaround times and, during the current peak in the pandemic, we have been achieving 95% of swabbing appointments on the same day or the next day, and more than 95% of results in less than 48 hours from the swabbing appointment, two thirds of which occur within 36 hours. These metrics compare very well against those of our European colleagues. Italy, France, Spain, the Netherlands and Denmark all work with 48 hours or less as a target from swabbing to result. We are meeting all testing demand and are still working within our testing capacity.

Since the beginning of this pandemic, we have built up capacity at our testing centres and acute hospitals. These services are stood up by healthcare professionals, community swabbers, the National Ambulance Service and Defence Forces personnel. To ensure we have the required staff, we have engaged in a recruitment campaign for swabbers, contact tracers and public health doctors. We continually assess the needs in the community and identify areas where improved access to local testing is needed. In recent weeks, this has included a large-scale testing centre in Croke Park, a testing centre in Galway city and an additional pop-up centre in Cork city. Capacity at our laboratories has also been increased, so that today we can process more than 120,000 tests per week, with our logistics team working to forecast demand accurately each week.

We have set up and are continuing to deliver numerous serial testing programmes. This has included more than 291,000 tests for staff in residential care facilities, food production facilities and both residents and staff of direct provision centres.

These programmes have been set up in response to these settings being noted as at higher risk and their residents among the most vulnerable in our society. We are one of the few countries to conduct and maintain serial testing throughout peak testing demand.

As well as caring for these high-risk groups, we have an enhanced pathway for schoolgoing children and staff in school settings, ensuring that once we are aware of a detected case associated with a school setting, it is managed by our public health departments and turned around in the most optimal time, recognising the high importance of keeping schools open. There is a constant need to balance the demands between individuals feeling unwell in the community, outbreaks in congregated settings and testing in higher risk settings through serial testing programmes.

We have worked and will continue to work to ensure that our testing and contact tracing system is robust and performant. However, the increase in demand and the number of detected cases in our community in October has challenged our systems, particularly our contact tracing service. The rapid rise in the number of cases in early October exceeded the capacity of our contact tracing system as it was set up. For context, six weeks ago we were making 8,500 calls a week but this increased last week to 38,000 and we struggled with this capacity.

In response to this, and in a continuing effort to maintain effective turnaround times for contact tracing for the population at large, we asked a limited number of people, 1,971, who received a positive result from 16 October to 18 October to notify their own close contacts and organise tests through their GPs. This decision was taken to ensure that every person received information as quickly as possible, allowing them to be aware of their status and to take actions to care for themselves and to protect others from infection. While clearly this was not ideal and we appreciate the impact on those affected, it was deemed the only viable option in order to deal with the most recent cases quickly and reset our system. We apologise to the 1,971 people impacted and this week we will call everybody we missed to check that they have been able to identify their contacts and advise them to be tested. Since Friday, 23 October, our contact tracing system has been back on track and achieving its metric of all close contacts being contacted within 24 hours of the notification of the positive case.

In order to ensure we will be able to address future demand, the HSE is continuing to recruit additional contact tracers. More than 800 people have gone through our interview process, 274 new staff have been taken on board and a further 90 will join by the end of this week. We will continue to bring in an additional 60 to 70 every week. We plan to recruit 800 and then see if we need more.

As this pandemic develops, we continue to respond as effectively as possible while designing and implementing a long-term, sustainable test and trace operating model. The Covid-19 disease does not follow any plan. It is unpredictable and continues to challenge us all individually and equally challenge our testing and tracing service. We continue to do our utmost in our response, ensuring sufficient testing capacity and optimal turnaround times, all in the interests of public health.