Dr. Tony Holohan:

There is an emerging sense and much work being done not just in this country but at a European level. We expect the ECDC will be giving guidance on that. The emphasis in that guidance is likely to be on transitioning from a response very much focused on transmission as well as reducing the severe impacts of the disease to one focused on managing and limiting the severe impacts of the disease based on all the experience but especially the experience of Omicron. Much of the emphasis on that is going to be on, as the Deputy said, what is the right kind of surveillance, what role do things like contact tracing play, who should be tested as part of the surveillance system and then obviously the maintenance of testing for the purpose of clinical decision-making. We still need to test people for clinical purposes to inform clinical decision-making. We are doing some specific work on that as part of the work of NPHET at the moment. We expect to be in a position to give further advice on those matters to Government in the coming weeks through the usual mechanisms and informed by some of the work happening at an international level. Just as his question is suggesting, I think the Deputy will see a move in that general direction. We do not anticipate we are going to continue to be advising the need to test every individual irrespective of severity of symptoms and irrespective of, let us say, how vulnerable he or she might be individually to the disease itself.

On the question of vaccination, the Deputy is anticipating that may arise because these considerations are happening in every country. I wrote to NIAC more than two weeks ago to ask the committee to start to consider what the future of vaccination will be, given we have got to where we have got to in terms of both primary vaccinations and boosters with this programme. What is the continuing need for vaccination? What will be, based on the primary objective of protecting people from severe infections, the need for vaccination on an ongoing basis? Certainly one of the possibilities - and I am not anticipating what advice NIAC will give yet - is we could end up in a less frequent vaccination situation whereby the topping-up, as it were, of one's vaccination is for the purpose of preventing severe infection. It may well be that recommendation is not focused on the whole population but people with particular vulnerabilities.