Brian Leddin (Limerick City, Green Party) | Oireachtas source

I have four questions for the Minister on behalf of the Green Party, about testing, tracing, isolation and funding for our community and voluntary sector. We all agree that being innovative and effective in each of these areas is key to our continued success in suppressing Covid-19.

There has been a lot of discussion, including in this House, about testing capacity, volume and turnaround time. I would like to discuss how we can increase our testing capacity and reduce our wait times by considering alternative testing technologies. I note that for all our testing to date, we have used the highly sensitive and specific RT-PCR technique. This is very accurate but it is laboratory-based and, as we have seen, it takes time, especially when sent to Germany for processing. In order to reopen workplaces and be able to handle possible subsequent surges of Covid, we need more and more rapid testing options. Ideally, these could be processed in doctors' offices or in front-line clinical facilities rather than in laboratories. Amazon has announced that it intends to build testing facilities for its employees and I am sure that other employers will follow suit.

At NPHET's request, HIQA completed an excellent report, published on 17 April, on the rapid assessment of alternative diagnostic technologies for the detection of SARS-CoV-2. This report considered, but for now rejected, so-called rapid antigen tests for Covid-19 until their efficacy is more widely proven. On 8 May, the US Food and Drug Administration, FDA, approved just such a rapid antigen test, which gives a result in ten minutes via a non-laboratory based test. This will enable the US to double its testing capacity within the next month. It has been described by leading US health experts as a game changer. In Ireland, this kind of testing could be used directly in settings such as nursing homes and potentially also larger workplaces, offering a real-time view of likely or probable infection, and saving valuable time for vulnerable people. We understand that these alternative forms of testing have less accuracy than RT-PCR. In the case of rapid antigen testing, it is approximately 85% accurate but gives very few false positives. However, the need for more and more rapid testing is so great that we need to re-evaluate constantly the risk calculus around different forms of testing.

In light of the FDA's recent approval of this approach, will the Minister ask NPHET and HIQA to look again at the possibility of endorsing rapid antigen testing?

My second question relates to tracing. In recent days, as our focus has turned to reopening, we have seen renewed scrutiny of our end-to-end times for testing and tracing and we clearly continue to be challenged in this regard. We continue to look forward to seeing and to discussing the Covid tracker app's data protection impact assessment, DPIA, technical specifications and source code and we would welcome any updates in that regard. I note that the publication last week by the National Health Service in the UK of the DPIA for its app has facilitated a healthy debate in the UK about the trade-offs between privacy and public health. I would like to focus today not on the app, but on the contact tracing back office and whether and how we can use technology there to complement the Covid tracker app. Once an individual has tested positive, he or she is engaged by our contact tracing operatives to find out who else he or she might have infected. According to recent reports by the HSE and in the media, this process can be slow, especially in complex cases. Several European jurisdictions, including to my specific knowledge, the Czech Republic, have rolled out computer systems designed to help automate and accelerate that process. These systems use, with an individual's consent, more detailed location and banking data to help jog a person's memory of his or her movements and develop a more complete picture of the possible infective contacts. Early experience in the Czech Republic is that this approach has greatly helped with the speed and quality of contact tracing and they are ready and willing to share their system with other countries. Is any purpose-built technology currently being used by our contact tracing teams and, if not, will the Minister ask the appropriate part of the HSE to investigate such technology?

My third question relates to isolation. We saw reports last week that up to one third of arriving passengers at Dublin Airport were refusing to provide contact information, as requested on the arrival form. We understand that further regulations will be introduced to make this information compulsory. The other side of this topic is the question of whether arrivals are actually self-isolating. Will the Minister tell us how many checks have been carried out to verify that arrivals are self-isolating, what form the checks take and what level of compliance was seen in the checks? We do understand that expecting gardaí physically to visit every person who arrives during a putative two-week quarantine is impractical. Given that we have increasing test bandwidth available, and noting that just 113 people arrived at Dublin Airport this Monday, should we not mandatorily test all arrivals at our airports? Any positive results could then be handled and contact traced in the normal manner. If we used rapid antigen testing, results could be received before visitors are allowed to leave the airport. Will the Minister recommend mandatory testing of arriving passengers at all Irish airports?

On Friday last, the Government announced a €35 million Covid-19 stability scheme for the wider community and voluntary sector. However, at the same time, it is pushing ahead with a 1% cut in the HSE's 2020 disability services budget, which announced a €20 million cut. This is at a time when public funding for disability organisations has largely dried up due to the inability to fundraise during Covid-19 and at a time when the funding recommendations of the Government's own report, the Catherine Day report, are largely not implemented. Is there a plan to reinstate funding for the community and voluntary sector at the appropriate level?

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