Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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743. To ask the Minister for Health his plans for expanding testing into all healthcare settings including regularity with which healthcare workers will be tested and the way in which this will be rolled out to home help; and if he will make a statement on the matter. [9590/20]

Simon Harris (Wicklow, Fine Gael)
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A robust and real-time process of testing, isolation and contact tracing is central to our public health strategy for containing and slowing the spread of COVID-19, as advocated by the WHO and ECDC.

All healthcare workers meeting the current case definition for COVID-19 are referred for testing in line with current testing criteria. There is extensive guidance in place for healthcare workers and this can be found on the HPSC website:

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There is also clear guidance in place for the assessment, testing and return to work of healthcare workers.

In addition, current guidance requires the testing of all staff and residents when a new case emerges in a long term residential care facility (including mental health facilities) that have not yet had a case. 

As the deputy will be aware, a significant programme of testing across Long Term Residential Care Facilities commenced on 17 April following a NPHET recommendation. Over 100,000 tests have been completed under the residential care facilities mass testing programme. This includes the testing of all staff and residents in facilities that had an outbreak already, and the testing of staff in those facilities that didn't have an outbreak. This testing programme is now complete, and the results and findings will help inform and guide future testing strategy for these facilities. This is being given ongoing consideration by NPHET. 

It is important to note that testing is only one element of a comprehensive strategic response to COVID-19. Testing for COVID-19 only provides a point-in-time result. It confers no guarantee that the individual with a 'not detected' result is not incubating the infection or the level of virus is below detectable levels at the time of the test. 

Targeted, risk-based testing can yield important data to inform control measures, but does not constitute a control measure in and of itself. Testing should only be undertaken based on a public health risk assessment. A comprehensive response to the COVID-19 pandemic must include a strong focus on infection prevention and control and additional measures such as prompt identification and exclusion from work of symptomatic healthcare workers for example.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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744. To ask the Minister for Health the new criteria for Covid-19 testing; and if he will provide a report in relation to a number of areas related to testing (details supplied); and if he will make a statement on the matter. [9591/20]

Simon Harris (Wicklow, Fine Gael)
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A robust and real-time process of testing, isolation and contact tracing is central to our public health strategy for containing and slowing the spread of COVID-19, as advocated by WHO, EC and ECDC. Decisions on the criteria for testing are made by NPHET and are informed by international guidance including from the WHO and ECDC.

The criteria for testing is as follows: A patient with acute respiratory infection (sudden onset of at least one of the following: cough, fever, shortness of breath) AND with no other aetiology that fully explains the clinical presentation”.

On 28 May, NPHET agreed in principle to include in the case definition the sudden loss of smell (anosmia) and loss of taste (ageusia). This decision was subject to updated guidance from the ECDC and the ECDC published its updated case definition on 29 May. This can be found here:

In addition, all close contacts are now being tested twice (regardless of whether they have any symptoms) and contacted on a daily basis to monitor symptom development.

The criteria for testing in Long Term Care Facilities is broader than that above in recognition that the elderly may not display typical Covid-19 symptoms. Up to date criteria for testing can be found on the HPSC website.

Testing criteria is kept under review by NPHET as NPHET considers how best to target testing capacity. Our testing strategy will continue to evolve and will be based on public health risk assessments.

Turnaround times are improving rapidly thanks to process improvements and automation. Across community and hospital settings, overall end-to-end median turnaround times (meaning referral to contact tracing complete) last week for positive results was 2.3 days. The end-to-end turnaround time for negative test results is 2 days or less.

With regard to the number of contacts each positive case had, over the last 4 weeks (to 23 May) the median number of close contacts per case is 2. Typically contact tracing is completed on a same day or next day basis.

I am confident that the HSE is putting in place the measures to further reduce turnaround times and we are seeing continuing improvement. The HSE continues to streamline the process and to automate where possible. A range of process optimisation measures are being put in place, including automated swab appointments; offering the option to receive positive test results by text and enabling out of hours referrals. These are in addition to measures already in place including IT improvement, automation processes, and streamlined transportation logistics.