Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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282. To ask the Minister for Health the estimated full-year cost of conducting 200,000 Covid-19 tests per week through the existing network of State-owned and operated medical laboratories. [27805/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Resilience and Recovery 2020-2021 Plan for Living with COVID-19 recently launched by Government, commits the HSE to introducing a more accessible and sustainable testing service that will meet the demands coming into the Autumn/Winter months.

The HSE has recently been developing the future service model for testing and contact tracing. This model will aim to deliver a patient-centred, accessible, consistent, responsive and flexible service, with sufficient capacity to take us through the winter months and beyond. This plan includes recruitment of a permanent dedicated workforce for for Covid-19 Testing and contact tracing which has already commenced, and a range of other service improvements to be rolled out quickly.  For example, the HSE is currently recruiting over 700 people to take swabs and over 500 contact tracing staff all around the country.

This future model is currently being finalised by the HSE and will be submitted to the Department, together with costings, in the near future.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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283. To ask the Minister for Health if he has costed a move towards a Covid-19 saliva sample testing system; if so, the estimated full-year cost of conducting 35,000 tests per day via the system; and if he will make a statement on the matter. [27806/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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The current standard of care in Ireland for the detection of SARS-CoV-2 (the virus that causes COVID-19) involves testing of clinician-collected combined nasopharyngeal-oropharyngeal specimens with reverse transcription polymerase chain reaction (RT-PCR).

RT-PCR is considered the 'gold standard' in diagnostics for the detection of SARS-CoV-2 ribonucleic acid (RNA) in the acute phase of infection.

As the current plan is to continue to test by PCR, any spend on alternative tests to PCR is likely to be in addition to, rather than instead of, PCR. Therefore, to date, cost estimates in respect of saliva sample testing have not been created.  

The collection of nasopharyngeal swabs by healthcare workers involves an invasive technique that is uncomfortable for the patient, which is of particular concern for paediatric populations. A relative degree of skill is required by the provider, and due to risk of transmission, the procedure necessitates substantial personal protective equipment. Other issues include the potential for a shortage of swabs during large scale testing initiatives. Alternative specimens from the upper respiratory tract, such as saliva or nasal, may offer a means to mitigate these limitations.

In light of this, an Evidence Review to inform this consideration was published by the Health Information and Quality Authority (HIQA) on 21st August 2020.  HIQA is currently in the process of updating this review in light of the ongoing developments in the field. 

This issue continues to be under active consideration by the NPHET.