Antigen testing for Covid-19 should not be used to replace existing means of mitigating the spread of the virus, the state health watchdog advised.
There is “uncertainty” about the effectiveness of rapid antigen tests in screening people without symptoms, and their widespread use has significant resource implications, according to the Health Information and Quality Authority (Hiqa).
Hiqa, in its latest notice to the government, also recommended that the current minimum age for wearing a mask in the community – currently 12 in schools – not be reduced.
The notice came as 1,154 more confirmed cases of Covid-19 were reported in the state.
At 8 a.m. on Monday, 297 Covid-19 patients were hospitalized, including 63 in intensive care, said the Ministry of Health.
The five-day moving average is 1,327.
Antigen tests are cheaper and faster than standard PCR tests to detect Covid-19, but Irish public health officials have repeatedly questioned their accuracy and usefulness in the pandemic. Hiqa’s latest advice echoes the National Public Health Emergency Team’s reservations about their use outside of limited circumstances.
“Based on the current evidence, there is uncertainty as to the effectiveness of rapid antigenic tests for screening asymptomatic people with the aim of limiting the transmission of SARS-CoV-2,” said the opinion.
“There are also important resource, implementation, regulatory, ethical and societal considerations associated with the widespread use of rapid antigen detection assays in asymptomatic populations.”
Hiqa says testing may play a role in limiting transmission in certain circumstances, but only as an additional public health measure, rather than as a replacement for known mitigation measures.
“A negative antigen test in an asymptomatic person should not be considered a ‘green light’ to engage in activities that would otherwise be considered a high risk of transmission,” according to Hiqa chief scientist Conor Teljeur.
“In addition, the introduction of routine and widespread rapid antigen testing in asymptomatic populations would require a significant investment. Any decision to use them for screening in asymptomatic populations should take into account various factors, including the prevalence of Covid-19, the proportion of the population that has adequate immunity, and the vulnerability of the population involved. “
Regarding masks, Dr Teljeur said national and international evidence suggests that when existing mitigation measures – such as physical distancing, hand hygiene, increased ventilation and the absence of symptoms – are fully implemented, schools become “low risk environments”.
“As there are currently high infection rates in the community, we encourage parents and children to continue to follow public health advice before, during and after school activities. We also recommend that anyone with the possibility of benefiting from the Covid-19 vaccine to do so. “
Five countries – England, Denmark, Norway, Sweden and Switzerland – have either completely or largely removed masking requirements for all students, with Northern Ireland expected to follow suit shortly.
While it was outside the scope of this opinion, members of the Covid-19 expert advisory group who discussed Hiqa’s latest findings agreed that it was “premature” to consider revising the current requirement for second level students to wear masks.
And while the group considered the potential use of masks by fifth and sixth graders, the consensus was that no changes be made to the existing rules.
In Northern Ireland, there were five more deaths of patients who had tested positive for Covid-19, while 1,020 more cases of the virus were reported. There were 379 Covid-19 patients hospitalized in Northern Ireland, including 33 in intensive care.