HIQA publishes advice to NPHET on Covid-19 testing and restrictions

HIQA has today published the advice it submitted to the National Public Health Expert Team (NPHET) to support its response to COVID-19. The publication of this advice is accompanied by supporting evidence synthesis reports.

Current recommendations in Ireland are that close contacts of a COVID-19 case should be tested for COVID-19 and restrict their movements for 14 days. NPHET asked HIQA to undertake an evidence synthesis to identify if the current evidence supports this duration remaining at 14 days.

HIQA examined the available evidence on the incubation period (the time from exposure to symptom onset) of COVID-19. The review of the incubation period concluded that in the absence of testing, a 14-day period of restriction of movements is likely to capture 95 per cent of individuals who will become symptomatic.

Dr Máirín Ryan, HIQA’s Director of Health Technology Assessment and Deputy Chief Executive, said: “Without changes to the current testing strategy, we advised NPHET that the 14-day period of restriction of movements should remain. It is essential that people who are exposed or potentially exposed to COVID-19 restrict their movements to minimise community transmission as it has been shown that people with no symptoms can spread the infection.”

NPHET also asked HIQA to explore the potential impact of testing to reduce the period of restricted movements for close contacts of a COVID-19 case from 14 days. Based upon a modelling exercise, HIQA’s advice concluded that any testing strategy to reduce the period of restricted movements from 14 days presents an increased risk of transmission. An increased risk in transmission may not be acceptable when considering current levels of community transmission in Ireland.

Dr Ryan said: “If, at a later stage in the response, changes are made to the current testing strategy for those restricting movements, these changes need to come with a clear communication strategy. It is important that people understand the reasons for the two tests and the implications of receiving a ‘not detected’ first test result, as many people at this early stage may still be in the incubation phase of the disease. Irrespective of any changes, it is vital that people continue to adhere to all COVID-19 public health guidance.” The documents published today are available at https://www.hiqa.ie/reports-and-publications/health-technology-assessments?tid_1=All&field_hta_topics_target_id=112