Private testing fears voiced by NPHET advisory group

Concerns were expressed at an expert group on Covid-19 about the performance and governance of “substantial commercial and private testing” outside the HSE National Test and Trace Programme.

The expert advisory group (EAG), which provides advice to the national public health emergency team (NPHET), also expressed concern about the reporting of this testing, the potential adverse implications for contact tracing and “significant confusion for stakeholders”.

It was suggested at the meeting, held on 6 October 2020, that a multi-agency communication campaign was needed to “highlight to the public and other stakeholders the risks identified”.

A HSE spokesperson said it “does not have direct responsibility” for oversight of private testing laboratories.

“Notwithstanding this, the HSE published guidance for all private testing laboratories undertaking SARS-CoV-2 to ensure that all tests are reported and dealt with in an appropriate manner and in line with our infectious disease legislation. This requires the private laboratories to report positive Covid diagnostic tests to the HSE for the purpose of contact tracing.”

The HSE’s spokesperson said it has engaged in communications on this matter.

“This includes when we become aware of any specific issues with private laboratory reporting, we engage directly with the private testing laboratories directly to resolve any issues. In addition, we have communicated the HPSC guidance, and monitor the market for new providers to ensure they are aware of their obligations. “

According to the HSE, its website also offers factual and accessible public-facing information on private testing at https://www2.hse.ie/conditions/coronavirus/testing/private-testing-for-covid-19.html     

The spokesperson added that the HSE has put in a system seeking information on PCR testing activity to inform public health epidemiological information. The NPHET has determined PCR as the “standard test for diagnosing suspected cases of Covid-19”.

Meanwhile, the EAG meeting noted that a recommendation from the European Centre for Disease Prevention and Control, which advised ongoing serial testing of healthcare workers, presented “significant challenges in terms of current RT-PCR capacity, so this may be an important area to consider for use of RADT [rapid antigen detection test]”.

However, the lack of performance data in asymptomatic populations was referenced, emphasising the need for “validation studies to confirm utility in this setting”.

Covid-19 vaccination has since begun rolling-out to healthcare workers, but the effect of the vaccines on preventing infection and ongoing transmission remains unclear.

The HSE has indicated plans to use antigen tests in healthcare settings.