Covid-19 antigen testing under review for use in wider community 

The use of antigen testing is under review again, with a report expected from the National Public Health Emergency Team (Nphet) within two weeks following extensive field testing by the HSE.

A new Nphet sub-group, chaired by Professor Mark Ferguson, will report to Health Minister Stephen Donnelly on the potential role of antigen testing in the community, an issue which has divided scientists.

However, in a blow to hopes that these tests could see an earlier reopening of the hospitality sector, tests validated so far by the HSE show between 50% and 60% accuracy in asymptomatic people.

In Nphet’s submission to the Government’s Living with Covid plan, they indicate antigen tests “have the potential to play an important complementary role in our overall response”. 

Benefits include "easy sampling and self-administration, increased accuracy, and low cost such that in the future more testing may be performed in companies, communities, and by individuals.” 

But they call for “community-based rapid test research studies” first.

The HSE now has access to various tests through a European Commission deal, and have administered over 7,500 tests in a validation project.

A spokeswoman said they are used in hospitals, the food sector, and for outbreaks, including in workplaces where HSE paramedics use them in parallel with PCR tests.

This is in line with the commission’s guidance for use in areas with high positivity, supported by a second antigen test or a PCR test and given by healthcare workers.

Speaking at a Nphet briefing, Dr Ronan Glynn said: “What they [HSE] found as part of that validation is that many of the manufacturers' claims for some of the tests simply don’t stand up.” 

There are about 2,500 antigen tests.

Testers take a nasal or throat swab, which is placed in a liquid and onto a testing strip to analyse for proteins made by Covid-19 for quick results without being sent to a laboratory.

Truck drivers are the “guinea pigs” for testing in asymptomatic groups, said Eugene Drennan, president of the Irish Road Haulage Association.

Centres were set up in Cork, Wexford, and Dublin offering free weekly tests when France changed entry requirements for essential travel.

Mr Drennan said up to 6,000 tests were done in the last five weeks, each taking about 20 minutes.

“It has worked very well, there is great reassurance in it for drivers and their families. The positivity rate is 0.17%, in five weeks we’ve had five positives,” he said today.

Infection rates would be low, he said, as drivers closely follow guidelines over fear of getting sick while abroad.

But wider use could be a long way off, as the HSE is wary of false-negative results.

Speaking to RTÉ, HSE national lead for contact tracing, Niamh O'Beirne said: “It’s absolutely not the panacea, the accuracy is only 50% if you don’t have any symptoms.” 

The tests have scientific support in Ireland and globally.

A new review by international academics, including former University College Cork lecturer Professor Louise Kenny, published in medical journal The Lancet states: “In the midst of a raging plague, it is inequitable and unethical not to deploy high-quality rapid tests alongside existing public health interventions.” 

Prof Kenny, executive pro-vice chancellor, health and life sciences at the University of Liverpool, has worked on evaluation of Liverpool’s antigen project with over half a million people.

The review warns: “Fixating on the relative number of cases missed by rapid antigen versus molecular testing is unproductive ... universal access to frequent rapid tests would be a substantial improvement over infrequent tests or no tests.”

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