The head of the National Public Health Emergency Team (Nphet) has conceded that it would be a “good idea” to run a pilot programme of rapid antigen testing for people boarding international flights.
Tony Holohan, the chief medical officer, told the Oireachtas Transport Committee under persistent questioning on the subject that “so far as those tests can” efficiently track cases of Covid then “of course, it’s a good idea”.
Dr Holohan had earlier “urged caution” regarding the use of such testing in any situations other than where Covid-19 is highly prevalent.
“There is still much we need to learn about these tests and their actual - as opposed to hypothetical - benefits and limitations,” he said.
While such tests give a result far more quickly than the dominant PCR test used by the HSE, the overall results are believed to be much less reliable, particularly in the delivery of false negatives.
Regarding the Ferguson report into rapid testing, which was produced in March and suggested that such testing should be used as a complement to the slower, though more rigorous, PCR test, Dr Holohan said that he would have “no opposition whatsoever” to the use of antigen testing, but only once evidence as to its efficacy has been produced.
“I am not aware of any evidence, any data, any independent studies showing the efficacy of antigen testing in asymptomatic people,” he said.
He agreed that “of course it is plausible” that, under the current travel regime, a passenger could post a negative PCR test pre-flight only to board the plane while both positive and infectious.
Chair of the committee Kieran O’Donnell said that if Dr Holohan is agreeable to an antigen pilot programme for flights, then "it’s a step forward”.
Dr Holohan and his deputy CMO Dr Ronan Glynn denied that Nphet is “resistant” to using antigen testing as a means of reopening travel.
“These tests haven’t been done internationally. There are a whole range of concerns. It’s not just that we have no evidence in Ireland, there’s no evidence internationally,” Dr Glynn said.
“Many other countries are using antigen testing,” Mr O’Donnell said.
“We are not. Your caution has served us well, but we need a pilot scheme to give that level of validation that you are looking for."
Dr Holohan stressed that a way out of Ireland’s current travel lockdown, other than rapid testing, already exists - the vaccination programme.
“If we can keep transmission where it is at the moment, and up the vaccination programme as we want to, we’ll see extensive resumption of international travel in late summer, without the need for any testing whatsoever,” he said.
In his opening statement, the CMO said that antigen testing may be “considered” in high risk work environments such as meat processing plants, adding that “substantial work has been conducted to evaluate” rapid antigen testing in asymptomatic workers.
Rapid antigen testing should only be considered in “red light” scenarios, he said, that is controlled containment situations where the virus has already been locked down.
“Significant caution is urged in regard to any move towards employing rapid antigen testing for ‘green light’ or ‘enabling’ testing activities, particularly while not accounting for the prevailing epidemiological situation,” he said.