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To: Minister Simon Harris & The HSE

Corona Virus Response Ireland - Roll out more testing now

Refine the testing protocol for Covid-19 to include those with only mild symptoms and no known contacts with confirmed cases.

Why is this important?

The Covid-19 epidemic has affected 100 countries worldwide, and has already killed several thousand people, and the WHO have stated the threat of a pandemic is very real. It is an unprecedented public health and economic event in the era of global travel and data sharing. Ireland is in a position of having the benefit of other countries' hindsight. We are in the early stages of an outbreak at under 100 cases (which is widely recognised as the tipping point between containment and mitigation). How we act now determines whether this outbreak spreads exponentially immediately and overwhelms our already problematic health service, or whether we manage to slow the rate of infection and spread out the impact on our health service over time, avoiding bottlenecks in patient care and resources that will prove more fatal than the illness itself, and avoiding widespread panic that can be more contagious than the virus. The WHO posits a possible doubling rate of 4 days, making it two weeks until the outbreak is too widespread to contain.

It is stating the obvious to say that we cannot stop this infection from spreading. However we can slow it down and buy important time to make preparations, and eventually to develop a vaccination or sufficient herd immunity to protect the vulnerable (or in a more optimistic scenario to get to the end of the Flu season when it might abate).

Comparing the outbreaks in different countries and rates of spread, together with their testing and containment measures, it is clear that countries like China, Singapore and South Korea that have managed to reduce infection rates through strong action on movement and aggressive testing protocol. It is widely recognised that in countries where containment failed, testing protocol was inadequate.

It is now an acknowledged feature of Covid-19 that there are a large number of symptomless/mild symptom cases (estimated by the WHO to be up to 80%). This allows for subterranean community spreading under the radar in young healthy populations, which only becomes apparent when a spike in severe symptoms and pneumonia cases among the vulnerable appear.

In Singapore broad testing criteria using a combination of PCR and antibody testing have enabled much more effective tracking of routes of infection and breaking of infection patterns.

The HSE’s current testing criteria are when a person has symptoms of a fever, cough, shortness of breath/breathing difficulties AND the person has been to “an affected area” OR has been in contact with a confirmed case.
https://www2.hse.ie/conditions/coronavirus/coronavirus.html
This is dangerously narrow now that we have at least six cases of community transmission in Ireland not linked to travel or confirmed cases
Reasonable restrictions on large gatherings such as those implemented in France (over 1000 people), together with broadening of testing protocol to a much greater degree than being operated currently would go a long way to get a better picture of low symptom or asymptomatic cases. Testing should be made widely available, even to people with only mild symptoms. Also antibody testing should be carried out to reverse engineer routes of infection. Testing protocol should be expanded to include anyone with a fever OR with respiratory symptoms without a requirement for known contacts or travel to affected areas.
This is more in line with the strategy recommended by the WHO in their WHO-China Joint Mission on Covid-19 on pg.19 where they emphasise the urgent need for non-pharmaceutical measures in the early stages of an outbreak of the virus:
“Fundamental to these measures is extremely proactive surveillance to immediately detect cases, very rapid diagnosis and immediate case isolation, rigorous tracking and quarantine of close contacts, and an exceptionally high degree of population understanding and acceptance of these measures.”
https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
We call on the Minister for Health Simon Harris to act now to minimise the immediate lethality of this outbreak and thereby mitigating also its economic impact in the long term in Ireland.

Ireland

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Updates

2020-03-11 09:34:07 +0000

50 signatures reached

2020-03-11 00:31:07 +0000

25 signatures reached

2020-03-10 14:05:10 +0000

10 signatures reached