Time to bring in testing at all our ports
IN a letter to The Irish Times signed by a group of Irish researchers and published on June 8, more than 1,000 signatories said measures should be deployed to crush the virus on an all-island basis.
The objective is to suppress the new cases to zero as soon as possible. This has always been the objective. Vigorous testing, contact tracing and quarantine of positives – as well as social distancing and avoidance of big crowds until the daily community case load is zero – is the way forward. The letter is seriously deficient and non-prescriptive in the area of containment of further outbreaks.
All of our neighbours have large disease burdens, and Cheltenham and Anfield are totemic as sources of infection in March. The current daily incidence of new Covid19 infections is: 1,350 in the UK; 307 in Spain; 7,971 in Russia; 3,825 in South Africa; 331 in Italy; 770 in Germany; and 811 in France. This shows that unchecked international travel is inadvisable.
The recent experience in New Zealand where there had been no new cases in the past month and where the government declared that community transmission of Covid-19 had been eliminated serves as a timely warning to other island countries. Two women tested positive for Covid-19 after early release from quarof antine on compassionate grounds. Both had landed at Auckland airport on June 7 on a flight from Britain via Doha and Brisbane. Contact tracing and testing of all air crews, passengers, airport and hotel staff were carried out to ensure none was Covid19 positive. News Zealand will now allow people out of the two weeks’ mandatory quarantine if they test negative.
To keep the virus out of any island, the borders must be closed and all traffic must be fully tested for Covid-19. Each positive person must be immediately quarantined for 14 days and full contact tracing and testing must be carried out. How can this be done? Make PCR (polymerase chain reaction) testing at all sea and air ports of all crew and travellers, including truck drivers, mandatory.
The public assumption that PCR testing takes days is simply wrong. In Dublin’s Connolly Hospital, there are two GeneXpert PCR machines by Cepheid that turn around samples in one hour. I suggest all crew and passengers have a PCR gene test before entering the island of Ireland. This requires coordination and identical procedures at all entrances irrespective of the political geography in Ireland.
GeneXPert is a patented cartridge system which can be used in a module configuration up to 80. Its Express SARS-CoV-2 can give results in 30 minutes. It takes up about the same space as a desktop laser printer. A bank these or a similar system is the answer at ports and airports. The long check-in times at most airports allow appropriate testing in parallel with security checks. Sea ports can follow suit.
The urgency to address the problem is underlined by Ryanair, which has advertised 1,000 daily flights from July 1, with flights to Malaga, Lanzarote, Lisbon, Faro, Porto, Bergamo, Rome, Berlin and Amsterdam starting in the last week of June. Both jurisdictions must test all involved on returning to Ireland.
On Sunday, June 21, some 4,000 people passed through Dublin Airport. Any positive persons can be isolated in empty hotels. Finding hotels to do this should not currently be difficult. Passengers could be tested either before they leave a foreign port or immediately on landing anywhere in Ireland.
The use of coronavirus antibody tests as a proxy for immunity and thus avoidance of the PCR test is a judgement call at present. Whether infections with Covid-19 confer immunity to re-infection is not definitively known. What levels of antibody to the virus guarantee protection? Until the true rate of false positive IgG antibody tests is definitively known, a positive Abbott or Roche antibody test should not suffice but may be used as a least worst alternative.