Con­fu­sion over test­ing as 40,000 pa­tients in limbo

Coro­n­avirus: Rules tight­ened as two more die, 235 new cases de­clared and 39 in ICU

Irish Independent - - Front Page - Eilish O’Re­gan and Hugh O’Con­nell

SOME 40,000 pa­tients who were sus­pected of hav­ing the coro­n­avirus by their GP in the past week have been plunged into con­fu­sion af­ter learn­ing they will no longer be el­i­gi­ble for a test.

How­ever, they must still be­have as if they have the virus and self-iso­late at home for 14 days – and other mem­bers of their house­hold will have to re­strict their move­ments. GPs were only in­formed yes­ter­day morn­ing that the health ser­vice was aban­don­ing the pre­vi­ous “test, test, test” strat­egy.

The dra­matic tight­en­ing of the rules around test­ing will mean from now, GPs will only re­fer a pa­tient for a swab test if they have a fever and also a res­pi­ra­tory symp­tom, such as a cough or short­ness of breath. They will also have to fall into spe­cific groups, in­clud­ing those with un­der­ly­ing illnesses and health work­ers.

The new ap­proach by health bosses, which fol­lows on from WHO ad­vice adapted to the Ir­ish sit­u­a­tion, comes as two more peo­ple died from the virus yes­ter­day – a man with no known un­der­ly­ing ill­ness, and a woman. Both were from the east of the country.

An­other 235 peo­ple tested pos­i­tive yes­ter­day, bring­ing the num­ber of cases here so far to 1,564.

Some 49pc of cases are thought to be com­mu­nity trans­mit­ted.

Around 40,000 were in a back­log to be screened for the in­fec­tion but it is be­lieved most of these have been dropped from test­ing cen­tres.

There are now 39 pa­tients with the virus in in­ten­sive care – up from 17 last week.

Chief Med­i­cal Of­fi­cer Dr Tony Holo­han yes­ter­day de­fended the de­ci­sion to nar­row the cri­te­ria for test­ing and fo­cus on pri­or­ity groups.

He said the sys­tem could not cope with the 20,000 peo­ple seek­ing tests daily and just 6pc of them were test­ing pos­i­tive with many turn­ing out to have the win­ter flu in­stead.

“Our data showed yes­ter­day that only 6pc of our tests so far re­turned pos­i­tive; so for ev­ery 100 peo­ple we test we are only find­ing six peo­ple with Covid19. In light of this, our case def­i­ni­tion changed.

“Chang­ing case def­i­ni­tion is a stan­dard prac­tice in manag­ing pan­demics.

“Ul­ti­mately, we want our 6pc de­tected rate to in­crease, we want to find as many peo­ple as pos­si­ble with Covid-19, iso­late them and con­tain the spread.”

Dublin GP Dr Maitiu O Tuathail said fam­ily doc­tors are telling pa­tients they re­ferred for a test who had not re­ceived an ap­point­ment to pro­vide a swab that they will not now be tested.

“They need to self-iso­late at home away from other fam­ily mem­bers for 14 days,” he said.

House­hold con­tacts of those with symp­toms must now also fol­low re­stricted move­ments for 14 days.

Pa­tients who have re­ceived an ap­point­ment for a swab test can pro­ceed and they will re­ceive a test.

He said it is a stark turn­around from the pre­vi­ous ap­peal to peo­ple who had po­ten­tial symp­toms of the virus to con­tact their GP.

He wel­comed that pri­or­ity groups will be tested and will re­ceive a test re­sult ear­lier. How­ever he said it will mean that there is less of a pic­ture of the ex­tent of the in­fec­tion in the com­mu­nity.

Pa­tients who have not re­ceived an ap­point­ment, but may qual­ify for a test un­der the new cri­te­ria, must con­tact their GP again to be as­sessed and if they are el­i­gi­ble they will be sent for­ward.

The HSE has set up over 40 test­ing cen­tres across the country but pa­tients have en­dured de­lays of 10 days as stocks of some kits ran low.

Dr Holo­han said he still hoped it will be pos­si­ble to carry out 15,000 tests a day by the end of next month.

The Ir­ish Col­lege of Gen­eral Prac­ti­tion­ers (ICGP) said yes­ter­day that all pa­tients re­ferred for test­ing prior to and in­clud­ing last Tues­day who have not been tested or do not have an ap­point­ment will not now re­ceive one.

“Pa­tients who have been given an ap­point­ment for test­ing should at­tend for same. If you have been tested and had a swab taken you will re­ceive the re­sult ei­ther by text or phone call from a pub­lic health doc­tor,” said a spokes­woman.

“If you have not re­ceived an ap­point­ment for test­ing and you feel you meet the new cri­te­ria you need to ring your GP to dis­cuss if you need a new re­fer­ral for test­ing. GPs ac­knowl­edge the new ar­range­ments may cause some con­fu­sion with the pub­lic and would ask for their pa­tience.”

Mean­while, Taoiseach Leo Varad­kar said the fore­cast he made that there would be 15,000 cases of the coro­n­avirus here at the end of the month will not ma­te­ri­alise. How­ever, he said there are cases of the virus in the com­mu­nity which have not been de­tected.

St James’s Hos­pi­tal in Dublin had to make an ap­peal for pro­tec­tive cloth­ing and equip­ment for staff yes­ter­day and emer­gency sup­plies had to be trans­ferred from an­other hos­pi­tal.

Health Min­is­ter Si­mon Har­ris said: “Al­most 13 years’ worth of per­sonal pro­tec­tive equip­ment will ar­rive in Ire­land by the end of the week.”

The de­liv­ery is ex­pected from China on Sun­day.

“Usually we spend €15m a year on per­sonal pro­tec­tive equip­ment – we will spend €225 this year,” he told Vir­gin Me­dia News.

PHOTO: STEVE HUMPHREYS

Brav­ing the out­doors: Pauline Good­win, wear­ing a face mask, and her dog Pixie But­tons pause for a mo­ment in the sun­shine at the Royal Hos­pi­tal Kil­main­ham in Dublin.

Res­o­lute: Dr Tony Holo­han de­fended the de­ci­sion over test­ing

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