THE STATE’S HEALTH watchdog has not recommended that antigen testing should be used on a more widespread basis as a replacement for current Covid-19 mitigation measures. 

In new advice to NPHET today, HIQA has said there is “uncertainty regarding the effectiveness of rapid antigen testing for screening of asymptomatic individuals” due to a “relatively low number of studies”.

HIQA also raised “ethical concerns” around their use, such as the implications for false negative and false positive test results, and said that rolling out antigen tests at scale would “incur a significant total cost”. 

“A negative antigen test in an asymptomatic person should not be viewed as a ‘green light’ to engage in activities that would be otherwise considered as high risk for transmission,” HIQA’s chief scientist Dr Conor Teljeur said today.

Also, the introduction of routine and widespread rapid antigen testing in asymptomatic populations would require a significant investment. Any decision to use rapid antigen detection tests  for screening in asymptomatic populations should consider a variety of factors including the prevalence of Covid-19, the proportion of the population who have adequate immunity and the vulnerability of the population involved.

Despite this, HIQA says that antigen tests may have a role “in certain circumstances” and that they should considered as additional public health measure rather than a replacement for known mitigation measures such as face masks, vaccination and physical distancing.

Face masks

On the question of face masks in schools, HIQA has also not recommended their use for even younger children.

Children under 13 are exempt from the requirement to wear a face covering on public transport and other public spaces like shops, unless they attend secondary school. 

It is therefore not recommended that children in primary school wear masks and, after examining the issue, HIQA has not recommended that this advice should change.

The report states: “The evidence for the additional benefits of face mask use in younger age groups is of low certainty and benefits are likely to be small in the context of an existing suite of mitigation measures.”

In a statement this morning, Dr Teljeur adds: 

The use of layered mitigation measures in schools and childcare facilities, such as physical distancing, hand hygiene, cough etiquette, increased ventilation, and, most importantly, not attending when you have symptoms of COVID-19, reduces the risk of transmission of SARS-CoV-2. National and international evidence suggests that when these mitigation measures are fully implemented, schools become low risk environments.

“As there are currently high rates of infection in the community, we encourage parents and children to continue to observe public health guidance before, during and after school activities. We also recommend that anyone who has the opportunity to avail of the COVID-19 vaccine does so.”