HEALTH SURVEILLANCE STAFF were urged to slow down the number of Covid-19 cases they were inputting into the HPSC’s data-reporting system after a computer glitch slowed the official reporting of cases after Christmas, newly released emails show.
Correspondence between HSE officials seen by TheJournal.ie shows how Ireland was experiencing record numbers of Covid-19 cases earlier than officially reported.
Health officials referenced the discrepancy in daily Covid-19 figures at the start of January, but correspondence released under the Freedom of Information Act reveals the extent to which it affected the reporting of those figures at the time.
The issue led to frustration from HSE CEO Paul Reid, who at one point told Chief Clinical Officer Dr Colm Henry that he was at his “wits’ end” over the problem “despite constant reassurances” given to him that it had been resolved.
Another email showed that by 4 January, 10,000 swabs which had returned a positive result in previous days had not been verified or reported in official figures.
Figures contained in these emails show that:
The numbers show the scale of the backlog caused by the computer glitch just after Christmas.
The issue arose after a surge in positive cases were reported after Christmas and into the new year, just as the country re-entered Level 5 restrictions.
The surge in cases prompted a malfunction in the HPSC’s Computerised Infectious Disease Reporting (CIDR) system and meant that staff were unable to input data about positive test results for days in late December and early January.
The CIDR is the primary source for Covid-19 case numbers in Ireland, and daily case numbers reported to the public by the National Public Health Emergency Team (NPHET) are extracted from the system.
The glitch, which was publicised at the time, prompted an under-reporting of official figures for a number of days when Ireland was experiencing unprecedented volumes of new Covid-19 cases.
The cases were gradually included in daily Covid-19 figures in subsequent days, and the issue was first reported by NPHET at a briefing on 31 December, when there was a cumulative backlog of over 9,000 suspected cases yet to be verified.
However, issues with the CIDR system were first reported in the east of the country on Christmas Day, with officials reporting that the system was slowing and kicking them out.
That afternoon, a surveillance official from the HSE emailed other officials to explain that the CIDR system was becoming backed up due to volumes of data.
“I have had to redirect the two PwC [Pricewaterhouse Coopers] staff to stop inputting the enhanced data and to try reduce the number as this will clog the system,” they wrote.
The problem was temporarily resolved, but problems arose again in the days afterwards, when several HSE officials began to internally report major issues with the system.
One HSE surveillance official wrote on 26 December that staff were losing “a lot of time at crucial periods” and warned that reports were no longer reflective of the true epidemiological situation.
The same day, health officials confirmed a record 1,296 new cases of Covid-19 in Ireland and the country re-entered Level 5 restrictions the day afterwards, when inter-county travel and household visits were no longer permitted.
By 28 December, multiple members of HSE staff from around the country were reporting that their computer screens were going blank and that they were being kicked out of the system when inputting data to CIDR.
The problems led surveillance staff to direct the officials to input data only at certain times, while others were told to reduce the rate at which they were adding data about positive cases to the system to prevent it from overloading.
Reid ‘at wits’ end’
In an email on the morning of 28 December, the HSE’s Head of National Testing Niamh O’Beirne emailed Chief Clinical Officer Colm Henry about the problem.
The email included figures which showed that contact tracing centres were reporting 1,422 more positive cases than were on the CIDR system between 23 December and 28 December.
“We are coming into a week of very high case numbers, and I am unsure CIDR will be able to report them based on the above performance,” she wrote.
“I have raised this issue so many times and repeatedly over the last number of days, but unfortunately while work has been done on it by the CIDR teams, I don’t see this reflected in the accuracy of case numbers.”
Later that day, HSE CEO Paul Reid told Colm Henry that he was at his “wits’ end” over the discrepancy.
“Every time I get involved, I’m assured that this is addressed,” he said. “Can you discuss urgently [...] and revert to me asap please?”
A subsequent email from Reid to Henry that evening, after the latter said that the issue had been discussed by officials, emphasised the CEO’s concern about the matter.
“This is quite serious and going on for some time now, despite constant reassurances being given to me,” Reid wrote.
Head of testing Niamh O’Beirne then replied the same day to say that the health service would write to the Department of Health and NPHET to explain that the HSE would attempt to report cases by using a different system.
“This is an action we must move to from tomorrow as CIDR was 1,640 cases behind this morning plus the 2,000 cases that came in today,” she said.
“Tomorrow we expect in excess of 2,000 cases again by close of day.”
‘No significant discrepancy’
In an email on 29 December, Chair of the NPHET’s Epidemiological Modelling Advisory Group Professor Philip Nolan emailed HPSC director Dr John Cuddihy to say that despite the issue, there was “no epidemiologically significant discrepancy”.
“It should be noted that these occasional delays in reporting are of minimal epidemiological significance,” he wrote.
“The difference, between 8,803 positive tests and 8,150 cases is 743 or 8.4% [...] This is within the limits of what we would expect for duplicates and old infections.”
However, further correspondence between health officials showed that the discrepancy in official case numbers and positive test results began to widen in the days afterwards.
Despite efforts to fix the system, officials in public health described the “system stalling with white churning screens” on 29 December, while others reported having issues logging on to the system entirely.
On 30 December, Niamh O’Beirne informed Paul Reid that 2,500 positive tests had yet to be confirmed; by 1 January, she indicated that 9,970 positive test results had yet to be reported; three days later, an official from Ernst and Young wrote to O’Beirne to report that the discrepancy had reached 10,000.
A memo from Philip Nolan to the Taoiseach and ministers on 2 January explained that the results of around 9,000 positive tests had yet to be verified.
“Immediately after Christmas we had a surge of people coming forward for testing,” he wrote.
“There is a delay in checking, validating and formally reporting the very large volume of positive tests which we are now detecting.
“This in no way interferes with the process of identifying those cases, or of contact tracing those cases, or of managing those cases.
“It is simply a question of delays in formal reporting. It does mean there are about 9,000 positive tests which have yet to be confirmed as cases.”
Nolan warned the government that the actual epidemiological situation was worse than the official reports, suggesting the true 14-day incidence on 1 January was closer to 450-550 per 100,000 population, rather than the 321 per 100,000 that was reported.
He further noted that a significant number of positive tests were from those who may have felt unwell before or during Christmas, but did not get tested until after Christmas.
“The testing system wasn’t designed to report two, three, four thousand tests per day and this is why it is going to take several days to confirm all of those cases,” Nolan said.
He added that system enhancements had been put in place to speed up the validation and registration process, and the issue was resolved in the days afterwards.
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