Q&A: What are the new changes to Covid-19 testing and isolation rules?

The Department of Health has announced new changes to the Covid-19 testing rules to free up capacity in a testing system overwhelmed by a surge in infections due to the more infectious Omicron variant. New rules will also apply to people who have received a booster vaccine or have had a recent previous Covid-19 infection if they catch the virus, so that they won't have to self-isolate for as long.

How are the testing rules being changed?

From Monday, any person aged between four and 39 who has no underlying health conditions and has Covid-19 symptoms will not be advised to automatically seek a PCR test. Instead, they are being asked to self-isolate immediately and undertake regular antigen tests. They will be asked to contact the HSE and they will be sent out a kit of antigen tests by post. If they test positive for Covid-19 on any of these tests, they must only then seek a confirmatory PCR test. This is the first time that antigen tests are being advised for those who are showing symptoms of the disease.

What happens to other age groups?

Anyone aged 40 and over who is displaying symptoms is still being asked to seek a PCR test as soon as they start showing symptoms. Parents of children aged up to three are also asked to seek a PCR test for their children if their children start showing symptoms.

Are there exemptions?

Yes, any symptomatic healthcare workers, regardless of age, should continue to seek a PCR test from the HSE. Anyone with an underlying health condition that puts them at higher risk of severe disease or anyone with a clinical concern should contact their GP to arrange a test.

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When do these changes come into effect?

From Monday, January 3rd. The HSE will take a few days to “operationalise” the changes.

Why has the department made these changes?

The Covid-19 PCR testing system has been overwhelmed with people seeking tests as the number of infections has surged during the Omicron wave. The National Public Health Emergency Team announced 20,554 new Covid-19 infections here on Thursday evening, the State’s highest such daily figure of the pandemic so far and the fourth day this week that a new record has been set for daily infections.

What kind of pressure is the testing system under?

A huge amount. For the fourth day in a row, more than two in every five people being swabbed for Covid-19 were found to be infected with it. This suggests a far higher level of undetected disease in the wider population given the large numbers of people who are currently unable to book PCR appointments online due to the level of demand and the even greater number of people who are close contacts of those untested people.

The HSE has already surged its PCR testing capacity to 300,000 tests a week from 100,000 a few months ago, but even this isn't enough to meet demand. Extraordinarily high positivity rates of upwards of 40 per cent and close to 50 per cent on several days this week show how much the virus is spreading. World Health Organisation advice suggests that positivity rates should be at about 5 per cent for a government to understand how the virus is transmitting in a country, so the Government is a long way off having a handle on it in this wave of the pandemic.

Will these changes relieve pressure?

That’s the HSE’s hope. It expects demand for PCR tests to fall and to concentrate capacity in this regard on those at higher risk, ie the more vulnerable people who are not currently getting PCR tests because the HSE’s online PCR appointment portal has no free slots. Given that more younger people are currently getting infected, the changes should mean that more older people will have access to PCR slots.

Does the HSE have enough antigen tests to send out?

It says that it has enough capacity to distribute about 50,000 antigen test kits a day, or between 300,000 and 400,000 a week. It plans to distribute the tests for symptomatic people aged between four and 39 by post, so people should be receiving them the day after they contact the HSE.

What other changes are being introduced?

The Department of Health is making changes to the isolation period for people who have contracted the disease after receiving Covid-19 booster vaccines or having had a recent Covid-19 case and primary vaccination, to reflect the different category of risk applying to these people.

How long will they have to isolate for?

Instead of 10 days, they will have to isolate for seven days from commencement of symptoms (or receiving a positive test result if asymptomatic), but they can only leave isolation if their symptoms have substantially or fully resolved for the final two of those seven days. They must also limit contacts and follow strict public health advice for the three days after exiting.