Covid-19: Young people told to only get PCR test if antigen test positive

Younger people with Covid-19 symptoms will be required to have a positive antigen test before seeking a PCR test in a bid to ease pressure on the testing system under new rules which come into effect next week.

The changes will require those aged between four and 39 to have a positive antigen test before they can book a PCR test, in order to free up capacity in the HSE’s PCR testing system for older, more vulnerable people who are considered at greater risk from the virus.

The Department of Health announced the new rules, saying that symptomatic individuals aged between four and 39, who do not have an underlying health condition, are advised to self-isolate immediately and undertake regular antigen tests rather than book a PCR test.

Anyone with a positive antigen test should seek a confirmatory PCR test but those who receive a negative antigen test should continue to self-isolate until they are symptom-free for 48 hours.

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This marks the first time that that the Government has advised people showing symptoms of Covid-19 to undertake antigen tests rather seek an immediate PCR test.

The department advises any symptomatic healthcare workers to continue to seek a PCR test.

The changes are being introduced “in view of the very large volumes of disease now being experienced and to ensure best use of available testing capacity,” the department said.

Minister for Health Stephen Donnelly said that people aged between four and 39 who do not have underlying health conditions, who contact the HSE, will receive antigen tests delivered to them by post.

The changes come into effect from Monday, January 3rd, when the HSE will put plans in place to distribute antigen tests to these affected groups.

All other people showing symptoms of Covid-19, aged up to three years or older than 40 are being advised by the department to seek a PCR test as soon as they show symptoms.

The system has been overwhelmed by unprecedented demand for Covid-19 tests as the spread of the more transmissible Omicron has led to record numbers of infections.

Self-isolation rules

The department is also changing the self-isolation rules, reducing to seven days from 10 for people who catch Covid-19 and have received booster vaccines if they meet certain conditions.

The department said that those aged 13 and older who are at least seven days after their booster vaccination - or have had their two primary doses and a Covid-19 infection within the previous three months - should self-isolate for at least seven days from onset of symptoms.

They should only exit self-isolation after seven days “if symptoms have substantially or fully resolved for the final two of those seven days.”

For days eight to 10, they should limit “to the greatest extent possible” close contact with other people outside their household, especially in crowded, enclosed or poorly ventilated spaces.

They should wear a face mask in crowded, enclosed or poorly ventilated spaces and where they are in close contact with other people, the department said.

They are also being advised to take an antigen test before entering crowded, enclosed of poorly ventilated spaces and prior to having close contact with other people from outside their household.

They should also avoid contact with higher-risk people and work from home unless it is essential to attend in person.

The Department of Health also said in the statement announcing the new rules that Government departments have “risk management and contingency plans in place to ensure continuity of operations of critical sectors” and that the “situation is being monitored closely”.

This comes amid concerns that the high number of infections and close contacts will result in large numbers of asymptomatic people being forced out of work and to isolate at home.

The department said secretaries general of departments may exercise discretion for the exceptional use of derogations from the rules covering restrictions for close contacts.

The Government has also asked its public health advisers to keep the five-day restrictions on movements of close contacts who are not displaying symptoms under review “to minimise the risk to essential services and critical infrastructure,” the department said.

‘Snake oil narrative’

Labour Party leader Alan Kelly reacted to the announcement on antigen tests saying: “This is some jump from the snake oil narrative on antigen testing.”

He accused the government of being “all over the place” with the announcement.

Mr Kelly said: “They need to now make antigen tests free to all households and we need coherent new rules that prioritises PCR testing for those that need them the most.”

Mr Kelly also said: “There also needs to be a way of registering positive antigen test results.

“We need to see the Minister for Health coming out front, showing leadership and explaining publicly what he is going to do rather than issuing a statement at 7pm.”

The Infectious Diseases Society of Ireland criticised the changes saying that insisting on PCR tests to confirm infections “duplicates effort for little gain at a significant cost to the public purse.”

The group warned that a negative antigen test in a symptomatic person does not exclude Covid-19 infection and that these cases should be prioritised for PCR testing.

“Our concern is this will lead to confusion and place undue burden on symptomatic individuals who may opt not to comply with guidance rather than isolating and seeking/performing a test,” the society said in a tweet.

Hospitalisations

Minister for Health Stephen Donnelly said that the disease incidence has continued to rapidly increase with recent daily case counts “substantially exceeding” previous highs recorded during the pandemic to date.

He estimated that the 14-day incidence rate now stands at more than 2,300 per 100,000 people and that the latest data shows that 92 per cent of cases are due to the Omicron variant.

“We are seeing levels of new daily cases in hospital that we have not seen since last January,” he said, referring to the third and biggest wave of hospitalisations of the pandemic a year ago.

“While our booster rollout programme is going extremely well, the extent to which the epidemic is continuing to accelerate means that there is still significant concern regarding the likely impact of such high case counts on our health services,” said the minister.