Rapid antigen tests may be allowed as an alternative to the Covid-19 pass for some people, under proposals being examined by the National Public Health Emergency Team.

Medical exemption certificates or negative antigen or PCR tests could be introduced for people who are unable to get vaccinated for medical reasons, members of Nphet have suggested.

While many other EU states have retained Covid pass-type system, they have provision for alternatives, the minutes of a Nphet meeting last October 18th note.

Hospital Report

The meeting agreed the rapid testing expert advisory group should examine the feasibility of using rapid testing as a “component” of the Covid-19 pass for those who are unable for medical reasons to get fully vaccinated.

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In the month from mid-September to mid-October, 25 per cent of cases were Covid-19 breakthrough infections among fully vaccinated people. This group also accounted for 40 per cent of hospitalised cases, 20 per cent of ICU admissions and 42 per cent of deaths.

With almost 7 per cent of breakthrough infections occurring among vaccinated healthcare workers, the meeting heard there had been over 100 cases of hospital-acquired infection in the two preceding weeks.

Cases are increasingly among those who are fully vaccinated, and doctors have indicated the dependence on multi-patient wards in several sites is strongly associated with transmission of the virus within the hospital setting.

Members expressed concern that 13 per cent of close contacts of cases were testing positive for Covid-19 despite being fully vaccinated and showing no symptoms. “Concern around the potential for this cohort to transmit infection further was raised, with a particular concern in relation to healthcare workers, particularly given the current policy of not automatically testing asymptomatic fully vaccinated close contacts of confirmed cases.”

Most breakthrough infections in ICU are occurring in patients with high-grade immunosuppression, the meeting heard.

Although the meeting agreed to the reopening of the remaining parts of hospitality and other sectors then under consideration, a number of members expressed reservations about this “as it may increase virus transmission”.

The meeting agreed to keep masking, distancing and ventilation rules in place and the minutes record that Nphet “does not foresee these being removed until at least February 2022”.

At the time of the meeting, modelling forecast a peak of between 2,500 and 3,000 cases per day “in the course of” November, and a peak of 800-1,000 people in hospital in late November, of which 150-200 would require critical care. These models are currently being reworked.