Coronavirus: People seeking testing must now display two symptoms rather than one

People seeking testing for coronavirus will have to display two major symptoms rather than one before they are referred, following a major change in how those deemed suitable for testing are selected.

Patients will have to show fever and at least one sign of respiratory disease - such as cough or shortness of breath - before they can be referred for testing, under a change recommended by the National Public Health Emergency Team.

One further death and 204 new confirmed cases have been reported by the NPHET at its daily briefing on Tuesday evening.

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The deceased patient, a male in the east of the country, had an underlying health condition.

This brings to seven the number of deaths from Covid-19 in the Republic, and to 1,329 the number of confirmed cases.

Up no now, either fever or cough was considered sufficient for referral, but this led to a massive increase in demand, with 20,000 people a day seeking testing.

Chief medical officer Dr Tony Holohan said this had led to a lot of inappropriate testing and a focus was needed now on priority groups such as people in hospital or healthcare workers.

He admitted public health officials had “cast the net too widely, in good faith” when they loosened the criteria two weeks ago but added they had always said “we won’t get everything right”.

The latest change is likely to sharply reduce the number of people referred for testing from the present levels, which Dr Holohan described as unfeasible and unsustainable.

Backlog

To date, 17,992 tests have been carried out in laboratories across the country, according to NPHET. Just 6 per cent of samples tested positive.

An analysis of cases up to Sunday evening shows 55 per cent are in men and 45 per cent in women. There are 44 clusters involving 243 cases.

Some 277 patients (29 per cent) have been hospitalised and, of these, 29 have required admission to ICU.

The proportion of cases involving healthcare workers continues to rise, and now stands at 26 per cent (247 cases).

The proportion of community transmission cases also continues to rise, and now stands at 47 per cent.

Dublin has the highest number of cases at 535 - 55 per cent of all cases - followed by Cork, with 123 cases (13 per cent).

Dr Holohan said a number of factors had influenced its recommendations to Government for further restrictions to limit the spread of Covid-19. These included the fact that the number of cases was now over 1,000, an increase in admission to ICU, a number of deaths, the prevalence of community transmission and the number of cases involving healthcare workers.

Officials were unable to say how long the backlog for testing - which stood at 40,000 at the weekend - currently is.

Shortages

The average time for processing tests has increased from 10-12 hours last week to 26 hours now as a result of increased demand, according to Dr Cillian de Gascun, director of the National Virus Reference Laboratory. The waiting time for processing tests for hospitalised patients was significantly shorter, he said.

Swabs of the virus can stay live for seven to 10 days so no samples have expired due to the delays, he added.

The NVRL is processing 1,300 tests a day, while hospital laboratories are doing 750.

There were shortages of some parts of the kit used, he said, though testing capacity was being ramped up. In four weeks’ time, it is planned that 15,000 tests a day will be carried out.

“When you’re in the middle of a pandemic everyone is pulling on the same supply resource.”

The HSE's current stock of personal protective equipment (PPE) for healthcare workers are "low", according to HSE chief clinical officer Dr Colm Henry. However, it was hoped that a large consignment of masks, gowns and goggles would arrive from China on Sunday.

Dr Holohan said it was “very encouraging” that the average number of contacts in confirmed cases had dropped from 20 last week to about five.