The Health Service Executive (HSE) is to make new antigen tests for Covid-19 available in hospitals later this week.

It would be up to each hospital to decide when and where these tests would be used, according to the HSE.

Antigen testing is faster than the laboratory-based PCR test but is considered to be less reliable. However, the HSE has been working to validate antigen tests over recent months.

Hospital Report

It has secured a supply of 500,000 antigen tests from European Union stocks and these will be deployed to hospitals, HSE chief executive Paul Reid said.

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The Irish Nurses and Midwives Organisation (INMO) said the provision of the antigen tests should allow for the introduction of Covid-19 screening for all frontline healthcare staff, which nurses have been calling for.

The organisation maintained, however, that antigen testing in hospitals must be in addition to the PCR testing that has been in place for some time.

Reduced accuracy

According to the HSE, the health safety watchdog HIQA, on foot of a request from the National Public Health Emergency Team, had found that antigen tests to date showed reduced diagnostic accuracy compared with laboratory-based real-time reverse-transcription PCR tests following a health technology assessment process.

“It has been widely reported that antigen test sensitivity is significantly lower than PCR testing and can vary significantly across brands. Furthermore, their intended use is in symptomatic patients in the early stages of infection, with samples taken and tests conducted by trained health professionals,” a HSE representative said.

"There is limited performance data currently available for the use of antigen tests in asymptomatic populations. The European Centre for Disease Prevention and Control and the World Health Organisation recommend that any country considering implementing antigen testing should conduct appropriate clinical validation of the tests for use in that setting."

As a result, the HSE established a working group to verify and validate a range of tests available in the marketplace, together with the options and impacts arising from the deployment of those tests, the representative said. The working group included clinical leads from public health and the Health Protection Surveillance Centre as well as specialists in pathology, microbiology, general practice, acute sector, food sector and operations .

“The HSE have completed validation on a number of antigen tests for usage. Validation of further tests is ongoing. Over 4,000 antigen tests have already been used in a range of sectors,” the representative said.

“The validated tests will be made available to the acute hospital system for use alongside the existing PCR tests from the end of this week.”

Test capacity

The HSE has “invested heavily in both rapid and batch PCR systems which have served our hospitals well in this period of increased testing demand.”

The capacity for PCR testing had increased from 500 tests per day in hospitals to 6,500 per day, according to the health body.

“This has been achieved through an investment plan developed last year which saw investments in rapid and batch systems, some which can produce results in hours. Hence, utilisation of antigen tests will vary between hospitals.

“Antigen tests are different to PCR testing systems, which are geared towards high volume and automated, as they are a point-of-care test. Usage of the tests will be a matter for each hospital to consider as part of their local testing plan, alongside their PCR testing systems.”