Covid-19: Reducing risk of variants may be ineffective due to UK travel – Hiqa

Ireland’s efforts to reduce the risk of importing problematic Covid-19 variants may be ineffective due to high volumes of travel with the UK and the increasing prevalence of the delta variant there, the State’s health regulator has warned.

With as few as 35 per cent of incoming travellers to Ireland availing of free testing, the Health Information and Quality Authority describes the low uptake as "concerning".

The warning came as Northern Ireland’s public health agency said it has identified 111 probable or confirmed cases of the delta variant across the North, with 28 cases in the Co Down town of Kilkeel.

In a briefing paper circulated within the Northern Executive, the North’s health minister Robin Swann said: “While the number of confirmed cases of the delta variant remains small, the evidence from Great Britain indicates that this could change very rapidly.

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“Testing in the last few days has indicated that up to 25 per cent of new cases here may be delta variant.

“Based on emerging data from GB, the current assessment is that delta variant is likely to be 40-60 per cent more transmissible than Alpha variant.

“In addition, while vaccination remains effective, it is somewhat less effective against delta variant compared with alpha variant.

“In the event of the delta variant becoming dominant, modelling indicates the potential for a significant fresh surge of positive cases and hospitalisations by late summer/early autumn. It needs to be emphasised that this is by no means inevitable,” Mr Swann said.

Minimum quarantine period

In its report , Hiqa also highlights issues associated with the passenger locator form that incoming travellers are supposed to complete, saying there is an urgent need to better understand where passengers are coming from.

The regulator's criticisms are contained in a report that advises the Health Service Executive the minimum quarantine period for passengers arriving in Ireland should not be increased.

Currently, incoming travellers from non-designated states are required by law to quarantine at home for 14 days. They have the option of taking a free PCR tests with five days of arrival and can end quarantine if the result is negative.

Travellers arriving from a small number of designated states are required to enter hotel quarantine for 14 days.

For travellers from non-designated states, Hiqa has advised the timing of the free test should not be extended. To do so would only slightly reduce the risk of transmission of the virus, while substantially increasing the burden on passengers in terms of time spent in quarantine, it found.

The report also found that the addition of a “day 0” test, either PCR or rapid antigen, would provide “little or no benefit” in terms of reducing infection in the community.

Just 35 per cent of incoming passengers are availing of the “day 5” test, though the report says this may be an underestimate of actual uptake because some travellers are transiting through Ireland and others may be exempt from quarantine or could have availed of other forms of testing.

Import risk

No evidence has been identified for the level of adherence to mandatory quarantine, the report points out, and there is further uncertainty around the timing of exposure, ie, where it occurred during transit or in advance of travel.

Hiqa says since last November, there has been a trend of increasing risk of infection in people travelling to Ireland, which needs to be monitored.

“Due to the high volume of travel between Ireland and the UK (which is currently non-designated), the current system may be ineffective given the increasing prevalence of the delta [B.1.617.2, “Indian”] variant in the UK.

“In relation to the passenger locator form, it says better co-ordination across Government departments and agencies would facilitate the gathering and sharing of information so mandatory home quarantine could be monitored.

“This could be enabled by greater clarity on where responsibility lies for the range of border control measures.”

The risk of importing variants in people travelling to Ireland is concerning, according to Hiqa's chief scientist, Dr Conor Teljeur.

“To manage this, we need information on the countries passengers travelled through before arriving in Ireland. By improving the content, accuracy and coverage of the passenger locator form, it will be possible to better manage and monitor the current quarantine policy.” – Additional reporting PA