Department defends timing of adding India to hotel quarantine list

The Department of Health has defended its decision not to add India to the State's Covid-19 mandatory hotel quarantine list until early this month.

This was almost a month after Pakistan and Bangladesh – both on the Indian subcontinent – had been added to the list and came six weeks after a rise in cases of the problematic B.1.617 variant was first noted in India.

The so-called Indian variant is a source of concern for public health experts because it appears to be highly transmissible and impairs the effectiveness of vaccines, particularly after only one dose.

Chief medical officer Dr Tony Holohan has described it as the "black cloud on the horizon".

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The April 9th decision to add Bangladesh and Pakistan, on the advice of its expert advisory group on travel, was partially based on data from the United Kingdom.

The British government added Pakistan and Bangladesh to its "red list" on April 2nd. UK prime minister Boris Johnson had planned to visit India but this was cancelled on April 19th because of the deteriorating Covid-19 situation there. Four days later, India was added to the British "red list".

Restrictions

The UK has sequenced 5,600 cases of B.1.617, with cases doubling weekly, prompting many experts to call for its easing of restrictions to be slowed down. So far, 97 cases of the variant have been sequenced in the State.

The department said that in early April evidence with respect to incidence rates and genome sequencing results from India “did not support” including the country on the quarantine list.

“The [group] looks to many sources of data to make informed recommendations, and at this time increasing incidence rates, coupled with data relayed from the UK reporting increasing positivity rates in passengers arriving from Pakistan and Bangladesh, supported their designation as designated states,” the department said in response to questions from The Irish Times.

It said incidence rates in India and Nepal, along with positivity rates, lagged the increase seen in Pakistan and Bangladesh "and [they] were both subsequently added to the list once the available evidence supported this decision".

The advisory group recommended adding India to the list on April 22nd, but because consultation is required with other Government departments, it was not added until May 4th.

Risk

The department said that as many travellers from India transit through other states such the United Arab Emirates or Turkey, they would have been required to enter hotel quarantine from then.

It said the advisory group started monitoring the Indian variant in late March, but initially there was uncertainty whether the surge in cases was being driven by this variant or the so-called UK variant, which is already dominant in Ireland.

The designation of a country on the list is based on factors such as the proportion of variant of concern cases and the risk posed by the variant.

“The recommendation for mandatory hotel quarantine must be appropriate and proportionate to the potential threat posed by the variant, or cumulative variants from a designated area,” the department said.

It added that the "understanding" around B.1.617 "developed significantly in the course of April", and it was officially designated a variant of concern in the UK and by the World Health Organisation in early May.