Health team recommends less invasive Covid-19 tests for children

The State’s public health team has recommended less invasive, saliva tests for children who need to be tested for Covid-19.

The National Public Health Emergency Team (NPHET) have discussed the benefits of taking saliva or nasal specimens from children amid concerns they may find the current testing practices too traumatic or that parents would find it "unacceptable" particularly if their child only has a mild illness.

Currently, children must undergo the same invasive procedure as adults – a nasopharyngeal swab reaching a few centimetres into the head through the nose. They also have their throats swabbed.

At a meeting on August 6th, the team recommended to the Health Service Executive that, in collaboration with the National Virus Reference Laboratory, it “validate the use of oral fluid/saliva as a specimen type for testing for SARS-CoV-2 RNA in children”.

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The group were also presented with a paper from an expert group which said there was a “preference for less-invasive testing of children, with use of salivary or deep nasal samples recommended instead of nasopharyngeal/oropharyngeal for children in the community, if feasible”.

That expert group also recommended that the period of self-isolation and restriction of movements of close contacts of children should be in line with any emerging guidance from the European Centre for Disease Prevention.

According to minutes of that meeting, the public health team stressed that a direct risk to children in this context was that “other serious illnesses such as meningitis or septicaemia could initially go unrecognised because of a focus on Covid-19 as a diagnosis”.

It comes after a Hiqa report released last week said saliva or nasal specimens may offer a viable alternative to the current standard invasive test for the coronavirus which collects specimens from the back of the nose and throat.

At the same meeting in early August, officials also discussed changes to the current modelling work around potential future Covid-19 cases.

The chair of the Irish Epidemiological Modelling Advisory Group (IEMAG) presented a paper which outlined that the group’s work had “changed” and needed to be reviewed.

“The uncertainty surrounding Covid-19 makes it difficult to predict how long modelling advice and expertise will be required to support the NPHET and the nature of the expertise that would be most useful.

“However, the value of sustaining some specific statistical advisory and modelling capacity within the health system was acknowledged.

“The NPHET thanked the IEMAG for the considerable contribution it had made in responding to the pandemic to date and acknowledged the importance of its work continuing, albeit through potentially different channels in time. It was agreed that further consideration would be given to the options proposed before a new approach to carrying out this significant work was formalised.”