Why fast testing and tracing is essential in battle against Covid-19

A senior health official involved in the State’s response to the Covid-19 crisis believes that if aliens were dreaming up a disease to kill us, it would be Ebola. A gruesome, torturous, terrifyingly infectious disease for which there is no cure, and which kills vast numbers of those it infects.

However, Ebola is too effective – it kills the host before they have a chance to spread it. A disease to interfere with our societies, to frustrate, to impede and to divide – all the while notching up a significant body count – would be Covid-19, the official believes.

As surely as this disease ripped through nursing homes, it is also tearing through Irish society. Intractable problems are being thrown up at every hand’s turn, from childcare and education to sport and public transport.

The turnaround time for testing and tracing to be completed  is the single most important thing for its effectiveness

If there is one hand we have to play against the virus, in the absence of a vaccine, it’s the hope that we can identify and destroy clusters of infection before they get out of control. With this, societies and economies might live alongside Covid-19. Without it, we are in retreat.

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Therefore, intense scrutiny of the State's track-and-test effort should come as no surprise. And it's not as if there hasn't been reason for concern. Take, for example, the clear tensions between the National Public Health Emergency Team (NPHET) and the HSE, which last month prompted Paul Reid to complain that directions from NPHET: "commit the HSE to an intensity of implementation which bears absolutely no resemblance to what we previously discussed and has taken no account of what can be achieved by when."

Then there’s the technological limitations – data errors and mismatched software – which hold back the process. The head of the National Virus Reference Laboratory, Cillian de Gascun, made clear the impact of these limitations on Thursday. “[It] can be a small thing, an individual or human error at the start, from a data entry perspective it’s very difficult to catch that once it gets into the process.”

Most importantly, there are the criticisms of the turnaround time for testing and tracing to be completed – the single most important thing for its effectiveness. The critics are expert: epidemiologists, immunologists, and public health professionals, with frontline experience. Prof Mary Codd, for example, who established and runs a contact tracing centre in UCD, is also professor of epidemiology and associate dean of public health at the university. This week, she said tracing is "not timely enough yet".

Meaningful progress

The HSE has now set a target, for next week, of clearing 90 per cent of cases through the entire process within three days. If it is achieved, this will be meaningful progress. It must hold together under pressure, as well – the HSE example presumed 450 positive cases a day, or 3,150 a week. But already, we have seen weeks where that figure has far been exceeded – such as the week of April 12th, when there were more than 5,000 positive cases. Mr Reid has said the system can perform no matter the demands, and that must hold true.

HSE chiefs point to the complexity of tracing cases in hospitals and nursing homes – but is there anything to believe cases “in the wild”, when restrictions come down, will be any easier? When the stranger you sit next to on a bus must be found, and contacted? How much can the new system handle before circuit breakers kick in, and we find ourselves back in lockdown?

The State is fond of pointing to the massive effort it has made to set up a test-and-trace system in weeks. This is not in doubt, and neither is the commitment or hard work of all involved. However, what counts is whether the virus can slip through these hastily-constructed defences – which will now be tested in the heat of battle.