Surge in demand for Covid-19 tests slows tracing system

A surge in demand for Covid-19 tests has led to a slowdown in the State’s test and trace system, it has emerged.

Turnaround times are also being impacted by significant increases in the number of close contacts that must be traced, with up to 50 individuals being traced from a single positive case in some instances.

A HSE spokeswoman said on Monday evening that a “slight slowdown” in turnaround times was being driven by a “large increase in a short timefame in the number of Covid-19 swabs being tested”.

As infections have climbed around the country, data from the HSE’s testing and tracing dashboard suggests the time taken from referral for a test to the completion of contact tracing calls has gone from three days on average at the start of the month to 3.8 days.

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However, on Tuesday the HSE said the publicly available figures do not represent the end-to-end turnaround time, but are “three different component parts of the turnaround times”. *

A spokeswoman said the HSE’s median end-to-end turnaround time, when weighted for various factors including the overall percentage of positive and negative tests, has grown to 2.83 days.

Experts recommend that the entire end-to-end process should take less than three days, and the HSE has a target of completing the entire process within three days in 90 per cent of cases.

Longer turnaround times are also being driven by people presenting for tests from the community, rather than from residential settings like nursing homes, or from within the healthcare system, the HSE said, while there had been “an increase in close contact referral from positive cases”.

Serial testing of staff at nursing homes, recommended by the National Public Health Emergency Team (NPHET), and a new programme of testing at meat processing plants, is also having an impact. With more positive tests being returned, at about 2 per cent of all swabs taken, there are more calls to be made by contact tracers.

Complex settings

The number of close contacts that must be traced is rapidly increasing, from about two to three on average during lockdown to between five and six.

“There are also outlier cases with up to 50 close contacts [and] flights and complex work settings which take significant time and specialist experience.”

On August 4th, when test and trace took three days, contact tracers were making 260 calls per day. This has increased to more than 800 per day in recent days, which “is likely to cause an increase in time to complete all contact tracing calls for positive cases”.

In order to make these calls, contact-tracing centres operated by the Revenue Commissioners in Limerick and Dublin began operations over the weekend, along with the Army band. A centre in UCD, which had been stood down, recommended operations on August 9th.

On Monday, Early Childhood Ireland, which represents childcare providers, said it feared delays in Covid-19 testing would have serious implications on maintaining the necessary staff ratios to keep services in place.

CEO Teresa Heeney said: "We're told that testing occurs, on average, within 48 hours, however with the reported delays, childcare staff who display symptoms could be waiting up a week to be tested and to receive results.

“Having staff out for such a duration would put huge pressure on childcare providers’ ability to maintain the legal staff to child ratios and would also be a huge public health concern.

“This has a knock-on effect on providers being able to keep specific rooms open, and potentially the entire setting functioning fully.”

The NPHET’s latest figures on Monday showed there were no further deaths from Covid-19 but an additional 56 confirmed cases of the virus in the State. This followed an additional 266 confirmed cases over the weekend.

* This article was updated on 18 August 2020 to reflect new information supplied by the HSE