At first public health authorities did not recommend their use at all. When hospitals began using them as standard, they were advised against. In time, the position evolved: people should use them only if they were ill with Covid-19 symptoms or were looking after a person with the virus. Explaining the grounds for the HSE’s scepticism, one senior official said the use of this particular tool in the fight against Covid-19 would create unnecessary cost and lead to “a false sense of security”.

The tool in question was the face mask, the wearing of which the State's public health officials strongly resisted in the early stages of the pandemic. But the belated acceptance of their utility has echoes of the current shift in attitude towards rapid antigen testing. In fairness, initial reluctance to endorse universal mask-wearing was partly a function of supply shortages and a lack of understanding in the Spring of 2020 about how Covid travelled through the air. The State's early doubts were shared by the World Health Organisation. Yet none of those excuses apply to the continuing resistance to antigen testing. The kits are widely available. Many countries count on them as an indispensable tool in their infection control strategies, and they have won approval from health regulators. The European Centre for Disease Prevention and Control says they can help reduce transmission and can complement the more reliable but slower PCR tests.

The case for antigen testing is clear, in other words, and has been for some time. The tests have been used successfully in high-risk settings such as meat plants, and seven months ago a Government expert group recommended the development of a plan for their use more broadly. The Government is on board, and proposes to subsidise the kits, but chief medical officer Tony Holohan remains hesitant. He points to a survey for Nphet last week which found that a majority of people who used antigens had symptoms at the time, and only a third of them went on to take a PCR. That's not good: a person with symptoms should always get a PCR test and self-isolate. But to conclude from this that antigens should not be encouraged seems a stretch. Regular use of antigens by people who have no symptoms could play a very important role in controlling transmission. It's arguable that one reason some people are using antigens inappropriately is that the official ambivalence towards them has meant there has been inadequate public communications on how and when to use them.

Hospital Report

Throughout the pandemic, people have shown themselves more than capable of absorbing detailed public health guidance and following it responsibly. Antigen tests are not perfect, and understanding their limitations is vital. But to eschew them is to deprive us of a powerful weapon in the battle against the virus.