Covid-19 Thursday: 20,554 new cases; changes to isolation period

THE Health Protection Surveillance Centre has today been notified of 20,554 confirmed cases of Covid-19.

As of 8am today, 619 Covid-19 patients are hospitalised, of which 88 are in ICU.

Dr Tony Holohan, chief medical officer, Department of Health said: ‘For the fourth time this week, we are reporting Ireland’s highest ever number of confirmed cases of Covid-19.

‘The most effective way to minimise the risk of any of us transmitting this virus to others is to avoid mixing indoors with people from other households. I know this is not the advice any one of us wants to hear, particularly in advance of New Year celebrations. However, given the current profile of the disease, it is essential that all of us continue to keep our social contacts as low as possible in the days ahead.

‘In the last 24 hours, 148 people with Covid-19 were either admitted to hospital or received a ‘detected’ test result while in hospital. Hospitalisations at this level are not sustainable and are having a significant impact on our health service. It is important to note that these admission figures are increasingly likely to be driven by the surge in Omicron infection which now accounts for over 90% of PCR confirmed cases in Ireland. Over 90% of people in hospital and intensive care with Covid-19 are there for the management of Covid-19; less than 5% of those in hospital or intensive care have ‘incidental’ (asymptomatic, non-infectious) disease.’

Dr Ronan Glynn, deputy chief medical officer, Department of Health said: ‘Omicron is far more contagious than previous variants and incidence across the country is now much higher than at any point in the pandemic. Because of this, many people, despite being boosted and having taken other measures to protect themselves will be infected with SARS-CoV-2. However, their booster will protect the vast majority from serious illness or hospitalisation, and it will help to protect our health service and critical care capacity.

‘To date, over two million people have received their booster, without this very significant uptake, the current impact on hospitalisation would be considerably worse. Please come forward and avail of your booster as soon as it is available to you. If you have not yet had any Covid-19 vaccine, it is never too late, please come forward and avail of it as, without it, you are at risk of very significant illness if you are exposed to the virus.’

Meanwhile, following receipt of advice from the chief medical officer, the Minister for Health, Stephen Donnelly has tonight announced updates to Ireland’s public health response to the pandemic.

These updates relate to community testing of symptomatic individuals and the isolation of cases with confirmed Covid-19 infection.

Current advice is that all those with symptoms of Covid-19 should self-isolate and seek a PCR test.

In view of the very large volumes of disease now being experienced and, to ensure best use of available testing capacity to ensure rapid identification of Covid-19 infection, and, to support adherence to the public health advice:

• Symptomatic individuals aged 4-39 years should self-isolate immediately and undertake regular antigen tests rather than booking a PCR test. Anyone with an antigen test which detects Covid-19 should seek a confirmatory PCR test. Those with repeated ‘not detected’ antigen tests should continue to self-isolate until 48 hours after their symptoms have resolved.
• Symptomatic healthcare workers should continue to seek a PCR test.
• As per current advice, anyone with an underlying condition which puts them at higher risk of severe disease or anyone who has a clinical concern should contact their GP.
• All other symptomatic individuals (those aged 0-3 years and those aged older than 40 years) should seek a PCR test as soon as they display symptoms of COVID-19.

Isolation period for those diagnosed with Covid-19:

Current guidance in relation to self-isolation advises that adults who receive a positive PCR test result for Covid-19 should self-isolate for 10 days from commencement of symptoms (or date of PCR test if asymptomatic).

This advice has now changed to allow for those who have been boosted, either through receipt of three vaccine doses or through a combination of primary vaccination and recent infection, and those who have not, as follows:

• Those aged 13 years and older who are at least seven days post booster vaccination or those who have completed their primary vaccination course and have had Covid-19 infection within the previous three months, should self-isolate for a minimum of seven days from commencement of symptoms (or date of first positive test if asymptomatic) with exit after seven days only if symptoms have substantially or fully resolved for the final two of those seven days. Those exiting isolation after seven days (from days 8 to 10 post onset of symptoms) should:
• Limit to the greatest extent possible close contact with other people outside their household, especially in crowded, enclosed or poorly ventilated spaces
• Wear a face mask in crowded, enclosed or poorly ventilated spaces and where they are in close contact with other people
• Take an antigen test before entering crowded, enclosed or poorly ventilated spaces and prior to having close contact with other people from outside their household
• Avoid contact with anyone who is at higher risk of severe illness if infected with Covid-19
• Work from home unless it is essential to attend in person
• Adhere to all other basic public health protective measures.

• All others aged 13 years and older who receive a positive PCR test result should continue to self-isolate for 10 days from commencement of symptoms with exit after ten days only if symptoms have substantially or fully resolved for the final two of those ten days.
• Current isolation requirements for young children (those aged 0-12 years) diagnosed with Covid-19 will continue in place.

Minister Donnelly said: ‘Antigen testing for those aged 4-39 years, who do not have an underlying condition will be provided using the model currently in place within the HSE - home delivery from a central distribution point. The HSE has advised that arrangements to provide for distribution of antigen tests can be operationalised from next Monday 3 January 2022. In the meantime, if antigen tests are available to you and you display symptoms of Covid-19, you can use antigen tests as directed as an alternative to PCR testing. As always, if you have any clinical concerns, at any time, please contact your GP.’

The Department of Health and the HSE will now work together to operationalise these updates.

Further to this, and due to the rise in incidence, government departments have risk management and contingency plans in place to ensure continuity of operations of critical sectors. The situation is being monitored closely.

Secretaries general of relevant departments may exercise discretion for the exceptional use of derogations from close contact guidance in specified circumstances.

In addition, the government has asked that public health keep the current guidance (in respect of the restricted movement requirements for close contacts, who are not displaying any symptoms) under review to minimise the risk to essential services and critical infrastructure.

Minister Donnelly added: ‘Disease incidence has continued to rapidly increase in Ireland, with recent daily case counts substantially exceeding the highest previously reported in the pandemic to date. The 14-day incidence is now estimated at over 2,300 per 100,000 population. We are seeing levels of new daily cases in hospital that we have not seen since last January. The latest data on S-gene target failure data indicates that approximately 92% of cases are due to the Omicron variant.

‘While our booster rollout programme is going extremely well, the extent to which the epidemic is continuing to accelerate means that there is still significant concern regarding the likely impact of such high case counts on our health services.

‘Remember to layer up on all of the protective measures available to us including mask wearing, good ventilation, antigen testing and adherence to other public health guidance.’