We’ve no idea howCovid is getting into Ireland’s homes
Frustrated experts complain that lack of good contact tracing data has left us ‘f ighting blind’ in bid to combat the virus
EXPERTS have called for more detail from health authorities on where Covid cases are coming from as well as a far better contact tracing system in order to combat the spread of the disease.
The calls come as the HSE says it is still working on a system to find out how infections are entering households but experts say this has taken too long and should have been implemented over the summer.
Official data shows the vast majority of clusters or outbreaks are associated with households, but the figures do not show how they get into people’s homes in the first place.
Trinity College Dublin neuroscientist Dr Tomás Ryan told the Irish Mail on Sunday there is massive concern in the scientific community that we still don’t know much about how the virus is spreading at a local level.
He said while numbers were at their lowest over the summer, a system to pinpoint exactly how the disease is entering homes could have been developed and as a result, we’re still ‘fighting blind’ against the disease.
‘Backward contact tracing was going to be essential in understanding what’s happening in the community,’ he said. ‘I think one of the major limitations that we have at the moment is that we don’t know where in Ireland our major sources of transmission are.
‘We’ve learned recently that travel is contributing much more than our surveillance network indicates. And travelling into the country is a major issue.’
‘This has contributed to cross-border transmission with Northern Ireland. And we don’t know how much transmission is happening in the hospitality sectors, in retail places, and workplaces, etc. It’s all very vague. Our surveillance is so poor we have to rely on international evidence for what is happening in these sectors.’
Dr Ryan said we need mobility analysis carried out by public health professionals in order to understand how the virus is spreading in the community and in different counties. This will be crucial when we reopen the country, Dr Ryan said.
He also said numbers need to be low in order to do this efficiently as we only have around 60 public health professionals in Ireland who can explain the findings of retrospective tracing.
‘We want to get it down to 10 to 20 cases a day,’ he said.
‘Realistically, that’s where we need to go, that would enable the public health agencies to have strict infrastructure to properly look at everything and to have that information.’
Our current data around outbreaks or clusters – defined as more than one case in a particular setting – is captured by the Health Protection Surveillance Centre (HPSC). There have been a total of 8,311 outbreaks in Ireland since the beginning of the pandemic, 4,992 of those are considered open or ongoing cases, and 3,319 are considered closed.
In week 46, ending November 14, there were 1,057 new outbreaks found with 954 recorded in ‘private households’. There are currently 4,210 household cases that are open. There were six new outbreaks in nursing homes, with 51 considered open cases. There were 15 community-based cases with 100 considered open. We had one new travel-related case with eight considered open.
According to the data, the highest rate of Covid-19 transmission occurs in households but experts worry about the lack of information around how the disease enters households in the first place.
The HSE was unable to provide more detail on the outbreak data or illustrative anonymised case studies showing how the disease had spread when requested by this paper this week.
Public health expert Professor Anthony Staines told the MoS: ‘We have a lot of so-called household transmission, and those cases are
‘Travelling into the country is a major issue’
coming from somewhere, they’re not spontaneously generated within households.
‘We know this is a quite infectious disease and if someone brings it into a house there’s a fairly high chance that other people in the house will get infected too. But what we can control is where the cases are coming from, and we don’t know that, because we’re not tracking back far enough. Most cases, we track them back 48 hours, which is not nearly far enough because for most people it takes four or five days before you know from exposure to testing positive at least. We’re missing that. So we have all this community transmission which is a polite way of saying, we have no idea where these cases come from and we have household transmission, which is not dissimilar. We don’t really know the origins of a lot of those cases.’
Earlier this week, HSE chief Paul Reid said that it is still recruiting a
‘stabilised workforce’ in order to implement retrospective tracing. It had been understood from a previous HSE statement that the system would be implemented in early December, however Mr Reid said on Thursday that the HSE is still ‘moving towards it’.
Mr Reid told reporters: ‘We’re still working through all of that and part of recruiting our stabilised workforce is to move towards that.
‘We’ve been using the last few weeks to build towards those processes and whatever system changes we need to make in terms of extra questions we need to ask as part of that process. We’re still looking at all of that. Primarily, we want a stabilised workforce in the first instance and to stay above the contacts we’re getting.’
Dr Colm Henry of the HSE did not pinpoint where outbreaks are occurring at a press conference earlier this week but said that the outbreaks they
are seeing have similar traits. ‘There is increased focus and you’ve seen the commentary in recent months on what are called super-spreader events,’ he said.
‘And they seem to have certain themes in common, they’re indoors, congregation, poor ventilation, crowding and then a lot of alcohol.
‘So, whatever the emergence with a vaccine or however well we perform in the next few weeks, certainly, the one thing we want to avoid are potential super-spreader events, where that confluence of themes and congregation and poor ventilation indoors lends itself to transmission and it’s been pointed out before. We talk a great deal about household settings, when you trace further back you will trace where that’s been done, you’ll find that in many cases, these cases trace themselves back to congregated settings’