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Test of luck Plans to end mass Covid-19 testing revealed starting with under 13s

A paper drawn up for the National Public Health Emergency Team (Nphet) proposes to, in the first instance, "discourage" the testing of children under 13 who have mild symptoms, provided their condition does not deteriorate.

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VACCINATED adults and children under 13 with mild symptoms of Covid-19 would no longer be advised to get a test for the disease under a plan to dismantle the State's mass testing regime, it has been revealed.

A paper drawn up for the National Public Health Emergency Team (Nphet) proposes to, in the first instance, "discourage" the testing of children under 13 who have mild symptoms, provided their condition does not deteriorate.

Vaccinated adults with mild symptoms would also no longer require a test.

The document was drawn-up by Professor Martin Cormican, the HSE's national lead for infection control, on July 22.

However, it has not yet been adopted by Nphet and there is no timeline for its implementation.

Nphet is to meet this week, with discussions likely to include the current requirement for all school children who are close contacts to be excluded from classes.

HSE chief executive Paul Reid said yesterday that this rule is "probably unnecessary."

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HSE chief executive Paul Reid (PA)

HSE chief executive Paul Reid (PA)

HSE chief executive Paul Reid (PA)

Prof Cormican's paper notes that current guidelines discourage testing of under-13s with mild symptoms but that the concerns of parents and schools have led to more, wider testing taking place.

The paper says the current testing regime is "medicalising daily life in ways that may have significant social consequences", including keeping children home from school.

Prof Cormican proposes that as part of overall planning for the future there should be a "stepwise transition" from testing to confirm all possible cases to testing when this is necessary for clinical diagnostic purposes.

"The success of the vaccination programme requires a fundamental revaluation of the approach to testing and how it links to the evolving public health response," the paper states.

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His paper says step one, to no longer test under 13s with mild symptoms, and step two, to no longer test close contacts who are fully vaccinated or have had Covid-19 in the last nine months, could start now.

Step two is largely in line with current public health advice, but Prof Cormican's paper states there should be exceptions for people who have travelled in the previous 14 days, and those suspected of being in contact with people infected with a variant of concern.

The third step would involve advising people against being tested, if they have "significant vaccine protection" and mild symptoms, who are expected to be self-limiting, with exceptions for those.

The next step would see advice against testing of all persons who are asymptomatic, including those who are not vaccinated, unless specifically required based on public health risk assessments.

The document notes that based on current vaccine uptake it is reasonable to assume the number of people not vaccinated will be small.

This would be followed by stopping testing of people with mild symptoms, including those not vaccinated, unless they were part of a specific public health or infection and prevention control risk assessment, such as an outbreak investigation.

The final steps would see people only tested if they are symptomatic and it is requested by the doctor caring for them for clinical purposes.

Testing could also be carried out as a part of a sentinel surveillance system together with other approaches to monitoring incidence of the disease in the population.

Prof Cormican's paper, released under Freedom of Information request, notes "there will be an ongoing requirement for careful monitoring of the incidence of disease and health service impact with preservation of appropriate capacity to scale up testing if there is an increase in disease".

It also notes that in addition to the impact on schoolchildren, the negative impacts of the current testing regime include delays in access to healthcare, undermining years of work encouraging self-care of viral respiratory tract infections, the discomfort and inconveniences for many people of testing, the cost to the health service, and the environmental impacts of mass testing.

The paper states that the current regime means "a continuing focus on Covid-19 that is disproportionate to its clinical and public health impact can result in diagnostic tunnel vision/confirmatory bias."

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