The Health Information and Quality Authority (HIQA) has today published its advice to the Health Service Executive (HSE) on the potential impact of different serial testing scenarios using rapid antigen detection tests (RADTs) to detect SARS-CoV-2 in meat processing plant workers.

In Ireland and across the globe, meat processing plants have experienced a considerable number of COVID-19 outbreaks. A recent analysis completed by HIQA noted that outbreaks in meat processing plants in Ireland were associated with approximately 3,000 cases of COVID-19. The results of the analysis showed that those working in meat processing plants are at a higher risk of COVID-19 than the general population. To address this risk, a suite of measures have been introduced including serial testing of workers using monthly RT-PCR testing. HIQA examined the impact of also using RADTs to further mitigate transmission risk in these settings.

HIQA modelled the impact of different serial testing scenarios using RADTs in meat processing plants in Ireland both in addition to, and as an alternative to, the current practice (that is, monthly RT-PCR based serial testing).

HIQA found that the preferred testing strategy used RADT-based serial testing once weekly with positive antigen tests confirmed by RT-PCR. This scenario increased the detection of cases, reduced the number of days of infectious individuals being in a plant and reduced the overall cost relative to the current practice of monthly RT-PCR testing. Twice weekly RADT-based serial testing could also be considered.

Dr Conor Teljeur, HIQA’s Chief Scientist, said: “We have advised the HSE on the benefits of introducing RADTs for serial testing in meat processing plants at a frequency of once a week. However, before discontinuing monthly RT-PCR-based serial testing, further evaluation will need to be carried out to ensure this strategy is both acceptable to relevant stakeholders and is implementable within the individual plants. We would favour a stepwise transition to frequent RADT-based serial testing, with the switch from monthly RT-PCR conditional on successful deployment of RADT-based testing within a plant.”

Dr Teljeur continued: “The higher risk associated with transmission in meat processing plants is multifactorial. As with other high risk settings, contributing environmental issues can include the reduced ability to social distance, cold air, limited ventilation and loud work spaces. In addition, a number of non-environmental risk factors exist for the sector, such as shared accommodation, low wages and access to support payments.”

Due to the specificity of the data to meat processing plants, the results of this analysis cannot be applied to other settings.
This advice was accompanied by an evidence synthesis report.

This report can be found from the link at the top of the page.
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Further information:
Marty Whelan, Head of Communications & Stakeholder Engagement
01 814 7480/085 805 5202, mwhelan@hiqa.ie

Notes to Editor:

• HIQA has today published the following document to inform NPHET’s response to COVID-19:
  • Advice to HSE: Potential impact of different serial testing scenarios using RADTs to detect SARS-CoV-2 in meat processing plant workers
  • Evidence synthesis: Potential impact of different serial testing scenarios using RADTs to detect SARS-CoV-2 in meat processing plant workers
• HIQA’s COVID-19 Evidence Synthesis Team produces a variety of outputs including rapid health technology assessments, scoping reports, rapid reviews of public health guidance, modelling analyses and evidence summaries. Working with its COVID-19 Expert Advisory Group, HIQA uses these outputs to inform the development of advice.
• The topics HIQA researches are outlined and prioritised by NPHET to ensure rapid access to the best available evidence relevant to the SARS-CoV-2 outbreak.
• Rapid Antigen Detection Tests (RADTs) are simpler than molecular tests such as rRT-PCR from an equipment point of view, potentially allowing detection of SARS-CoV-2 at the point of care. They also produce results faster than tests used in the laboratory setting. However, such tests typically have reduced diagnostic accuracy compared with laboratory-based rRT-PCR and therefore are not suitable for all settings.
• This analysis assumed that RADT-based serial testing is based on nasal swabs obtained by supervised self-sampling with onsite processing of the test by individuals who have undergone competency-based training. It also assumed that all positive tests would be confirmed with RT-PCR.