HIQA publishes the advice it submitted to NPHET on higher risk activities and settings associated with COVID-19 transmission

Date of publication:

HIQA has published its advice for NPHET on the settings and activities which are associated with a higher risk of COVID-19 transmission. The publication of this advice is accompanied by a supporting evidence synthesis report which examined data from international sources and found that indoor, high occupancy, poorly ventilated environments, where there is shouting and singing, insufficient use of face coverings, and prolonged contact, present an increased risk of SARS-CoV-2 transmission.
These findings support NPHET’s current stance on settings and activities presenting a high risk of transmission.

Dr Máirín Ryan, HIQA’s Director of Health Technology Assessment and Deputy Chief Executive, said “The international evidence highlights that the main factors that contribute to spread of COVID-19 are indoor settings, crowds, and prolonged contact with others. Much can be done to mitigate risk in these settings, such as ensuring good ventilation and people following public health advice to use face coverings, keep physical distance and wash their hands frequently.”

HIQA also found that most SARS-CoV-2 clusters occur in household settings, and so household members are at a high risk of becoming infected if a COVID-19 case is present. Dr Máirín Ryan said: “Our findings reinforce the importance of adherence to self-isolation guidance, despite the challenges it can pose, for those with COVID-19, those awaiting test results and those with symptoms suggestive of COVID-19. This means following the HSE guidance on self-isolation including staying indoors, in a room with a window you can open, and completely avoiding contact with other people, including where possible other household members, for at least 10 days.”

HIQA’s advice to NPHET on the risks attached to different activities and settings, can also help individuals make informed decisions, to reduce their risk of acquiring or transmitting the virus.

The documents published today are available from a link at the top of the page.

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 documents to inform NPHET’s response to COVID-19:
    • Advice to the National Public Health Emergency Team: What activities or settings are associated with a higher risk of SARS-CoV-2 transmission?
    • Protocol: What activities or settings are associated with a higher risk of SARS-CoV-2 transmission?
    • Evidence summary on activities or settings associated with a higher risk of SARS-CoV-2 transmission.
  • There is consistent evidence that SARS-CoV-2 clusters most commonly occur in household settings, and that there is a higher rate of onward transmission in households, compared with other settings.
  • Other settings where large numbers of clusters have been consistently observed include nursing homes, hospitals, meat and food processing plants, large shared accommodation, sporting activities, bars, nightclubs and restaurants, gyms, offices, shopping centres, cruise ships, weddings, shopping malls, prisons, mines and religious settings. Many of these settings have been associated with superspreading events; these are defined as events that result in the transmission of infection to a larger number of individuals than is usual.
  • Activities involving dining, drinking, exercising, singing or shouting, prolonged face-to-face conversation, especially in indoor crowded environments, were associated with an increased risk of transmission in several studies. A range of public health measures, such as use of face coverings, physical distancing, hand washing and improved ventilation, may reduce some of the transmission risk.
  • While there is consistent evidence that the risk of transmission is substantially lower in outdoor settings, clusters in outdoor environments have been observed, particularly when there are large gatherings, limited social distancing, dense congregation, and mixing among groups.
  • The findings of this review are time sensitive; as time progresses, a different picture of where clusters occur may emerge, particularly given the wide scale adoption of protective public health measures in settings previously identified to be high risk.
  • Since September 2020, HIQA has provided evidence based advice in response to requests from NPHET.
  • HIQA’s advice to NPHET is informed by research evidence developed by HIQA’s COVID-19 Evidence Synthesis Team, with expert input from HIQA’s COVID-19 Expert Advisory Group.
    • The topics HIQA researches are outlined and prioritised by NPHET to ensure that they have rapid access to the best available evidence relevant to the SARS-CoV-2 outbreak.
  • 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, and evidence summaries, supplemented by an evidence-to-advice framework to guide the development of advice, where appropriate.
  • HIQA’s COVID-19 Expert Advisory Group is a multidisciplinary group, comprising nominated representatives from the relevant clinical specialties and areas of expertise, methodology experts, and public representation.