The Health Information and Quality Authority (HIQA) has today published its advice to the National Public Health Emergency Team (NPHET) on whether or not the minimum age of mask wearing should be reduced. Separately, HIQA has also published its advice to NPHET on the use of rapid antigen testing for screening or surveillance of asymptomatic individuals to limit transmission of SARS-CoV-2.

Based on the available evidence, including consideration of the latest international practice as well as input from its COVID-19 Expert Advisory Group, HIQA has advised NPHET that the current minimum age for mask wearing in the community should not be reduced.

HIQA’s Chief Scientist, Dr Conor Teljeur, said: “The use of layered mitigation measures in schools and childcare facilities, such as physical distancing, hand hygiene, cough etiquette, increased ventilation, and, most importantly, not attending when you have symptoms of COVID-19, reduces the risk of transmission of SARS-CoV-2. National and international evidence suggests that when these mitigation measures are fully implemented, schools become low risk environments.”

“As there are currently high rates of infection in the community, we encourage parents and children to continue to observe public health guidance before, during and after school activities. We also recommend that anyone who has the opportunity to avail of the COVID-19 vaccine does so.” 

HIQA also reviewed the use of rapid antigen testing in real-world settings for screening or surveillance of asymptomatic individuals (those who have no known or suspected exposure to SARS-CoV-2) to limit transmission of SARS-CoV-2. Based on the current evidence, there is uncertainty regarding the effectiveness of rapid antigen testing for screening of asymptomatic individuals with the aim of limiting transmission of SARS-CoV-2. There are also significant resource, implementation, regulatory, ethical and social considerations associated with the widespread use of rapid antigen detection tests (RADTs) in asymptomatic populations.

HIQA has advised that RADTs may have a role in limiting transmission in certain circumstances, but only as an additional public health measure, rather than a replacement for known mitigation measures. 

Dr Teljeur continued: “A negative antigen test in an asymptomatic person should not be viewed as a ‘green light’ to engage in activities that would be otherwise considered as high risk for transmission. Also, the introduction of routine and widespread rapid antigen testing in asymptomatic populations would require a significant investment. Any decision to use RADTs for screening in asymptomatic populations should consider a variety of factors including the prevalence of COVID-19, the proportion of the population who have adequate immunity and the vulnerability of the population involved.” 

You can find these documents at the link at the top of the page.

Ends.

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: Reduction of the minimum age for the application of mask wearing requirements and recommendations.
  • Advice to the National Public Health Emergency Team: Use of rapid antigen testing for screening or surveillance of asymptomatic individuals to limit transmission of SARS-CoV-2.
  • Evidence summary for use of rapid antigen testing for screening or surveillance of asymptomatic individuals to limit transmission of SARS-CoV-2

• NPHET asked HIQA to provide advice on the following policy question:
  • "Should the minimum age for the application of mask wearing requirements and recommendations be reduced?

• Current guidance states that children over the age of 13 years, and those in secondary school, should follow adult guidance for face mask usage. Younger children can choose to wear a mask or be requested to do so by a healthcare professional.

• Information and guidance on mask usage in Ireland can be found here.

• NPHET also asked HIQA to provide advice on the following policy question:
  • “What is the emerging evidence with regard to the effectiveness of rapid antigen testing of asymptomatic populations, to limit the spread of SARS-CoV-2.”

• Screening tests are intended to identify occurrence of SARS-CoV-2 infection at the individual level, even if there is no reason to suspect infection. Surveillance testing is used to gain information at a population level; this usually involves testing a representative group of the population as opposed to all individuals.

• Sixteen relevant studies were identified that provided evidence regarding the effectiveness of RADTs for screening of asymptomatic individuals to limit transmission of SARS-CoV-2. Eight examined the effectiveness of RADTs for mass testing, four for pre-event screening and four for serial testing in different settings (high school students, prison inmates and staff, students and staff of a university sports programme, and staff in care homes). No evidence was found regarding the use of RADTs for surveillance of asymptomatic individuals.

• Overall, there is uncertainty regarding the effectiveness of rapid antigen testing for screening of asymptomatic individuals at limiting the transmission of SARS-CoV-2. This uncertainty is due to the relatively low number of studies identified, the predominantly observational and/or uncontrolled study designs used, and concerns regarding the methodological quality of these studies.

• HIQA provides evidence-based advice to NPHET to inform public health policy, advice and practice in the context of COVID-19. HIQA’s advice is informed by research evidence developed by HIQA’s COVID-19 Evidence Synthesis Team.

• This advice to NPHET is developed with expert input from HIQA’s COVID-19 Expert Advisory Group. HIQA’s COVID-19 Expert Advisory Group is a multidisciplinary group, comprising nominated representatives from the relevant public health and clinical specialties, methodology experts, and public representation.

• 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.