36 Irish casualties points to a testing process that is out of control.

Reporting and processing is a problem in Ireland and across Europe. Our latest casualty numbers are moving from horrible to horrific. And I will certainly get to that later in the piece. But first I want to start with Belgium and France to make sure we in Ireland are indeed recording everything properly here.

In the last week France and now today Belgium have reported revised coronavirus case and casualty figures. I have previously written about France and their 15,000 + addition of previously unreported cases.

Today it is Belgium’s turn. The Belgian daily report of their data is usually early in the morning. They detail the previous day’s number of cases and unfortunately their increasing number of deaths too. Today (April 7th 2020) they dropped a note with their reported figures. World-o-meter included the below explanation along with their daily updated coronavirus report for Belgium.

1380 new cases and 403 new deaths in Belgium: including 241 previously unreported deaths in retirement homes [source] “

Link to French report below.

France reports 15,000 previously unreported cases.

This is a worrying recent trend emerging from Europe. I doubt it is sinister but at best it indicates authorities unable to control and keep up with their emerging data. It leads to a very simple question in the Irish context.

How are the HSE coping with Ireland’s data. How are we treating nursing home and residential care coronavirus victims?

How are we handling contact tracing volumes?

I genuinely do not know the whole answer to these questions at the moment. Are they being reported accurately? – My information is that residential care home patients that have taken a test and are confirmed positive are being reported in the official figures. Where a question mark remains is whether a confirmed positive in a nursing home or care centre is triggering mass testing of all other patients in the same facility. And if one of those people dies quickly are they included in official statistics. Like France and Belgium, Ireland is experiencing major difficulties with cluster outbreaks in Health care facilities.

Our major problem at the moment is the processing of tests. My understanding is that as of 6 pm today (April 07th 2020) German efficiency hasn’t delivered significant results for Ireland as of yet.

Also the changing contact tracing criteria have caused problems. A source close to one of the contact tracing centres has indicated to me that there is still ongoing change regarding the 1st call procedures to be followed when calling people that have tested positive. The prioritization of who to call is also being reviewed regularly. Happily though, my source was able to reveal that health workers are being treated at highest priority in regards to turnaround time.

One major consternation amongst the contact centres is around the time lag. Prioritization is great for the prioritized, but more than one person in Ireland was confirmed positive and contact traced today that had their test taken over 10 days ago.

This places the staff in the brutal scenario of potentially ringing patients or next of kin to confirm they are positive when the person in question could in fact already have died. It also must be stated that the vast majority of the people from these older results have already resumed their lives due to very mild symptoms. The data indicates that the public messaging on self isolation did indeed make it’s mark in mid- March on people and that the Taoiseach’s address on St Patrick’s day played it’s part in this increased and early awareness .

Today’s HSE NUMBERS of 36 deaths against another day of mid 300 new cases indicates we have lost control of not the testing but the processing of tests. I certainly hope this is the case because the only other countries that have reported a daily new case/death rate of 10%, like we did today, are Spain and Italy. If this is a consistent theme in the days ahead we have some real trouble ahead. At the moment I am going to choose to believe it is because we have thousands of tests unprocessed. Again my information is that Germany has not yet returned any significant number of tests we have sent to them for processing.

The contact tracing centres are braced for a huge escalation in work load towards the end of this week or early next week as the backlog eases. It is expected that we will see a multiple of today’s positive case numbers once this happens. For anyone anxious about this try to remain calm and remember that a good percentage of this is simply a long overdue processing backlog of older test results.

Unfortunately though any honest analysis of today’s huge number of deaths begs the question: Did any person die today that was a prioritized case, before they officially received a call from a contact tracing centre or indeed before they received an official positive coronavirus test result?

We need to regain control of the processing of tests.

I fear we have been lulled into a false sense of security for the past couple of days. The HSE have responded to media questions and have indicated they will be ramping up their test capacity to 4,500 tests a day this week. However the number of tests we are doing is the wrong question to ask.

The number we need to know is how many tests are the Irish HSE and labs processing each day?

I feel that this figure over the past week has been much lower than the number of tests performed. I haven’t seen updated numbers for completed tests (positive/negative) since last week.

In the first two weeks of the crisis the initial bottle neck was the ability to perform the coronavirus test. While this is probably still an issue for people, now a more worrying one, and one where I believe the major logjam is at the moment revolves around processing tests. And it may well be causing us to relax a little bit too much.

RTE and the Irish Times reported earlier in the week, that a deal is completed with a German lab to process 2,000 tests a day for us and as mentioned earlier a backlog have been sent to Germany. How efficiently is this being managed?

Link to the RTE Report here

I think, based on the steady flow of consistent case numbers (350-450) being released by the HSE for the last four or five days ( up to Tuesday night April 07th ) the German numbers haven’t been at all fully reported yet and these are simply the number of tests being processed by the Irish Labs and marginal German returns and this is their upper limit capacity.

Keep a close eye on the daily briefings for the next few days. I have a hunch we are going to get an uptick that is in the 1,000 – 1,200 + range on at least one day. If we do I would suspect it is from the overflow of unprocessed German results.

Tighter questioning of the HSE is required this week on testing.

How many tests are taken each day?

How many completed tests are awaiting processing?

How many tests are fully completed and processed?

And don’t forget about those residential care facilities.

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