Border GPs say a lack of collaboration in contact tracing between the Republic and Northern Ireland is contributing to the spread of Covid-19 in the region.
Frustrated doctors say contacts of cases on one side of the Border, who live on the other, are coming to them for advice because they are not being phoned by contact tracing teams.
The Health Service Executive has acknowledged that data protection issues prevent Northern Irish contact tracers making direct contact with cases and contacts across the Border.
Hospital Report
Instead, cross-Border notifications are sent by public health officials to their counterparts in the Republic, who then contact affected people.
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The challenges of tracking the virus in the region are further complicated by a key difference in contact tracing policy between the Republic and Northern Ireland. In the Republic, all close contacts are contacted and offered a Covid test whereas in Northern Ireland only close contacts with symptoms are offered a Covid test, the HSE says.
Dr Shane Corr, in Carrickmacross, Co Monaghan, said he has dealt with a number of patients who are close contacts of positive cases living in the North.
“There is still no mechanism for cross-Border contact tracing in Ireland seven months into the pandemic and cases are seeding in both jurisdictions in consequence,” he said. “It leaves us in an invidious position.”
Dr Corr said he was not aware of any mechanism by which Northern Irish contact tracers can contact their Southern counterparts, or trace contacts in the Republic.
“What is the point of locking down the country if people are able to cross the Border in either direction infecting people on the other side, and there are different rules for contact tracing?”
Another Monaghan GP, Dr Ilona Duffy, said her understanding was that there was supposed to be linkage between the two jurisdictions but "clearly, it's not working".
“We’re on the border and we have a lot of patients who work in Northern Ireland and live here, and vice versa. A lot of people are not being traced by the system. There’s no clear guidance and it’s been going on for ages.”
“All we can do is arrange a test for them and give them general advice,” she said.
In response, the HSE said non-resident close contacts of Covid-19 cases can be identified as part of a public health assessment.
To remain compliant with data protection requirements, public health officials in the North send cross-Border notifications of cases and contacts to the Health Protection Surveillance Centre. It then sends this information to the local department of public health, which uploads it to the national contact management platform to facilitate “timely” testing and tracing.
There is a reciprocal arrangement for sending notifications from the Republic to the North, the HSE said.
Senior public health officials from both sides of the Border meet a number of times a week to ensure any issues or incidents are managed correctly, it added.
Dr Duffy described the processes for managing contact tracing in the Republic as “convoluted” and “archaic”.
She said she knew of one doctor who wanted to work in contact tracing but whose application was delayed by a request for his Leaving Certificate.
Garda vetting was also causing unnecessary delays, she said, given that none of the staff to be appointed would be dealing with patients face-to-face.
