Here’s why the MAC says SA should stop tracing, quarantining of Covid contacts

The Ministerial Advisory Committee (MAC) on Covid-19 has recommended that contact tracing and quarantining be stopped with immediate effect for contacts of cases of coronavirus.

The MAC said it made the recommendations due to the high proportion of people with immunity to Covid-19 due to either infection or vaccination, and therefore quarantining of contacts should be stopped as it was no longer viable in South Africa’s current social and economic climate.

The committee made the recommendations in an advisory to Health Minister Dr Joe Phaahla, dated 16 December 2021.

“As current testing only identifies a small minority of all Covid-19 cases, quarantining contacts of these cases serves no demonstrable general public health purpose. Furthermore, quarantining is not feasible in many social settings, and is associated with both significant strain on staffing levels and costs to the individual and to the broader society.

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“Since quarantining contacts of cases no longer serves a public health role, identifying contacts of Covid-19 cases (i.e. contact tracing) equally serves very little role.

“In addition, contact tracing is impractical once the Covid-19 caseload rises (due to the large number of contacts that have to be identified for each case), and is extremely burdensome in its use of human and financial resources,” the MAC said in its advisory.

The committee made the findings after a technical working group was constituted consisting of experts from the MAC on Covid-19, the National Institute of Communicable Diseases (NICD), the National Institute of Occupational Health, and the fields of public health and infectious diseases.

Should the recommendations be adopted by the Department of Health, they would apply to vaccinated and non-vaccinated contacts and no testing for Covid-19 is required, irrespective of the exposure risk, unless the contact becomes symptomatic.

14-day quarantine period

In early 2020, South Africa implemented a 14-day quarantine period for “high-risk” contacts of patients with coronavirus.

High-risk individuals were defined as those who had face-to-face contact or were in a closed space with a Covid-19 case for at least 15 minutes, including healthcare workers unless they were wearing appropriate personal protective equipment.

This was later amended to reduce the isolation time to 10 days, and also to allow for healthcare workers to undergo testing for Covid on day five or seven of their quarantine, and to return to work if this test was negative.

Since then, several changes to the Covid-19 situation have occurred in the country.

The MAC said: “The proportion of people with immunity to Covid-19 (from infection and/or vaccination) has risen substantially, exceeding 60-80% in several serosurveys.

“We have learned more about the manner in which Covid-19 is spread, and also now have to contend with variants of concern whose epidemiology differs from that of the ancestral strains of SARS-CoV-2.

“Crucially, it appears that efforts to eliminate and/or contain the virus are not likely to be successful. Therefore, it is critical that the role of containment efforts like quarantine and contact tracing is re-evaluated.”

Compiled by Thapelo Lekabe

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