Covid experts explain why quarantining, isolating contacts was scrapped

As South Africa exits the fourth wave of Covid-19 and sees more regulations adjusted, the ministerial advisory committee (MAC) confirmed that quarantining and isolation will be scrapped. 

Head of infectious diseases at Helen Joseph Hospital and MAC member Dr Jeremy Nel explained in government’s weekly Covid media briefing that quarantine and isolating people was not only costly, but to a large extent, ineffective. 

“We propose that quaranting be discontinued with immediate effect for contacts of cases of Covid-19. This applies equally to vaccinated and non-vaccinated contacts.

“No testing for Covid-19 is required irrespective of the exposure risk, unless the contact becomes symptomatic.”

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Why quarantining and isolating has been scrapped 

High risk patients are hardly ever identified, and testing for Covid-19 is skewed towards those exhibiting symptoms.

With two years worth of data on the ever-evolving virus, experts have found a staggering number of asymptomatic cases. 

In addition, Nel explained that tests have to be conducted just before or as symptoms present themselves, as this is when people are most infectious. 

Not all symptomatic patients get tested either, and not all negative tests are true negatives, he added. 

In addition, the definition of high risk “probably isn’t meaningful anymore”.

Aerosol spread through microscopic particles in the air are not taken into account, and neither are newer variants, which often come with increased transmissibility, Nel explained. 

Pre-existing immunity, either through prior infection, vaccination or both, is also not taken into account. 

Quarantining and isolating prospective and Covid patients in facilities such as hotels and quarantine areas is also a costly exercise. 

It adds financial strain and also puts often healthy workers out of the workforce. 

And lastly, Nel said quarantining and isolation adherence was “erratic” at best. 

“By the time a case has been isolated, most of the transmission has probably occurred already.” 

Adjusted Covid protocols 

Some of the changes made by Cabinet on Monday had caused confusion, National Department of Health Minister Joe Phaahla conceded in Friday’s briefing. 

There is no longer a need to test for asymptomatic contacts. 

If a person tests positive, they need only “take precautions in mingling with people closely” for five to seven days. 

Contact will also stop, unless closer outbreaks that occur in clearly identifiable congregant settings, such as work meetings or offices, take place. 

Those who test positive during routine testing such as that required when travelling but are asymptomatic do not need to self-isolate. 

If mild illness is experienced, isolation has been reduced to seven days. If someone has been hospitalised, they are required to spend an additional week at home before returning to work. 

Changes to Covid-19 protocols will be gazetted over the next few days, Phaahla said. 

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Stable but not out of the woods 

Phaahla confirmed a steady decline in new Covid-19 infections, but said this decline was slower than in previous waves. This, he said, painted a “confusing picture”, creating a “stalemate”. 

“The curve is not flattening, it’s been on a plateau.” 

The Free State, Gauteng and Mpumalanga have shown increases in new infections over the last week. Despite widely varying positivity rates, new case loads have remained fairly stable. 

Phaahla said epidemiologists believed the plateau was linked to the reopening of schools and increased movement, attributed to people returning from holiday. 

He said there was reason to be “optimistic” as people begin to settle down and movement is reduced, with the current 10.6% positivity rate said to decline to 5% by the end of February.

“The fourth wave remains stable but we are not out of the woods. Covid is far from being eliminated,” Phaahla warned. 

The healthcare sector is not under strain at present, Phaahla continued. Just over 5,000 people have been admitted to hospital, 85% of which are in general wards. This takes up just 4.2% capacity. 

And in terms of vaccinations, South Africa crossed the 30 million threshold on Wednesday. Although this took longer than expected, Phaahla said this was still a “significant milestone”. 

At present, at least 18 million adults have at least one vaccine, representing 46.7% of the population. 41.6% of adults have been fully vaccinated. 

Just over one million 12 to 17 year olds have received their first dose of the vaccine. 

There have been 646,000 booster shots administered. 

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