Search and Hit Enter

Christmas, isolation, quarantine … it’s all been cancelled

Christmas has been pretty much cancelled for many of us. And now South Africa seems to have cancelled caution. My reading of a new briefing from SA’s director general of health (which appears to tear up a lot of the guidelines on contact tracing, quarantine and isolation) is that the new guidelines are:

You will probably get some variant of Covid at some point, you won’t get terribly sick (or even a little bit sick), get on with your life.

I want to celebrate but am going to hold back a little. Besides it is a little late to rescue this year’s Christmas fun. But maybe there is just no pleasing me … Even my fourth negative Covid test (this morning, the morning of Christmas Eve) gave little cause for celebration since Plan A and Plan B were beyond hope of resuscitation.

Plan A: A long-awaited reunion centred around the return of Patsy and Eddie (the sisters who are serving life sentences abroad) and Co. That lunatic Boris Johnson wrecked this plan with the panicky, random Red List announcement (and reversal after just enough time had passed to royally screw things up for many people, never mind the damage done to businesses/livelihoods in South Africa’s hospitality sector).

Plan B: Party-hopping around the Western Cape, mucked up directly by Covid (Does everyone except me have Omicron?)

All Plan Bs seem to have been cancelled with everyone infected or at risk somehow.

Then suddenly this message from SA’s director general of health arrives in my inbox (my sources swear by its authenticity, no matter how crazy it seems).

Is Christmas on again … or maybe we are supposed to go back to work …

Is this herd immunity?

To: Heads of Provincial Health Departments
Subject: Revision to contact-tracing, quarantine and isolation and isolation protocols:
23.12.2021

(The following revisions have been accepted based on the Covid-19 MAC advisories of
16.12.2021)


1.1 Proportion of people with some immunity from infection and/or vaccination is high
• past infection in 60-80% in several sero-surveys
1.2 Containment strategies are no longer appropriate – mitigation is the only viable strategy
• Especially true of the newer, more infectious/transmissible variants like Omicron

1.3 New knowledge about the virus:
a) high proportion of asymptomatic disease,
b) high degree of asymptomatic and pre-symptomatic spread,
c) aerosol spread.
d) only a small proportion of cases are diagnosed.

1.4 We never identify most high risk patients
a) Testing skewed towards symptomatic (minority)
b) Not all symptomatic people test
c) Not all negative tests are true negatives
1.5 “High risk” definition probably isn’t meaningful anymore
a) Doesn’t take into account aerosol spread
b) Doesn’t take into account the newer variants (increased transmissibility)
c) Doesn’t take into account pre-existing immunity

1.6 Quarantine has been costly to essential services and society as many people stay away from their work and thus lose their income and children miss on their schooling.

Thus, the following is applicable with immediate effect :

Contact Tracing

2.1All contact tracing be stopped with immediate effect except in congregate settings and
cluster outbreak situations or self-contained settings.
2.2 All contacts must continue with their normal duties with heightened monitoring (daily temperature testing, symptom screening) of any early signs. If they develop symptoms then they should be tested and be managed according to the severity of the symptoms
2.3 All contacts must not be tested unless if they develop symptoms

Quarantining for contacts of confirmed cases of Covid-19

3.1 All quarantine is to be stopped with immediate effect
3.2 This applies to both vaccinated and unvaccinated contacts
3.3 No testing for Covid-19 is required irrespective of the risk exposure unless the contact becomes symptomatic

Isolation

• Isolation rules are applicable to both vaccinated and unvaccinated individuals
• Isolation rules are applicable to high and low risk individuals
• Return to work from Day 10 onwards must as always take into consideration the individual’s clinical status. Only those patients well enough to work should do so.
4.1 Asymptomatic Individuals
a) No isolation period required
b) To do self-observation for 5-7 days for development of any symptoms with enhanced
precautions including avoiding attending settings where many people gather, mask
wearing and social distancing.

Mild disease

Mild diseases refers to persons who have symptoms and have tested positive but who do not require hospitalisation. do not have shortness of breath, dyspnoea or abnormal chest imaging. Mild disease symptoms and signs include but are not limited to the following: fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhoea, loss of taste and smell.
Isolation period is maintained at 8 days.
The person in this category must wear a mask at all times (even at home, work and all
public spaces) for the duration of the 8 days period of isolation.
Where a healthcare worker returns to work after Day 8 such a worker must wear a N95
mask at all times and must at all times avoid contacts with extremely high risk patients
(especially severely immune-compromised patients).
There is no need for Covid-19 test (either PCR or antigen test) be performed prior to
returning to work after 8 days isolation period.
For mild cases, isolation beyond 8 days must be supported by the medical report.

Severe Disease:

Severe disease refers to persons who test positive and have exacerbated symptoms i.e
shortness of breath, dyspnoea, chest pain and abnormal chest imaging and who require
hospitalisation to manage the clinical presentation.

Isolation period is maintained at 10 days after clinical stability is achieved
The person in this category must wear a mask at all times (even at home, work and all
public spaces) for the duration of the 10 days period of isolation.
Where a healthcare worker returns to work after Day 10, such a worker must wear a N95
mask at all times and must at all times avoid contacts with extremely high risk patients
(especially severely immune-compromised patients).
There is no need for Covid-19 test (either PCR or antigen test) be performed prior to
returning to work after 10-day isolation period
For severe cases, isolation beyond 10 days must be supported by the medical report

Return to work

All people that have been infected and have been in isolation, must be ready to return to work after completing mandatory period of isolation as above and no further testing is required after either 8 or 10 days of isolation.

No Comments

Leave a Reply

%d bloggers like this: