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SA could soon drop quarantining of Covid-19 contacts as this doesn't serve its purpose, says MAC

19 December 2021 - 08:17
A general ward of quarantine beds at the Nasrec quarantine site near Soweto. South Africa is set to do away with quarantining Covid-19 cases as this no longer serves the public health role and is not feasible.
A general ward of quarantine beds at the Nasrec quarantine site near Soweto. South Africa is set to do away with quarantining Covid-19 cases as this no longer serves the public health role and is not feasible.
Image: Dino Lloyd

The 10-day requirement to quarantine when you have come into contact with a Covid-19 case, and the subsequent contact tracing, could soon become a thing of the past if health minister Joe Phaahla approves a proposal to discontinue these prerequisites.

In an advisory dated December 16 and signed by the co-chairs of the ministerial advisory committee (MAC) on Covid-19, Prof Kholeka Mlisana and Prof Marian Jacobs propose that quarantining be discontinued with immediate effect for contacts of cases of Covid-19 as this “no longer serves a public health role”.

“Identifying contacts of Covid-19 cases (that is) 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,” they said in a statement addressed to Phaahla and acting director-general for health Nicholas Crisp.

If approved, the discontinuation will apply to both vaccinated and non-vaccinated contacts.

“No testing for Covid-19 is required irrespective of the exposure risk, unless the contact becomes symptomatic. We further propose that contact tracing be stopped. 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,” reads the document.

Mlisana didn't respond to queries about the advisory.

Crisp told TimesLIVE that the advisory is “probably authentic”, but he hasn’t seen it yet. “I know that there is an advisory which was being discussed, but I haven’t seen it yet. I doubt if the minister has seen it too. We don’t implement advisories until the minister has had a chance to consider them.”

Crisp said he was not sure if the advisory would be implemented as it was a ‘difficult discussion”.

The advisory noted that 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”.

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

The advisory said quarantine is only likely to be effective and practical in certain circumstances as a control measure for a disease outbreak, and did not have a role for endemic diseases, where control is not possible.

The advisory noted that the proportion of people with immunity to Covid-19, either from infection 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 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.”

TimesLIVE


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