‘Negligible benefit’: Experts urge South Africa to end quarantine and contact tracing

Leading South African doctors advising the government’s Covid-19 response have called for quarantine and contact tracing to be stopped immediately, saying the measures are of “negligible public health benefit”.

The Ministerial Advisory Committee (MAC) on Covid-19, co-chaired by Professors Koleka Mlisana and Marian Jacobs, wrote to South African Health Minister Joe Phaahla on Thursday to argue that existing quarantine and contact tracing protocols were “outdated” and no longer effective containment measures.

The MAC pointed out that only a very small proportion of Covid-19 cases were detected through testing, as up to 84 per cent of cases were estimated to be asymptomatic.

“It stands to reason that if the vast majority of cases are not diagnosed, then the vast majority of case contacts are also not diagnosed,” Profs Mlisana and Jacobs wrote.

“This means that quarantining and contact tracing are of negligible public health benefit in the South African setting.”

South Africa introduced a 14-day quarantine period for “high risk” contacts of Covid-19 patients in early 2020. This was later reduced to 10 days.

“Since then, several changes to the Covid-19 situation have occurred,” they wrote. “The proportion of people with immunity to Covid-19 (from infection and/or vaccination) has risen substantially, exceeding 60-80 per cent 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.”

The MAC also said the definition of “high risk” contact – those who “had face-to-face contact or [were] in a closed space with a Covid-19 case for at least 15 minutes” – was “based on an outdated understanding of the transmission dynamics” of the virus.

“The definition concentrates on droplet spread while ignoring aerosol spread, which can occur over distances greater than 1-1.5 metres, and also does not require as close a temporal association with the index case,” they wrote.

“In addition, it ignores the increased intrinsic transmissibility of subsequent variants of concern compared to the ancestral strain, as well as the fact that pre-existing immunity (from vaccination and/or natural infection) further changes the transmission dynamics.”

The experts said quarantining was not feasible in many social settings, and had a “substantial economic and social burden”.

Those include “significantly depleting” staffing levels at healthcare facilities and other frontline roles such as police, and “significantly reducing economic and governmental activities due to high levels of staff absenteeism”.

“We propose that quarantining be discontinued with immediate effect for contacts of cases of Covid-19,” they wrote.

“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.

“We further propose that contact tracing be stopped.

“Since quarantining of contacts of cases no longer serves a public health role, identifying contacts of Covid-19 cases equally serves very little role. In addition, contact tracing is impractical once the Covid-19 caseload rises, and is extremely burdensome in its use of human and financial resources.”

The letter came as Mr Phaahla announced that South Africa would remain under modified “level one” lockdown restrictions over Christmas, amid concerns over the spread of the Omicron variant, News24 reported.

https://www.news.com.au/technology/science/human-body/negligible-benefit-experts-urge-south-africa-to-end-quarantine-and-contact-tracing/news-story/108421f9be53815b5d01a3b5e48eb36f

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Daily Covid cases in South Africa have fallen for the fourth day in a row as Omicron continues to fade in the variant's original centre

Data from the National Institute For Communicable Diseases (NICD) shows 15,424 South Africans tested positive in the last 24 hours, down by a third on the nearly 24,000 cases confirmed last Tuesday.

A fifth fewer people were tested for the first in the last 24 hours compared to the same period last week, but test positivity — the proportion of those tested who are infected — has been trending downwards for eight days.

But hospitalisations and deaths – which lag two to three weeks behind the pattern seen in case numbers due to the delay in an infected person becoming seriously unwell – have risen.

More than 630 people were hospitalised across the country, up only 5 per cent in a week but the highest daily number in the country's fourth wave.

The previous record was last Wednesday when 620 people were hospitalised. Meanwhile 35 deaths were recorded, a 46 per cent uptick on last Tuesday.

The falling case numbers come despite only 25 per cent of South Africans being double-jabbed and boosters not being dished out in the country.

It raises hopes that the UK's Omicron wave will also be short-lived, with Britain also having a layer of protection in its booster programme.

It comes as UK scientists wait for data on how deadly the Omicron surge will be, with uncertainties about how severe it is and how well vaccines protect against serious outcomes.

But promisingly, cases already appear to be plateauing in the UK, with around 90,000 daily infections recorded for the last six days.

That's despite gloomy Government modelling warning that 1million Britons could be catching the virus daily by the end of the year.

Boris Johnson today said no to Christmas curbs because there is 'no evidence' on Omicron to justify it.

The NICD confirmed 55,877 people had been tested across South Africa in the last 24 hours and 15,424 (27.6 per cent) tested positive.

And test positivity dropped to 27.6 per cent, which is the lowest figure recorded in 10 days and marks the eighth day of infection rates trending downwards.

Britain's daily Covid cases have plateaued for the fifth day in a row as an expert claimed that the Omicron wave may have peaked already.

There were 90,629 infections in the past 24 hours across the UK, up 52 per cent on last Tuesday's toll but down slightly on the figure yesterday — despite wild projections of up to a million daily infections by New Year,

Cases have remained flat since last Friday when they hit a peak of more than 93,000.

In London, which has become a hotbed for Omicron, the wave also appears to be slowing. A total of 20,491 cases were recorded in the capital today, down slightly on yesterday's tally of 22,750.

The slowing statistics may be behind Boris Johnson's decision not to bring in tougher restrictions before Christmas , with the Prime Minister claiming today there was 'not enough evidence to justify' them.

Gloomy Government modelling presented to ministers last week said the mutant variant was doubling every two days and was infecting up to 400,000 daily by the weekend.

Professor Paul Hunter, an infectious diseases expert at the University of East Anglia, told MailOnline that Mr Johnson had made the right decision because cases 'look like they've peaked'.

He said: 'It's not all doom and gloom, it does look like Omicron has stopped growing. The numbers over the last few days seem to have plateaued and maybe even be falling.

'It's a bit too soon to be absolutely sure about that, but if it is the case Boris Johnson will breathe a sigh of relief. We have to be a little bit careful because it's only a few days.

'And because we're getting closer to Christmas there is nervousness that people may not come forward for testing because they don't want to test positive and miss out on meeting relatives.

'Omicron overtook the other variants around December 14 so most of any changes from there on would be down to Omicron. So if it was still doubling every two days that would have shown and we should have been at 200,000 cases yesterday and certainly more than 200,000 cases today.

'But the fact it has been around 91,000 raises the point that it might actually have peaked. But it will probably take until at least Wednesday to get an idea of a day that is not affected by the weekend. But I am more optimistic than I was a few days ago.'

Some 3.3million people in the country have tested positive since the pandemic began, but the true figure will be many millions more as not everyone who catches the virus is tested.

The majority of the new cases were recorded in Kwazulu-Natal (4,009), followed by Western Cape (3,324), as the virus spreads away from the ground zero Gauteng.

The province, which is home to Johannesburg and is where Omicron was first spotted, recorded the third-most cases (3,316).

Meanwhile, 633 people were hospitalised in the last day, up 5.7 per cent in a week, bringing the country’s total number of hospitalisations since the pandemic began to 459,844.

A total of 9,023 people are currently receiving hospital care.

And a further 35 Covid deaths were recorded, up 45.8 per cent on last Tuesday when 24 fatalities were registered.

The data from the country suggests the outbreak is fading around a month after it was first detected, while ministers and scientists in the UK are panicking about the impact the wave will have over the coming weeks.

And the UK has strengthened its response to the variant through its booster campaign, while third jabs have not been dished out in South Africa and just 23 per cent of its population are vaccinated.

However, UK experts have warned Britain's older and denser population is more susceptible to a big and deadly outbreak.

England's chief medical officer Professor Chris Whity last week said he expected to see the UK's daily cases rise extraordinarily due to Omicron, but also 'come down faster than previous peaks', mirroring South Africa's experience with the strain.

Professor Whitty told MPs on the Health and Social Care Committee last week: 'I think what we will see with this is — and I think we’re seeing it in South Africa — is that the upswing will be very incredibly fast even if people are taking more cautious action.

He added: 'It’ll probably therefore peak really quite fast.

'My anticipation is it may then come down faster than previous peaks but I wouldn’t want to say that for sure.'

It comes as Britain's daily Covid cases have plateaued for the fifth day in a row as an expert claimed that the Omicron wave may have peaked already.

There were 90,629 infections in the past 24 hours across the UK, up 52 per cent on last Tuesday's toll but down slightly on the figure yesterday — despite wild projections of up to a million daily infections by New Year.

Cases have remained flat since last Friday when they hit a peak of more than 93,000.

In London, which has become a hotbed for Omicron, the wave also appears to be slowing. A total of 20,491 cases were recorded in the capital today, down slightly on yesterday's tally of 22,750.

Professor Paul Hunter, an infectious diseases expert at the University of East Anglia, told MailOnline that Mr Johnson had made the right decision because cases 'look like they've peaked'.

He said: 'It's not all doom and gloom, it does look like Omicron has stopped growing. The numbers over the last few days seem to have plateaued and maybe even be falling.

'It's a bit too soon to be absolutely sure about that, but if it is the case Boris Johnson will breathe a sigh of relief. We have to be a little bit careful because it's only a few days.

https://www.dailymail.co.uk/news/article-10333235/Omicron-continues-fade-ground-zero-South-Africa-Covid-cases-fall-FOURTH-day.html

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Also see my other blogs. Main ones below:

http://edwatch.blogspot.com (EDUCATION WATCH)

http://antigreen.blogspot.com (GREENIE WATCH)

http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)

http://australian-politics.blogspot.com/ (AUSTRALIAN POLITICS)

http://snorphty.blogspot.com/ (TONGUE-TIED)

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