COVID-19 close contact isolation debate as Australia faces peak Omicron BA.2 wave
As Australia enters winter, changes to restrictions are under discussion as governments try to strike a balance between living with COVID-19 and protecting the community.
Advice from the Commonwealth’s main public health committee, the Australian Health Protection Principal Committee (AHPPC), has suggested that the isolation of close contacts should soon end.
Most jurisdictions have issued exemptions for close contacts in critical workforces to ensure essential services continue, but some are now questioning the need for asymptomatic close contacts to spend a week in isolation.
The AHPPC said quarantine could be replaced by other risk mitigation measures for close contacts once the peak of the BA.2 Omicron subvariant passes.
Here’s what that means.
Are any changes to the close contact rules in the works?
The rules for close contacts are unlikely to be scrapped altogether, but experts believe it may be time to scrap the isolation requirement.
The AHPPC suggested that instead of self-isolating, close contacts should get faster tests, wear masks outside the home and stay away from high-risk environments like hospitals and health centers. aged care facilities.
People who have been in close contact with a COVID-19 case must currently self-isolate for seven full days, with the same isolation rules applying in all states and territories.
There are some variations between states in how long people are exempt from these rules after recovering from a COVID infection.
Epidemiologists the ABC spoke to shared mixed views on changing the isolation rules.
Some believe the next logical step to ‘living with COVID’ is to treat it like any other respiratory infection, while others say relaxing close contact rules could cause the number of COVID-19 to rise again. case.
Infectious disease doctor Peter Collignon said it made sense that close contact rules would change after the current wave of cases passed.
“The consequences of COVID are much lower than a year ago,” said the Australian National University professor.
“People who are close contacts, if they’re vaccinated, they should be able to go around to have a reasonable normalcy of doing their jobs, because otherwise we’re going to have a lot of people permanently out of work.”
Professor Collignon believes that the high vaccination rate will protect the whole population against serious illness or death.
“It’s much more important than isolating people for seven days or 14 days because they are close contacts,” he said.
University of Melbourne epidemiologist Nancy Baxter said even with the protective vaccination provided, public health safeguards were still needed for close contacts.
“If someone comes to work, and as a close contact, of people with COVID at home, what will the rules be for that person? How will those rules be enforced?” Professor Baxter asked.
The power to change close contact rules rests with state and territory governments, and it appears no one is planning to scrap the isolation measures yet.
Professor Baxter said governments should always aim to reduce the number of infections as part of the ‘living with COVID’ plan.
“The question we want to ask ourselves is, ‘How often do you want to catch COVID?’ and if there is anything we can do besides vaccination and stimulation that could protect us against COVID four times a year,” she said.
“If people aren’t willing to wear masks, I think we really need to focus on improving ventilation, especially as we enter these winter months.”
What states culminate?
Before any changes are made, state governments will need to ensure that cases have peaked and are trending downward.
Modeling has proven flawed throughout the pandemic, but the latest data suggests cases will peak nationwide by mid-April at the latest and some jurisdictions will hit peaks over the next two days.
In Victoria, for example, the virus’s reproduction rate has been around 1.07 for a week now.
Professor Baxter said Victoria could experience a slight spike, after which the number of cases would plateau at a high level.
“It’s probably, in part, because of the transmissibility of BA.2, but also because we’re dealing with this new sub-variant at the same time that we’ve relaxed all of our restrictions.”
There are fears that easing restrictions before winter – coinciding with the country’s first flu season with widespread COVID cases – could cause problems for the health system.
Professor Collignon said hitting the peak of cases earlier would hopefully mean lower infection rates during the winter months.
“This particular winter, because we’ve had so much COVID over the past few months, we may not get the big numbers that I and others expect,” he said.
What does this mean for vulnerable Australians?
For Melbourne woman Sally Smith, the idea of rule changes that increase the risk of infection is difficult to reconcile with the inevitable increase in deaths.
His father, Ronald Cooper, was an active, healthy, triple-vaccinated 80-year-old when he contracted COVID-19 in early March.
He died in the intensive care unit at Wagga Wagga Base Hospital two days after testing positive, from a suspected blood clot which usually occurs due to COVID-19.
“We’re 100% sure there’s no COVID, no clot, no death. It was 100% COVID and it was a man who wasn’t done,” Ms. Smith.
“He had full confidence that he was going to survive.”
Ms Smith said it was hard to hear that her father’s death would be seen as more acceptable because of his age.
“He’s definitely not what people would think of when they heard of someone in their 80s who died of COVID. They wouldn’t think of someone living life to the fullest like my dad still was,” said Ms. Smith.
“At the end of the day, these are real people, this is real family, it takes lives that wouldn’t otherwise be taken, I don’t think we can dismiss that, or say that their deaths are somehow justified. because most people are going to survive. That sounds cruel.
Some older Australians told the ABC that even with up-to-date vaccination coverage, they still carefully weigh the risks of participating in activities that could expose them to the virus.
Should we be worried about “Deltacron” and other variants?
A new coronavirus variant named “Deltacron” has been detected in Australia, a hybrid that contains elements of the Delta and Omicron strains.
The first case of Deltacron was reported by New South Wales on Friday, and on Saturday Queensland Heath said it had detected “a number of cases”.
Early estimates suggest it is at least 10% more transmissible than Omicron.
Professor Collignon said that while the new variants may be more transmissible, they are generally less deadly.
“The bad news is that they tend to spread a little easier, but that’s what viruses do over time. They probably become less aggressive or virulent, but more infectious.”
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