Isolation Error: Govt should have considered a few hard realities before tweaking Covid isolation rules

By: |
July 06, 2020 1:10 AM

Not enough is known about viral persistence in the case of Covid-19 to justify shortening home isolation period.

The government should remember erring on the side caution is not a bad thing at all.

Any person who had tested positive for Covid 19 and was advised home isolation will stand discharged after the tenth day from the onset of symptoms (of which, she has to have been fever-free for the final three consecutive days). The patient is however advised to isolate self at home for a further 7 day while monitoring her health. There shall be no testing to confirm virus-free status at the end of home isolation. These and a handful of other changes make up the gist of the Centre’s new guidelines on home isolation, which now is extended to asymptomatic cases now, in addition to doctor-certified very mildly symptomatic/pre-symptomatic cases, as stated under the May 10 guidelines. Under the May 10 guidelines—superseded by the new guidelines—home isolation was to be discontinued after 17 days of onset of symptom (or date of sample submission in case of pre-symptomatic cases), with the patient experiencing no fever for the final 10 of the those days.

While the move will certainly push recovery figures up over a shorter period of time, the government should have considered a few hard realities before it tweaked the home isolation duration in the manner it has. To be sure, even the US Center for Disease Control advises the same home isolation protocol as the new guidelines. But, our understanding of the SARS CoV-2 virus, its pathology inside the body and, indeed, the body’s response to it has many blanks at present. There have been reports of viral persistence—people reporting the virus weeks after infection getting detected—and what has been loosely termed “reinfection” (testing positive some time after having tested negative). No one is sure how long the virus stays in the body—a February report of the WHO studying Chinese data had found that the disease took an average of two weeks (14 days) to clear up, while a study published in late March in The Lancet, with data from Hong Kong, had found that the virus could be detected in a third of the patients after 20 days of the initial onset of symptoms.

The CDC notes that although there is no evidence of clinically recovered persons with recurrent detection of viral RNA transmitting Covid-19 to other, but it also says, it is still not possible “to conclude that such persons are no longer infectious.” The government should remember erring on the side caution is not a bad thing at all.

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