PM wants to scrap mandatory quarantine by the end of the month but critics question his motivation
https://www.theweek.co.uk/-The Week Staff
Boris Johnson has announced that he hopes to scrap remaining coronavirus restrictions, including mandatory isolation, in England by the end of February.
The current domestic restrictions are due to expire on 24 March, but the prime minister told MPs in the House of Commons today that he expected to lift them a month early if “the current encouraging trends in the data continue”.
It means that the legal requirement for those who test positive for Covid-19 to isolate for at least five days will end and be replaced by government “guidance”, which will encourage people to stay at home. But there will be “no legal requirements backed up with fines of up to £10,000” forcing people to stay at home if they become infected, said The Guardian.
Johnson said he would outline the government’s strategy for living with Covid when Parliament returns from recess on 21 February. Downing Street sources told the BBC that there could also be an update on the remaining travel rules when Johnson sets out his strategy later in the month.
Johnson’s decision has “taken most by surprise”, said the BBC’s health correspondent Nick Triggle. While hospital cases are “continuing to fall” and the “huge wave” of Omicron infections has translated into relatively few deaths, “infection levels are still high and it’s unclear what this will do to the spread of the virus”.
Triggle concluded that England is “fast approaching the point where it treats Covid like any other respiratory illness”.
While the move is said to be popular with many Tory backbenchers, ITV’s Robert Peston tweeted that “no one in or around” the Scientific Advisory Group for Emergencies (Sage) or New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) is “aware of any scientific advice given to the PM that the requirement to isolate for those infected with Covid-19 should be terminated from end of the month”.
Peston added that the typical reaction to the announcement had been: “It’s politics, isn’t it.”
The PM’s official spokesperson has this afternoon clarified that the government would not be recommending that people go to work with Covid.
“What we would simply be doing is removing the domestic regulations which relate to isolation,” he said. “But obviously in the same way that someone with flu, we wouldn’t recommend they go to work, we would never recommend anyone goes to work when they have an infectious disease.”
The infectiousness question
The current regulations require someone who has tested positive for Covid-19 to isolate for a full five days. If they test negative on a lateral flow test on days five and six of their isolation, then they are permitted to stop isolating.
The government’s decision to cut the quarantine period down to five days last month sparked questions about how long patients are infectious after catching Covid.
According to current government advice, people who have Covid-19 can infect others “from around two days before symptoms start, and for up to ten days after”.
Infected people can pass on the virus even if they have “mild symptoms or no symptoms at all, which is why they must stay at home”, the guidance continued. “People who live in the same household as someone with Covid-19 are at higher risk of developing it. They could spread the disease to others even when feeling well.”
Speaking to the Today programme before the five-day rule change was announced, Professor Neil Ferguson, who helped shape Britain’s coronavirus lockdown strategy, said that the isolation period could be reduced if “coupled with lateral flow testing”.
“It’s always a trade-off between effectiveness and people’s adherence,” said Ferguson, a professor of epidemiology at Imperial College London. Reducing the time that people had to isolate by a few days “would not reduce the effectiveness of the measures that much” if combined with regular testing while in quarantine, and could boost compliance.
Paul Hunter, a professor of medicine at the University of East Anglia, told the Daily Mail that people with Covid are most infectious “in the first five days”.
“Some people are no longer infectious after three days and it makes no sense to keep them locked up,” he added. “Isolating people for ten days when they are no longer infectious will harm the economy and leave vital public services, such as the NHS, short-staffed.”
Although lateral flow tests are a helpful tool in the fight against the coronavirus, they have “always been imperfect”, said the Financial Times (FT).
The tests detect about 72% of symptomatic cases, and 58% of asymptomatic case, according to a meta-analysis of studies by the Cochrane Library medical database.
By contrast, PCR tests can detect the presence of a virus “earlier and in smaller quantities because they amplify the sample and pick out genetic signatures”, the FT said.
Viral loads “increase in bursts”, often around 48 to 72 hours after initial infection, the paper continued.
Catherine Moore, a consultant clinical scientist at Public Health Wales, explained that “the big downside of lateral flow devices is probably their sensitivity in the early parts of the infection when you may not have lots of virus on board straightaway”.
Moore pointed to social media posts by people who had tested negative in the morning but positive in the afternoon. “That’s just showing you that the viral load increases over the day, which you would expect to see,” she said.
If further tests are not taken after a negative result, however, such cases may be missed.
Not everyone is pleased about the PM’s plan to drop self-isolation requirements entirely. For many people with an immune condition or those who are unable to get vaccinated for medical reasons, the prospect is a terrifying one.
Susan Walsh, chief executive of Immunodeficiency UK, told the BBC that the government’s proposal to end self-isolation has caused “so much anxiety”. “People are using terms like health apartheid,” she added. “There’s no real protection for these people.”
“I understand that a lot of people are really fed up with all the restrictions,” one woman with an immune condition told the broadcaster. “But I just feel like a second-class citizen now.”
Today, Guardian columnist Frances Ryan tweeted: “There is no possible reason to end the legal requirement to isolate if you test positive for Covid.
“Coronavirus has not stopped being a highly contagious deadly disease. Clinically vulnerable people have not stopped existing. A politically motivated punt that will cost lives.”