Quirks of quarantine regime seem to defy logic
Boris Johnson is gamely accepting self-isolation but as he’s probably immune, is it really necessary?
THE self-isolation of Boris Johnson has highlighted a number of quirks in Britain’s quarantine system that seem to defy common sense.
While the Prime Minister will be anxious to follow the rules, the need for 14 days of seclusion for someone who is almost certainly immune, and could easily take a test to check if he is infected, does seem extreme. Here are the main flaws of self-isolation.
You can’t test your way out
The two-week window is based on the incubation period of the virus and how long it takes for symptoms to show. Coronavirus has an incubation period of five days and 97 per cent of people who contract the virus will show symptoms within 11 days.
So by setting 14 days for the self-quarantine period, officials are allowing time for the virus to emerge and symptoms to develop before people can be certain that they have not been infected by the virus and that they cannot spread it to others.
Yet one of the chief peculiarities of the self-isolation rules is that people must remain at home for 14 days, even if they test negative.
The situation is all the more bizarre because people who think that they have coronavirus symptoms and isolate while awaiting test results are allowed out immediately if it turns out they are not infected.
Someone with coronavirus symptoms only needs to self-isolate for 10 days as it assumed that they were infected several days previously. So someone who actually has the disease needs to stay inside for less time than someone who does not have the virus.
A recent study by Harvard and Yale showed that asymptomatic people did not shed the virus for as long as symptomatic people – 6.7 days versus 10.5 days – which suggested that it was much safer to release asymptomatic people earlier than those who had symptoms.
At last night’s press conference, Matt Hancock, the Health Secretary, said: “The Prime Minister going into self isolation is an absolutely clear demonstration that everybody, no matter who you are, needs to follow the rules.
“If you are asked by NHS Test and Trace to self isolate, then it is absolutely vital that you do. We keep those things in review but we’re not able to make any changes yet.”
Mr Johnson said he feels as “fit as a butcher’s dog” and “bursting with antibodies”, which should protect him against another bout of disease.
The Prime Minister was taken into intensive care in hospital seven months ago, and it is likely he is now immune to the virus. Although it is possible that Mr Johnson could catch the virus for a second time, the odds are minuscule. Of 55 million cases globally, there have been just 10 confirmed cases of reinfection.
There are some fears that antibodies may wane after just a few months, but a study by the University of Birmingham found that T-cells against coronavirus were present in everyone who developed the disease for at least six months, and probably far longer.
However, there are currently no antibody tests that can measure immunity with sufficient accuracy to release people from isolation.
A paper published last week in the BMJ suggested that tests recently bought by the Government would get it wrong 20 per cent of the time.
It’s too long to stick to
A recent study found that 14-day quarantine periods are ineffective because few people are able, or willing, to comply with the full two weeks.
Research by Oxera and Edge Health, scientists who have worked for the NHS and the Government, which looked into isolation periods of travellers returning to the UK, found the most effective strategy for preventing further transmission of Covid was testing arrivals three days into quarantine, freeing them if the results were negative.
This minimised the number of days that potentially infectious people were in the community by 60 per cent compared with just 25 per cent for full quarantine, because of non-compliance.
A study by King’s College London found that fewer than one in five people experiencing symptoms of coronavirus between May and August self-isolated for the seven day period.
The research also showed that just 10.9 per cent of people alerted by the NHS stayed at home for the full 14 days. Researchers said it was impractical to expect people not to leave the house, particularly when they had children or needed medication.
It may happen several times
For many, particularly those with schoolchildren, self-isolation can happen several times in a row.
Many people are being contacted several times a day by NHS Test and Trace because they live in large shared households with several people who have tested positive, meaning there could be several start days for the 14-day isolation period.
William Lloyd, 19, a Durham psychology student, said he had to block the number of NHS tracers after feeling harassed by the number of calls. He said: “I live in a house with nine other people at the moment and I think six people tested positive so we were all getting 10 calls a day. I stopped picking up at some point, and I got five calls in the space of 10 minutes so I blocked them in the end. Because everyone was testing positive at different times, the tracers didn’t know how long we should be isolating for.
“We asked Test and Trace whether we will have to self-isolate again if we get contacted again, and some have said yes, and others have said not for three months, but they don’t seem to know.”
Household inconsistencies
There is also an odd inconsistency among people who live in a household with someone who has coronavirus or symptoms.
If someone in the household tests positive, their housemates must selfisolate for 14 days from the start of the test.
But if they then develop symptoms themselves, they must reset the 10-day clock. It means that someone could end up self-isolating for much longer than two weeks, even though they have never picked up the virus.
Although they can have a test if they get symptoms, even if they receive a negative test result, they would not be allowed to stop self isolating if someone in the household continues to show symptoms.