Isolation Requirements

We should adopt 72-hour isolation periods that end with a negative test.

Current Policy

Under Phase 2 of the Government’s Omicron plan, those positive for COVID-19 must isolate for 10 days, household contacts must isolate until the end of the 10 day period for the positive case, and non-household close contacts must isolate for 7 days. All of those isolation periods remain the same, whether or not the case or contact tests negative in the interim. The only exemption is for close contacts considered “critical workers” by the Government, who can access rapid antigen tests and return to work if their daily test is negative.

Potential Benefits

Isolation requirements, if they successfully isolate infectious people, can slow the spread of the disease and reduce the immense pressure on the health system which can result from a sharp peak in infections and hospitalisations. However, the benefits of New Zealand’s isolation requirements in an Omicron environment are relatively slim.

For starters, isolation requirements for close contacts are only as good as the contact tracing which informs them. The flaws in our contact tracing system have already been laid out. For many, their isolation period only begins once they are no longer infectious. Thus, there are no public health benefits to them isolating.

Similarly, the requirement that those who have tested positive stay in isolation for 10 days, whatever their test results say, flies in the face of evidence and international best practice. Very few people remain infectious 10 days after their first positive test. According to the CDC, the real period of infectiousness is closer to 3 days after symptoms appear.

Costs

Isolation periods which are too long may actually increase the spread of the disease. If people are afraid of excessive isolation periods, they are less likely to get tested and to comply with contact tracers. Most people want to protect themselves and their families, but if the possible cost of getting tested is a pointless 10 day home detention sentence, many will decide it is not worth the risk.

Conversely, excessive isolation periods also encourage people to live in a self-imposed lockdown to avoid the risk of missing work and important events due to isolation. These self-imposed lockdowns can be as damaging to hospitality businesses as those imposed directly by the Government.

And, of course, excessive isolation periods also impose significant costs on those who have to obey them. They are needlessly being held inside, unable to work and provide for their families and unable to participate in society.

This can also have wider societal consequences. If entire workplaces — or even a sufficiently large proportion of their workforce — are struck down by excessive isolation periods, our economy could soon grind to a halt. Although the Government has made allowances for “critical industries”, its judgement about what industries are truly “critical” is not infallible. The economy is far too complex to be divided into critical/non-critical. We may soon find that many supposedly “auxiliary” industries play a critical role in maintaining our standard of living.

Conclusion

Isolation requirements must adapt to the scientific evidence. Keeping people locked in their houses longer than is necessary imposes real costs — to them, for society overall, and for the quality of our COVID-19 response.

We need to rethink our approach to the isolation of positive cases. The best measure of whether you are still infectious with COVID-19 is your result of a rapid antigen test (RAT). That’s because RATs pick up traces of the virus in your upper respiratory tract. If there is no virus there, no virus can be spread when you breathe out. Singapore’s test protocol recognises this and asks mild positive cases to remain isolated for 72 hours before taking a daily RAT every day until the result is negative. As soon as a case receives a negative result, whenever that occurs after the initial 72 hours, they are free to go. This approach — or the CDC’s approach of simply shortening isolation periods to 5 days — should be adopted here in New Zealand.

Similarly, for close and household contacts, a testing-led isolation policy is the most sensible approach. We know that a negative RAT result means a contact is unlikely to be infectious. Contacts should be regularly tested and, if they test negative, should be allowed to continue their lives as usual.

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Prime Minister: Give us control of our lives again by removing restrictions that no longer stack up.

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Isolation Requirements

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LET'S MOVE ON