COVID: Is England scrapping self-isolation too soon?

London, Feb 24: The legal requirement to self-isolate after testing positive for COVID-19 has been lifted in England and scientists are concerned the changes will lead to more infections and potential new variants.

As of February 24, people no longer legally have to self-isolate, but the UK government says that until April 1, it still advises people who test positive to stay at home and avoid contact with others for five days and then test negative two days in a row.

Mask-wearing and social distancing has not been compulsory in England since late January.

Zoe Hyde, an epidemiologist at the University of Western Australia, told DW that while easing quarantine requirements for contacts of cases may be justified if protocols like testing negative were in place, this was not the case for positive cases.

"Ending the requirement for known cases to isolate is completely at odds with public health," said Hyde.

"It's a recipe for more transmission, more waves of disease, new variants, and sustained disruption to health systems and the economy," she added.

But Catherine Bennett, chair in epidemiology at Deakin University in Australia, pointed out that the change in rules won't result in all positive cases choosing not to self-isolate.

"This is part of the transition to living alongside the virus where we move away from rules that are increasingly difficult to enforce," Bennett told DW.

"Removing rules to self-isolate doesn't mean people must stop isolating, just as having rules doesn't mean everyone is following them. So whilst there might be more people out mixing than there currently are, it won't be a step change from 0% to 100%," Bennett said.

Pressure to work

Sarah Pitt, a principal lecturer at the University of Brighton and fellow at the UK-based Institute of Biomedical Science, said she is worried people who are ill with COVID and should be resting will be under pressure to go to work once the isolation requirement falls.

"This might affect the time it takes for them to recover, might increase the risk of them developing long COVID, and they can also infect other people," Pitt told DW.

The loss of financial assistance for people who are too ill to work adds another layer of pressure.

From February 24, self-isolation support payments will end, along with national funding for practical support and the medicine delivery service.

"Removing the legal requirement to self-isolate means that people will not receive the same financial assistance that they had before, so some people will have to go to work when they really should be at home," said Pitt.

Concern over variants

Scientists have also expressed concern about the change to England's self-isolation rules and the potential for new variants.

"Variants can emerge anywhere in the course of viral replication, and the higher the infection rates, the sooner we might see [another] one," said Bennett.

In a press statement about the UK government's "plan for living with COVID," it says the government will "begin to treat Covid as other infectious diseases such as flu."

But the coronavirus is more contagious than influenza.

Pitt said the coronavirus is very unpredictable and has not settled down yet.

"There is absolutely nothing in the virology which suggests that any new variants will be milder than omicron," Pitt told DW.

On Twitter, Deepti Gurdasani, a clinical epidemiologist at Queen Mary University of London, expressed concern about the omicron sublineage BA.2 amidst the UK government's plan to end all self-isolation.

"In the midst of this, our govt appears to have made a decision to halt free testing for the majority, and self-isolation for all. It was never a question of *if a VOC emerges*. We have one now, and it is growing in the UK, and globally," Gurdasani wrote, referring to variants of concern.

In a statement on February 22, the World Health Organization (WHO) said studies have shown that BA.2 has a growth advantage over BA.1, and that initial data suggests BA.2 is "inherently more transmissible" than BA.1, which is currently the most common omicron sublineage reported.

Living with the virus

Investment in public health messaging is important to create behavior change, according to Bennett.

The epidemiologist said that if the public understands that simpler measures like mask wearing indoors helps reduce transmission risk when infection rates are rising, this will help reduce the need for more formal rules.

"Then we are moving into a more sustainable approach to infectious disease control," Bennett told DW.

Booster vaccinations could also help counterbalance the changes to England's self-isolation rules, she added.

"If increasing booster doses can reduce symptomatic infection from omicron by half for five months or more, then this could offset the changes to isolation rules if there was more effort to make the vaccines available globally," Bennet said.

But living with COVID-19 means understanding the virus, said Pitt, including how infectious it is, how it spreads and how serious the disease can be ― even in vaccinated people.

A sensible precaution would be to continue to wear face coverings on public transport, Pitt told DW. As of February 24, masks will no longer be required on public transport in London. But Transport for London, the government body responsible for most of London's public transport, recommended that passengers who can wear a mask continue to do so.

"We do not complain when healthcare workers wear gloves to examine patients these days," says Pitt, "but that precaution only came in as a measure to protect against HIV in the 1980s and 1990s."

Wearing masks could become a part of life to protect people from the coronavirus and other airborne diseases, just like wearing surgical gloves did.

"It was controversial at the time, but it is normal practice now," said Pitt.

Edited by: Carla Bleiker

Source: DW