Explainer – How The Radical New Changes Around Isolation Affect You, Your Family, And Your Work

It may be the price needed to tackle Covid-fuelled staff absences with some workplaces around the country nearly grinding to a halt.

The radical changes around isolation, and stay-at-home orders for people who are positive for the virus or a close contact of a confirmed case, come into effect at midnight tonight.

It comes as the highly infectious Omicron variant is still raging, with another 20,909 new cases yesterday.

So are the new measures a leap in the dark or, as Dr Tony Holohan said, a proportionate response?

What changes are being made for people who test positive for Covid-19?

The self-isolation period now for everyone who tests positive is seven days. This applies to vaccinated and unvaccinated people.

Up to now if you got the virus and had received your booster vaccine, you self-isolated for seven days. If you had not been boosted it was 10 days.

This it is now cut to seven days, regardless of vaccination status. You must take regular antigen tests over the seven days, with the last test on the final day.

Are there changes to the length of time someone who is a close contact of a confirmed case must restrict their movements and stay at home?

If you have no symptoms and are boosted, you no longer need to restrict your movements for five days.

However you need to take antigen tests for seven days, and also wear a medical face mask or a higher grade FFP2 mask for 10 days.

Who else is exempt from restricting their movements if they are a close contact?

A person with no symptoms who has had two doses of vaccine and tested positive for Covid since December 1 does not have to restrict their movements. They do not have to undergo a test unless they are symptomatic.

What if somebody is a close contact and not boosted?

They still have to restrict their movements, but it has been cut from 10 to seven days.

When should the period of restriction start?

From the date of last contact with the positive case – or, if not known, from the date of notification.

Is there other advice for close contacts who are not restricting their movements?

They should limit contact with people outside their households, especially in crowded, enclosed and poorly ventilated places. But clearly this will be difficult for the thousands who are in the workplace.

They should also try to avoid contact with anyone at higher risk of severe illness should they get Covid. The close contact should also work from home unless it is essential to attend. But this will not be practical for staff in sectors such as hospitality or schools which have been badly hit by absences.

Nurse Frances Whyte carries a tray of Moderna vaccine boosters at the RDS vaccination centre in Dublin yesterday. Pic. Clodagh Kilcoyne-Reuters

Are there also changes around the type of Covid-19 test a person requires?

Yes. For people aged four to 39 there is no longer an obligation to have a positive antigen test result confirmed by a PCR test. However, it is still necessary to get a confirmatory test for those aged 40 and older.

So if someone tests positive with an antigen test how do they inform the HSE?

A portal is expected to be open in the next few days and they can set out their close contacts.

Do people have to purchase antigen tests themselves?

If they are close contacts, they will be sent the tests by the HSE. Close contacts to date have been given three antigen tests, with two days between each test. The HSE will also send tests to people who have symptoms.

What is the rationale behind these changes?

Dr Holohan said the changes are not without risk. But he said a high proportion of people have received a booster shot, and this has helped to provide a high level of protection from serious illness. This is one of the key reassurances behind the new measures.

Also, despite the sky-high rate of 20,000-plus cases, the numbers sick enough to be hospitalised have not translated into big numbers – though more than 1,000 people were in hospital with the virus yesterday. There were 92 seriously ill Covid patients in ICU, and though the daily admissions have slightly increased in recent days, there appears to be a strong level of confidence that they will not get worse.

We may be reaching or at the peak of the Omicron wave. The main pressure is that it comes against a background of very high levels of staff absences, due to them having to self-isolate or restrict their movements, causing major disruption to some public services, including the health service, and also private businesses.

When will these changes come into effect?

They will be implemented from midnight tonight, and will be in place until the end of February.

Is Ireland an outlier in cutting the isolation period?

No, in fact it’s even lower in the US, at five days. The UK is also planning to reduce it to five days. The US Centre for Disease Control (CDC) said its decision to cut the isolation was “motivated by science” demonstrating that the majority of transmission occurs early in the course of the illness, generally in the one or two days prior to the onset of symptoms and two to three days after.

If I have a positive antigen result only, can that be used to get a Covid cert?

It is still unclear, but it is likely that a PCR test will continue to be needed for a Covid recovery cert for several months yet.

Will an antigen test suffice for a sick cert?

There is no clarity on that yet. A cabinet memo said this will need to be worked out.

Do the changes come with medical backing?

They have been signed off on by Dr Holohan, who said while the stay-at-home restrictions for close contacts are eased, they are being replaced by antigen testing and high-grade face masks.

The risk is that much depends on people being responsible and doing the test as well as wearing the mask. Most will follow the rules but not everyone will and that is where there could be chains of transmission.

What has been the reaction to the changes?

The Irish Nurses and Midwives Organisation (INMO) said the change has the potential to lead to more people contracting the virus. It said that allowing potentially infected asymptomatic people to work will impact on transmission.

Christine Loscher, professor of immunology at DCU, said she is concerned at abandoning the need for close contacts to restrict their movements across the board. She said exceptions could have been made for certain hard-hit areas and is worried about the higher risk it will pose to vulnerable people.

Will antigen tests now be made available for free?

There are no plans to subsidise or make antigen tests free. But the HSE will send them to the homes of people who test positive or are close contacts.

What about making medical face masks or high-grade masks more affordable?

This is not on the agenda now. FFP2 masks are expensive and the HSE is expected to send them to people who are positive or are close contacts.

Is this the next step before lifting some restrictions?

The current restrictions will be in place until the end of the month at least. Nphet will meet next week and do an analysis of patterns of infection and the wider spread, so this will determine a lot of the next stage of decisions.

Are there any figures we should be mindful of as the isolation and stay-at-home measures are relaxed?

There has been an increase in infection among older age groups and this needs to be carefully monitored. However, they are highly boosted so they have strong protection .

If we reach a peak soon, how fast will the cases go down?

The problem is that there is no true measure of daily cases. The true figure is around 30,000 to 40,000 cases a day, though only around 20,000 or more are being officially recorded. Nevertheless there should be a clearer signal soon.

But we were told by Prof Philip Nolan of Nphet that it will be a slow grind downwards. It means that it will be many more weeks before the Omicron storm has abated.

The risk would that that the relaxation of isolation measures might slow the descent even more.

Visit our Covid-19 vaccine dashboard for updates on the roll out of the vaccination program and the rate of Coronavirus cases Ireland

(Source – Irish Independent – News – Eilish O Regan – 13/01/2022)

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