Like several countries struck by omicron, the new variant of the coronavirus, France has decided to significantly reduce the duration of isolation in the event of contamination or contact.
Reduced isolation periods to avoid the risk of seeing the omicron variant bring the country to a halt. After several days of waiting and the continuous increase in new daily contaminations (125,000 cases on average this week), the Minister of Health, Olivier Véran, unveiled in the Sunday newspaper the new rules applicable from Monday for positive people and contact cases, whatever the variant. Concerning contaminated individuals with a “Complete vaccination schedule”, the quarantine is reduced to seven days (instead of ten previously), and even reduced to five days in the event of “Negative antigen or PCR test” and absence of “Clinical signs of infection for 48 hours”, specifies the minister. For unvaccinated positive people (or only partially), isolation remains for ten days, unless a screening test on the seventh day turns out to be negative.
Contact cases vaccinated with a booster dose, which were to isolate themselves for one week in the event of omicron suspicion, are now exempt from any imprisonment. On the condition of going to be tested at least three times as a preventive measure, by a PCR or antigen test on D0 (day when they learn that they are in contact), then on D2 and D4 by self-tests “provided free of charge in pharmacy”. Contact cases not vaccinated or who have not yet been recalled, will have to isolate themselves for a week.
Thorny subject
On December 23, the Scientific Council warned of a “Possible disorganization of society” and a disruption of “Public and private services”, Due to “Absenteeism” caused by the unprecedented proliferation of contaminations. Formulations reused by members of the government over the following days. “We just have to expect that in January we will operate in a degraded mode”, had also formulated the epidemiologist Arnaud Fontanet, during the press conference organized that day by the authority. “In a context of the dazzling omicron variant, it is now necessary to review the exclusion rules”, underlined Olivier Guérin, geriatrician and member of the Scientific Council.
The policy of isolation is a thorny subject that divides even the ranks of scientists. Some are worried about seeing these new reduction measures increase the possibilities of transmission, and thus actively participate in the viral circulation, in the event of non-compliance with the strict barrier gestures in individuals who think they are out of the woods (through the negativity of an antigen test or a self-test, sometimes fallible), but potentially still contagious. Others believe that the least worst compromise had to be found. “Knowing that on average a person infects more than 10 people, with 100,000 cases per day, it is 1 million contact cases in quarantine of seven to seventeen days, or more than 10 million days of downtime generated , analyzed epidemiologist Antoine Flahault on December 22 on Twitter. Isolating the positives for five days is useful, isolating the contact cases, with omicron is wishful thinking every day ”, he had concluded.
Avoid paralysis of the functioning of the public hospital
Within a week, many countries revised their copy of their isolation strategy to minimize the organizational disruption to daily life caused by omicron. In the United States, the Centers for Disease Prevention and Control (CDC) issued the recommendation, on December 27, to reduce isolation from ten to five days for asymptomatic people, and to exempt cases from quarantine. contacts with an up-to-date vaccination schedule. Spain decided to shorten isolation from ten to seven days for positive without symptoms on Wednesday, in an effort to balance “public health” and “economic growth”, in the words of the government.
Same shrinkage in England since December 22, symptomatic people included, who can leave their homes after a week if their two antigenic tests, carried out on the sixth and seventh days, prove negative. Israel on Wednesday shortened its isolation time from fourteen to ten days in the event of infection. The Italian government, for its part, announced on Thursday the end of all isolation for fully vaccinated contact cases (now under the regime of “Self-monitoring”), but maintained the ten days for positive people.
Object of all the fears in the face of a probable paralysis of its functioning, the hospital system has already been based, for a week, on very flexible directives to be able to hold. For the positive cases among the staff, the High Council of Public Health (HCSP) issued its recommendations on December 24 and indicates that, at “Exceptional title”, in a context of “Risk of a break in the continuity of the healthcare offer”, asymptomatic people, or even paucisymptomatic (showing very few clinical manifestations), may derogate from the isolation rule. “These staff will not be able to take care of patients at risk of severe form of Covid-19 or in vaccine failure for example”, specifies the HCSP in its document, which insists on the fact that any eviction decision must be taken “In the absence of a possible alternative and after a benefit / risk analysis”.
With regard to health professionals declared a contact case, the body had specified in a previous opinion, on December 11, that they “were to” stay in office. “At the hospital, contact cases are no longer being evicted simply because we are no longer able to do so. This is already not possible, because of the difficulties of hospital operation ”, explained Olivier Guérin during the Scientific Council meeting.