SA drew global praise for new self-isolation rules. They lasted 5 days.

Business Insider SA
Quarantine is back
  • The department of health on Tuesday withdrew a days-old circular that had radically changed South Africa's approach to self-isolation and contact tracing.
  • You are now, again, required to self-isolate if you had contact with someone who later tests positive for the coronavirus.
  • The change had been based on scientific advice. It is not clear on what basis it has been rolled back.
  • In the five days during which the new rules lasted, they drew attention around the world. 
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From Tuesday night, anyone who tests positive for the coronavirus in South Africa – regardless of whether they show symptoms of Covid-19 or not – must again go into self-isolation, while anyone they were in contact with should be contacted, and urged to get tested.

That is due to the sudden reinstatement of national contact tracing and isolation protocols that, just five days earlier, the department of health had described as "costly to essential services and society as many people stay away from their work and thus lose their income and children miss on their schooling."

The now-reinstated rules had also served little to no purpose, the health department said at the time. 

So, on 23 December, in a formal circular to the heads of provincial health departments made public the next day, the national department's director-general Sandile Buthelezi announced that South Africa had immediately dropped contact tracing, and would no longer impose restrictions on asymptomatic carriers of the coronavirus.

But on Tuesday Buthelezi's department said in a media statement that, "in line with the principles of transparency and openness, the department has decided to put the implementation of the revised policy changes on hold, while taking all additional comments and inputs received into consideration."

It did not say why that decision had been made, only that a new version of the rules would be issued "once all additional inputs and comments have been considered".

"This means the status quo remains, and all prior existing regulations with regards to contact tracing, quarantine and isolation remain applicable," the department said, somewhat confusedly.

At the time that statement was issued, the status quo was actually that only people showing symptoms of Covid-19 were subject to restrictions on their movement.

Under the rules that were in force for those five days, those who tested positive for the coronavirus but showed no symptoms were asked to do only two things: self-observe for five to seven days for the onset of symptoms, while "avoiding" large groups of people and being careful to follow the mask and social distance rules that apply to everyone, all the time.

The implications were laid out unequivocally in a FAQ published on the government's SACoronavirus website on 24 December.

FAQ on quarantine and isolation, on 24 December
An excerpt from a set of frequently asked questions published by the department of health after the rule change on 23 December.

Meanwhile, there was no contact tracing "except in congregate settings and cluster outbreak situations or self-contained settings", such as prisons. The contacts of an infected person would not be tested, and were expected to "continue with their normal duties with heightened monitoring" – which would keep health workers at work even after an exposure event.

The rules that lasted five days were based on a 16 December advisory from the Ministerial Advisory Committee (MAC) on Covid-19, which had warned it "serves little overall public health purpose" to force isolation on the asymptomatic, while doing so led to loss of income and school time, and threatened the stability of institutions such as hospitals when key workers were not available.

The rule change made headlines in the USA (where the New York Times described it as "yet another step toward a slow acceptance that many countries around the world will likely need to find a way to live with Covid"), in the United Kingdom, in Germany, and beyond.

It was cited when, on Monday, the USA moved to a shortened five-day isolation period for some people with Covid-19, in part based on booster data from South Africa, and rapidly welcomed by many experts both local and foreign, who framed it as a vital move towards living with the coronavirus, and away from futile efforts to eradicate it.

The withdrawal of those same rules were on Tuesday met largely with confusion.

(Compiled by Phillip de Wet)

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