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Covid-19 isolation rules remain – Expert Reaction

Cabinet has agreed to retain mandatory measures for positive Covid-19 cases to isolate for 7 days, and retain the mandatory use of masks for visitors to health care settings.

Cabinet will consider advice on whether a test-to-return to work rule would work for low-risk, mild, or asymptomatic cases.

The SMC asked experts to comment.

Dr Rawiri Keenan (Te Atiawa/Taranaki), Adjunct Senior Fellow, Medical Research Centre, Te Huataki, University of Waikato; Senior Research Fellow, Dept of Primary Care and General Practice, University of Otago Wellington, comments:

“The isolation rules remaining in place make sense and is a relief for the current and future health service. Not only will this help reduce the acute Covid burden but also the longer term effects from those who also get long Covid. It would be nice for the government to also seek advice around airborne mitigations, especially given teachers and students were mentioned and they carry a high risk heading into winter.

“As we keep hearing, Covid is milder with vaccines for many of us, but as we have also seen, the elderly and disabled community have a significantly higher risk of death and our team of 5 million mentality should stay strong to looking after each other.

“With flu, whooping cough, RSV and measles likely to feature this winter on an already stretched community and hospital health sector, it’s important as many people as possible get vaccinated and the message around airborne transmission gets out there stronger also.”

Conflict of interest statement: “I am a team member for projects with Victoria University of Wellington and University of Otago funded by the Ministry of Health evaluating the Covid vaccine roll-out. I am a Locum GP; Member of Te Rōpū Whakakaupapa Uruta; Member of Te Aho o te Kahu Clinical Assembly and Member of Health Quality and Safety Commission Patient Experience of Care Governance Group.”

Dr Siouxsie Wiles, microbiologist and Associate Professor, University of Auckland, comments:

“I am relieved that the Government has chosen to keep the current COVID settings of mandatory isolation for people who test positive and masking in healthcare settings. Rather than thinking of these as “restrictions” we should welcome them as important public health measures that help reduce the transmission of COVID-19, protecting our lives, livelihoods, and health system. While some people will argue this puts us more out of step with other countries, it is worth remembering that if we had followed those countries at the beginning of the pandemic, thousands more of our friends, families, and colleagues would have died and thousands more would be out of the workforce due to long COVID.”

No conflict of interest.

Associate Professor Dianne Sika-Paotonu, Immunologist, Associate Dean (Pacific), Head of University of Otago Wellington Pacific Office, and Associate Professor, Dean’s Department, University of Otago Wellington, comments:

“The announced maintenance of the current Covid-19 settings including the mandatory isolation period is welcome news at this time. Our health and associated support systems in Aotearoa New Zealand typically experience greater pressure during the winter months and the Covid-19 pandemic has generated significant and additional stress and strain to our already overloaded systems.

“Heading into the winter months, Covid-19 is still causing problems and we’re continuing to experience the impact of the SARS-CoV-2 virus with newer versions of Omicron present.

“Self-isolation measures for Covid-19 limit the spread of the SARS-CoV-2 virus and also help ensure people don’t become any sicker than they might be right now. Self-isolation is a temporary step, but very important one for everyone so people can get better, and also not pick up or spread any other illnesses going around.

“People also need to know if they have Covid-19 so they can get organised, and get the help they might need, let others around them know, and sort things out with work, family, whānau, kāinga and aiga – including getting hold of antiviral medications sooner rather than later.

“Antivirals need to reach those who require them, at the time they need them, in order to prevent severe illness and hospitalisation – and try to help our hospitals and support systems, primary and community care. For antivirals to be effective, people with Covid-19 need to get access to them quickly and the sooner the better – within 5 days of symptoms showing. Accessibility and availability issues will limit and hamper the usefulness of antivirals to treat Covid-19.

“The bivalent Covid-19 boosters (available for those aged 30+ years and those at high risk), contain mRNA coding for the original virus strain (– giving broad protection against Covid-19), plus an mRNA code common between the Omicron variant BA.4 and BA.5 lineages (– giving better protection against Omicron specifically).

“Regular childhood vaccine schedules (non-Covid-19) for children tamariki and tamaiki in Aotearoa New Zealand have been significantly affected by the Covid-19 pandemic. Childhood vaccination rates for non-Covid-19 conditions have been impacted by the pandemic which leaves some of our most young unprotected from serious conditions that we currently have vaccines for such as measles or whooping cough – all childhood vaccinations are important.

“Simple public health measures that include being up-to-date with vaccines and boosters, isolating when sick, testing, wearing a mask where possible, proper ventilation, being outdoors, and other public health measures, remain important steps to (1) help protect against the most severe impacts of Covid-19, (2) help protect against reinfection, and also (3) help protect against other illnesses still circulating at this time.”

No conflict of interest declared.

Dr Dion O’Neale, Programme Co-Lead, COVID-19 Modelling Aotearoa, comments:

Note: this is an excerpt from a comment made before the announcement.

Previous work by COVID-19 Modelling Aotearoa estimated that around 15% of cases are still infectious at the end of a 7-day isolation period while an estimated 85% became non-infectious in less than 7 days.

“Rapid antigen tests (RATs) provide a great way of determining whether someone is still infectious. Using a test-to-release criteria for helping to inform people when it is safe to end their isolation can help to reduce both the number of hours infectious in the community and the number of hours of excess isolation. Test-to-release criteria are also useful for reducing transmission from people who might still be infectious even though their symptoms have reduced sufficiently for them to feel that they are able to return to work, or school.”

Conflict of interest statement: “I, along with others from COVID Modelling Aotearoa, am funded by the Ministry of Health to provide advice on the COVID response and from a Health Research Council grant to look at equity related to COVID in Aotearoa.”