New Covid-19 quarantine, isolation regulations

Self-care important

31 July 2020 | Health

The minister of health and social services Dr Kalumbi Shangula announced new regulations pertaining to quarantine and isolation of Covid-19 patients.


The minister already announced intentions to build more flexibility into the quarantine and isolation protocols in Namibia on 29 June.

“This is to be guided by the evolving scientific and epidemiological information about the Covid-19 pandemic. It is critical that our policies are driven by scientific evidence and informed by expert views and knowledge. The science is clear that there is no evidence of risk that somebody can infect another person with the virus after 10 days of infection, if their symptoms have gone away.”

According to Shangula, this means the number of recoveries will rise quickly.

“We now know that recovery should be based on resolving symptoms and counting at least 10 days after infection started. It has been proven that a person may test positive for Covid-19 for many weeks after symptoms have resolved. However, this does not mean such a person is still infective or poses a risk to others.”

The minister said that changing the policy for quarantine and de-isolation is the right thing to do.

“We now have the scientific and medical evidence that this is safe and longer quarantines and isolations are not necessary. This is what neighbouring countries have done. It is what many other countries around the world have done, and it is what the WHO and the CDC recommend.”

The newly introduced changes will also affect the policy for quarantine, which can be shortened.

“A single test for the coronavirus on the seventh day of quarantine will be done, and if it is negative, then the quarantine can end. This will help people get back to their normal lives sooner. It will decongest quarantine facilities and will still keep us safe according to all the latest science.”

Three tier structure

It has been decided that the Quarantine Protocol for Coivid-19 adopts a 3-tiered structure.

Tier 1 is where there is no community transmission. The duration of quarantine is reduced from 14 to 7 days in approved facilities. All patients are to be tested at the end of the quarantine on day 7 and to be released on negative PCR. If positive, the person goes into isolation.

Tier 2 is where there is established community transmission. The length of quarantine is proposed to be a minimum of 7 days. Contacts would all be tested at the end of the quarantine on day 7 and released once a negative result is obtained. If positive, they would enter isolation. Contacts would be allowed to quarantine at home if suitable.

Tier 3A involves travellers arriving in Namibia. The length of quarantine is reduced from 14 to 7 days in approved facilities. Travellers are expected to arrive with negative PCR-based results, not older than 7 days. They will only be tested on day 7 and will be discharged with negative results.

Tier 3B is valid for special dispensation under the “Tourism Revival Initiative”. The length of quarantine is 7 days in approved facilities. Travellers are expected to arrive with negative PCR-based results and be tested within 7 days of arrival in Namibia. They will be tested on day 5 and discharged on negative results.

Three threshold system

The minister also announced that isolation protocols in Namibia will adopt a three part threshold system.

Threshold 1 is where more than 60% of health facility bed capacity dedicated to Covid-19 patients are available. All positive cases are managed in isolation units at Covid-19 designated health facilities, regardless the severity of illness.

Threshold 2 is when more than 60% of the health facility bed capacity dedicated to Covid-19 patients are occupied by confirmed and suspected cases. Only severe and critical cases and those at higher risk of developing severe disease or complications due to co-morbidities will be managed at these health facilities. All other cases will be managed in other designated and repurposed Covid-19 non-healthcare isolation facilities. The Erongo and Khomas regions currently fall under this threshold.

Threshold 3 involves isolation in health facilities only to be used for severe cases. Non-severe cases or cases at higher risk of developing severe disease due to co-morbidities, will be managed in repurposed facilities. All other cases/persons who have living spaces that are amenable for home isolation would be allowed to do so.

De-isolation

A new revised de-isolation protocol will also be followed.

“Asymptomatic patients will be discharged from isolation 10 days after the positive test for SARSCoV-2. Symptomatic patients will be discharged from isolation 10 days after the onset of symptoms, with at least three additional days without symptoms.”

The minister said that all patients will have a test conducted on day 10 after the initial test, for asymptomatic or day 10 after symptom onset for symptomatic.

“If the test is positive, the patient will be instructed to exercise additional caution with physical distancing, wearing of mask, and hand hygiene for the next 10 days.”

These recommendations are in line with the latest WHO and CDC guidance.

“Any confirmed Covid-19 case that has been de-isolated according to the aforementioned criteria will be considered as having recovered. Thus, recovery would no longer be based on re-testing negative for the virus.”

Health workers

Current evidence suggests that the virus is transmitted between people through close contact and droplets.

Aerosol-generating medical procedures are also associated with increased risk of infection.

“Against this background, the ministry developed a framework to classify healthcare workers into either high or low risk, depending on the context of their work environment and the level and nature of possible exposure to infection. Those regarded as high risk are required to be quarantined in line with the SOPs, while those regarded as low risk are not required to quarantine. The risk categorization is conducted by the Infection, Prevention and Control Experts to ensure objectivity.”

The minister once again emphasised the importance of self-care and called on the Namibian public to more vigilant and take personal responsibility.

“Let us protect ourselves individually. Let us protect our neighbours. Let us protect our communities. Let us protect our country. Together, we can vanquish Covid-19. We must do our part to stop the spread of this disease in its tracks.”

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