Spend the current current days of quarantine or isolation five days. This is the change that takes ruminating between the health makers in Spain since the end of last year. The Community of Madrid and Catalonia are two of the autonomies that have most clearly spoken in favor of this important reduction in the isolation time for those who give positive in Coronavirus and quarantines for narrow contacts of positives without the complete vaccination guideline .
But is this measure covered by the tanbust scientific evidence? It is logical to think that the answer to this question is in immunology, virology and sisters disciplines that study and know the behavior of SARS-COV-2 once an organism is infected. Well, so that no readers are surprised, it is convenient to clarify that there is no unique answer to this issue. Neither an easy answer or, at least, we have not found it here.
Vicente Soriano, expert in infective diseases, professor of joining and former WHO advisor, considers that it is sufficiently justified by five days that isolation time for positives.
"Five days, as the centers for the control and prevention of diseases of the United States (CDC), since it looks like the window of contagiousness, then convenient to make antigen tests available, at the same time it is very Convenient vaccinate with third doses of vaccines. And, from the Government, to make oral antivirals accessible as soon as possible ".
Indeed, on December 27, 2021, less than two months ago, US CDC collected a recommendation on its website with the aforementioned change in quarantines. The text says: "Given what we know so far on the VOCID-19 and the omicron variant, the CDC are shortening the recommended isolation time for the public. People with Covid-19 should be isolated for 5 days and, if they are Asymptomatic or their symptoms are disappearing (without having a fever for 24 hours), then continue using mask for 5 days when they are close to other people to minimize the risk of infecting them. The reason for the change is the scientific demonstration that most of the transmissions of SARS-COV-2 occur in the first days of the disease, usually in the first and second day before the start of symptoms, and within 2 to 3 later days. "
Soriano explains: "It seems that in the coronavirus, as in other respiratory viruses such as flu syncytial flu, everything is very fast. At the moment you get infected, the cells from the respiratory epithelium in the nose, in the pharynx and in The mouth begins to become infected and everything is fast. In five days a local immunological response appears, so it is called innate immunity. Those who are vaccinated or have been exposed to Coronavirus will also have an adaptive immunity response. So in five days The virus no longer replicates ".
After those five days you can continue to be positive in the antigen test by "the residual proteins of the virus or nucleic acid sequences that are in the mouth or in the respiratory secretions for days or weeks. So it could give positive the antigen test or The PCR residually for weeks without being contagious, "clarifies the expert.
"Thus, the transmission period of virus that multiply basically is reduced to five days - Soriano - and are located, above all, very early. It is 24-48 hours after exposure to the Lord who coughs and infects you. And depending on these data that are published, the CDCs have decided that the virus transmission period is five days. "
"Anyway, it seems common sense, that if that period is reduced to five days, an antigen test is done. And, in the case of negative, end of confinement". And if it's positive? "Well there is the doubt. In any case, in Spain is now seven days and return to the routine, without test. In the United States they have decided that they are five days, control test, and finish confinement. In the end, they are two Days of difference one with test and another without test ".
In these two ways, why is it decuated? "It's hard to take a party, but I'm more for the opinion of the Americans, if in animal experiment it's five days, because it's five days," replies Soriano.
But this reasoning does not find many followers among scientific societies in Spain. Marcos López Hoyos, president of the Spanish Society of Immunology (SEI) sees clear that the insulation of positives should not be reduced. He considers that, from a scientific point of view, "there is no reason for that change in quarantines because the viral burden is there." He even, he points out "There are many cases that after those seven days continue to give positive and, therefore, that person can be a transmitting the virus".
Elena Vanessa Martínez, President of the Spanish Society of Epidemiology (SEE), also considered a reduction of the time of the insulation or quarantines: "We are now seeing, from the reduction of time of ten to seven days, which from Those seven days there are many people who are still positive. And that can not be easily right now, because the levels of virus transmission that we have are high. There is no scientific evidence that the virus is not transmitted from five days. Rather there is the contrary evidence. "
"The problem of the transmission -Remember Martínez- is the probability that exists that the infection reaches that vulnerable that the disease can be seriously". So with this level of incidence, the President of the SEE does not see reasons to open the debate to reduce those isolates "we have to continue protecting the most vulnerable population," she insists.
On this issue, WHO has pronounced this Thursday with the publication of a provisional guide on the tracking of contacts and quarantine in those areas with extremely high levels of circulation of the omicron variant of the COVID-19. The starting point of the international organization is the quarantine and isolation of 14 days for positive and close contacts, a reality that bends, on days, which is currently in force in Spain.
Well, those 14 days WHO admits that they can be cut "when there is an increase in cases and health services are under pressure" [in a scenario of shortage of health workers, for example, and lack of material and human means for the Tracking and control of these sick people] 10 days without a diagnostic test and 7 days with a negative test, "as long as the person does not develop any symptoms."
In addition, WHO affirms that "the risk of transmission after quarantine for 10 days (based on omicron data) is estimated at around 1 percent, with an upper limit of approximately 10 percent". If the quarantine period is shortened, WHO recommends that people continue to carry a medical mask "well adjusted at all times" until completing the period of 14 days.
The possibility of quarantines or 5-day isolates are not collected in the WHO guide on tracking of contacts and quarantines.
At this point it is further investigated in this "scientific evidence" with more opinions from scientists or to raise the question towards a more global approach: that is, to place the quarantine measure within the general context of the virus containment strategy.
Jonay Ojeda, spokesman for the Spanish Society of Public Health and Health Administration (SESPAS), Razona in that direction: "We do not have a solid evidence that current insulation and quarantines are having a repercussion in the fall of the cumulative incidence. Another way, the decrease in the incidence at this time is very debatable that is related to the isolates, the quarantines or with the few restrictive measures that may remain ".
Therefore, the epidemiologist continues, "that descent of the incidence probably have to do with other factors related to the infranotification of cases and with the immunity of both natural and produced by vaccines".
Exposed the situation, they are the sanitary authorities that must make a decision on this. The last time there was a change in the duration of the quarantines and insulation was in the last Interiorritional Council of 2021, where this 10-day time was lowered, of that, only two months ago.
Date Of Update: 21 February 2022, 07:01
