The “ideal” quarantine period for a person infected with COVID-19 is still 10 days, but whether that’s possible amid an explosion of Omicron cases is another question entirely, says Canada’s top doctor.
For nearly two years since the declaration of the COVID-19 pandemic, the typical quarantine period for someone who contracts the virus has been 10 days.
That’s changing, though, as the extremely contagious Omicron variant multiplies around the world and pushes even highly vaccinated countries like Canada to new case records. Many places of work, including critical employers like hospitals, are struggling with huge numbers of staff sidelined by infections.
As a result, some provinces — like Ontario– are choosing to slash quarantine periods.
“This is a balancing of the risks compared with the need to protect your critical infrastructure,” said Dr. Theresa Tam, Canada’s chief public health officer, in a press conference on Wednesday.
“Even with five days of quarantine, contagiousness is possible after that.”
Tam, along with federal ministers at the press conference, was asked several times about the approaches being taken by some provinces and territories, which include cutting the quarantine period to five days from 10, despite that risk of continued contagion.
Quebec also declared at the end of December that the province had “no choice” but to allow health-care staff who test positive for COVID-19 to keep working while infected.
“We’re stuck in a vise where hospitalizations are increasing and more and more health workers have to take time off,” said Quebec Health Minister Christian Dubé on Dec. 28.
“In other words, we have more and more sick people and less and less people left to take care of them.”
Alberta this week also cut its quarantine period for fully vaccinated people.
Ontario cut the quarantine period for fully vaccinated people who have symptoms of COVID-19 on Dec. 29 and has placed significant limits on the ability of residents to obtain tests for the virus.
The decisions came after a controversial move by the U.S. Centers for Disease Control and Prevention on Dec. 27 to cut its own recommended quarantine periods, while also loosening its rules for allowing health-care workers to return to work after testing positive.
Tam said the provinces and territories are best-placed to decide on the balance between preventing infections and keeping society functioning, and that striking the balance is “a challenge.”
“It is often a question of risk management and deciding one’s tolerance of risk,” she said. “Yes, (10 days) is always ideal but it is not always possible given the current situation.”
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Is there an 'invisible wave' of COVID-19?
Omicron’s lightning spread and level of infectiousness have left countries scrambling.
First identified by South African scientists in late November, the variant is a heavily mutated form of the coronavirus that causes COVID-19 and features the ability to evade some aspects of the immune response gained by vaccines.
While several recent studies have supported the idea that illness associated with Omicron is less severe than with the Delta variant, Omicron is also exponentially more infectious.
Simply put — even a milder variant can lead to sharp jumps in hospitalizations if it infects a much larger proportion of the population, as is the case now with Omicron.
Cases in Canada have soared over the past month, shattering infection records set in the early days of the pandemic. Hospitalizations are also rising, and several hospitals have been declaring internal “code oranges” to try to cope with the number of staff sidelined by infections.
And less staff combined with more people needing care equals strain for health-care systems already struggling to keep up.
“We’re going to have significant issues with absenteeism, either from infection or exposure to this virus in the coming months, just because there’s so much of it around,” said Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital.
He said there is emerging evidence that most people are less infectious after five days and that if someone were to test positive for the virus still at that point, it would be “reasonable” for them to continue to isolate for the full 10 days.
But rapid tests, he also noted, are in short supply, as are PCR tests administered by health-care professionals.
New restrictions on who can access PCR testing in Ontario, as well as a lack of rapid tests, have prompted concerns about whether current case reports are failing to capture the extent of the Omicron surge.
Yet officials on Wednesday said they did not believe there is an “invisible wave” of cases going undetected, and said other tools like wastewater testing and community testing still work.
“There are other tools the provinces can use to compensate for the missing data,” said Health Minister Jean-Yves Duclos, announcing that 140 million additional tests will be shipped to provinces this month.
Tam said the country is doing more daily testing than at any other period of the pandemic.
“We will be able to look at the trends,” she said. “The provinces are not testing every case but there are so many tests being done that we would not miss a wave going through a community.”
Prime Minister Justin Trudeau said the strain of the surge will likely last “a few months,” but he suggested it will be important to keep using “numerous different tools” to measure the wave.
“We will use all of these various tools to ensure that we have the most accurate idea possible of the Omicron wave across the country and just because we’re using varied tools, it doesn’t mean that there’s an invisible wave,” he said.
For now, there are no plans by officials to change the definition of “fully vaccinated.”