Is there scientific support to reduce quarantines from seven to five days?

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Go from the current seven days of quarantine or isolation to five days.

This is the change that has been ruminating among health officials in Spain since the end of last year.

are two of the autonomies that have most clearly spoken in favor of this significant reduction in isolation time for those who test positive for coronavirus and quarantines for close contacts of positives without the complete vaccination schedule. .

But

It is logical to think that the answer to this question lies in immunology, virology and sister disciplines that study and understand the behavior of SARS-CoV-2 once it infects an organism.

Well, so that no reader is surprised, it should be made clear that there is no single answer to this question.

Not an easy answer or, at least, we have not found it here.

Vicente Soriano, an expert in infectious diseases, professor at UNIR and former adviser to the WHO,

considers that it is sufficiently justified to reduce that isolation time for positives to five days.

"Five days, as recommended by the United States Centers for Disease Control and Prevention (CDC), as it seems the contagious window. After that, it is convenient to make antigen tests available.

. And, on the part of the Government, make oral antivirals accessible as soon as possible".

Indeed, on December 27, 2021, less than two months ago, the United States CDC posted a recommendation on its website with the aforementioned change in quarantines.

The text reads: "Given what we know so far about COVID-19 and the omicron variant, the CDC is shortening the recommended isolation time for the public. People with COVID-19 should isolate for 5 days and if they are asymptomatic or their symptoms are clearing up (no fever for 24 hours), then continue to wear a mask for 5 days when around others to minimize the risk of infecting them

usually in the first and second days before the onset of symptoms, and in the 2 to 3 days afterward."

Soriano explains: "It seems that in the coronavirus, as in other respiratory viruses such as influenza or respiratory syncytial virus, everything is very fast. At the moment you get infected, the cells of the respiratory epithelium in the nose, in the pharynx and in the mouth starts to get infected and everything goes very fast.

so it is called innate immunity. Those who are vaccinated or have been exposed to the coronavirus will also have an adaptive immune response. So in five days the virus no longer replicates.

After those five days, you may continue to test positive for antigens because of

So you could test positive for antigens or the pcr residually for weeks without being contagious", clarifies the expert.

"So the period of transmission of viruses that multiply is basically reduced to five days - Soriano clarifies - and they are located, above all, very early.

And based on those data that are published, the CDC has decided that the period of transmission of the virus is five days."

"In any case, it seems common sense that if that period is reduced to five days, an antigen test is done. And, if it is negative, the end of the confinement."

. In any case, in Spain now it is seven days and back to the routine, without testing. In the United States they have decided to make it five days, a control test, and end the confinement. In the end, there are two days apart, one with test and one without test".

Of these two ways, which one do you prefer?

"It is difficult to take sides, but I am more for the opinion of the Americans. If in experiments on animals it is five days, then it is five days," Soriano responds.

Immunology and Epidemiology, for the

But this reasoning does not find many followers among scientific societies in Spain.

.

He considers that, from a scientific point of view, "there is no reason for that change in quarantines because the viral load is there."

He even points out "there are many cases that after those seven days continue to be positive and, therefore, that person can be a transmitter of the virus."

Elena Vanessa Martínez, president of the Spanish Society of Epidemiology (SEE),

also considers early a reduction in the time of isolation or quarantine: "We are seeing now, from the reduction of time from ten to seven days, that from those seven days there are many people who continue to be positive. And that cannot matter right now, because the levels of transmission of the virus that we have are high. There is no scientific evidence that after five days the virus is not transmitted, rather there is evidence to the contrary."

"The problem of transmission -recalls Martínez- is the probability that the infection reaches the vulnerable person who can pass the disease in a serious way".

So with this level of incidence, the president of the SEE sees no reason to open the debate to reduce these isolations "we have to continue protecting the most vulnerable population," she insists.

WHO guidance on tracing and quarantine

On this issue, the WHO

in those areas with extremely high levels of circulation of the omicron variant of covid-19.

The starting point of the international organization is the 14-day quarantine and isolation for positives and close contacts, a reality that doubles, in days, what is currently in force in Spain.

Well, those 14 days, the WHO admits, 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 resources for 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, the WHO states that "the risk of transmission after the 10-day quarantine (based on pre-omcron data) is estimated to be around 1 percent, with an upper limit of approximately 10 percent."

If the quarantine period is shortened, the WHO recommends that people continue to wear a "well-fitting" medical mask

.

The possibility of quarantine or isolation of 5 days is not included in the WHO guide on contact tracing and quarantine

.

By elevation: Is it a useful measure?

At this point, it is worth investigating further this "scientific evidence" with more opinions from scientists or raising the issue towards a more global approach:

Jonay Ojeda, spokesman for the Spanish Society of Public Health and Health Administration (Sespas), reasons in this direction

. Explained from In another way, the drop in incidence at the moment is very debatable as to whether it is related to isolation, quarantine or the few restrictive measures that may remain.

Therefore, continues the epidemiologist, "this drop in incidence probably has to do with other factors related to the

of cases and both natural immunity and that produced by vaccines."

Once the situation has been exposed, it is the health authorities that must make a decision in this regard.

The last time there was a change in the duration of quarantines and isolations was in the last Interterritorial Council of 2021, where this time was reduced from 10 days to 7 days, that was only two months ago.

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