How Daily Testing Could End Misery Of Self-Isolation For Covid Contacts

A pilot in Liverpool will replace quarantine with regular coronavirus testing. Here's how it works and what it means.
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The message has been simple since the rollout of Test and Trace: if you come into “close contact” with someone who has tested positive for coronavirus, you need to self-isolate for 14 days.

Now all that looks likely to change. Starting in a pilot area, close contacts of people who have tested positive for coronavirus will be offered daily testing for a week. They won’t have to self-isolate at all unless they also come up positive.

Currently, a negative test isn’t deemed sufficient evidence that a person really is safe to be out and about. That’s why Boris Johnson, who tested negative last week, is still self-isolating after coming into contact with a sick MP.

So what’s changed?

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Members of the public complete a test swab during a lateral flow Covid test at Rhydycar leisure centre in Merthyr Tydfil
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The aviation industry has repeatedly called for quarantine requirements to be eased for people who test negative for Covid-19.

Research published this month from consultants Oxera and health analytics firm Edge Health suggested that up to 90% of infected passengers could be detected following just five days of quarantine.

The analysis pointed to international examples, including in Iceland where 69% of infected travellers were identified upon arrival with a further 21% identified five days later.

It came too late for EU trade commissioner Phil Hogan, who resigned in August after breaching a 14-day quarantine he should have completed upon returning from Belgium.

He had excused it by saying he received a negative Covid-19 test. But according to enquiries made by the Irish Times to the HSE Live Coronavirus information line at the time, incoming passengers should still have quarantined for 14 days regardless of any negative test result as the disease can incubate for days, delivering a negative result even for a person who later becomes positive.

“A test is only a point in time,” the adviser explained to the newspaper. “So I’m afraid the 14-day [quarantine period] still stands regardless of testing negative or not.”

Will daily testing work?

Professor David Alexander works in emergency planning and management and says he’s sceptical about the government’s ability to manage an increased testing regime.

“The more testing there is, the better off we are,” he told HuffPost UK. “With testing we get a bigger, better picture of what’s going on with this wretched disease.

″[But] a lot of this depends on how they can muster their forces and do this, and so far their record has been abysmal at doing things properly.”

Was self-isolation working anyway?

The government has already been criticised for its relative lack of support for those left stuck at home and unable to work. Eventually it bowed to pressure and offered a one-off payment of £500 to people on low incomes who were told to self-isolate.

Professor Alexander, from the UCL Institute of Risk and Disaster Reduction, contrasts the UK with South Korea, which has carefully managed and monitored its quarantining population, supplying meals and resources to ensure it is adhered to.

He added: “I’m not at all sure that quarantine works if you just let people get on with it.”

Accepting that two weeks’ self-isolation was an unacceptable burden for some, last month transport secretary Grant Shapps launched a taskforce to find ways of reducing the period with a “test and release regime”. Even that, though, would still have involved a self-isolation period of at least a week.

Has more testing been shown to reduce infections?

Yes. Downing Street said there would be an expansion of the mass testing already trialled in Liverpool to help areas deemed to have “very high” Covid levels, offering them a direct route out of the harshest restrictions.

More than 200,000 people in the city underwent rapid lateral flow tests which produce results within 30 minutes.

The pilot of mass coronavirus testing in Liverpool found 700 positive cases that would have not been detected otherwise, Public Health England director Dr Susan Hopkins said last week.

Downing Street said the testing, along with restrictions on movement, had led to a drop in Covid cases in the area.

Liverpool, which was placed in Tier 3, will now also trial the repeated testing scheme as a replacement for quarantine, starting on Monday, with the government looking to roll it out across the NHS and care homes in December, and the rest of the UK by January.

Who else will it help?

The government is also looking to roll out testing in care homes next month – which, it says, will allow each care home resident in the country to have up to two visitors who can be tested twice a week with physical contact permitted.

It is not yet known what areas are destined for Tier 3 once national lockdown lifts, with ministers preparing to outline the details on Thursday.

But Downing Street has said a greater number of areas are expected to enter the higher tiers than before, to preserve the gains made against Covid-19 during the full lockdown.

Additional testing plans also include all staff working in food manufacturing, prisons and the vaccine programme being offered weekly testing from next month.