Editor’s Note: This article has been updated with additional comments.
The government has announced that from Monday, January 17, self-isolation for people who test positive for COVID-19 can end after 5 full days, provided they test negative on days 5 and 6 and they do not have a high temperature. People whose rapid lateral flow tests remain positive should remain in isolation until they have had two consecutive negative tests taken on different days.
The self-isolation period was already reduced in December from 10 to 7 days if people tested negative on days 6 and 7.
The default self-isolation period remains at 10 days and people can only leave self-isolation sooner if they meet the new requirements.
The new measures were aimed at “supporting essential public services and keeping supply chains going through the winter”, the government said. He stressed that it remained crucial that people in isolation wait for release until they have received two negative rapid lateral flow tests on 2 consecutive days, to reduce the risk of still being infectious.
The decision was made after “careful consideration” of modeling by the UK Health Security Agency. Health and Social Care Secretary Sajid Javid said: “After considering all the evidence, we have taken the decision to reduce the minimum period of self-isolation to 5 full days in England. These 2 tests are essential to these balanced and proportionate plans.”
However, the government’s announcement was met with opposition.
The Royal College of Nursing responded by issuing a press release asking health and care workers to be exempted from reduced self-isolation. Pat Cullen, General Secretary and Chief Executive of the RCN, said: “By the Government’s own estimate, almost a third of individuals are infectious 5 days after symptoms start. Health and care workers will enter this group in large numbers and there may be minimal space for error or complacency.
“Current and growing workforce pressures must not lead to dangerously reduced isolation requirements.
“This change could increase the risk of transmission to other staff and patients. When providing close care, including to people with compromised immune systems, nurses need to be confident that not patients at risk.”
Lawrence Young, virologist and professor of molecular oncology, Warwick Medical School, agreed: “This policy certainly does not follow the science. Reducing the self-isolation period to 5 days runs the risk of highly infectious people returning to the work or school,” he told the Science Media Center. “This is not helped by current issues with the availability of lateral flow tests and concerns about who is reporting the results of these tests.”
However, NHS providers gave the announcement a cautious reception. Deputy Managing Director Saffron Cordery said: “There has always been a need to balance returning to work as soon as possible for staff who have self-isolated due to COVID, on the one hand, with the need to protect patients and other staff against COVID cross-infection in healthcare facilities on the other hand.
“This is particularly important given the increased transmissibility of the Omicron variant and the impact this could have on vulnerable patients in healthcare settings.
“Trusted leaders will welcome UKHSA’s findings that the new arrangements do not significantly increase the risk of nosocomial infection. This means that their staff will be able to return to work sooner, CFLs permitting.
“This is an important development given the enormous operational pressures facing the service and the risks to patient care associated with the current level of staff absences related to COVID isolation.
“Trusted leaders will continue to follow UKHSA guidance to ensure everything is done to minimize the risk of hospital-acquired infections.”
Concern about availability of testing and PPE
The College of Paramedics also widely welcomed the move, but expressed concern about the availability of test kits and protective equipment. A spokesperson said United Kingdom“We know there has been an issue for our members in accessing lateral flow test kits and with the extremely close delivery of care that paramedics give, it is essential that we aim to protect at both paramedics and the people who use their services, both in emergency and primary care.
“Levels of illness are forcing an already overstretched workforce to work even harder and it is important that employers use the latest risk assessments for better respiratory protective equipment for their staff.”
The BMA, which last weekend declared the NHS in a “perilous state”, with 1 in 5 doctors self-isolating in the previous 2 weeks, also said access to testing and PPE remained problem.
Dr Penelope Toff, chair of the BMA’s Public Health Medicine Committee, said United Kingdom: “All sectors and, in particular, the health services are experiencing disruption due to widespread absences due to the rapid spread of Omicron, but health care workers do not want to risk infecting colleagues and patients – many of whom are clinically vulnerable, so they can only return to work safely after a shorter period of isolation and two negative lateral flow tests if they have access to high-quality masks, and many are finding that this is not is still not the case.”
She continued: “The government accepts that under this new policy at least 7% of people will still be infectious when they leave isolation, even after two negative lateral flow tests on days 5 and 6, this which means that these continued infection control measures among the public and in healthcare settings are absolutely vital.”
In last week’s survey, nearly half of physicians said they were extremely concerned about staffing levels, but less than half said they could still access lateral flow testing and nearly half said that when working in red zones they were not provided with respirator masks.
Other tips to review
The government will also review guidelines for people identified as close contacts of people with COVID-19, which currently remain unchanged: fully vaccinated contacts are not required to self-isolate but must take daily rapid lateral flow tests for 7 days ; unvaccinated contacts are legally required to self-isolate for the entire 10-day period.
Following the announcement, Mr Javid said: “We are carrying out more tests than any other country in Europe. We have increased the distribution of free lateral flow tests from 120 million in November to 300 million in December…and we we expect to make around 400 million tests available this month – that’s 4 times the pre-Omicron plan.”
He added: “UKHSA data shows that around two-thirds of positive cases are no longer infectious at the end of day 5 and we want to use the testing capacity we have developed to help these people leave the safe isolation.”
Different British countries have set their own isolation rules and Welsh ministers have said they have no plans to reduce their period of self-isolation. A further review of Wales’ COVID-19 restrictions is scheduled for Friday. Northern Ireland First Minister Paul Givan indicated his support for such a policy, but said it was a decision for Health Minister Robin Swann to make. In Scotland, people can end self-isolation early after 2 negative LFD test results 24 hours apart from day 6.