New tracing, testing and quarantine on cards — but confusion irks scientists

Friday marked a month since the government did an about-turn on contact tracing and quarantine guidelines — after relaxing them a few days earlier.

It said an “amended circular” would follow but it has not appeared, leaving scientists bewildered and angry about the muddle.

Professor Francois Venter, who runs Ezintsha at Wits University, said the government had scored “an astonishing own-goal”, adding: “Everyone is confused and implementing this in a different way.”

Health department deputy director-general Nicholas Crisp said the Covid ministerial advisory committee is taking a fresh look at protocols.

“Revised regulations emanating from the National Coronavirus Command Council” are expected as soon as the president’s co-ordinating council has met, he said.

Crisp said the situation “is very fluid” but Venter said the about-turn meant the government had moved from following “world-leading  advice to a confused mess in just a few days” when it changed the protocols then reversed the move.

“I have no idea why this is so complex and why it takes so long to make decisions which are so well justified by their own experts, or why communication is so poor,” said Venter.

On December 23, the health department released a statement saying “all contact tracing should be stopped with immediate effect” and any known contacts “must continue their normal duties” and not be tested unless symptoms developed.

The exceptions for the no-contact-tracing rule were congregate settings, cluster outbreak situations or self-contained settings (such as prisons).

It also said “all quarantine [of those exposed] is to be stopped with immediate effect” and that “no testing for Covid -19 is required irrespective of the risk of exposure unless the contact becomes symptomatic”.

Isolation of the sick remained in place, but fell away for the asymptomatic.

On December 28, a circular was released explaining the reasons for the changes announced a few days earlier — but also revoking them.

The circular said 60% to 80% of people had some immunity because they had caught Covid and recovered or because they were vaccinated.

It also said “the world has learned more about the virus” including that many people do not have symptoms and only a small number of people are diagnosed.

It added: “Quarantine is expensive and many people lose their income because they cannot go to work, while children have to stay home from school.”

The earlier revision was “based on a number of scientific factors”, it said, but the department had “put the implementation of the revised policy changes on hold while taking all additional comments and inputs received into consideration”.

This meant the status quo remained and “all prior existing regulations with regards to contact tracing, quarantine and isolation remain applicable”.

The department apologised for “any confusion and inconvenience caused” and said an amended circular would follow.

Professor of vaccinology Shabir Madhi, dean of health sciences at Wits, said he suspected the about-turn happened because of the “initial recommendation being in contravention of the regulations encompassed under the State of Disaster Act” and that the “inertia around a simple issue was hardly surprising”.

He said only about 10% of cases have been identified in the current context of Omicron, vaccination and previous infections, and about 75% of exposed contacts go untraced, making the regulations useless anyway.

He said having “entered a different phase of the pandemic”, there is “no rational basis to continue with a policy which in the first place did not work to prevent the spread of infections in the South African context”.

The health department was not available to comment on whether the state of disaster, now extended to February 15, was a factor in the about-turn.

Hlonipha Mokoena, a professor of history at the Wits Institute for Social & Economic Research, said tensions around government-led responses were intensifying as the pandemic dragged on.

“As is becoming apparent in other countries, the measures put in place to deal with the virus are unpopular and there is revolt against their extension,” she said.

“The fact that the ‘disaster’ is not over is no longer relevant; people are chafing against the constant cautiousness, regulation and prescription.”