Debate renews over COVID-19 close contact isolation rules

As Australia moves into winter, changes to restrictions are up for discussion as governments try to strike the balance between living with COVID-19 and protecting the community.

Advice from the Commonwealth’s top chief public health panel, the Australian Health Protection Principal Committee (AHPPC), has suggested close contact isolation should come to an end soon.

Most jurisdictions have issued exemptions for close contacts in critical workforces to ensure essential services can continue, but now some are questioning the need for asymptomatic close contacts to spend a week in isolation.

The AHPPC said quarantine could be replaced with other risk-mitigation measures for close contacts once the peak of BA.2 Omicron sub-variant had passed.

Here’s what that means.

Are changes to close contact rules on the way?

It’s unlikely rules for close contacts will be scrapped altogether, but experts believe it may be time for the isolation requirement to go.

The AHPPC has suggested instead of isolating, close contacts would need to do more rapid testing, wear masks outside of the house, and stay away from high-risk settings like hospitals and aged care facilities.

People who have come into close contact with a COVID-19 case must currently isolate for seven full days, with the same isolation rules applying across all states and territories. 

There is some variation across the states in regards to how long people are exempt from these rules after recovering from a COVID infection.

Epidemiologists the ABC spoke to have shared mixed views on making changes to isolation rules.

Some believe the logical next step in “living with COVID” is to treat it like any other respiratory infection, while others say easing close contact rules could push case numbers up again.

Infectious diseases physician Peter Collignon said it made sense for close contact rules to change after the current wave of cases passed.

“The consequences of COVID are much less than a year ago,” the Australian National University professor said.

“People who are close contacts, if they are vaccinated, they should be able to go around to have reasonable normality of doing their job because otherwise, we’re going to have large numbers of people out of the workforce continuously.”

Professor Peter Collignon sits and looks into the camera with a bookcase behind him.
Peter Collignon says Australia is in a far more secure position now compared to previous years of the pandemic. (ABC News: Tamara Penniket)

Professor Collignon believes the high vaccination rate will protect the wider population from serious disease or death.

“That’s much more important than isolating people for seven days or 14 days because they’re close contacts,” he said.

University of Melbourne epidemiologist Nancy Baxter said even with the protection vaccination provided, there was still a need for public health protection measures to be in place for close contacts.

“If someone’s coming into work, and as a close contact, people with COVID in the home, what are the rules going to be for that person? How are those rules going to be enforced?” Professor Baxter asked.

“If we were all still wearing masks, and someone was getting RAT tested every day, I think it could be managed relatively safely.”

The power to alter close contact rules lies with individual state and territory governments, and it looks like no one is planning on scrapping isolation measures yet.

Prof. Baxter said governments should still aim to reduce infection numbers as part of the “living with COVID” plan.

“The question we want to ask ourselves is ‘how many times do you want to get COVID?’ and whether there’s something we can do in addition to vaccination and boosting that might help protect us against getting COVID four times a year,” she said.

“People don’t seem to be willing to wear masks unless it’s mandated. That’s unfortunate because masks are an excellent way of reducing transmission.

“If people aren’t willing to wear masks, I think we really need to focus on improving ventilation, particularly as we’re going into those winter months.”

Which states are peaking?

Before any changes are made, state governments will need to be sure cases have peaked and are trending downwards.

Modelling has proven to be imperfect throughout the pandemic, but the latest data suggests cases will peak across the country by mid-April at the latest and some jurisdictions will hit peaks over the next couple of days.

In Victoria, for example, the virus’s reproduction rate has been sitting at around 1.07 for a week now.

Professor Baxter said Victoria could be experiencing a mild peak, after which case numbers would plateau at a high level.

“We’re likely close to our peak, but it seems to be a flat peak, not the peaks that we were used to where it goes up, spikes up and then comes down fairly quickly,” she said.

“That’s likely, in part because of how transmissible a BA.2 is, but also because we’re dealing with this new sub-variant, at the same time that we’ve relaxed all of our restrictions.”

A woman poses against a colourful background for a portrait
Nancy Baxter says case numbers may stay at relatively high levels with a lack of COVID restrictions being enforced. (Supplied)

There are concerns that relaxing restrictions ahead of winter – coinciding with the country’s first flu season with widespread COVID cases – could cause issues for the health system.

Prof. Collignon said hitting peak cases sooner would hopefully mean the infection rates were lower in the winter months.

“This particular winter, because we’ve had actually so much COVID over the last few months, we may not get the large numbers that I and others are expecting,” he said.

“We shouldn’t be overwhelmed this winter, again, because we’ve got such high levels of vaccination in our community.”

What does it mean for vulnerable Australians?

For Melbourne woman Sally Smith, the idea of rule changes that increase the risk of infection is hard to reconcile with the inevitable increase in deaths.

Her father, Ronald Cooper, was an active, healthy and triple-vaccinated 80-year-old when he contracted COVID-19 in early March.

He died in the Wagga Wagga Base Hospital intensive care unit two days after testing positive, from a suspected blood clot that commonly occurs because of COVID-19.

“We’re 100 per cent certain that no COVID, no clot, no death. It was 100 per cent COVID, and he was a man who was not done,” Ms Smith said.

“He had full faith he was going to survive.”

A seated man surrounded by 5 standing women
Ronald Cooper died in early March while positive for COVID-19. (Supplied)

Ms Smith said it was hard to hear that her father’s death would be considered more acceptable because of his age.

“He definitely isn’t what people would think of when they hear somebody in their 80s passed from COVID. They wouldn’t be thinking of somebody who was living their life to the full the way my dad still was,” Ms Smith said.

“He certainly wasn’t sitting at home, waiting for his life to end.

“At the end of the day, it’s real people, it’s real family, it’s taking lives that wouldn’t otherwise be taken, I don’t think we can dismiss that, or say that their death is somehow warranted because most people are going to survive. It seems cruel.”

Some older Australians have told the ABC that even with up-to-date vaccination coverage, they are still carefully weighing up the risks of participating in activities that could expose them to the virus.

Should we be worried about ‘Deltacron’ and other variants?

A new variant of coronavirus named “Deltacron” has been detected in Australia, a hybrid that contains elements of both the Delta and Omicron strains.

The first Deltacron case was reported on Friday by New South Wales and, on Saturday, Queensland Heath said it had detected “a number of cases”.

Early estimates suggest it’s at least 10 per cent more transmissible than Omicron.

Prof. Collignon said while new variants could be more transmissible, they were usually less deadly.

“Every time there’s a new variant or a new recombination we all get worried, but the reality is the vaccines still work and that’s the good news,” he said.

“The bad news is they tend to spread a bit more readily, but that’s what viruses do with time. They probably become less aggressive or virulent, but more infectious.”

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