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Do boosted close contacts need to restrict their movements?

Well, about that…

This is an extract from a recent edition of The Journal’s coronavirus newsletter, which cuts through the noise and misinformation to give you clear, accessible facts about the coronavirus, Ireland’s fight to contain it, as well as developments further afield. 

This is your one-stop-shop for Covid news during a time when it can be hard or overwhelming to try and stay up to date with the latest.

You can read the full edition heresign up to receive the newsletter here or at the bottom of the page. This version contains additional updates.

THE ADVICE FOR close contacts in Ireland has changed, changed, and changed again over recent months.

You’d be forgiven for struggling to keep up.

But one element has been clear: people with boosted immunity – either through a booster vaccine or a Covid infection since 1 December – who are close contacts of a confirmed case are no longer required to restrict their movements if they have no symptoms, according to official guidelines.

However, it’s not that simple. The reality is that people in this situation do have to restrict their movements, albeit to a lesser extent than previously advised.

(People who are not boosted, who received their booster less than seven days ago, or who are unvaccinated still have to restrict their movements. There is also separate advice for being a close contact of someone who cannot isolate.)

That’s not to say the fine print wasn’t communicated by government and public health officials, but is the key message getting lost?

Many people have been in this situation since the guidelines changed on 14 January and likely headed to the HSE website for advice as a source of trusted information (it’s also the first result on Google).

Once there, click into ‘I got my booster more than 7 days ago’, and you’ll get the lowdown on taking antigen tests (three over seven days, but there is no need if you’ve had Covid since 1 December).

Next, under restricted movements, it says that “you do not need to restrict your movements”.

That’s fairly definite, isn’t it?

You’ll also read that you have to “wear a medical or respirator face mask if you have to be around other people” for a period of ten days.

So does this mean life as normal, but you just have to up your mask game a little? Well, no.

Does this mean you can go to the pub? Technically no.

And how about work? Park that thought for a second.

covid-19-pandemic-middle-aged-woman-in-grey-blouse-wearing-ffp2-mask Stock photo of a woman putting on an FFP2/N95 mask. Source: Alamy

The fine print is omitted, but is included on gov.ie – scroll down and you’ll find this, advising people who are close contacts to:

  • limit close contact with people outside their household, especially in crowded, enclosed or poorly ventilated spaces
  • wear an appropriate face mask in crowded, enclosed or poorly ventilated spaces and where they are in close contact with other people
  • take an antigen test before entering crowded, enclosed or poorly ventilated spaces and prior to having close contact with other people from outside their household
  • avoid contact with anyone who is at higher risk of severe illness if infected with Covid-19
  • follow all public health protective measures.
  • In the clamour around reopening, and the focus on the fact that there’s no longer a need to quote-unquote restrict your movements, this nuance is in danger of being lost.

“I think there has been a real dropping of the ball in terms of close contacts,” Christine Loscher, professor of immunology at DCU, told The Journal.

The message was very much that you don’t need to restrict anymore, and most people’s interpretation of the new close contact rules is exactly that [...] but when you look at the list of requirements, it was actually quite restrictive.

Loscher said the close contact rule was a key tool in breaking chains of transmission – ‘was’ being the operative word there.

“I don’t think it was a good idea [to change the guidelines] and I still don’t think it is a good idea.”

She used household contacts as an example: there’s a roughly 30% chance of catching Covid in this situation, meaning close to one in three of these close contacts are potentially infectious before an antigen test picks it up.

Loscher highlighted the risk of transmission if people are still taking part in social activities (which they should be avoiding, according to the fine print) and attending work (in situations where it is not possible to work from home) if they are not wearing an FFP2 mask at all times.

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This is clearly mentioned in the guidelines, but it’s a bit of an oxymoron; you don’t need to restrict your movements, but you do have to wear an FFP2 mask around other people, so in theory, you can go to the pub if you keep your mask on at all times.

We’ve heard time and time again from experts that clear communication is vital in keeping the public on board with public health measures.

The issue around having to work from home if you are an immunity-boosted close contact is, currently, up in the air.

This was recommended by NPHET but doesn’t appear on gov.ie, however is quite clearly outlined here in the chief medical officer’s letter, dated 11 January, to the Minister for Health:

“Work from home unless it is essential to attend in person.”

The Journal understands that the omission is considered a technicality. The overarching public health advice was already to work from home until this week, and so this line wasn’t included.

However, at the time of writing, the advice still hasn’t been updated. It’s an element of potentially huge importance and impact, so employers and employees alike need clarity.

Asked why the full detail wasn’t included on its website, the HSE’s response was that “all the required measures are outlined on the HSE website”.

At the time of writing, there has been no confirmation to a follow-up query on whether this means that the additional advice does not form part of the HSE’s advice

But if you are a close contact, and want to protect those around you in both social, work, and home settings, stick to the fine print.

This is an extract from a recent edition of The Journal’s coronavirus newsletter, which cuts through the noise and misinformation to give you clear, accessible facts about the coronavirus, Ireland’s fight to contain it, as well as developments further afield. 

This is your one-stop-shop for Covid news during a time when it can be hard or overwhelming to try and stay up to date with the latest.

You can read the full edition heresign up to receive the newsletter here or at the bottom of the page. This version contains additional updates.

About the author:

Nicky Ryan

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