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HIQA releases study evidence behind new change to Covid-19 self-isolation period

People with a confirmed case are to self-isolate for 10 days now, down from 14.
Sep 15th 2020, 11:30 AM 17,520 13

HIQA HAS RELEASED the details of the studies it used as evidence for cutting the self-isolation period for Covid-19 cases to 10 days. 

The Health Information and Quality Authority (HIQA) published an evidence summary on international studies on its website. The studies look at the duration of infectiousness in people who test positive for COVID-19.

Public health measures like self-isolation and restriction of movements (or quarantine) are used to reduce the spread of SARS-CoV-2 within communities.

Up until yesterday, people with COVID-19 were expected to self-isolate for 14 days from when they first develop COVID-19 symptoms or from when they test positive if they do not have symptoms.

The summary was developed by HIQA following a request from NPHET. It has informed NPHET’s decisions on changes to the self-isolation period for those with COVID-19.

HIQA said that the evidence summary identified 15 international studies; 13 viral culture studies and two contact tracing studies.

These studies can indicate the duration of potential infectiousness of people and can inform the duration of self-isolation required for individuals diagnosed with COVID-19.

Dr Máirín Ryan, HIQA’s Deputy CEO and Director of Health Technology Assessment, said: “It is important that the Irish guidance on the duration of self-isolation is informed by the most up-to-date evidence from around the world.

“While a prolonged self-isolation period can have a large impact on people’s lives, their families and businesses, it is important that the duration is sufficient to prevent the spread of the disease to others.”

She said that from the evidence HIQA reviewed, patients with mild-to-moderate COVID-19 disease are unlikely to be infectious beyond 10 days from their first symptoms.

However, some limited evidence from a small number of studies found that patients with severe-to-critical symptoms and those who are immunocompromised may be infectious for 20 days or more.

She noted that as most of the studies they looked at related to adults with symptoms, there is currently no evidence to support a different duration of infectiousness in children or in those who never develop symptoms.

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Ryan said that while they are gaining greater insight every day about COVID-19, “the evidence is still evolving and remains limited”.

The most recent evidence points towards individuals with mild disease being at risk of transmitting the virus to others for up to 10 days after symptom onset. This underlines the critical importance of rapid diagnosis, tracing and isolation of suspected COVID-19 cases to reduce the spread of the disease.

She said that informed by this evidence summary, the revised public health advice is now that self-isolation for patients with COVID-19 in the community is a minimum of 10 days from the onset of symptoms. She noted that the last five days must be fever free or 10 days since their positive test in those who have no symptoms.

She added: “This evidence summary focused on evidence relevant to those with COVID-19, and therefore, has no impact on the duration of quarantine for close contacts of confirmed cases, household contacts of people with symptoms of COVID-19 or people arriving into Ireland from a non-green list country. The current guidance for people in these categories remains the same, they must restrict their movements for 14 days.”

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Aoife Barry


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