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In France, the government is considering halving quarantine times for coronavirus, taking it from the classic 14 days to a week, or when possible to five days. The change will be discussed at the end of the week, but it has already received approval from the committee of doctors and researchers that provides scientific advice to the government. Such a choice would be in contradiction with the guidelines of the World Health Organization, which recommends two weeks of quarantine for people who have come into contact with positive, verified or probable cases.
Incubation and quarantine
The goal of quarantine is to ensure that a person who may have been infected (and is, for example, waiting for a tampon to confirm it) remains isolated from others, in order to reduce the risk of new infections. Determining this is not always easy, for example because in the last phase of the incubation period (the time from when you are infected until the disease develops) many individuals are already contagious, even if they have not developed symptoms, which may also not appear . never, in the event that COVID-19 has an asymptomatic course.
The incubation period varies significantly from person to person, but based on the data collected so far, it is in a range between 2 and 14 days – the average incubation period for COVID-19 is 4-5 days. People who develop symptoms tend to report the first effects of the disease within 2 to 7 days, with almost all symptoms showing at least one symptom within the twelfth day of infection.
To date, it is not clear how contagious the positives are in the incubation period, but some research has shown a peak in viral load in the upper respiratory tract approximately 4 days after infection or within 7 days of onset. symptoms.
What the WHO says
Based on this information, the WHO has so far recommended maintaining a 14-day quarantine for positive or presumptive positive contacts, awaiting feedback through tests on their actual positivity:
WHO recommends that all contacts of people with probable or confirmed COVID-19 be quarantined in a dedicated facility or home for 14 days from the time of exposure.
A contact is a person in any of the following situations from 2 days before to 14 days after the onset of symptoms in the confirmed or probable case of COVID-19:
• face-to-face contact with a probable or confirmed COVID-19 case within one meter of distance and for more than 15 minutes;
• direct physical contact with a probable or confirmed case of COVID-19;
• direct assistance for a person with a probable or confirmed case of COVID-19 without adequate personal protection;
• other situations, as indicated by local risk assessments.
How it works in Italy
Most countries have so far followed WHO guidelines in enforcing the 14-day quarantine. In Italy, for example, the quarantine is planned to:
A healthy person (close contact) who has been exposed to a case of COVID-19, with the aim of monitoring symptoms and ensuring early identification of cases. For COVID-19 the quarantine period is 14 days after the date of the last exposure (maximum incubation period of the disease, if the contact had acquired the infection).
Isolation, on the other hand, applies to truly infected people and aims to separate them from healthy ones to reduce the spread of infection. For the Ministry of Health, in this case the isolation does not have a predetermined time and is applied until the individual is no longer contagious.
Reduction
Speaking in a radio broadcast on Tuesday, September 8, French Health Minister Olivier Véran said he had received a favorable opinion from the scientific committee to reduce quarantine times in France “in a number of situations”. Véran explained that many French people do not respect the two-week quarantine and that a reduction of the time could favor greater compliance:
We are most contagious in the first five days after the onset of symptoms or the positivity test. So, this contagion is significantly reduced: it is present even after a week, but it is very weak.
The proposal will be discussed by the government next Friday and has provoked various reactions in France, especially in a period in which the number of new positive cases detected daily has increased significantly again. Fewer days of quarantine could encourage more virtuous behavior on the part of those affected, but it could also imply a greater risk of spreading the epidemic.
Véran also said that there is “virtually no difference” in a situation where 5 percent of people can still be contagious after five days, compared to 2-4 percent of people who can still be contagious after. of 14 days. quarantine. However, not everyone is convinced of this estimate, considering that some aspects of the methods of contagion still need to be clarified not only by symptomatic patients, but also by those who do not present symptoms.
The WHO guidelines are not binding, so that each country can be regulated independently, but its meaning is, in any case, to provide governments with a homogeneous approach to managing the pandemic, avoiding different and contradictory options. between different countries. Exceptions to the 14-day rule for specific cases could complicate communication of the rules to the public, creating confusion on a very sensitive issue for everyone’s health.
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