COVID-19: Isolation period may be reduced to eight days [video]

Speaking to eNCA, the chairperson for the COVID-19 ministerial advisory committee, Professor Salim Abdool Karim, says that the guidelines of isolation could be changing from 14 days to 8 days.


South Africa has seen a surge in new coronavirus cases duing the months of June and July month, and Gauteng has once again been classified as a COVID-19 epicentre.


Just a month ago, COVID-19 was something that happened to that elusive "someone else". However, more and more South Africans are now coming face-to-face with the virus.

COVID-19 update: Isolation guidelines

Exposure to the coronavirus


The question remains: How much contact is enough or too much, and how long should a patient suspect of having the disease spend in isolation? Professor Karim explains:


"There's no scientifically valid number. There is some assessment based on estimations with mathematical models. For simplicity, we use 15 to 30 minutes."


He says that more than 30 minutes should be cause for concern, while less contact spanning 15 to 30 minutes falls in a "grey area", and contact lasting fewer than 15 minutes isn't adequate exposure. "It's arbitrary, but we use it as a guide", Professor Karim adds.

How long should one self-isolate?


Professor Karim explains that the current guidelines are based on evidence that came "quite early on, in March and April". He explains that the committee chose to go with the WHO recommendation of 14 days.


However, new info has now come to light. Professor Karim says that three new studies show "quite compellingly, in my view" that an individual would have viable virus for up to about seven days.


"They may test positive on the PCR (polymerase chain reaction) test, but aren't infectious because they don't have viable virus".


Therefore, the COVID-19 ministerial advisory committee is looking to change the current protocol from 14 days in isolation to eight days. Professor Karim also explained the difference between isolation and quarantine.

Difference between isolation and quarantine


If somebody is exposed, they will need to go into quarantine. The committee suggests five days of quarantine while a patient is being assessed for clinician symptoms, such a fever and coughing.


Patients would be able to return to their normal daily activities if they are cleared of all symptoms at the end of the five-day period. "So, five days for quarantine as a suspect, if you have no symptoms; eight days of isolation if you have the infection," he says.


But how could one know if you have the infection if you don't have symptoms? When should one start counting? Professor Karim explains that it should be counted from the date of exposure:


"We know that most people will develop symptoms within about five days. We based it on the evidence that's available currently of when symptoms develop following exposure".

Long-term brain damage


Recent reports suggested that COVID-19 could cause long-tern brain damage. According to Professor Karim, the data is still in early stages.


"In science, we are hesitant to just jump on early data. We want some confirmation. There's a certain level of inflammatory changes, which those come a swelling that occurs in the brain and some kind of building occasionally".


He explains that "it's like a mini-stroke because it affects the small vessels, whereas a normal stroke would be a clot in a major vessel." Some of these changes to the brain will revert over time. In some patients, it may not.


Professor Karim explains that it could result in oxygen deficits due to various factors and that damage to the brain "may not get undone over time". He said more evidence is needed before drastic changes are implemented

Watch: Professor Karim explaining isolation guidelines