Doctors urge Ontario to scale back isolation, quarantine rules

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The days of Ontarians having to stay at home for a week or more after testing positive for COVID-19 or being identified as a close contact may soon be coming to an end.

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The Ontario government is evaluating a recent move by the U.S. Centers for Disease Control that would significantly cut back isolation and quarantine days, and a number of hospital physicians are encouraging them to head in this direction.

While Dr. Kieran Moore, Ontario’s chief medical officer of health, was scheduled to give a press conference on Tuesday, it was postponed following the news from south of the border.

“In light of the recently updated guidance from the [CDC] on shortening the recommended isolation and quarantine period, the Office of the Chief Medical Officer of Health and Public Health Ontario are evaluating this guidance against Ontario-specific evidence,” wrote Alexandra Hilkene, a spokesperson for the Ministry of Health, in a note to media.

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The updated U.S. CDC guidelines say that those who test positive for the virus now only need to isolate for 5 days, so long as they no longer have symptoms.

As for close contacts, if they have received a booster or a second mRNA shot less than six months ago, they no longer need to isolate at all. While it’s recommended that all others isolate for 5 days, the CDC acknowledges that this may not be “feasible” for everyone.

Dr. Moore is expected to make an announcement later this week, but Ontario doctors are already hopeful that the province will head in this direction.

“I am very supportive of shortening isolation times and think this can be done in Canadian settings,” says Dr. Isaac Bogoch, a staff physician at Toronto General Hospital, in an email to the Sun.

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“While most people appear to be contagious for roughly two days before and after symptom onset (recognizing that many will have very mild symptoms), a small percentage of people may still be contagious at the five-day mark.”

Dr. Bogoch adds that: “[t]his policy could further reduce the risk of transmission from recovering patients by reducing isolation to a slightly longer period (e.g. 7 days), or by having people test negative using a rapid test prior to coming out of isolation.”

For Dr. Sumon Chakrabarti, an infectious diseases physician at Trillium Health, now is definitely the time to implement such a change.

“The whole idea of testing, tracing and isolating was predicated on the idea that we had no vaccine and we had to do something to break transmission chains,” he said in an interview with the Sun.

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“Doing this kind of detailed test, trace and isolate is a very resource intensive process that doesn’t have a very high yield anymore,” Dr. Chakrabarti adds — pointing out that if isolation days aren’t significantly adjusted then various sectors in the workforce are going to be depleted for no good reason.

Dr. Martha Fulford, a pediatric infectious diseases physician and Associate Professor at McMaster University, says in an email that scaling back isolation rules now “seems like a very appropriate thing to do.”

But these policy changes also provoke a larger question.

“We should be asking what our end point is,” Dr. Fulford says.

“We have very high vaccination rates, we understand the risk factors for severe disease (e.g advanced age, obesity) and we have early treatments available. Is there any reason now to continue to isolate healthy, low risk adults? Can we shift and focus only on precautions for those at high risk and testing only of those who are symptomatic or those who are close contacts of high risk individuals?”

It appears that perspectives and policies on dealing with COVID-19 in Ontario are set to rapidly change.

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