Zero Covid Strategy

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    Zero Covid Strategy

    Covid-19: Is it safe to reduce the self-isolation period?
    bmj.com/content/375/bmj.n3164

    Elisabeth Mahase

    Author affiliations

    Two years after the covid-19 outbreak began and a year since vaccinations started, many governments are now reducing the length of time people with covid have to isolate. Elisabeth Mahase looks at the evidence behind the different strategies
    What are the isolation rules in different countries?

    In the US, new rules mean that people have to isolate for only five days, while in the UK they have to isolate for 10 days unless they have negative lateral flow tests on days 6 and 7, at which point they can stop isolating.12

    In France and Japan the isolation period is 10 days, while in New Zealand it is 10 days if the person is fully vaccinated (including 72 hours free of symptoms) but 14 days if they are unvaccinated (again including 72 hours free of symptoms). Germany, Jordan, and Brazil are following the World Health Organization’s recommended 14 day isolation period.
    Could the UK follow the US’s five day rule?

    The UK prime minister, Boris Johnson, is reportedly resisting calls for the isolation period to be cut to five days, at least until more evidence is available about the effects of the recent move from 10 to seven days.3

    Regarding a potential move to five days, NHS Providers’ chief executive, Chris Hopson, said, “Trust leaders are currently grappling with the need to keep vulnerable patients safe from catching covid-19 in a healthcare setting and ensuring staff who are having to isolate due to covid-19 can safely return to work as quickly as possible. The key concept here is safe return . . .We must follow the science and evidence on what is safe and what is not.”
    Is it safe to reduce the self-isolation period from 14 days?

    While most countries started out with WHO’s recommended 14 day isolation period, many have reduced this requirement during the pandemic. Michael Ryan, executive director of the WHO Health Emergencies Programme, called the changes “judgment calls” made to deal with covid-19 cases while minimising the impact on people’s social, economic, and educational lives.

    Speaking at a press conference on 29 December, he said that most people would incubate and show symptoms or be positive within the first six days of becoming infected. The chances of transmitting the disease after that are lower, although still a risk.

    “There are trade-offs,” said Ryan. “If people shorten the quarantine period, there will be a small number of cases that will develop disease and potentially go on to transmit because they’ve been let out of quarantine earlier. But that will be a relatively small number, and a lot of people who won’t transmit will also be released from that quarantine.

    “So, it is a trade-off between the science and being absolutely perfect in what you try to do, but then having the minimal disruption that you can possibly have to your economy and your society. And governments are struggling to find that balance.”
    Has omicron changed anything?

    The US Centers for Disease Control and Prevention certainly thinks so. In its five day isolation announcement it said that the change from 10 days was motivated by evidence that most omicron transmission occurred one to two days before the onset of symptoms and in the two to three days thereafter.4

    However, Ryan warned against countries changing rules on the basis of early data. He said, “The data is not certain because we’re dealing with a very limited number of studies and a limited number of individuals. We’re also talking mainly about younger people. Maybe younger people have a shorter duration than older, but we just don’t know. So, we need to be very careful with interpreting these data.

    “But I think the most important thing at this moment is that we need to be careful about changing tactics and strategies immediately on the basis of what we’re seeing in early data.”
    Should lateral flow tests be used to reduce isolation?

    Commenting on the UK’s policy to allow people out of isolation early if they have two negative lateral flow test results, Ryan said that it was again a “judgment call.” He said, “The window within which [the antigen test] can pick up the virus is narrower than the window with the PCR test, which is much more sensitive. But again, the antigen test is very convenient. It’s very quick and can be done at home, it can be done on site, and there are a lot of practical real world advantages to doing that. So again, it’s a trade-off.”
    Are people still following the isolation rules?

    In the UK, the Office for National Statistics looked at the behaviour of 895 individuals required to self-isolate after testing positive for covid-19 between 29 November and 4 December 2021.5 This showed that around three quarters (74%) fully adhered to the requirements throughout their self-isolation period—a similar level to that reported in July (79%), September (78%), and November 2021 (75%).

    However, one in four people (25%) reported having carried out at least one activity during self-isolation that was not adherent to the requirements, such as leaving their home or having visitors for reasons not permitted under legislation.

    Tim Gibbs, head of public services analysis at the Office for National Statistics, said, “We are continuing to see that a majority of those testing positive for covid-19 are following self-isolation requirements. Although there are negative impacts of self-isolation, such as on wellbeing and mental health, it’s critical that we continue to follow self-isolation rules.”

    This article is made freely available for personal use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
    https://bmj.com/coronavirus/usage
    References


    Limb M
    . Covid-19: Self-isolation after infection cut to seven days in England. BMJ2021;375:n3137. doi:10.1136/bmj.n3137 pmid:34949594

    Tanne JH
    . Covid-19: CDC shortens isolation period as US cases hit record high. BMJ2021;375:n3161. doi:10.1136/bmj.n3161
    FREE Full TextGoogle Scholar

    Dathan M, Courea E. Boris Johnson resists calls to cut self-isolation to save NHS. Times 2021 Dec 29. https://www.thetimes.co.uk/article/c...rged-82vnxjk9z

    Centers for Disease Control and Prevention. CDC updates and shortens recommended isolation and quarantine period for general population. 27 Dec 2021. https://www.cdc.gov/media/releases/2...-guidance.html

    Office for National Statistics. Coronavirus and self-isolation after testing positive in England: 29 November to 4 December 2021. 23 Dec 2021. https://www.ons.gov.uk/peoplepopulat...o4december2021


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    Zero Covid Strategy

    https://www.bloomberg.com/news/video...-omicron-video
    “Covid Zero” Hong Kong Fights Omicron
    "I think we've put a lot of eggs in the basket of zero-Covid." @hku_SPH's @Bencowling88 discusses Hong Kong's #Covid Zero policy as the city tightens restrictions

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    Hong Kong Faces Worst of Both Worlds as Omicron Ruins Covid Zero Jinshan Hong 04:30 AM IST, 08 Jan 2022 11:27 AM IST, 08 Jan 2022 Save (Bloomberg) -- Hong Kong is at a Covid-19 tipping point. The once-vibrant gateway to China sacrificed its status as an international hub to “Covid Zero,” its strategy for eliminating the virus by isolating itself from a world awash in the patho

    Read more at: https://www.bloombergquint.com/onweb...ins-covid-zero
    Copyright © BloombergQuint


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    Quote Originally Posted by dynamco:
    Hong Kong Faces Worst of Both Worlds as Omicron Ruins Covid Zero Jinshan Hong 04:30 AM IST, 08 Jan 2022 11:27 AM IST, 08 Jan 2022 Save (Bloomberg) -- Hong Kong is at a Covid-19 tipping point. The once-vibrant gateway to China sacrificed its status as an international hub to “Covid Zero,” its strategy for eliminating the virus by isolating itself from a world awash in the patho

    Read more at: https://www.bloombergquint.com/onweb...ins-covid-zero
    Copyright © BloombergQuint
    Great. The more global coverage the better.

    I wonder if CL & her cronies are aware they're ruining HK's once great reputation as a place to work & make money, as a financial centre, as a flight hub, as a tourist destination, and a few more I cant be bothered to list.

    Perhaps a more pertinent question would be, do they care? Not much. Only loyalty now is to Beijing.

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    SCMP Robin Hibberd
    Omicron’s emergence is the catalyst for Hong Kong to rethink its zero-Covid strategy
    • Sealing off the city helped save lives early on and bought people time to get vaccinated, but it also made us complacent
    • The arrival of the highly contagious Omicron variant means compulsory testing and quarantines are no longer practical, and it may well be time to break the seal
    Published: 1:30pm, 7 Jan, 2022

    Residents at a block in Tung Chung undergo mandatory testing for Covid-19 on January 1 after a preliminary positive imported case was reported. Tracing and enforcing testing of thousands of people who may have been in hundreds of locations across the city is a tall order. Photo: Edmond So
    As we enter our third year in the grim grip of the Covid-19 pandemic, I’ve tried to cheer myself up periodically by looking for positives in Hong Kong’s zero-Covid approach to the pandemic.
    And positives are not hard to find. The city has seen only 12,732 infections and 213 deaths since the beginning of the pandemic. Singapore, a city state with less than 75 per cent of Hong Kong’s population, has seen over 283,000 infections and 835 deaths.
    Unfortunately, on most days, the positives are crowded out by thoughts of how much long-term disruption the city’s zero-Covid policy has brought to our lives. Restaurants that close at 6pm are one thing, but the zero-Covid-driven quarantine regime for travellers is a much more serious matter. It has cut deep into the fabric of the city and our lives.
    We’ve been all but hermetically sealed off from the world for the past two years in support of zero-Covid. Who wants to spend weeks in quarantine as the cost of a holiday, a family visit or a business trip?
    And with few exceptions, non-resident visitors have been barred from the city. Recent attempts to align ourselves with the mainland’s similar policy seem to have stopped us from exploring alternate approaches to handling the pandemic.
    As the months and now years have passed, Hong Kong’s positioning as Asia’s world city is looking increasingly farcical. Perhaps “Hong Kong: Asia’s hermit city” might be a more authentic brand positioning.
    A catalyst seems to have been lacking for Hong Kong to rethink its zero-Covid strategy. The emergence of the Omicron variant may have changed that. The impracticality of sealing the city off from this highly infectious Covid-19 variant is becoming increasing evident.
    The authorities need look no further than their own increasingly frantic actions to see that their ability to keep out Covid-19 is being stretched to breaking point. It’s time to reconsider the city’s approach.
    A glaring example of how the zero-Covid policy is becoming impractical can be found on the government’s Local Situation Dashboard website. A review of the site on January 5 showed a staggering number of active sites in the city where people were now subject to compulsory testing.
    Hong Kong businesses cry foul over abrupt return to anti-Covid-19 social-distancing rules
    Something like 180 separate sites were named. They included obvious ones like the Moon Palace restaurant in Festival Walk and the Spectrum of the Seas cruise ship. Restaurants across the city figure prominently. But the listing also included a wide assortment of bus and minibus routes, bus terminals, retailers, grocery stores and ferry piers.
    Few if any of these latter locations require or enforce the use of the government’s contract tracing “Leave Home Safe” app. With no way to be contacted by the authorities, it is doubtful that the people subject to these latest compulsory testing orders are even aware of the orders, let alone making the effort to get tested.
    Yet effective tracing and testing is integral to maintaining zero-Covid. Infected people and their contacts need to be found and isolated. But as the Moon Palace outbreak has recently shown, the health authorities are having trouble getting people to come forward – even when they have been informed that they need to be tested.
    The prospect of coming forward and then possibly being placed in government quarantine may well be deterring some people.
    Tracing and enforcing testing of thousands of people who may have been in hundreds of locations across the city is a tall order. And ensuring testing compliance by people who don’t even know they are subject to a testing order is wishful thinking.
    If keeping Omicron out of the city really requires this level of contact tracing and testing, we are now truly beyond what is practical and possible.
    Zero-Covid seems to have made sense early in the pandemic. It no doubt saved lives and bought us time that should have been used to get the population vaccinated.
    But living in a zero-Covid bubble saw us become complacent. We deluded ourselves that we could maintain the bubble indefinitely and took our foot off the gas on the vaccination front. The result is we now have low vaccination rates among the elderly, the group most vulnerable to Covid-19.
    With the highly infectious Omicron variant, Hong Kong’s bubble looks to have burst. If, by some miracle, it has not, it is only a matter of time before the next variant arrives. Zero-Covid now looks increasingly unrealistic as a policy for protecting our community’s health, our economy and our personal well-being.
    It is time to pivot to a practical strategy that allows us to break the seal on Hong Kong and rejoin the world.
    Robin Hibberd is a financial services executive and long-time resident of Hong Kong. He is a former president of the Canadian Chamber of Commerce in Hong Kong


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    https://news.rthk.hk/rthk/en/compone...7-20211228.htm

    Govt advisor - Zero Covid policy NOT Sustainable

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    Should HKG listen to world renowned experts or Patrick Nip ? now Gabriel is going to join HKJC Charities section since these local Govt fools do not listen to science

    https://www.lshtm.ac.uk/newsevents/e...-gabriel-leung
    https://www.scmp.com/news/hong-kong/...-not-work-long
    https://twitter.com/bencowling88?lang=en
    https://twitter.com/gmleunghku