Koleka Mlisana
© Misha Jordaan, Gallo ImagesKoleka Mlisana is seen during the Africa’s Webinar on Covid-19.
The Ministerial Advisory Committee (MAC) on Covid-19 has written to Health Minister Joe Phaahla, recommending that the quarantining of contacts be stopped as it is no longer viable in the current social and economic climate.

Furthermore, the committee said contact tracing was no longer necessary and should also be halted with immediate effect.

The MAC is co-chaired by Professors Koleka Mlisana and Marian Jacobs.

In a memo to Phaahla on Thursday examining contact tracing and quarantining, the committee said several changes to the Covid-19 situation had occurred since 2020, necessitating the re-evaluation of the management of the disease.

More people had developed an immunity to Covid-19, MAC said.

It said:
The proportion of people with immunity to Covid-19 (from infection and/or vaccination) has risen substantially, exceeding 60-80% in several serosurveys [measuring of antibody levels against infectious diseases].
"We have learned more about the manner in which Covid-19 is spread, and also now have to contend with variants of concern whose epidemiology differs from that of the ancestral strains of SARS-CoV-2.

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"Crucially, it appears that efforts to eliminate and/or contain the virus are not likely to be successful. Therefore, it is critical that the role of containment efforts like quarantine and contact tracing is re-evaluated."

With only a small number of contacts identified from a proportionally small Covid-19 cases, quarantining was no longer effective for containing the spread of the disease, MAC said.

The committee said testing was highly skewed toward detecting symptomatic cases, while the vast majority of cases are asymptomatic and go undetected.

"In addition, among the small proportion of symptomatic cases, testing is far from universal, since patients may not seek testing when their symptoms are mild and when testing would be burdensome and expensive. Furthermore, the SARS-CoV-2 test sensitivity is suboptimal, sometimes leading to false negative results.

"The inability of the current testing strategy to identify the bulk of cases is illustrated by the high SARS-CoV-2 seropositivity rates seen across multiple provinces in serosurveys, implying that only a fraction of cases (perhaps one in 10, or even less) are ever diagnosed."

It added:
It stands to reason that if the vast majority of cases are not diagnosed, then the vast majority of case contacts are also not diagnosed. This means that quarantining and contact tracing are of negligible public health benefit in the South African setting.
According to the MAC, quarantining has a substantial economic and social burden and impacts significantly on the depleting staffing levels at healthcare facilities, and other front line workers, which could threaten the integrity of these institutions.

It also reduces economic and governmental activities due to high levels of employees who have to leave their work and quarantine for at least 10 days.

"On an individual level, the consequences of prolonged quarantining include loss of income, loss of employment, and loss of schooling time. We propose that quarantining be discontinued with immediate effect for contacts of cases of Covid-19. This applies equally to vaccinated and non-vaccinated contacts. No testing for Covid-19 is required irrespective of the exposure risk, unless the contact becomes symptomatic. We further propose that contact tracing be stopped," it said.

Phaahla announced on Thursday that South Africa will remain on adjusted Level 1 lockdown restrictions during the festive season following the identification of a new Covid-19 variant named Omicron.

At least 16 080 new case have been recorded since the last reporting period, and 48 Covid-19 related deaths, bringing total deaths to 90 345 to date.