THE quarantine period in Namibia has been shortened from fourteen to seven days.
At the same time, the number of follow-up tests to prove that patients who tested positive have also been reduced.
The Minister of Health and Social Services during a briefing on the current COVID-19 situation in Namibia from the Situation Room at State House indicated that the symptomatic condition of a patient and an active contact will henceforth be the decisive factor in the future management of cases.
This follows evolving research about the COVID-19 pandemic that shows that an extended period of quarantine is no longer needed.
“It is critical that our policies are driven by scientific evidence, and informed by expert views and knowledge. In our decision making, we make use of the best information available to us, both in our country and from across the globe. On this basis, a decision was taken to bring changes in our policies on quarantine and isolation for people suspected or found to be infected with the coronavirus,” he said.
Dr. Shangula said that the science is now clear that there is no evidence of risk that somebody can infect another person with the virus after ten days of infection and after their symptoms have gone away.
“This means that the numbers of recoveries will rise quickly. This is to be expected. It is because we now know that recovery should be based on resolving symptoms, and counting at least ten days after infection started. It has been proven that a person may test positive for COVID-19, for many more weeks after the symptoms have resolved. However, this does not mean such person is still infective or poses a risk to infect others,” he said.
He said the same policies have been adopted by neighbouring countries and many other countries around the world after recommendations in this regard by the World Health Organisation (WHO) and the Center for Disease Control (CDC).
Dr. Shanngula said a single test for the coronavirus on the seventh day of quarantine will be done, and if it is negative, then the quarantine can end.
“This will help people get back to their normal lives sooner, it will decongest the quarantine facilities, and it still keeps us safe according to all of the latest science,” he said.
Dr.Shangula said that new Quarantine Protocol will adopt a three-tiered structure.
Tier 1: where there is no community transmission, which is most of Namibia at the present time. The duration of quarantine is reduced from 14 to 7 days in approved facilities. All to be tested at the end of the quarantine on day 7 and released on negative PCR. If a positive, the person goes into isolation.
Tier 2: where there is established community transmission, the length of quarantine is proposed to be a minimum of 7 days. Contacts would all be tested at the end of the quarantine on day 7 and released once a negative result is obtained. If a positive result is obtained, they would enter into isolation. Contacts would be allowed to quarantine at home if their home is suitable.
Tier 3A: Travellers arriving in Namibia. The length of quarantine is reduced from 14 days to 7 days in approved facilities.
Travellers are expected to arrive with negative PCR-based results, not older than 7 days. They would only be tested on day 7 and discharged with negative results.
Tier 3B: Special dispensation under the “Tourism Revival Initiative”. The length of quarantine is 7 days in approved facilities.
Travellers are expected to arrive with negative PCR-based results and tested within 7 days of arrival in Namibia. They will be tested on Day 5 and discharged on negative results.
The health minister said that it has been decided that Isolation Protocol in Namibia, will adopt a three-part threshold system:
Threshold 1: when more than 60% of health facility bed capacity, dedicated to COVID-19, is available. All positive cases are managed in isolation units at COVID-19 designated health facilities regardless of severity of illness.
Threshold 2: when more than 60% of the health facility bed capacity, dedicated to COVID-19, is occupied by confirmed and suspected cases, only severe and critical cases and those at higher risk of developing severe disease or complications due to co-morbidities will be managed at health facilities. All other cases will be managed in other designated and repurposed COVID-19 non-healthcare isolation facilities.
Currently, Erongo and Khomas Regions are in Threshold 2.
Threshold 3: isolation in health facilities would only be used for severe cases. Non-severe cases or cases at higher risk of developing severe disease due to co-morbidities will be managed in repurposed facilities. All other cases, which have living spaces that are amenable for home isolation, would be allowed to do so.
COVID-19 non-health isolation facilities and home isolation will follow strict criteria outlined clearly in the Case Management SOP.
“After a COVID-19 epidemic review of all available data, Case Management experts recommend a pivot in Namibia’s de-isolation criteria. Currently, for de-isolation, Namibia uses a test-based approach and requires two negative PCR tests taken at least 24 hours apart,” he said.
Dr. Shangula said Namibia will move to a revised de-isolation protocol as follows:
Asymptomatic patients will be discharged from isolation 10 days after the positive test for SARS-CoV-2.
Symptomatic patients will be discharged from isolation 10 days after onset of symptoms, with at least 3 additional days without symptoms.
All patients will have a test conducted on Day 10 after the initial test, for asymptomatic or Day 10 after symptom onset for symptomatic.
If the test is positive, the patient will be instructed to exercise additional caution with physical distancing, wearing of mask, and hand hygiene for the next 10 days.
“These recommendations are in line with the newest WHO and CDC guidance. Any confirmed COVID-19 case that has been de-isolated according to the aforementioned criteria will be considered as having recovered. Thus, recovery would no longer be based on re-testing negative on PCR,” he said.
Dr. Shangula said the risk categorisation and quarantine of health workers has also been revised.
“Current evidence suggests that SARS-CoV-2 is transmitted between people through close contact and droplets. Aerosol-generating medical procedures are also associated with increased risk of infection. Against this background, the Ministry of Health and Social Services developed a framework to classify Health Care Workers into either High or Low Risk, depending on the context of their work environment and the level and nature of possible exposure to infection,” he said.
Those regarded as High Risk HCWs are required to be quarantined in line with the SOPs and those regarded as Low Risk HCWs are not required to quarantine. The risk categorization is conducted by the Infection, Prevention and Control Experts to ensure objectivity.
“The message cannot be re-emphasised enough. Let us protect ourselves individually. Let us protect our neighbours. Let us protect our communities. Let us protect our country. Together, we can vanquish COVID-19,” he said.
Dr. Shangula again urged all Namibians to do their part to stop the spread of this disease in its tracks.
In order to protect themselves, their families, and their communities from illness and prevent loss of life, people must:
* Wear face masks each time we go out in public,
* We must practice prescribed social distancing protocols,
* We must avoid crowded places and public gatherings,
* Practice hand hygiene, by using alcohol-based sanitizer or washing hands with soap and water for at least twenty seconds,
* Avoid going out in public, unless it is absolutely necessary,
* Avoid large gatherings, especially those held indoors, and
* We must avoid unnecessary travel, especially from region to region.
“These are the realities of our times. The only way Namibia can suppress the spread of the disease is by following and complying with these measures without fail, at all times, and by everyone,” he concluded.