Thursday, January 19, 2023

Hong Kong To End Mandatory Isolation For COVID Cases on January 30th


In a more perfect world, anyone who knew themselves to be infected with COVID (or influenza, RSV, or any other respiratory virus) would voluntarily self-isolate (preferably at home) until they were no longer contagious.  

By doing so, far fewer people would contract the virus, deaths and hospitalizations would be greatly reduced, and the virus would have fewer opportunities to mutate. 

But it wouldn't end an epidemic, as many people are contagious before their first symptoms appear, and many others may never develop recognizable symptoms. 

Transmission would still occur, just on a lesser scale. 

In Hong Kong, which has followed much of Mainland China's Zero-COVID playbook, anyone who tested positive for COVID was ordered to isolate for 14 days (and in some cases, longer).  

They reduced the length of mandatory isolation in early December (see Hong Kong Eases Some COVID Restrictions In Wake Of Mainland's Policy Changes), and today announced that requirement will be abandoned entirely at the end of this month. 

While HK Chief Executive Lee Kar-chao emphasized all of the reasons why this move should have little impact (high levels of vaccine uptake, significant community immunity, better medical treatments, and relatively mild disease) this policy change is not without some risk. 

XBB.1.5 doesn't respect existing immunity, and it appears poised to be the next big global wave.  So far, it doesn't appear to be any more severe than BA.5, but data remains limited, and of course we've no idea of the impact of future variants that will come down the pike.  

Between mounting economic and societal pressures to return to a more `normal' existence - and the strong likelihood that XBB.1.5 will do whatever its going to do regardless of their isolation rules - Hong Kong's government has opted - like much of the rest of the world - to declare victory and hope for the best. 

The (translated) announcement follows, after which I'll have a short postscript.

The isolation order for new crown patients will be revoked on the 30th of this month

January 19, 2023

Chief Executive Lee Kar-chao said that the society's immune barrier against the novel coronavirus is already very strong, and most of the patients' illnesses are mild. The government's management of the epidemic needs to move to a new stage and a new model. He announced that the measures to issue isolation orders to patients with new crowns will be withdrawn on the 30th of this month.

When attending the Chief Executive's question-and-answer meeting in the Legislative Council today, Lee Ka-chao said that the measure to revoke the quarantine order is to take into account that the vaccination rates of the second and third doses of the local new crown vaccine are 93% and 84% respectively, and that since the fifth wave of the epidemic, A large number of citizens have been infected and developed immunity, making the effective vaccination rate of the third dose of the vaccine equal to 95%. The society's mixed immunity barrier against the new coronavirus is already very strong.

He also pointed out that after three years of the new crown epidemic and the continuous evolution of the virus, the local medical system’s prevention and control capabilities have been improved, and effective antiviral drugs are available, and the virus’s risk to local public health has been significantly reduced.

The customs clearance between Hong Kong and the Mainland took more than 10 days. Li Jiachao pointed out that the risk of the epidemic has not increased, and the trend of the epidemic has become even lower. From the highest daily record of nearly 30,000 positive cases, it has dropped to more than 3,000 announced yesterday.

Li Jiachao said that citizens' awareness and ability to deal with COVID-19 have also been greatly improved. Most of the patients' illnesses are mild. management as one of the upper respiratory diseases.

Mandatory isolation can make sense early in a pandemic, when levels of the virus are low in the community, but quickly loses its effectiveness as community cases increase.  

Voluntary isolation - staying home when you are sick - makes sense anytime.  If you must go out in public, wearing a mask can help protect others. 

No, it won't stop an epidemic.  But it very well might save lives - particularly among the elderly, or those with comorbidities - and it will reduce the burden on our healthcare system. 

And that should be our goal every year, not just during this pandemic.