How often this happens in the real world is hard to say. Testing is strictly voluntary, and generally done at home using rapid tests, and there is no requirement to report test results.
Given the number of people I've seen in stores, and out in public, with the `sniffles', or coughing (without wearing a mask), I'm guessing compliance is pretty low. Recently an unmasked person sneezed at a grocery store I was in, and muttered an embarrassed `It's only an allergy' to those of us within spraying distance.
Maybe it was, but this is why I'm still masking up in public. I've seen a small uptick in mask usage among others in my region over the holidays, but it is remains only a tiny percentage.
There is a growing sentiment among the public, and governments, that it simply isn't worth the effort to prevent COVID infections. They believe that `herd immunity' will eventually de-fang the virus, and allow the world to move on.
That comes at a price, of course. Both in terms of morbidity and (admittedly fairly low) mortality from the acute infection, and the less well quantified, but onerous burden of `long COVID' among the survivors.
The rub is, herd immunity will only kick in once the virus stops mutating radically every few months, and for now, that rapid-replacement-cycle shows no signs of abating.
The latest Omicron subvariant XBB.1.5 appears to be the most immune evasive strain to date (see WHO Rapid Risk Assessment On Omicron XBB.1.5), and most (if not all) of the monoclonal antibody treatments we have are likely to be ineffectual.
Faced with limited vaccine effectiveness, a dwindling array of pharmaceutical treatment options, and a steady stream of new, rapidly spreading variants, the importance of NPIs (Non-pharmaceutical Interventions) has begun to grow again.
Today the World Health Organization released an updated Clinical Management of COVID-19: Living Guideline that continues to call for mitigation efforts, including the isolation of both asymptomatic and symptomatic COVID cases, and strong recommendation for universal and targeted continuous masking in health care facilities.
This 187-page document is focused on the clinical management of COVID-19, and does not address recommendations for the general public. For their stance on vaccines, masks, and other interventions for other sectors, see this weeks WHO Statement On Addressing COVID Challenges.
The call for 10 days of isolation for symptomatic (and 5 days for asymptomatic) COVID cases isn't new, but they have streamlined and revised the protocol from the previous version.
I'll have a very brief postscript after the break.
Clinical management of COVID-19: Living guideline, 13 January 2023
13 January 2023
COVID-19: Clinical care
Download (2.3 MB)
Overview
The WHO COVID-19 Clinical management: living guidance contains the most up-to-date recommendations for the clinical management of people with COVID-19. Providing guidance that is comprehensive and holistic for the optimal care of COVID-19 patients throughout their entire illness is important. The latest version is available in pdf format (via the ‘Download’ button) and via an online platform, and is updated regularly as new evidence emerges.
The latest version (6th version) contains important updates and recommendations which relate to discontinuation of transmission-based precautions (including isolation) and release from COVID-19 care pathway.
** NEW** Conditional recommendation for ten days of isolation for individuals who are symptomatic due to SARS-CoV-2 infection; and five days of isolation for individuals who are asymptomatic with SARS-CoV-2 infection (published 13 January 2023).
** NEW** Conditional recommendation for the use of rapid-antigen testing to reduce the period of isolation for individuals with SARS-CoV-2 infection (published 13 January 2023).
To view previous (now outdated) versions of this guideline, please see the links below:
Version Date Link
1 27 May 2020 (accessible as pdf only), was originally published under the title "Clinical management of COVID-19: interim guidance, 27 May 2020".
2 25 January 2021 access via an online platform or as pdf
3 23 November 2021 access via an online platform or as a pdf
4 23 June 2022 access via an online platform or as a pdf
5 15 September 2022 access via an online platform or as a pdf
- increasing vaccine uptake in the general population;
- administering additional vaccine doses to priority groups;
- promoting mask-wearing indoors and in public transportation;
- ventilating crowded and public spaces such as schools, bars and restaurants, open-space offices and public transportation; and
- providing early and appropriate therapeutics to patients at risk of severe disease.
I would humbly suggest a sixth.
If you are sick, stay home.
It doesn't matter whether you have COVID, the flu, RSV, or some other respiratory virus. These viruses kill tens of thousands of people every year.
It is literally the least you can do.
