South Africa’s government, buoyed by encouraging data showing that infections from the omicron variant aren’t as severe, has dropped quarantine restrictions for all but symptomatic people.
That includes allowing people who have tested positive but show no symptoms to gather with others, so long as they wear a mask and social distance. A top health official explained that since the variant spreads so quickly, there are likely many infected people socializing with others and it no longer made sense to quarantine only those who have tested themselves.
The move was yet another step toward a slow acceptance that many countries around the world will likely need to find a way to live with COVID-19, rather than avoid it. The new measures follow recommendations from a committee of experts who called for focusing on vaccinations rather than contact tracing and quarantining.
“There is greater recognition that, in the face of a hyper-contagious variant like this, quarantining and isolation are no longer effective as public health containment measures to contain the virus,” said Francois Venter, a researcher at the University of the Witwatersrand in Johannesburg and a former member of the committee.
The new protocols go into effect immediately, the health ministry said in a notice to local health department heads. The revisions were based on data showing that immunity resulting from previous infections was as high as 80%. That, coupled with a vaccination rate of nearly 45% among adults in the country, has kept hospitalizations lower, the South African government said.
A high proportion of cases in South Africa have been asymptomatic, so quarantine measures have been skewed toward those with symptoms. That has been particularly true in the recent wave of infections driven by the omicron variant, during which cases increased steeply but just more than 5% led to hospital admissions.
“Containment strategies are no longer appropriate — mitigation is the only viable strategy,” the notice said.
The new regulations are intended to benefit essential services, the ministry said. Since the pandemic began, nearly 1 in 5 public health sector workers have contracted the coronavirus, the health ministry said this month.
Under the new guidance, people who test positive but are asymptomatic will no longer need to quarantine. People showing mild symptoms like fever, cough and loss of taste or smell are still required to isolate for eight days. It is also no longer necessary to show a negative COVID-19 test before returning to work after isolation.
Ramphelane Morewane, acting deputy director-general of the health department, said that “most people who are walking around may be asymptomatic,” and people who test positive but don’t have symptoms should wear masks and take other precautions to avoid transmitting the virus.
COVID-19 testing will be required if a person has symptoms. Anyone who came in contact with someone who tested positive would not need to quarantine, and must instead do “self-observation” for five to seven days and avoid crowded gatherings, the ministry said.
A booster shot of the Pfizer vaccine will be available starting Tuesday for people who received their first dose at least six months ago or who are at higher risk for becoming severely ill. South African authorities also authorized a booster shot for the Johnson & Johnson vaccine.
The rollout of the Johnson & Johnson shot follows a local study of its efficacy against breakthrough infections, including after the detection of the omicron variant. The study administered more than 230,000 booster shots, largely to health workers, and found that its protection against hospital admission was “at least equivalent to other vaccines,” the health ministry said.
South African health authorities said they would not follow a recommendation from the U.S. Centers for Disease Control and Prevention that COVID-19 vaccines other than Johnson & Johnson’s should be preferred amid increasing evidence that the shot can trigger a rare blood clotting disorder.
South African health authorities issued a circumspect response, saying the CDC warning was in the context of the United States having “an abundance of vaccines.”
Linda-Gail Bekker, one of the study’s lead researchers, said the data from South Africa showed that “in low- and middle-income countries, this single-dose vaccine has great utility.”