Let it Rip! The Undeclared Policy Change on Direct Contacts
The Curious Case of the Falling Statistics
If you take the historic average ratio of Direct Contacts: Active cases it is roughly 3:1. Therefore if the current Active Case figure of 4,287 is accurate, then the Direct Contact figure should be somewhere in the region of 10,000 - 12,000..
But instead the number of direct contacts is rapidly falling. Over the past week, we’ve seen 5095, 5035, 3957, 3299. What is happening?
This is the policy for direct contacts:
“From Saturday 1 January, Islanders who are a Direct Contact of someone who is positive with COVID-19 will no longer be required to take a PCR test followed by 10 days of Lateral Flow Tests. Instead, Direct Contacts will only be required to undertake 10 days of Lateral Flow Tests.”
“Islanders who are identified as a Direct Contact will continue to be notified by the COVID Safe team by text message or email. Any Islander who tests positive on an LFT will need to attend for a confirmatory PCR test by booking online or calling the Coronavirus helpline.”
The Undeclared New Change in Policy
But Islanders are no longer being identified as a direct contact! I asked people to notify me what has happened when they have tested positive on a PCR – for instance, seeking healthcare, or getting a positive lateral flow, booking a PCR, and getting a positive PCR test.
They were contacted to be notified on procedures for self-isolating after a positive PCR test, and how they can test and come out of self-isolation. For example, no symptoms and clear on day 6 and 7 lateral flows 24 hours apart can leave self-isolation.
Yet none of them was asked for a list of direct contacts over the past 4 days – as has happened in the past. Some of them had anticipated this, and prepared lists. The contact tracing team were not interested!
Now this change of policy can’t have happened without some authorisation from Ministers backed by STAC. But we don’t know this, because the STAC minutes are not released on a timely basis, and no change of policy on collating direct contacts and notifying them has been released as a public statement either.
Instead, direct contacts are reliant on those testing positive on PCRs to notify them – if they are well enough to do so, of course. If not contacted, they will not be doing the required 10 days of lateral flow tests, and those statistics will also be missing. If they’ve caught Covid – and Omicron is much more infectious – they will have probably passed it on by the time they test positive on a lateral flow or though seeking healthcare because of symptoms. And remember the window of spread begins before any symptoms begin to show, which is why Covid is so hard to contain.
Deja Vu?
Remember when Covid began, back in 2020? Gary Burgess reported that Jersey was following the UK in “accepting it will continue to spread and that the majority of people will ‘need’” to get it to build herd immunity with a vaccine likely a year or so away.” (Gary Burgess, ITV News)
"To date, there is a view that the virus will have to go through the island in some shape or form, at some point", said John Le Fondre
“The aim has been to allow the virus to move through the island at a slow safe rate, without putting pressure on the health services” said Jersey Medical Director, Patrick Armstrong
And Gregory Guida, then an Assistant Minister, posted on Facebook (the post may have been removed, but I kept a copy):
“Less lockdown means more cases. We didn't have many cases to start with and we were too efficient in suppressing the spread, but the risk was very high as the vulnerable population was then completely exposed. Now that we can keep the most vulnerable protected, we need to open up and get more cases.”
The Unspoken Revival of Herd Immunity
It was clear back then that the strategy was to go for herd immunity. The rising number of hospital cases and deaths put paid to that, and like the UK, Jersey was forced to go to lockdown. Fast forward to 2022...
Omicron is very good at evading vaccines, but double vaccinated plus booster means the cases are not so likely to need hospitalisation or death among the general population, as we have seen with the numbers. The statistics and research on Long Covid is very basic, and what is emerging is very worrying, over all age groups over 20, but Long Covid is being largely ignored.
It seems likely that there is now a return to the statements made in 2020, and a desire to treat Covid as a common cold.. As readers may remember, last year it was mentioned that the situation would be re-assessed, and testing might well stop by May 2022 – that was before Omicron but the same desire would appear to be in place.
In other words, the policy has covertly shifted back to herd immunity, and treating Covid like any other illness. As it is significantly more deadly – affecting and damaging not just the lungs but other organs and having neurological impacts – and more mutations may be on the way – this is I think a foolish strategy.
A recent New Scientist noted that there is no selective pressure for Covid to become mild, and like smallpox, it could spread widely in more severe mutations. Policy is not best informed by wishful thinking, and “living with Covid” is a high risk strategy which overlooks factors like long covid, and the chances that a more severe mutation may well be on the way.
Taking Responsibility
The health Minister is urging us to take responsibility for our own response to Covid. But that should not mean, as seems to be the case, an abrogation of a government from doing its duty to safeguard its citizens, including the most vulnerable.
Moreover, we can only take responsibility if we can assess risk, and if the statistics are not there or are incomplete, and if tracing and notifying direct contacts is not done, we will be in the dark for assessing risk.
That might not matter if Covid were more like influenza, and some reported symptoms of a bad cough and cold. But to take that as representative of the whole is to ignore the medical data, and fail to heed the warning that the next mutations could well be more deadly. Covid is somewhere between influenza and smallpox, one is where we learn to accept a number of deaths, and the other is where there will be a serious health crisis, one which spreads relatively slowly, and one which spreads very fast indeed.
Given its rapid propensity to mutate, far more than strains of influenza, it is important for at least the next five years to maintain an infrastructure capable of holding Covid at bay. If anyone is in doubt of that, I suggest they watch the recent Royal Institute Christmas Lectures, which outlines some of the seriousness of the unprecedented situation we now find ourselves in.
Vaccines are part of the solution, but only one part. For now trace and track of direct contacts, and even if it is now a lateral flow regime, contacting them, is another part of the solution. It appears to be one that the government has now – without fanfare, without any public statement – decided to largely give up on that.
The Curious Case of the Falling Statistics
If you take the historic average ratio of Direct Contacts: Active cases it is roughly 3:1. Therefore if the current Active Case figure of 4,287 is accurate, then the Direct Contact figure should be somewhere in the region of 10,000 - 12,000..
But instead the number of direct contacts is rapidly falling. Over the past week, we’ve seen 5095, 5035, 3957, 3299. What is happening?
This is the policy for direct contacts:
“From Saturday 1 January, Islanders who are a Direct Contact of someone who is positive with COVID-19 will no longer be required to take a PCR test followed by 10 days of Lateral Flow Tests. Instead, Direct Contacts will only be required to undertake 10 days of Lateral Flow Tests.”
“Islanders who are identified as a Direct Contact will continue to be notified by the COVID Safe team by text message or email. Any Islander who tests positive on an LFT will need to attend for a confirmatory PCR test by booking online or calling the Coronavirus helpline.”
The Undeclared New Change in Policy
But Islanders are no longer being identified as a direct contact! I asked people to notify me what has happened when they have tested positive on a PCR – for instance, seeking healthcare, or getting a positive lateral flow, booking a PCR, and getting a positive PCR test.
They were contacted to be notified on procedures for self-isolating after a positive PCR test, and how they can test and come out of self-isolation. For example, no symptoms and clear on day 6 and 7 lateral flows 24 hours apart can leave self-isolation.
Yet none of them was asked for a list of direct contacts over the past 4 days – as has happened in the past. Some of them had anticipated this, and prepared lists. The contact tracing team were not interested!
Now this change of policy can’t have happened without some authorisation from Ministers backed by STAC. But we don’t know this, because the STAC minutes are not released on a timely basis, and no change of policy on collating direct contacts and notifying them has been released as a public statement either.
Instead, direct contacts are reliant on those testing positive on PCRs to notify them – if they are well enough to do so, of course. If not contacted, they will not be doing the required 10 days of lateral flow tests, and those statistics will also be missing. If they’ve caught Covid – and Omicron is much more infectious – they will have probably passed it on by the time they test positive on a lateral flow or though seeking healthcare because of symptoms. And remember the window of spread begins before any symptoms begin to show, which is why Covid is so hard to contain.
Deja Vu?
Remember when Covid began, back in 2020? Gary Burgess reported that Jersey was following the UK in “accepting it will continue to spread and that the majority of people will ‘need’” to get it to build herd immunity with a vaccine likely a year or so away.” (Gary Burgess, ITV News)
"To date, there is a view that the virus will have to go through the island in some shape or form, at some point", said John Le Fondre
“The aim has been to allow the virus to move through the island at a slow safe rate, without putting pressure on the health services” said Jersey Medical Director, Patrick Armstrong
And Gregory Guida, then an Assistant Minister, posted on Facebook (the post may have been removed, but I kept a copy):
“Less lockdown means more cases. We didn't have many cases to start with and we were too efficient in suppressing the spread, but the risk was very high as the vulnerable population was then completely exposed. Now that we can keep the most vulnerable protected, we need to open up and get more cases.”
The Unspoken Revival of Herd Immunity
It was clear back then that the strategy was to go for herd immunity. The rising number of hospital cases and deaths put paid to that, and like the UK, Jersey was forced to go to lockdown. Fast forward to 2022...
Omicron is very good at evading vaccines, but double vaccinated plus booster means the cases are not so likely to need hospitalisation or death among the general population, as we have seen with the numbers. The statistics and research on Long Covid is very basic, and what is emerging is very worrying, over all age groups over 20, but Long Covid is being largely ignored.
It seems likely that there is now a return to the statements made in 2020, and a desire to treat Covid as a common cold.. As readers may remember, last year it was mentioned that the situation would be re-assessed, and testing might well stop by May 2022 – that was before Omicron but the same desire would appear to be in place.
In other words, the policy has covertly shifted back to herd immunity, and treating Covid like any other illness. As it is significantly more deadly – affecting and damaging not just the lungs but other organs and having neurological impacts – and more mutations may be on the way – this is I think a foolish strategy.
A recent New Scientist noted that there is no selective pressure for Covid to become mild, and like smallpox, it could spread widely in more severe mutations. Policy is not best informed by wishful thinking, and “living with Covid” is a high risk strategy which overlooks factors like long covid, and the chances that a more severe mutation may well be on the way.
Taking Responsibility
The health Minister is urging us to take responsibility for our own response to Covid. But that should not mean, as seems to be the case, an abrogation of a government from doing its duty to safeguard its citizens, including the most vulnerable.
Moreover, we can only take responsibility if we can assess risk, and if the statistics are not there or are incomplete, and if tracing and notifying direct contacts is not done, we will be in the dark for assessing risk.
That might not matter if Covid were more like influenza, and some reported symptoms of a bad cough and cold. But to take that as representative of the whole is to ignore the medical data, and fail to heed the warning that the next mutations could well be more deadly. Covid is somewhere between influenza and smallpox, one is where we learn to accept a number of deaths, and the other is where there will be a serious health crisis, one which spreads relatively slowly, and one which spreads very fast indeed.
Given its rapid propensity to mutate, far more than strains of influenza, it is important for at least the next five years to maintain an infrastructure capable of holding Covid at bay. If anyone is in doubt of that, I suggest they watch the recent Royal Institute Christmas Lectures, which outlines some of the seriousness of the unprecedented situation we now find ourselves in.
Vaccines are part of the solution, but only one part. For now trace and track of direct contacts, and even if it is now a lateral flow regime, contacting them, is another part of the solution. It appears to be one that the government has now – without fanfare, without any public statement – decided to largely give up on that.
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