Covid Commentary: Follow the Science? I don't think so

Follow the Science? I don't think so

Jersey Guidelines:

Direct contacts should be tested to help slow the spread of COVID and protect others. You will be asked to attend 1 PCR test.

If you are notified that you are a direct contact of a positive case, you are not required to isolate unless you have symptoms, but you must think very carefully about the activities you undertake and the places you visit for the next 10 days, even if you receive a negative test result.

If you live in the same home as someone who has tested positive, you should allow the guidance above and self-isolate until your first negative test.

A change in policy is that people who are direct contacts now only need to be tested once instead of three times. 

We have seen cases of people  who tested negative on the first test and positive on a subsequent test, but the numbers since April are not yet available - although an FOI request recently submitted may reveal them.

It seems that this is a risky strategy, potentially leaving many positive cases in the community not isolating and spreading the virus - and conveniently not recorded on the figures. 

It is clear that the surge in cases has led to a situation where the first test is coming for a direct contact too late in the day, and that can lead to increased transmission - especially as direct contacts don't have to self isolate until they have a test unless they show symptoms. It is a way of coping with numbers and balancing the risk in a lose-lose situation. 

The actions currently being taken are not "following the science", but because track and trace is collapsing again.

Part of the problem is the conversations with positive cases about direct contacts is not being used to target day 5 and day 10 cases. Where people are not part of the same household, the strategy to prioritise direct contacts first test makes sense as a way of making the best of a bad job. But internal household transmission is very high - we know that from the statistics - so it would make better sense to target those cases with a day 5 and day 10 test, or at the very least a day 5 test.

In fact, just as I write this I have a case in point in my email from a correspondent about a couple of colleagues of theirs whom we will call Mr and Mrs X. Mrs X felt unwell and tested positive. Her husband tested negative on the first test, but - showing no symptoms yet - tested positive on his second test. He is still showing no symptoms.

One of many reports published this year - "SARS-CoV-2 Transmission From People Without COVID-19 Symptoms" in the Journal of Infectious diseases noticed that:

"Transmission by persons who are infected but do not have any symptoms can arise from 2 different infection states: presymptomatic individuals (who are infectious before developing symptoms) and individuals who never experience symptoms (asymptomatic infections, which we will refer to as never symptomatic)."

An examination of the data showed that "more than half of transmission comes from asymptomatic individuals." They comment that "effective control also requires reducing the risk of transmission from people with infection who do not have symptoms."

Jersey has just opted for a strategy which has, in fact, according to the science, increased the risk of transmission from asymptomatic carriers.

And they also comment that: "Measures such as mask wearing and social distancing empower individuals to protect themselves and, if infected, to reduce risk to their communities."

Researchers from the University of Bristol found that an entire population that wears masks in public leads to a reduction in the transmission of SARS-CoV-2 by almost 26%! The study demonstrated that around the same time that masks mandates were lifted, the persistence of mask-wearing by a majority of the population led to a notable reduction in SARS-CoV-2 transmission.

Isn't it time that some of those measures returned - legally enforceable to help contain the spread? Mask wearing, as studies show, is not 100% effective, but helps significantly to reduce spread.

A False Sense of Security: Predicting Numbers

There was certainly a high level of transmission within schools, and I suspect now that they have closed, while numbers will rise, there may be a dip in case numbers, or a slow down in the rise in cases per day. 

But that will not be because numbers have plateaued, but because one major vector of transmission has been closed. The danger is that it will give a false sense of security, and another major vector - nightclubs opening - may be brought forward as a result.

The UK has gone for a much more unrestricted freedom, and there has from midnight been masses of people going to nightclubs, as they opened doors. It would be wise to see if that causes a surge in England before Jersey follows suit.

Long Covid Update

Another correspondent who has had Covid over three weeks ago, still has a persistent cough, no sense of taste or smell, and has gone deaf in one ear. They had just one vaccine before catching it.

Meanwhile another correspondent reports going temporarily deaf in one year when having Covid, and still getting breathlessness and chronic fatigue, though not as badly as when they had Covid. They had two jabs, over 14 days past, when their family all contracted Covid.

Sense of smell and loss of taste seems to be a persistent symptom, but one correspondent described it as sudden, just like a switch had been thrown, one second there, another gone. 

Please continue to send me details which will be anonymised of any cases you know personally of Long Covid. It is important we raise the profile of this as it will, I think, prove to be very significant.

The Beta Variant

At the moment the Delta variant has high transmissibility, so is sweeping Jersey and the world. The new French Beta variant is not as transmissible, but can evade more vaccinated people. Therefore as Delta is slowed and perhaps halted as more get double vaccinated or catch it, the Beta will still be able to transmit Covid and therefore will be likely to "take over". This is what you would expect with the standard evolution of viruses.