COVID: Is England scrapping self-isolation too soon?

The legal requirement to self-isolate after testing positive for COVID-19 has been lifted in England, and scientists are concerned that the changes will lead to more infections and potential new variants.

As of February 24, people no longer legally have to self-isolate, but the UK government says that, until April 1, it still advises people who test positive to stay home and avoid contact with others for five days and then test negative two days in a row.

Mask-wearing and social distancing have not been compulsory in England since late January.

Zoe Hyde, an epidemiologist at the University of Western Australia, told DW that, while easing quarantine requirements for contacts of cases could be justified if protocols such as testing negative were in place, this was not the case for positive cases.

"Ending the requirement for known cases to isolate is completely at odds with public health," Hyde said.

"It's a recipe for more transmission, more waves of disease, new variants, and sustained disruption to health systems and the economy," she added.

But Catherine Bennett, chair in epidemiology at Deakin University in Australia, told DW that the change in rules wouldn't result in all positive cases choosing not to self-isolate.

"This is part of the transition to living alongside the virus where we move away from rules that are increasingly difficult to enforce," Bennett said.

"Removing rules to self-isolate doesn't mean people must stop isolating, just as having rules doesn't mean everyone is following them. So, whilst there might be more people out mixing than there currently are, it won't be a step change from 0% to 100%," Bennett said.

Pressure to work

Sarah Pitt, a principal lecturer at the University of Brighton and fellow at the UK-based Institute of Biomedical Science, told DW that she worries that people who are ill with COVID-19 and should be resting would be under pressure to go to work once the isolation requirement falls.

"This might affect the time it takes for them to recover, might increase the risk of them developing long COVID, and they can also infect other people," Pitt said.

The loss of financial assistance for people who are too ill to work adds another layer of pressure.

From February 24, self-isolation support payments will end, along with national funding for practical support and the medicine delivery service.

"Removing the legal requirement to self-isolate means that people will not receive the same financial assistance that they had before, so some people will have to go to work when they really should be at home," Pitt said.

Concern over variants

Scientists have also expressed concern about the change to England's self-isolation rules and the potential for new variants.

"Variants can emerge anywhere in the course of viral replication, and, the higher the infection rates, the sooner we might see one," Bennett said.

A press statement about the government's "plan for living with COVID" says the United Kingdom will "begin to treat Covid as other infectious diseases such as flu."

But the coronavirus is more contagious than influenza.

Pitt said the coronavirus was very unpredictable and had not settled down yet.

"There is absolutely nothing in the virology which suggests that any new variants will be milder than omicron," Pitt said.

On Twitter, Deepti Gurdasani, a clinical epidemiologist at Queen Mary University of London, expressed concern about the omicron sublineage BA.2 as the UK government plans to end all self-isolation.

"In the midst of this, our govt appears to have made a decision to halt free testing for the majority, and self-isolation for all. It was never a question of *if a VOC emerges*. We have one now, and it is growing in the UK, and globally," Gurdasani wrote, referring to variants of concern.

In a statement on February 22, the World Health Organization (WHO) said studies had shown that BA.2 has a growth advantage over BA.1, and that initial data suggests that BA.2 is "inherently more transmissible" than BA.1, which is currently the most common omicron sublineage reported.

Living with the virus

Investment in public health messaging is important for creating behavioral change, Bennett said.

The epidemiologist said that, if the public understands that simpler measures such as mask wearing indoors helps reduce transmission risk when infection rates are rising, this will help reduce the need for more formal rules.

"Then we are moving into a more sustainable approach to infectious disease control," Bennett said.

Booster vaccinations could also help counterbalance the changes to England's self-isolation rules, she added.

"If increasing booster doses can reduce symptomatic infection from omicron by half for five months or more, then this could offset the changes to isolation rules if there was more effort to make the vaccines available globally," Bennet said.

But living with coronavirus means understanding the virus, Pitt said, including how infectious it is, how it spreads and how serious the disease can be ― even in vaccinated people.

A sensible precaution would be to continue to wear face coverings on public transport, Pitt said. As of February 24, masks will no longer be required on public transport in London. But Transport for London, the government body responsible for most of London's public transport, recommended that passengers who can wear a mask continue to do so. 

"We do not complain when health care workers wear gloves to examine patients these days," Pitt said, "but that precaution only came in as a measure to protect against HIV in the 1980s and 1990s."

Wearing masks could become a part of life to protect people from the coronavirus and other airborne diseases, just like wearing surgical gloves did.

"It was controversial at the time, but it is normal practice now," Pitt said.

Edited by: Carla Bleiker