Why does quarantine in Poland often last for many weeks? We apply outdated guidelines, we waste time and money

According to the guidelines that apply in Poland to patients in isolation due to a positive result of the SARS-CoV-2 coronavirus test, the condition for release from isolation is obtaining two negative tests with an interval of at least 24 hours. This leaves many people in isolation instead of 14 days, several weeks, and during that time they have several tests done. The WHO guidelines on exempting patients from COVID-19 have been updated. It’s time to do the same in Poland – points out the immunologist Dr. Paweł Grzesiowski.

1. With the development of the COVID-19 pandemic, the guidelines for clinical care of COVID-19 patients as well as methods of preventing transmission of the virus in society have changed.
2. The most frequently commented on was the change of the WHO position regarding the wearing of protective masks in public spaces by potentially healthy people
3. Another change, which, unfortunately, has not been applied by Poland so far, concerns the criteria for exempting people from isolation who have obtained a positive test for the presence of the SARS-CoV-2 coronavirus. The criterion of obtaining a twice negative RT-PCR test result before release from quarantine has not been recommended by the WHO for two months.
4. Obsolete guidelines take up to two months to isolate people who no longer have COVID-19 symptoms

The guidelines change during a pandemic

The COVID-19 pandemic has severely shaken healthcare systems around the world. Thanks to guidelines and recommendations, it was possible to better or worse control the outbreaks. As the epidemic progressed, and as we learned more about the SARS-CoV-2 coronavirus, the guidelines have changed. Recommendations for wearing protective masks were the most commented.

Initially, the WHO took the position that masks should be worn by people who manifest symptoms, as well as health care workers and workers, e.g. in nursing homes or where they deal with people at risk. Later, these recommendations evolved and now, in the WHO recommendations, we can read that in the case of areas with widespread transmission, with limited ability to implement control measures, especially in places where physical distance cannot be kept (e.g. in means of transport, shops or other crowded areas). places) WHO recommends rulers to encourage the public to use face masks.

See also: WHO recommendations on the wearing of masks

As with the use of masks, changes to the guidelines have also occurred in terms of exempting COVID-19 patients from isolation. Our government seems to have “slept through” this change. WHO’s interim updated guidelines were released on May 27, 2020, and we are still not complying with them.

Zobacz: Recommendations for the management of patients infected with SARS-CoV-2 who do not require hospitalization

Two negative COVID-19 test results are guaranteed to be immune from insulation

The WHO recommendations, published on January 12, 2020, assumed that in the case of a person who tested positive for COVID-19, release from isolation could only take place after the person had obtained two negative RT-PCR results at least 24 hours apart. The recommendation was based on experience and knowledge related to similar coronaviruses, including SARS and MERS.

As the pandemic unfolds, recommendations for releasing people who test positive for COVID-19 have changed. On May 27, WHO updated the criteria for discharge from isolation as part of the clinical care pathway for a patient with COVID-19. They apply to all COVID-19 cases, regardless of the place of isolation and the severity of the disease. What changed?

Criteria for exemption from isolation (i.e., discontinuation of precautionary measures related to disease transmission) without retesting (WHO):

1. For symptomatic patients, release from isolation should be 10 days after symptom relief plus at least 3 additional days without symptoms (fever and respiratory symptoms).
2. In the case of asymptomatic patients, release from isolation should take place 10 days after obtaining a positive SARS-CoV-2 test result.

This change was preceded by consultations with experts and WHO member states, who indicated that the previous criteria, in view of the limited laboratory resources, equipment and personnel in intensive transmission areas, caused a number of problems.

It is about, also visible in Poland, extending the periods of isolation to several weeks after the symptoms have subsided, which affects the well-being of the isolated people. Numerous examples show that people who tested positive for the SARS-CoV-2 coronavirus still have prolonged isolation after symptoms have cleared because they did not get two negative RT-PCR tests.

Zobacz: Przemek has been in quarantine for 47 days. “It is a lie that the situation in Silesia is under control”

The fact of changing the guidelines in force in Poland was pointed out by Dr. Paweł Grzesiowski, a pediatrician, immunologist, doctor of medical sciences, academic teacher at the Medical Center of Postgraduate Education.

In an interview with Medonet, about the expectations of the new minister of health, Grzesiowski noted that the former health minister Łukasz Szumowski had not signed any decisions regarding the fight against the pandemic for weeks:

Decisions must be made about modifying the quarantine and disqualification guidelines. Taking two swabs of convalescents, both of which must be negative, is no longer needed in the light of current medical knowledge. At the moment, we have a scientific basis to deviate from this. The great effort and cost associated with “swabs” should only be shifted to testing suspects and epidemiological investigations.

The new criteria for discharging people with SARS-CoV-2 coronavirus infection are known from May 27, 2020, but in Poland they have still not been updated. The National Health Fund estimates one test for the presence of SARS-CoV-2 coronavirus performed using the RT-PCR method at PLN 280. At this point, using the outdated guidelines, several thousand people are undergoing tests every day to give them a pass to release from insulation. Due to the lack of decisions on adopting new criteria, we lose daily resources that could be spent on testing people suspected of being infected.

Will the new health minister order an update of the isolation guidelines?

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