Saturday, October 1 2022

Health Department pulled welcome changes to isolation, quarantine and contact tracing policies

On December 23, the Chief Health Officer announced major changes to Covid policy:

Contacts of people who test positive would no longer need to be quarantined. Previously, they had to quarantine for two weeks.

The health department would stop tracing the contacts of people who tested positive for SARS-CoV-2.

With some caveats, people who test positive for SARS-CoV-2 should self-isolate for eight days, up from ten.

The ad was unclear in places. It contained an impractical requirement that people with HIV wear a mask at all times at home. The experts had also recommended reducing the isolation to five days. But for once the government had acted quickly following expert advice, so the announcement was welcome progress.

Good reasons were given for the policy change. Hospitals have not been overwhelmed during the current fourth wave of infections and there have been far fewer Covid deaths. This is a consequence of the fact that about half of adults have received at least one dose of vaccine, the high rate of people with some immunity to have been previously infected, and, possibly, the fact that the omicron variant is less virulent. Moreover, the omicron is so contagious that contact tracing has become completely impossible. There have been so many health workers and other government employees quarantined that service delivery is suffering.

Then, on December 28, the strangest statement was issued by the Department of Health, retracting the December 23 policy change. The reasons are unclear. Apparently, unidentified people complained, so the health department with exemplary bureaucratic prose says: “So, in accordance with the principles of transparency and openness, the department has decided to suspend the implementation of policy changes revised, while taking all additional comments and input received into consideration. This means that the status quo remains and all previous existing regulations regarding contact tracing, quarantine and isolation remain applicable.

The confusion comes as much of the country is on vacation, and after nearly two years of lockdowns and restrictions that are now barely observed or enforced. The reversal further undermines trust in government and will likely worsen poor adherence to Covid protocols. It sends this signal: the government is weak and does not want to stick to its own decisions.

This confusion is due to a hodgepodge of overlapping responsibilities and a lack of leadership. Who’s the boss now?

When a state of disaster was declared in March 2020, the government set up a Ministerial Advisory Committee (MAC) and a National Coronavirus Command Council. Then-Health Minister Zweli Mkhize began issuing daily statements on the number of Covid deaths, a task for the civil service (i.e. health officials) and not to policy makers. Meanwhile, policy decisions seemed to come from the command council with some input from MAC.

Mkhize was then engulfed in a particularly unpleasant corruption scandal and forced to resign. Hard-working and underappreciated Joe Phaahla has apparently taken a step back while former acting CEO Nicholas Crisp often ended up championing government policy in the media. The minister’s name does not even appear on the December 23 revised policy statement.

This is not the way to do things. The minister must make policy changes and take unequivocal responsibility for them. Health officials should implement the policy. When a policy of justified improvement, like that of December 23, is made, the minister must defend it, or even improve it. We are still in a state of disaster: leadership, not dithering, is more vital than ever.

The author is the publisher of GroundUp.


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