Officials explain delays in quarantine exiting

The media were able to get some answers from health officials about a number of issues troubling people with regard to the Covid pandemic during a special Zoom meeting on Tuesday. The most frequent worry facing the public is the issue with not receiving prompt results following an exit PCR and the subsequent delay in release from quarantine.

Incorrect details

Chief Nursing Officer Hazel Brown said there were a couple of reasons why people were not receiving timely results of their exit PCR tests.

“Sometimes it’s the lab that has to rerun these tests. Sometimes its incorrect email addresses. Sometimes we have no email addresses. There are times when we have no contact details. We have many many instances when we are calling the phone numbers that are given us they are no longer in service or we have reached the wrong person, so there are a number of issues with us contacting persons,” she advised.

LFTs “a waste”

While acknowledging their worry about not only the inconvenience but also the dangers of isolation, particularly with regard to people’s mental health, Nurse Hazel said the use of the lateral flow testing in order to decide if someone was infectious or not (in order to be released from quarantine) was a waste of precious resources and not environmentally friendly.

Such a use of the lateral flow test was not its preferred use because lateral flow tests were designed to pick up early infection, but could not be used to monitor the progress of the infection, she advised.

“Long after the lateral flow test is negative, the person may remain infectious and that is something that I’m really struggling to get people to understand,” she stated. “Once you get a positive lateral flow and you’ve done your PCR, you wait for your PCR. It’s really and truly a waste of that lateral flow test because, first of all, it doesn’t change the outcome, and the PCR is the requirement for exit legally once you are positive.”

Nurse Brown saids she was concerned for the environment as well.

“As you know, these lateral flow kits are plastics and we don’t have any way of recycling. We are looking at the dump as well,” she said.

Nurse Brown asked the media to help them get the public to understand the correct use of the lateral flow and put it into the context of conservation as well as the value that it brought to the outbreak.

The HSA’s molecular biologist Jonathan Smellie advised that the processing of PCRs took a considerable amount of work and that was one reason for the long delays some people may be experiencing with this current huge increase in outbreaks of Covid-19. He said that each test went through 35 separate steps. Public Health also had a number of tests that it had to do before it reached the lab, Nurse Brown added.

“A lot of those steps are repeated because we have to have two qualified persons review each sample before they leave the lab,” Mr Smellie advised.

Nurse Brown went on to say that it was a “dangerous practice” to allow people back to work only when they were LFT-negative, because they were “probably still positive” and, with the resurgence of the Delta strain taking place which may cause more serious hospitalisations, it was “of great concern”, but she acknowledged it was a reality and she did believe it was happening.

The moment they heard of such breaches they immediately act upon it, she advised.

US/UK approach

The United States and the UK both take a different approach to the Cayman Islands when it comes to quarantine. The US Centers for Disease Controal and Prevention (CDC) says that concentrations of Covid-19 infection in upper respiratory specimens decline after onset of symptoms. Infectiousness peaks around one day before symptom onset and declines within a week of symptom onset, with an average period of infectiousness and risk of transmission between 2-3 days before and 8 days after symptom onset, they explain on their website.

“The likelihood of recovering infectious virus is very low after 10 days from onset of symptoms, except in people who have severe Covid-19 or who are moderately or severely immunocompromised,” the CDC says.

In the UK, the government regulations require a positive person to isolate for five full days and if they have two negative lateral flows on consecutive days people can end isolation, or after ten full days without negative results. Isolation begins when people show symptoms, not when they get a positive test.

“Your self isolation period includes the day your symptoms started or the day your test (LFT or PCR) was taken if you do not have symptoms,” the www.gov.uk website advises.

The UK Government website also states: “If both your LFT tests were negative, it is likely you are not infectious at the time the tests were taken.”

Both the CDC and the UK Government website state that the likelihood of being infectious after 10 days isolation is low.