The UK Government must prioritise support, such as specialist accommodation, to enable people to self isolate after testing positive for COVID-19, infectious disease experts say today.
Dr Muge Cevik, an infectious diseases researcher at the University of St Andrews, and colleagues write in the latest edition of The BMJ that most countries have used testing as a tool to interrupt transmission chains – but individual ability to quarantine until test results are available, and to isolate if positive, depends on the space and resources to do so.
They say that the UK Government should now focus on people working in high-exposure occupations, who live in overcrowded housing, or who do not have a home, and offer help such as free and safe accommodation, adequate income support, job protection, and help with caring responsibilities.
The authors highlight several models that have enhance compliance with quarantine and isolation, including in the USA, where schemes provide people with positive COVID-19 results with a raft of supportive services, including free deliveries of food and medicines, transport, and dog walking, to help them quarantine either at home or in free hotel accommodation.
“These interventions have led to high rates of test uptake, number of contacts identified, and adherence to self-isolation, contributing to reducing total household and community transmission,” they say.
UK survey data already suggests that fewer than one in five people follow isolation protocols, with lower adherence rates among men, younger people, key workers, those living with dependent children, and those in lower socioeconomic groups.
A willingness to self-isolate was high across all respondents, but the ability to isolate was three times lower among individuals earning less than £20,000 a year or who had less than £100 in savings.
This, write the authors, is consistent with reports that lost wages is the main reason for not following isolation guidelines.
Even small improvements in people’s ability to quarantine and isolate can have an important effect on slowing transmission, hospital admission, and death, especially among those most at risk of COVID-19, they say, adding: “The next phase of the public health response must align testing strategies with people’s lived realities. Ultimately, people need to be able to isolate without fear of a substantial damage to their work, income, family, or caring responsibilities.
“We can’t wait for vaccine mediated decreases in morbidity and mortality to manifest. Too many lives have been lost or destroyed. Integrating equitable support services for those most at risk for COVID-19 is a national emergency and governments should act accordingly.”
Cevik M, Baral SD, Crozier A et al. Support for self-isolation is critical in COVID-19 response. BMJ 28 January 2021
Leave a Reply