Need for stricter measures to limit spread
As reflected in other countries who are before us in their ’Omicron wave’, this SARS-CoV-2 variant is responsible for the sharp increase in numbers of positive cases seen over the last few days in view of the greatly increased transmissibility of this variant. In light of this, MAPHM recommends that immediate measures should be taken to reduce the spread of the virus to support the massive drive to offer booster doses to the adult population and concurrently vaccinate younger children- aimed to reduce serious illness, hospitalisations and death. Uncontrolled viral spread may still cause massive strain on our hospital resources, and this should be avoided at all costs.
Throughout this pandemic, the priorities for public health have been to safeguard the health of vulnerable individuals and limit the overall impact on our national health services while ensuring that children are able to receive a formative education within school premises. These priorities have not changed with the arrival of the Omicron variant. Some short-term restrictions are necessary to limit further transmission of the virus and allow schools to reopen in the New Year. These should include stopping mass gatherings and social events. It is recommended that smoking should not be allowed in outdoor public spaces as this allows spread when the mask is removed.
Enforcement of existing laws is key. Current legislation around mass events and wearing masks in crowded work and leisure environments (including offices and in crowded outdoor areas) should be respected and enforced.
Update quarantine rules
Notwithstanding the urgent need to step up measures to reduce further spread of the virus, MAPHM recommends that the current policies and legislation for quarantine are reviewed to reflect the latest evidence on how the virus is spread.
Emerging evidence is showing that persons who have SARS-CoV-2 are mostly contagious in the few days before and after onset of symptoms. Hence, the current, mandatory 14-day quarantine for cases, primary (high-risk) contacts AND secondary contacts of COVID-19 cases is both unnecessary and counterproductive. Instead, MAPHM proposes that:
- People with confirmed COVID-19 should continue to be immediately informed about their status so they and their household members can be isolated/ quarantined at home.
- Quarantine for positive cases and members of their household should be reduced to ten days to reflect the latest scientific evidence showing that the majority of SARS-CoV-2 occurs early in the course of the illness.
- High-risk contacts who are vaccinated should be placed in quarantine for 7 days. If symptoms develop, testing is recommended, but is not otherwise required (i.e. testing is not needed for release from quarantine).
- Household members of primary contacts (i.e. secondary contacts) should not be kept in quarantine if asymptomatic.
- Providing for the appropriate use of self-tests in the community setting.
- To invest further in Digital Public Health infrastructure in order to improve operational workflows and improve Public Health response.
Amending the current policy to one that reflects the current situation and emerging evidence will substantially reduce the mental, physical and financial burden of prolonged and unnecessary quarantine for potentially thousands of quarantined individuals in Malta without overburdening the national health service. At the same time, amending the current policy will help to reduce the shortage of healthcare and other necessary workers.