The new quarantine regulations released by the Ministry of Health this week are riddled with contradictions. Although the updated procedures represent a significant departure from previous guidelines, the Ministry has not bothered to explain their rationale to the public. At the onset of yet another wave of infections, this ambiguity is likely to diminish public compliance and hamper efforts to prevent the continued spread of the coronavirus.
The Ministry’s regulations introduce a new requirement for the vaccinated and recovered coronavirus patients who have been in contact with a confirmed coronavirus patient to conduct a rapid antigen test. This is a positive step towards fighting the outbreak of the Omicron variant, which has spread widely even among those who are fully vaccinated. Anyone whose antigen test comes back positive must then undergo a PCR test, which, if it also comes back positive, designates the testee as a confirmed case and requires that they go into quarantine. The problem is the question of what happens after a negative result from a rapid test.
The Ministry has failed to lay out any clear procedure for those who receive a negative result from a rapid test. Instead, they say only that “for one week after exposure to a confirmed case, it is recommended to avoid entering crowded places for purposes of leisure or recreation, and to avoid contact with high-risk populations.” That is to say that despite the negative test result, there is still a risk that that person may spread the disease, and they should therefore limit their contact with others.
Four Questions
This recommendation raises a number of questions that the Ministry has left unanswered:
What should someone who works in a crowded place do after being exposed to a confirmed coronavirus patient? Is such a person less likely to endanger those around him than a person who comes to the same place for purposes of leisure and recreation? According to the recommendation, someone who has been exposed to a confirmed case would not be allowed to attend a theatrical production lest he infect other members of the audience. But it would be perfectly fine for him to work at the same event as an usher or security guard, coming into contact with hundreds of people.
What about cashiers and others who work in places that may not be crowded, but still come into contact with many people? If the Health Ministry is concerned enough to suggest that someone with a negative test result after a potential exposure should still avoid crowded places, why would they still send that same person to ring up groceries for dozens of people? Would it not be safer for that person to stay home for a set period of time, two or three days, perhaps, and then conduct an additional test?
What if someone who has been in contact with a coronavirus carrier works in a place with high-risk populations, such as in a nursing home or medical facility? The Ministry suggests that someone in this position stay away from members of high-risk populations, but that is impossible for the many people whose jobs involve serving those same populations.
If someone who’s been exposed to a coronavirus carrier is encouraged to avoid leisure and recreation in crowded places, should they not also avoid public transportation? Their daily commute to work may bring them into contact with many people, possibly including high-risk populations, all in a closed space and for what could be an extended period of time?
The Rules of the Game have Changed
Since the early stages of the pandemic, recovered patients have been exempt from quarantine even after exposure to a confirmed carrier. And since the beginning of the vaccination campaign, the same rules have applied to those who are vaccinated. Even after the requirement to be tested after potential exposure was introduced, it was not applied to those who have recovered or been vaccinated.
This policy was based on research that showed that the vaccinated were less likely to be infected than the unvaccinated and that even after being infected, those who are vaccinated are less likely to infect others. The exemption from quarantine became an additional incentive to get vaccinated.
In Israel, as in most developed countries, the demands of the quarantine guidelines were enabled by financial support from the government. At first, time spent in quarantine was counted as sick leave for which workers received partial compensation from their employers, and following a ruling from the Supreme Court legislation was passed to provide additional compensation to workers.This arrangement served another function in addition to the critical financial support it provided to workers: it limited the spread of the coronavirus by preventing workers from having to choose between their livelihoods and public health.
Clear Instructions and Reimbursement
The Omicron variant is challenging common assumptions about how to fight the spread of the pandemic. It has shown that those who have been vaccinated can become infected at higher rates than previously seen. And so the updated quarantine guidelines rightfully apply to those who have been vaccinated and come into contact with virus carriers.
But aside from the requirement to be tested, the Health Ministry leaves the cruel dilemma between making a living and protecting public health to individual workers to settle on their own. In the absence of a clear policy requiring and financially compensating for quarantine, members of the working class who cannot work remotely will be forced to leave their homes, take public transportation, and work in crowded places, all while carrying the potential to further spread the coronavirus.
If the government is interesting in keeping workers from having to make these lose-lose decisions, they can consider any number of options, such as requiring quarantine until receiving results from a PCR test, a reduced quarantine of two to three days followed by an additional antigen test, or even conducting daily rapid tests, as was done in the “Green Classrooms” initiative. But whatever option they choose, they must offer a clear message on the level of danger and the necessary precautions to take in accordance, as well as financial support to enable working people to take those precautions.
This article was translated from Hebrew by Sam Edelman.
