As COVID-19 cases rise rapidly the government has cut the facility quarantine period by a week to free up space and save money, as new research shows most patients are no longer infectious after two weeks.
By FRONTIER
When State Counsellor Daw Aung San Suu Kyi announced in a September 7 video conference that the government planned to reduce mandatory quarantine from 21 days to just 14 days, she suggested it was mostly down to science.
Speaking in her capacity as the chair of the National-level Central Committee on Prevention, Control and Treatment of COVID-19, Aung San Suu Kyi said the change was made to adhere more closely to guidelines from the World Health Organization. The Ministry of Health and Sports began implementing the new policy on September 9.
“Since the disease cannot spread to others after [two weeks] even if patients still have symptoms, according to the WHO, people can go outside without causing problems,” she said.
But she also seemed to acknowledge suspicions that government resources were beginning to buckle under the weight of Myanmar’s “second wave” of COVID-19 cases. The number of people in quarantine had increased almost 50 percent in the three weeks since the first second wave case was detected in Sittwe. Aung San Suu Kyi said the new policy would also open up space for new suspected cases to quarantine and make it easier for health workers and volunteers to manage them.
More than 40 people are currently in quarantine in Mrauk-U, in Rakhine, where there is space for 200, according to the township’s Covid-19 Prevention and Coordination Committee. It is unclear how close Yangon and Sittwe are to capacity.
Anyone traveling from COVID-19 hotspots, who has symptoms or who has had contact with a known case is required to quarantine.
Anyone leaving facility quarantine will still have to quarantine at home for another week.
The previous 28-day quarantine policy – including three weeks in a state facility or approved hotel – was introduced on April 16.
The decision to cut the facility quarantine period to two weeks follows research done in Singapore showing that the coronavirus cannot be transmitted after 11 days, and that a viable level of the virus cannot be found in patients after the second week of illness, said Dr Khin Khin Gyi, director of contagious disease prevention and eradication at the health ministry.
The study, which included 73 patients, found that the virus could not be isolated or cultured after 11 days of illness, and though patients may continue testing positive, they are no longer infectious. Previous studies in Germany and Britain found patients were no longer infectious after eight and nine days, respectively.
“These studies are definite scientific evidence showing that even if a person tests positive for the virus, they can no longer infect others,” Khin Khin Gyi said.
The WHO on August 19 recommended that anyone in contact with a confirmed or probable COVID-19 case be quarantined at a designated facility or at home for 14 days from their last exposure.
The change is in line with international standards, said Dr Sid Naing, a public health expert and the country director of Marie Stopes Myanmar, a London-based INGO that provides family planning services.
“There is no reason for the disease to spread after two weeks of quarantine,” he said.
Apart from saving money, reducing the quarantine period to 14 days would reduce the pressure on healthcare workers and volunteers, said Dr Than Naing Soe, spokesperson of the Ministry of Health and Sports and director of the Health Literacy Promotion Unit.
“We can’t hold on to a policy forever. We need to consider research findings and the resources of our country, and find the right balance.”
Cutting costs
As of September 8, 2,776 government quarantine sites were accommodating 29,631 people throughout the country, an increase from the 19,139 in quarantine on August 15, before the second wave began.
State and regional governments pay the costs of running these facilities, while those who choose hotel quarantine pay for it themselves.
Rakhine State government spokesperson U Win Myint said the government provides blankets, mosquito nets and toiletries for those undergoing facility quarantines and spends K3,000 on each person a day for food.
“It will be better reducing the quarantine to 14 days. It will more effectively manage the space available in facilities and reduce the cost of food overall,” he told Frontier.
Aside from cutting room and board costs, the new policy also means savings in healthcare and cleaning expenditure too, said Dr Than Tun Aung, deputy director-general and chief of the Ayeyarwady Region Public Health and Medical Services Department.
A quarantine official from Hlaing Township in Yangon Region confirmed that the regional government is providing blankets, mosquito nets, toiletries and daily food to people undergoing facility quarantine.
Three quarantine centres that opened in Hlaing in March were housing about 800 people as of September 7.
The official said those under quarantine are sent home after testing negative twice.
About 6,200 people had been quarantined in the region, up from just 4,000 people on August 15. The new figure included 1,000 returnees from Rakhine State, according to Yangon Region Public Health Department deputy chief Dr Chit Ko Han.
Seven new quarantine centres opened in five days to accommodate the increase, he said, adding that regional government ministers had provided assistance for the centres.
Other states and regions that have recorded large increases include Rakhine State (2,968, up from 645), Nay Pyi Taw (1,257, up from 302), Mandalay Region (1,810, up from 934) and Ayeyarwady Region (1,498, up from 592).
But Chit Ko Han said Yangon’s large population presents “significant” challenges to controlling the spread of the virus. He urged those at quarantine centres to strictly obey guidelines and instructions.
Khin Khin Gyi, an epidemiologist with the health ministry, agreed.
“People’s obedience is very important to control the infection, and people at quarantine centres need to follow the rules,” she said.
As of September 9, Myanmar had reported 2,009 COVID-19 cases, including 14 deaths and 553 recoveries.
