Friday, December 1, 2023

Omicron cases peak in India: Time to revise protocol?

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As states rush to impose curbs amid the Omicron threat, the time taken to determine if someone is Omicron positive or not is contributing to more cases as patients come in contact with their family and friends. At a time when the total number of Omicron cases has reached, the big question is that do we assume that all Covid positive cases with an international travel history are Omicron cases? If so, should every Omicron positive patient be hospitalised or the Centre should now consider home isolation protocols. Moreover, what should be the home isolation protocol?

With the Delta wave now gradually declining and increasing number of Covid-19 cases becoming Omicron, we should be able to increase our ability to isolate case faster. At the moment, the guidelines state separate isolation facility for those testing positive at airport, each positive sample to be sent for genomic testing for Omicron, immediate contacts of positive patients on flight traced, treatment protocols for Covid-19 delta to apply for Omicron. 

However, what is happening is that  those tenting positive at airports are sent to isolate at home. Omicron detection takes 2-3 days due to lack of genomic testing facilities. Meanwhile. patient continues to be in home isolation until Omicron is detected. If Omicron is detected, even asymptomatic patients are shifted to hospital. The homes of Omicron patients are then sealed and all contacts are testing. The immediate contacts are then t undergo testing and follow same protocol. All omicron patients, regardless of symptoms, are sent to hospital isolation. 

Speaking about International Omicron protocols, United Kingdom requires all arrivals to show negative Covid test taken 48 hours prior to departure. After arrival, re-test only with RT-PCR within 2 days. Unvaccinated travellers are to be tested within 2 and after 8 days of arrival. Compulsory self-isolation while tests are awaited. Omicron patients, not needing urgent care, to stay in 10 days home isolation. Isolation at healthcare facilities are for Omicron emergency cases. Contacts of positive patients are to self isolate and get tested. 

United States, on the other hand, mandates no separate protocol for omicron suspected or confirmed patients. Asymptomatic Covid-19 patients are to isolate at home for 5 days and wear masks for next 5 days. Exposed unvaccinated contacts are to quarantine for 5 days followed by 5 days of mask wearing. Exposed vaccinated and boosted contacts need not quarantine if they are asymptomatic. Symptomatic emergency cases to access healthcare facilities. 

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