Contact Tracing and Quarantine in the Context of COVID-19 – Interim Guidance, 6 July 2022 – Global

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Key points

• In the context of growing global population immunity to COVID-19 vaccination and previous SARS-CoV-2 infection, WHO recommends that identification, contact, quarantine and follow-up are prioritized for high-risk individuals who have been in contact with a confirmed or probable case of SARS-CoV-2 infection, rather than targeting all contacts.

• This group includes people over the age of 60, immunocompromised or with multiple comorbidities; pregnant women and people living or working in high-risk environments such as health care facilities, nursing homes and long-term care facilities. The rationale for prioritizing high-risk contacts for identification and follow-up is that they are more likely to develop serious illness and will benefit most from early diagnosis and medical support.

• Contact tracing should be performed for all contacts during times characterized by uncertainty such as the emergence of new variants of concern or as indicated by national health authority assessments. In these uncertain situations, contact tracing activities should be adapted to the context and the availability of resources.

• Sustained quarantine measures should be applied for (i) high-risk contacts, (ii) in high-risk settings, and (iii) uncertain situations (such as the emergence of a new variant of concern).

• Whenever possible, contacts should have access to free or affordable and reliable testing, including self-testing. Additionally, public health messages should provide clear information about COVID-19 testing options.

• All contacts who in the last 90 days have (i) completed the primary vaccination, or (ii) received a booster dose of the vaccine, or (iii) reported a previous infection with COVID-19 n don’t need to be quarantined.

• High-risk contacts and those living in high-risk settings, who have not completed a primary series or received a booster dose of vaccine, or who have not reported a previous infection in the past 90 days, must be quarantined for 10 days. Quarantine can be shortened to 5 days if the contact tests negative on day 5 and has no symptoms.

• In uncertain situations (such as the emergence of a new variant of concern, or as otherwise indicated by assessments conducted by national health authorities), all contacts should be quarantined for 14 days as a precautionary measure, although that this period can be shortened with tests, if the characteristics of the new variant and its detection methods are appropriate.

• Digital technologies, such as the contact tracing app, which require few resources from public health systems, should be explored, evaluated and implemented to support contact tracing management, notification and effective public health messages.

• National and local health authorities should use risk-based approaches to contact tracing and quarantine, which include consideration and adaptation to their local circumstances and disease epidemiology, immunity population, health system capacity and risk tolerance.

Which is new

This document is consolidated and updated guidance based on “Contact tracing in the context of COVID-19”, WHO interim guidance, last updated February 2021 and “Considerations for quarantine of contacts of COVID-19 cases”, the interim guidance, last updated in June 2021, as well as the interim guidance “Contact tracing and quarantine in the context of the Omicron SARS variant -CoV-2”, published in February 2022. These guidelines replace the three WHO interim guidance documents mentioned above on contact tracing and quarantine. in the context of COVID-19.

The current guidelines are based on the most recent available evidence on SARS-CoV-2 infection. It applies to the range of phenotypic characteristics observed in all variants encountered up to the time of its release and considers the future evolution of the virus. 1 In view of the increasing immunity to severe illness and death from SARS-CoV-2 infection due to previous infection and vaccination, the WHO recommended strategy for contact tracing and quarantine has shifted from the goal of interrupting all chains of transmission to reducing COVID-19-related morbidity and mortality, especially among high-risk groups. Accordingly, WHO recommendations focus on priority groups, settings and situations for sustainable management of contact tracing and quarantine activities as a risk-based approach, rather than targeting all people in contact with a confirmed or probable case of SARS-CoV-2 infection.

In the current situation, characterized by high levels of population immunity, the dominance of Omicron and the absence of a new variant of concern (COV), the quarantine period is reduced from 14 to 10 days if no test is not available. If tests are available, quarantine can be reduced to 5 days if the contact is symptom-free and tests negative on day 5. In previous guidelines, COVID-19 vaccination of contacts was not considered, while the WHO now recommends that contacts who in the last 90 days have either been vaccinated (competing with the primary series or with a booster dose) or already infected do not need to be quarantined.

A risk-based approach is also encouraged in situations where the number of cases overwhelms health services, resources and capacities are overstretched, and the unavailability of large numbers of people in isolation or quarantine is impacting health services. essential societal functions. Based on the above principles, updated recommendations are provided on contact tracing, testing and quarantine of contacts.

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