British Columbia has become the only province in Canada to end minimum isolation requirements for people who have been in close contact with COVID-19 cases.
The change was quietly updated to the BC Centre for Disease Control’s website earlier this week and confirmed by Health Minister Adrian Dix on Thursday.
People who are fully vaccinated and don’t have symptoms can go about their normal lives so long as they feel well after an exposure, but they should avoid high-risk settings like long-term care or visiting immunocompromised relatives, the guidance said.
Previously, close contacts of those who tested positive for COVID-19 were required to isolate for five days and stay away from high-risk settings for an additional five days. The change came as Omicron cases resulted in record hospitalizations and overwhelmed provincial testing resources.
Unvaccinated or partially vaccinated people must still isolate for 10 days from their symptom onset or positive test result.
Testing is now being further limited to people who are immunocompromised and at high risk of severe illness, adults who are unvaccinated or partially vaccinated and people living and working in high-risk settings like long-term care, health care or shelters.
Fully vaccinated people who have tested positive for COVID-19 still need to isolate for five days minimum or until symptoms resolve.
Provincial health officer Dr. Bonnie Henry said today the change doesn’t mean public health officials are treating COVID-19 as endemic, a common illness like the flu.
But she noted public health is moving towards treating it like the common cold or flu. “We cannot eliminate all risk.”
“The Omicron variant is different, so we have adapted the response,” she said. Its shorter incubation period makes contact tracing nearly impossible at the volume of cases B.C. is seeing, she added.
“We all need to assume we have been in contact with someone who has the virus,” Henry said. “If we have symptoms that might be COVID, might be influenza, might be a cold, we need to stay home until we feel better. Continue to follow that path of staying home until you get better.”
As much as half of COVID-19 transmission is from people who remain asymptomatic or before they develop symptoms.
Even people who are fully vaccinated and boosted can continue to shed the virus for up to 10 days, Henry acknowledged. But the risk decreases significantly three to five days after symptoms first appear.
The new guidance diverges significantly from other provincial approaches. None have removed minimum isolation times for close contacts of cases.
Heidi Tworek, who holds the Canada Research Chair in history and policy of health communications at the University of British Columbia, said it’s unclear why Henry is prepared to accept continued Omicron transmission and the effects on health-care workers.
The province could choose to maintain measures that limited transmission, Tworek said.
“What are actually policy choices are framed as inevitabilities... but that is only true if you consider a very restrictive policy landscape,” said Tworek in an interview.
By not explaining why high-risk and vulnerable people should accept the eased restrictions, Henry has given the impression the province has given up protecting them, Tworek added.
Henry repeated that the province’s limited testing data and hospitalization rates indicate a slowing in transmission, and suggest the province is past its peak of infection. Canada’s chief public health officer Dr. Theresa Tam also said COVID may have peaked in some parts of the country.
Hospitalizations are still not expected to crest until next week. An independent modelling group predicted this week that hospitalizations will continue to rise until mid-February.
There are currently 891 people in hospital with COVID-19. Hospitals are already challenged by COVID-19 patients and higher numbers of sick staff.
Ending minimum isolation times will help ease this pressure as more health-care workers will be able to return to their jobs, Henry said.
It appears Omicron is less severe than previous variants for most people, according to hospitalization data reported today.
But the province’s high rate of transmission means many still are going to hospital, particularly those over age 70 and people who are unvaccinated.
Between Dec. 14 and Jan. 6, about 1.2 per cent of people with confirmed COVID-19 cases were hospitalized, much less than the 6.2 per cent hospitalized from Sept. 30 to Oct. 27. With much reduced testing, independent models suggest actual case counts are as much as eight times higher than what is officially reported.
Data from the 606 individuals in hospital most recently suggests that while age is the biggest risk factor for severe illness requiring hospitalization, unvaccinated people are nine times more likely to be hospitalized than those with three doses.
For people in very high and high-risk categories, the risk of hospitalization is about 9.1 per cent, one-sixth of the risk in the fall.
Henry said the data shows the importance of getting fully vaccinated and boosted as soon as possible.
“Even if you are younger and don’t have any doses of vaccine on board, your risk goes up dramatically,” she said.
Henry urged the public to stay home when ill and also expressed optimism that a “gentler summer” was ahead in B.C.
“We’re working hard to get through this surge,” she said. “We are hopefully at a place where we are getting through this wave again and we will be in a better place very soon.”