December 4, 2020

Why Ayuso does not have to keep isolation if he has had close contact with COVID-19

Isabel Díaz Ayuso announced yesterday that had had close contact with a COVID-19 positive person. He began a preventive quarantine that forced him to cancel his attendance at Mass on the day of La Almudena, patron saint of the city of Madrid. Ayuso already passed the coronavirus in March, she was isolated for 26 days in two luxury apartments owned by businessman Kike Sarasola at a very low cost, from where it maintained its activity. And this Tuesday he reported that he has tested negative for COVID-19 and that “they have confirmed that I maintain the antibodies and I cannot infect.” So tomorrow Wednesday he will resume his entire face-to-face schedule.

What the president of the Community of Madrid does is correct according to the protocols of the Ministry of Health. The last Strategy for the Early Detection, Surveillance and Control of COVID-19, updated on September 25, establishes a quarantine and symptom monitoring of the person who has maintained close contact – less than two meters for 15 minutes – with a confirmed case during the 10 days after the last encounter, 10 more if they are cohabiting and cannot isolate themselves. This is so whether the contact has a positive PCR –it will be treated as a case– as well as a PCR or negative antigen test, a minimum of 10 days must be kept. The test has to be done “depending on the epidemiological situation,” describes Health. The Community of Madrid renounced in its own protocols to carry out PCR on people who were not cohabitating, vulnerable or sanitary due to insufficient resources.

But there is an exception to these quarantines, which is what allows Ayuso to resume his activity. It is included in the table that accompanies the management of asymptomatic close contacts: having had a positive CRP in the last three months, with COVID-19 already overcome; or have an antibody test with an IgG result –the antibodies that appear once the infection is over, the IgMs do so at the beginning– positive. Ayuso’s is the second option, as she has reported: she has undergone a diagnosis, and in November she retains the antibodies that her body generated in March to fight SARS-CoV-2.

Ayuso’s steps are therefore correct. Not so much his claim. That you can avoid quarantine by having a positive antibody test is an epidemiological decision that responds to the population. This comes because there is still no scientific consensus on the functioning of antibodies and reinfections and it is a process that still involves many unknowns, but the evidence does suggest that it is unlikely that you can be contagious if you have antibodies. And that is why this exception is stipulated for isolations at the community level. That is to say, the population risk that supposes that people with antibodies get rid of the 10 days of isolation is low, some experts explain to, because people who, despite having recently overcome the disease, are contagious would constitute exceptions. But at the individual level, no one can ensure that they cannot transmit the virus because they have already passed it. It is the same reason why, although you have already had COVID-19, you should continue to maintain precautionary measures such as the use of masks, distance and hygiene.

COVID-19 reinfections confirmed in the world they are still just a handful, and some of them poorly documented. A milder course of the disease has been recorded in almost all of them. The virologist Margarita del Val explained it like this: “It must be remembered that no one has shown that antibodies serve to protect against anything, they are a way of measuring who has faced the infection. The tests have false positives and false negatives. They are valid at the population level, but at the individual level they give information that is quite contradictory because it is incomplete; they are young tests. (…) Although there are very few cases of reinfection, it is beginning to be seen that in general they tend to be more benign than the first infection, so one has to be reasonably reassured that probably if it becomes infected again, it will be more benign. But coronaviruses were already circulating in the population and immune people get infected, so what cannot wait is that it will not be contagious. Nothing to visit without protection to vulnerable people saying ‘I’m not going to infect you’, because precisely now he will be more asymptomatic and if he has it, he will not find out “.


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