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Much attention has been focused on the social distancing regulations and what they do and don’t say. But the second limb of the rules to reduce the spread of C19 - the self-isolation rules - have received less attention. This thread reflects on the self-isolation rules./...
As with the social distancing rules, there is a mix of criminal law and guidance. The criminal law rules require a person to self-isolate if they have received a positive test, or been notified by PHE or local authority (not the App) of close contact with a positive case./...
Note, though, that a person is only entitled to a test if they have one of the trinity of core symptoms: persistent cough, high temp or loss of taste/smell.
The consequence is that the legal requirement to self-isolate, which is dependent on a positive test of some person (you or a close contact), in practice only arises if a person has one of the trinity of core symptoms./...
Second, there is self-isolation guidance. This instructs people to self isolate if they have one of the trinity of symptoms. This is not binding but should be followed.
The guidance, like the law, however does not apply to persons who have other symptoms. Indeed it says that it does not relate to people who have other symptoms./...
Thus the guidance states:/...
And to be clear, ‘symptoms’ is defined as the trinity of core symptoms. Mention is made of the possibility of other symptoms but people are *not* told to self isolate if they have other symptoms (and they can’t get a test so the legal requirements cannot be triggered)/...
There is also guidance on the NHS website which also makes clear there is no requirement to take action if you don’t have the core symptoms:
Again, ‘main symptoms’ is defined as persistent cough, high temp, loss of taste/smell./...
The oddity is that it’s been clear for months that people can either *first* present with other symptoms or *only* present with other symptoms. (The latter often confusingly lumped with persons who have no perceptible symptoms at all in references to ‘asymptomatic’ cases)/...
The Gov has accepted such persons are infectious (eg the Health Sec has attributed the catastrophic transfer of patients to care homes on ‘asymptomatic’ transmission, and recently announced testing for non core symptoms cases in certain key sectors). /...
What are the other symptoms people can have? Medical studies refer to stomach complaints, headaches, muscle pain, runny nose, sore throat etc : https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
In children stomach ache, nausea and headaches are reportedly common: https://www.bmj.com/content/370/bmj.m3484
And so my point is that both the self isolation law and the guidance - which have not been materially amended for months but do not relate at all to persons without core symptoms - appear striking under-inclusive (and thus under-protective)./...
Such persons are not required or advised to self-isolate or take precautions. They have been going about their daily lives in the same way, and doing so entirely consistently with law and guidance /...
There may be a good reason why people with a wider range of symptoms than the trinity of core symptoms are not asked or required to isolate (or given a test). One obvious reason is that this would impact a much larger number of people who do not in fact have the virus./...
But requiring such persons to self-isolate would impact far fewer people than a general lockdown, which is where we now are. /...
It doesn’t on the face of it make much sense for people with core symptoms to be required to isolate and obtain a test but the guidance does not even address people with other symptoms, let alone ask them to take precautions./...
Another explanation might be that given the number of entirely asymptomatic people, and lower levels of infectiousness, requiring people with other symptoms to self isolate may not make a sufficient contribution to stopping spread to make it worthwhile./...
But this seems somewhat unlikely in circumstances where government considers that closing tennis courts, golf courses etc makes a worthwhile contribution to stopping spread. /...
And so my conclusion is that given that we are desperately searching for ways out of lockdown, perhaps rather than focusing entirely on the social distancing rules, a renewed consideration could be given to the self-isolation guidance./....
Tightening the self-isolation guidance could at least potentially make a contribution to relaxing the social distancing guidance. /...
I should say that I do not underestimate the complexity of the balances that have to be struck. The scope of the self-isolation rules may be entirely sound and justifiable. My point has been to draw attention to the narrowness of the self-isolation rules as they currently stand.
