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Swiss study calls for five-day Ebola quarantine

Three-day quarantines are not enough to net all Ebola cases in a given area, scientists at the Swiss Federal Institute of Technology in Zurich (ETHZ) said this week after using genetic sequencing to map the early spread of the virus in Sierra Leone.

Swiss study calls for five-day Ebola quarantine
A house is disinfected in Waterloo, Sierra Leone, after a man died from Ebola. Photo: Florian Plaucher/AFP

One of the three west African countries hardest hit by the raging epidemic that has killed nearly 3,900 people, Sierra Leone launched a nationwide three-day shutdown last month in a bid to find unreported cases.
   
But a team of scientists at ETHZ has determined through sequencing of early cases in the country that the average incubation period of the virus is around five days.
   
This means Sierra Leone, which turned up hundreds of new cases thanks to the shutdown, could have discovered many more if it had extended the quarantine for a few more days.
   
"You might happily stay home for three days but then on day four the disease breaks out when you actually leave the house again, and then you would transmit," research team head Tanja Stadler told AFP.
   
While the average incubation period for Ebola is five days, a person can carry the virus without showing symptoms or being contagious for anywhere from two to 23 days, she pointed out.
   
It remains unclear if nationwide shutdowns are effective at all, but if countries do opt for that route they should take guidance from the average incubation period, Stadler said.

How many missing links?

Her team, which works out of an ETHZ lab in the Swiss city of Basel, genetically sequenced 72 people infected with Ebola in Sierra Leone in May and June to build a virus family tree in a bid to reveal more about its transmission path.
   
Since Ebola mutates slightly each time it is transmitted to a new person, the scientists looked at how similar the virus was in different patients to evaluate how many missing links, or unreported cases, there were in their reconstituted transmission chain.
   
Their findings, published in the scientific journal PLOS earlier this week, show that each infected person on average transmitted Ebola to 2.18 others and that around 30 percent of cases had gone undetected.
   
Devastatingly, the data clearly shows that Ebola spread constantly through June, meaning that "whatever public health interventions were performed in Sierra Leone at that time did not help," Stadler said.
   
Sierra Leone in June counted only a few hundred infections and around 50 deaths, and it remains unclear if the findings can help inform the country's response today, as infections soar towards 2,800, with nearly 900 people already dead.
   
"Unfortunately, we don't have data from after the shutdown, because the method we developed would allow us to quantify if during (or following) the shutdown the transmission actually decreased," Stadler said.
   
Accessing Ebola data is complicated, since only a few dozen labs around the world have the security clearance to work with the deadly pathogen, and because it is dangerous for people on the ground to handle and send out the blood samples.
   
At least five of the doctors and nurses who helped gather the samples the Swiss study is based on have since died of Ebola, Stadler pointed out.
   
But she stressed that if armed with new data her team's method could quickly and quite accurately calculate the number of undetected cases in a given area.
   
"Hopefully people now know they should forward us new data if they get it," she said, adding that she hoped the research might inspire other labs to "dig deeper with other data sets."

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QUARANTINE

Switzerland to cut quarantine period for vaccinated and extend current measures

Switzerland will shorten the obligatory quarantine for anyone testing positive for Covid to five days, while extending the current measures until at least March. The duration of immunity for the Covid certificate will also be shortened.

Swiss Interior and Health Minister Alain Berset gestures during a press conference.. (Photo by Fabrice COFFRINI / AFP)
Swiss Interior and Health Minister Alain Berset gestures during a press conference.. (Photo by Fabrice COFFRINI / AFP)

Switzerland on Wednesday announced a range of changes to the existing Covid measures. 

As had been widely reported ahead of the announcement, the Covid quarantine period for positive cases was shortened from the current ten days to five for vaccinated and recovered people. 

People can leave quarantine after five days, provided they are symptom free for 48 hours. Based on the new advice, it does not appear a person needs to test negative – although the government has been contacted for a confirmation on this question. 

EXPLAINED: Why did Switzerland relax Covid quarantine rules?

The quarantine change applies both to people who have tested positive and those who have had close contact with someone who has tested positive. 

“Close contact” will also be redefined. Now it will not include everyone someone with Covid has had contact with, but will be limited to the people they live with and people who had “regular and close” contact with a person who tested positive. 

The close contact quarantine will not apply to people who have had a booster in the past four months, but it will apply to those who have had two doses.

The unvaccinated will need to remain in quarantine for the original ten days. 

Cantons can decide to grant exemption to the quarantine rules. 

The duration of immunity under the rules of Switzerland’s Covid certificate will be reduced from one year to 270 days, i.e. nine months.

This is due to the belief that immunity due either to vaccination or recovery declines earlier than previously thought. 

The 270-day requirement applies to those who are fully vaccinated or to people who have previously had the virus.

This shortening of the time period for the validity of the Covid certificate will apply from February 1st, as with the EU’s rules for international travel. 

The current Covid measures, which are outlined in the link below, will also be extended. 

EXPLAINED: What are Switzerland’s current Covid measures?

While they were set to expire on January 24th, they will now be extended until March 31st. 

The government said the extension was necessary due to the situation in the country’s hospitals. 

Amid skyrocketing infection rates, the Swiss government said it had prepared additional measures which could be implemented quickly and immediately if the situation required it. 

“Should the situation in hospitals deteriorate significantly, the Federal Council can still act swiftly by imposing stricter measures such as the closure of facilities and institutions or by limiting capacity at large-scale events, regardless of the consultation,” the government said in a press release

The government is currently in consultation with experts and the cantons about these and further measures, including tighter mask rules and a change in testing rules.

This consultation will last until the 17th of January, however those listed here are expected to apply. 

For the full list of changes announced you can visit the government site HERE.

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