The sixth wave of the coronavirus has changed many things that we took for granted in relation to the coronavirus, but there is something that it has not been able to change: the enormous amount of uncertainty surrounding things as basic as the appropriate length of a quarantine.
And perhaps the worst thing is that the fundamental problem is not in the research we have on it, but in the crooked use that has been made of it. Researchers and experts have been mapping the elusive nature of the coronavirus for two years, while authorities lurched trying to attribute the consequences of their decisions to an indeterminate entity called “science”. Now with countries removing all restrictions from one day to the next and others maintaining regulations with little technical justification, it is no different.
That is why we have asked what we really know (and what we don’t) about omicron symptoms and the duration of quarantines.
How different are the symptoms of Delta and Omicron?
During the last weeks we have heard that ómicron does not have the same symptoms as the rest of the variants. Moreover, it has been repeatedly repeated that it was easy to know the variant that each patient ‘has’ by looking only at their individual symptoms. Above all, when we talk about alterations or losses of smell and taste. Regrettably, it is virtually impossible to determine the different variants of SARS-CoV-2 from a person’s symptoms alone.
We often confuse the individual with the population. In the case of COVID, differences in symptomatology may be relatively easy to identify statistically. It would not be crazy for the particular characteristics of the variant or the pre-existing immunity of the patients to modify the frequency with which some symptoms appear. The problem is that these differences are simply ones of degree: there is, to our knowledge, nothing ‘pathognomonic’ (ie specific) to each variant.
In this way, all variants share the same symptoms (fever, cough, tiredness, loss of taste or smell, sore throat, body aches, nausea, red eyes, or diarrhea) and most of them overlap each other. Moreover, today, a large part of those infected do not even develop symptoms. In the end, trying to find out which variant we carry is very similar to throwing an epidemiological pool.
Are there also no differences in the recommended confinements?
This topic (particularly due to the changes of the last weeks) has been very topical. What’s more, just a few days ago, the BMJ medical journal published one piece about a small Japanese study that seemed to show that the peak of viral load in omicron was later than previously thought. It was a tiny pre-print of 21 participants and it had many uncertainties, but that has not prevented it from being used as argument (for and against) lockdowns and quarantines.
The most interesting thing about the study, however, is that it does not add new information to what we already knew about SARS-CoV-2 in general and its variants in particular. It works like a gigantic Rorschach test on which we project our fears and anxieties. The truth is since the first months of the pandemic we know that people can remain contagious long after the first 5 to 10 days. As Sergio Ferrer points out, that has never been the point of debate.
The public discourse of “heeding the science” has managed to obscure the fact that most of the decisions that have been made during the pandemic were of a political and managerial nature: with better or worse luck, it was about finding a balance between reducing the circulation of the virus (and thereby containing infections and hospitalizations) and keeping society’s economic metabolism running. When quarantines are reduced and extended, you have to ask why (and not settle for ‘science says so’).
The questions about the nature of the virus are important because they draw us the map on which to act, but the decisions (with their associated costs) are always there. As we have explained several times, epidemics end when societies decide that it is time to stop fighting the pathogen in an exceptional way and that you have to live with it. And that moment, as the levels of pandemic fatigue point, seems to be closer than we think.
Image | Erik McLean