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Evolution of the doctrine of testing and isolation of cases and contacts in the context of the declining spread of the Omicron variant of Sars-CoV-2

In the context of the decreasing spread of the Omicron variant (sub-variant BA.1) of the SARS-CoV-2 virus, the High Council for public health (HCSP) updates the statement of 31 December 2021 concerning the screening and diagnostic testing strategies to be implemented for SARS-CoV-2 infected persons and contacts.

Taking into account the characteristics of Omicron (incubation period, viral shedding, infectivity), the HCSP sets out guidelines for a strategy of gradual reduction of measures with general and specific recommendations, for the general population and the school environment. In a risk management and public health approach, the recommendations are deployed and synthesized in 2 decision-making matrices of evolution in 3 phases (intermediate, favorable evolution, end of the epidemic linked to the BA.1 sub-variant).

The HCSP recalls:

  • the lesser possible severity of infections with the Omicron variant of the SARS-CoV-2 virus in persons with a complete vaccination schedule;
  • the very wide distribution of the Omicron variant in the general population;
  • the demonstrated efficacy of vaccination on severe clinical forms of Covid-19;
  • the uncertainty of the epidemiological evolution of the BA.2 sub-variant;
  • the low impact of the current epidemic on pediatric hospitalizations for Covid-19;
  • the increase in vaccination coverage in France;
  • the continued high compliance with barrier measures;
  • the current trend towards improvement in hospital stress.

In particular, the HCSP recommends to:

  • implement a progressive risk management strategy in this phase of decreasing spread of the Omicron variant by integrating individual and voluntary management;
  • develop simple, understandable, applicable and adaptable guidelines;
  • reduce barrier measures and surveillance of contact persons or children in successive phases;
  • prioritize health education over simple information to enable the population to take ownership of prevention measures.

The measures proposed in this opinion are evolving in several chronological phases but may be transitory and be subject to re-evaluation according to the epidemic’s evolution, which is uncertain at that time in the medium term, even if the current situation linked to the end of the Delta variant epidemic and the dynamic decrease in the incidence of the Omicron BA.1 variant is favorable. It is therefore necessary to build a complementary decision-making matrix to decide on the transition from the current phase (epidemic peak) to the intermediate and favorable phase in a dynamic decrease in incidence.

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