Boris Mendelevich: ‘Quarantine and self-isolation are different regimes’
The doctor, the State Duma deputy’s column on why it is important to stay home and the main difference between quarantine and self-isolation
The COVID-19 incidence in Russia crossed the bar of 28,000 people on 17 April. Regional and federal authorities almost weekly take new measures to reduce the spread of the disease. In a column for Realnoe Vremya, the State Duma’s deputy, physiatrist Boris Mendelevich talks about the difference between self-isolation and quarantine in detail.
Isolation is needed to smooth the peak of the disease
COVID-19 is an infectious disease caused by a new and so far not thoroughly studied virus SARS-CoV-2. It is dangerous, first of all, because of the high pace of spread. This is why governments of many countries are introducing a regime in which people will contact each other as little as possible. No, it won’t reduce the number of infected people but can keep the pace of the infection, which means that it will give us a chance to treat those who are already under the sway of the new coronavirus in the most effective way.
Imagine a situation when thousands of people, even a million city with its developed health care infrastructure will fall ill with the same infection. They will need doctors’ help and complex medical equipment at the same time. It is hard to handle such a flow — Italy is an example.
To avoid such a situation, isolation measures are taken. Every country depending on the incidence, health care possibilities, population density and other criteria make a decision when, for how long and what restrictive measures to introduce. In Russia, it is quarantine and self-isolation. And it is different regimes!
What’s the difference?
- Quarantine is isolation of a person who has been infected or suspected to have the possible coronavirus infection. The decision on such isolation isn’t voluntary, an official makes it (for instance, a doctor). This measure is taken when the person is already ill but is receiving treatment at home, contacted with infected people or can be infected for another reason.
- Self-isolation is a regime aimed to avoid contacts between people as much as possible. This reduces the pace of coronavirus spread. In such a regime, it is allowed going to a grocery store to buy food, walk a dog, throw waste. It is important to minimise physical contact with other people.
During his stay at home, he is given a sick leave (in this situation it is electronic). For instance, head of Russia’s consumer protection watchdog Rospotrebnadzor Anna Popova signed a decree on compulsory two-week isolation of people who had arrived from the countries with an unfavourable COVID-19 situation, and here quarantine is the case. During this time, the person can’t leave the perimeter he or she is isolated in. No shopping or a walk to waste containers are allowed. Quarantine is a stricter measure than the self-isolation regime.
The self-isolation regime has been introduced almost across the country, and Tatarstan became one of the first regions here. It is introduced by bodies of executive power of regions of the Russian Federation on the basis of a regime of high alert or emergency declared in a region. The full list of conditions of such a regime is determined by regional authorities.
Can one be fined?
Yes, can, moreover, there is an iron legislative basis for it. President Vladimir Putin signed a law on 31 March that tightens punishment for a violation of the regime and spread of fake news about the coronavirus. Amendments to the Code of Administrative Offences are introducing fines for a violation of sanitary and epidemiological measures, which led to a risk of disease spread.
They apply to both quarantine and self-isolation — both regimes envisage “non-compliance with rules of behaviour when the regime of high alert is declared on a territory with a risk of an emergency or in an emergency zone”. Citizens can be fined 15-40,000 rubles, officials — from 50,000 to 150,000 rubles or their activity can be suspended for three months. The biggest sanction for organisations is 500,000 rubles.
Separate measures will be taken against lawbreakers whose frivolity led to infection or death of other people: depending on the severity of consequences, there is punishment in the form of a fine up to 2 million rubles or imprisonment for up to 7 years.
Why should I be in self-isolation?
I think that every person who is responsible for one’s own and his relatives’ health must follow the self-isolation regime. And it is not only the case of the economy of money on fines.
As I already wrote, the virus hasn’t been studied completely, and there are different opinions about it even among virologists from if masks should be worn to the incubation period. Another question I have been often asked is about the immunity of those who have already recovered. There are different opinions about this: first, most scientists agreed that there was no threat to a person who has once had the coronavirus. But different sources describe examples of secondary infection. At the same time, we should understand that there can’t be different reasons for this. For instance, there is life-long immunity against some viruses. There is no immunity at all against others. Another type of viruses quickly mutate, and even immunity happens to be not ready for the new variety (let’s remember the flu that changes every year).
We should realise that only fundamental research can give accurate answers, but scientists simply don’t have the time for this: it is very important to treat infected people and avoid new infection. Each of us can make their contribution to this: follow hygiene rules and now stay home!