The World Health Organization (WHO) has reiterated in its latest set of guidelines on the Covid-19 pandemic that it still “recommend[s] the use of masks by the public in specific situations, and this update recommends their use irrespective of the local epidemiological situation, given the current spread of the Covid-19 globally”. 

“Masks are recommended following recent exposure to Covid-19, when someone has or suspects they have Covid-19, when someone is at high risk of severe Covid-19, and for anyone in a crowded, enclosed or poorly ventilated space. Previously, WHO recommendations were based on the epidemiological situation,” the new guidelines read.

According to the WHO, other instances where masks may be beneficial include: where a local outbreak has been confirmed, where there are rising hospital admission levels, and where levels of vaccination coverage and immunity in the community, and the setting people find themselves in, suggest increased risk. 

There are currently large outbreaks of Covid-19 in several countries. In South Africa, the situation remains stable. 

The Tsakane EXT taxi rank in Ekurhuleni on 28 June 2021. Experts have said commuter taxis are the perfect environment for spreading the Covid-19 virus. (Photo: Gallo Images / OJ KolotI)

WHO’s new guidelines for isolation

According to the latest advice from the WHO, a patient with Covid-19 testing negative on a rapid antigen test can safely leave isolation; but without testing, new guidelines suggest 10 days of isolation from the date of the onset of symptoms. Previously, the WHO advised that patients isolate for another three days after they become symptom-free. 

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For those who test positive for Covid-19 but do not have any signs or symptoms, the WHO now suggests five days of isolation in the absence of testing, compared to 10 days previously. 

The WHO said it had considered evidence that people without symptoms were less likely to transmit the virus than those with symptoms.  

Covid-19 treatments

Paxlovid (nirmatrelvir-ritonavir) is strongly recommended by the WHO in patients with mild or moderate Covid-19 who are at high risk of hospital admission. 

Two other drugs, sotrovimab and casirivimab-imdevimab, are also recommended by the WHO for the treatment of Covid-19. These are monoclonal antibodies but they are not very effective against current variants, a statement by the WHO reads. Monoclonal antibodies are manufactured proteins that act like human antibodies in the immune system. 

The South African Health Products Regulatory Authority (Sahpra) has received an application for the registration of Paxlovid, but the outcome is not known yet. 

South African situation

Earlier in January, scientists identified a subvariant of Omicron, known as XBB.1.5, in a sample taken in late December 2022. XBB.1.5 has been identified as highly transmissible, but the latest risk assessment by the WHO stated that it appeared to be missing the factor seen in variants causing severe Covid-19. The organisation, however, called for more study and data. 

Former health minister Dr Zweli Mkhize holds a mask during an inspection at King Dinuzulu Hospital in Durban on 18 January 2021. (Photo: Gallo Images / Darren Stewart)

Health workers outside a Covid-19 testing station in Alexandra, Johannesburg, on 31 March 2020. (Photo: Gallo Images / Dino Lloyd)

Health Minister Dr Joe Phaahla said no new regulations, mask mandates or lockdown orders were forthcoming in the near future. He said the provincial health departments had been instructed to step up testing. The testing of wastewater for viral particles would be increased and the wastewater of planes arriving from areas with high levels of infection would also be tested.  

A formal announcement on the availability of booster shots for everyone over the age of 18 is expected at the end of the month. DM/MC