Intended for healthcare professionals

Letters Quarantining

Covid-19: What’s in a name? Isolating the term “quarantine” from other contamination

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3674 (Published 21 September 2020) Cite this as: BMJ 2020;370:m3674
  1. Shyan Goh, orthopaedic surgeon
  1. PO Box 13, Northmead, NSW 2152, Australia
  1. sgoh{at}hotmail.com

Although “quarantine” and “self-isolation” involve similar measures,1 their purposes are quite different. The World Health Organization states: “The quarantine of persons is the restriction of activities of or the separation of persons who are not ill but who may [have] been exposed to an infectious agent or disease, with the objective of monitoring their symptoms and ensuring the early detection of cases. Quarantine is different from isolation, which is the separation of ill or infected persons from others to prevent the spread of infection or contamination.”2

Why should this distinction matter? The durations for quarantine and isolation are currently similar, but this will change with better understanding of covid-19 pathophysiology. Patients who test positive for covid-19 can shed viral RNA but are not infective within 8-10 days of symptom onset,3 so they are safe for discharge from isolation when not symptomatic. Some countries release asymptomatic covid-19-positive individuals after 10 days, whereas others demand 21 days of isolation. By contrast, the quarantine period (for asymptomatic people exposed to infected people) might remain at 14 days, although a shorter period is possible.4 Anyone who develops symptoms could be transferred to isolation away from others in quarantine.

The United States5 and Australia6 differentiate between quarantine and isolation; the UK7 does not. The attempt to simplify terms for the general public might become problematic if the isolation period for infected people changes while quarantine duration for asymptomatic people remains the same. This will create confusion, reduce public confidence in government advice, and erode adherence to covid-19 measures.

I recall Lewis Carroll’s Through the Looking Glass (1871): “‘When I use a word,’ Humpty Dumpty said, in rather a scornful tone, ‘it means just what I choose it to mean—neither more nor less.’ ‘The question is,’ said Alice, ‘whether you can make words mean so many different things.’ ‘The question is,’ said Humpty Dumpty, ‘which is to be master—that’s all.’”

The UK government needs to use words carefully while trying to be master.

Footnotes

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https://bmj.com/coronavirus/usage

References

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