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SocietyMarch 14, 2020

Covid-19: What does ‘self-isolation’ mean in practice?

Photo: Getty
Photo: Getty

Under new, sweeping travel restrictions, pretty much everyone arriving in New Zealand from Monday must undertake a fortnight of self-isolation. Here’s what that involves.

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Who needs to self-isolate?

When the clock strikes 12 on Sunday night, the new restrictions on travel come into force, which mean that any arrival at the New Zealand border must go into self-isolation – or “staying at home”, as the Ministry of Health has started describing it – for 14 days, with the exception of people coming from the Pacific islands.

Is anyone in isolation already?

To date more than 10,000 people have registered for self-isolation in New Zealand with Healthline. Around two-thirds of those have completed the fortnight.

Who are they? Those new rules don’t come into force until midnight Sunday!

Anyone returning from mainland China, Iran, Italy or South Korea is already required to complete self-isolation. As is anyone displaying symptoms of illness coming from a clutch of other countries. And then there’s the “close contacts” of anyone confirmed as having Covid-19.

How is self-isolation defined?

The Ministry of Health defines self-isolation as “staying away from situations where you could infect other people”. Specifically, it means any situation where you may come in close contact with others.

And how is “close contact” defined?

That’s face-to-face contact with another person who is within two metres for more than 15 minutes. The ministry offers the following scenarios to avoid: “social gatherings, work, school, childcare/pre-school centres, university, polytechnic and other education providers, faith-based gatherings, aged care and health care facilities, prisons, sports gatherings, restaurants and all public gatherings.”

Don’t share beds, linen or food

Can I open the window?

Yes of course you can open the window. “Aim to stay in a well-ventilated room with a window that can be opened. Try to keep the window open as much as possible to enable ventilation and airflow as this will help to keep clean air moving through your room.”

What about going outside and exercise?

You can go outside. You can even go for a walk. Just avoid public spaces, and people generally. Don’t join a mosh pit or parade.

What about getting food or medicine?

The Ministry of Health advises, “where possible, contact a friend, family member or delivery services to carry out errands like supermarket shopping on your behalf.”

Some people just don’t have those networks. For others the whole idea of self-isolating will look financially ruinous. Still others have dependents they need to attend to. Anything to help them?

Nothing concrete, but the prime minister did promise that she’d announce early next week a bunch of measures to help people in such situations. “We will also increase community support to those unable to support themselves in isolation,” she said.

What if you live with children?

Here’s the ministry advice: “If your children didn’t travel overseas with you, they can continue to attend school and other normal activities. You should reduce your close contact with them; however, that may not be possible with children, particularly young children. Try to explain to your children what is happening in a way that is easy to understand. Tell them you are staying at home to protect other people. Try to avoid worrying children. Remind them you are not sick, and it’s unlikely you will become sick, but you are being very safe to protect them and other New Zealanders.

“What we have seen so far is that children with Covid-19 appear to be less severely affected. It is nevertheless important to do your best to follow this guidance. If a child develops symptoms, you should contact Healthline. They will also need to stay at home for 14 days from the onset of their symptoms.”

Breastfeeding?

Again, let’s cross direct to the official guidance: “There is currently no clinical evidence to suggest that the virus can be transmitted through breast milk. Infection can be spread to the baby in the same way as to anyone in close contact with you. The benefits of breastfeeding outweigh any potential risks of transmission of the virus through breast milk or by being in close contact with your child, however, this will be an individual decision and can be discussed with your midwife, health visitor or GP by telephone.

“If you wish to breastfeed, take precautions to limit the potential spread of Covid-19 to the baby by: washing your hands before touching the baby, breast pump or bottles; avoiding coughing or sneezing on the baby while feeding at the breast; cleaning any breast pump as recommended by the manufacturer after each use; considering asking someone who is well to feed your expressed breast milk to the baby.

“If you are feeding with formula or expressed milk, sterilise the equipment carefully before each use. You should not share bottles or a breast pump with someone else.”

What about the mental strain?

“It is normal to feel stressed or lonely when self-isolating, but there are some things you can do to feel better,” says the advice. “Reach out to your usual supports, like family and friends, and talk about how you feel. We also recommend sticking to a routine such as having regular mealtimes, bedtimes and exercising.

“If you feel you are not coping, it is important to talk with a health professional. For support with grief, anxiety, distress or mental wellbeing, you can call or text 1737 – free, anytime, 24 hours a day, 7 days a week – to talk with a trained counsellor.”

What if you start to feel sick?

Call Healthline on 0800 358 5453 or your GP. Do not just bowl on down to your local doctor.

How is this self-quarantine thing policed?

It’s not “policed” per se. This is not internment. you won’t be assigned a parole office

Ardern says that all incoming passengers will fill in a form with their personal details, and receive a briefing from a nurse on self-isolation requirements. That information will then be provided to Healthline (0800 358 5453 or +64 9 358 5453), who will call to check on your status. Officials have been asked to “step up enforcement of self isolation through measures such as spot checks”.

What if people aren’t abiding by the requirements?

“If you don’t self-isolate there are quarantine powers available to us,” Ardern said on Q+A. “We can put you in a medical facility and monitor your movements … We can put someone on the door to make sure you don’t leave. Those are powers we haven’t had to use and I do not anticipate having to use, but they do exist.”

Why 14 days?

Because that’s plenty enough time for any symptoms to present.

Can you stay in the same house as others?

Yes, with a whole bunch of buts. Keep contact with other people to a minimum, and certainly under the two metres for 15 minutes threshold. Don’t share anything you use for eating or drinking, or towels, or pillows. Wash everything you use thoroughly with soap and water, is the official advice, then put them in the dishwasher or washing machine. You can probably work out which goes where.

What about visitors?

The ministry says: “You should avoid having visitors to your home, but it is okay for friends, family or delivery drivers to drop off food.”

How are you supposed to head home for self-isolation from the airport? Taxi? Bus?

A private car is ideal. The official advice is that if you must, you can use public transport to get home (try to sit in a row alone), but not again across the fortnight. Whatever you do, the golden rule is no face-to-face for 15 or more minutes with anyone within two metres. Avoid taxis or ride-share.

But: “You can use your own transport means (car, bike etc) whenever you wish.”

What about people arriving in NZ who have to fly domestic to their destination or other transport connections?

That’s OK, if necessary. Where possible, sit in a window seat in a row by yourself. The ministry says: “While travelling make sure you use hand sanitiser regularly. If you need to cough or sneeze, cover your mouth or nose, or you can cough and sneeze into your sleeve.”

As ever, if you are unwell you should seek advice from Healthline before you travel.

What about all the people at airports, and what about people who just ignore the rules, and what about and what about (etc)?

Again, the critical thing to remember is this is not internment and you won’t be assigned a parole officer. It will be imperfect. But combined with hand-washing, social distancing, an uptick in testing and generally staying the hell away from other people if you’re ill, the border measures are about about throttling the spread – “flattening the curve” and “stopping the spread”.

Any tips on a good book to read in self-isolation?

As it happens, yes. Scroll to the end of this.


Primary source: Ministry of Health guidelines. This article was updated on March 15 to incorporate remarks by the prime minister on TVNZ’s Q+A, to update the “close contact” measure from one to two metres, in line with a ministry decision announced on Sunday afternoon and incorporate new ministry guidelines.

Read more:
Flatten the curve
Stop the spread

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