Covid. WHO: “Yes to masks indoors in crowded places regardless of the local epidemiological situation. Paxlovid also for pregnant women”. Here are the new guidelines

Masks are recommended after recent exposure to Covid, when a person has or suspects they have Covid, when a person is at high risk for severe Covid, and for anyone in a crowded, enclosed, or poorly ventilated space. Pregnant or breastfeeding women with non-severe Covid should consult their doctor about whether to take Paxlovid, given the “likely benefits” and lack of reported adverse events.

13 JAN –

Yes to the use of masks indoors in crowded or poorly ventilated spaces. For asymptomatic Covid positives, the suggested isolation drops from 10 to 5 days in the absence of a swab. And green light to the use of the antiviral Paxlovid also for pregnant women.

These are the new WHO guidelines, taking into account the latest available evidence and the evolution of epidemiology.

Masks. WHO continues to recommend the use of masks, regardless of the local epidemiological situation, given the current global spread of COVID-19. Masks are recommended after recent exposure to Covid, when a person has or suspects they have Covid, when a person is at high risk for severe Covid, and for anyone in a crowded, enclosed, or poorly ventilated space. Previously, WHO recommendations were based on the local epidemiological situation.

Similarly to previous recommendations, WHO then recommends the use of masks in other cases, based on a risk assessment. Factors to consider include local epidemiological trends or increasing levels of hospitalization, levels of immunization coverage and community immunity, and people’s environments.

Isolation period. WHO advises Covid patients to be discharged from isolation early if they test negative on a rapid swab. In the absence of tests, for patients with symptoms, the new guidelines suggest 10 days of isolation starting from the date of onset of symptoms. Previously, WHO advised that patients be discharged 10 days after the onset of symptoms, plus at least three more days after their resolution.

For those who test positive but have no signs or symptoms, WHO is now suggesting 5 days of isolation without testing, up from 10 days previously.

Isolation can be done at home or in a dedicated facility, such as a hospital or clinic. Evidence considered by the guideline development group showed that “people without symptoms are much less likely to transmit the virus than those with symptoms. Although with a very low degree of certainty, evidence has also shown that People with symptoms discharged on day 5 after symptom onset are likely to infect three times as many people as those discharged on day 10.”

Antivirals. WHO has finally extended its strong recommendation for the use of nirmatrelvir-ritonavir (also known by the trade name “Paxlovid”). Pregnant or nursing women with non-severe Covid should consult their doctor about whether to take this drug, given the “likely benefits” and lack of reported adverse events.

WHO has also reviewed the evidence of two other drugs, sotrovimab and casirivimab-imdevimab, and maintains strong recommendations against their use for the treatment of COVID-19. These monoclonal antibody drugs cannot guarantee patient safety. These monoclonal antibody-based drugs have no or reduced activity against currently circulating variants of the virus.

There are currently 6 proven treatment options for Covid patients, three of which avoid hospitalization in high-risk people and three save lives in those with severe or critical illness. With the exception of corticosteroids, access to other medicines remains unsatisfactory globally.

January 13, 2023
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