British Prime Minister is experiencing the frustration of self-isolation first hand.

Despite feeling well, he is holed up in Number 10 Downing Street after coming into contact with a confirmed COVID-19 case.

Self-isolation is one of the most widely practised methods in the world for breaking the chains of COVID-19 transmission.

But it could be scrapped in England if an ambitious trial announced by the Prime Minister proves successful.

Already, there are big concerns about the strategy, with one public health expert calling the plan a “gigantic experiment”.

What’s the plan?

When someone is told by contact tracers that they’ve potentially been exposed to COVID-19, instead of self-isolating for 14 days, they’ll be able to carry on with their lives.

There’s one condition though: They’ll need to have a rapid COVID-19 test for seven days straight.

If they test positive, they’ll have to go into self-isolation at home.

Boris Johnson says COVID-19 contacts won't have to self-isolate. How is that possible?Boris Johnson says COVID-19 contacts won't have to self-isolate. How is that possible?
Rapid antigen tests can diagnose COVID-19 in 15 minutes. They’re relatively inexpensive and require a swab from the nose.(Supplied: St Vincent’s Hospital)

“The system is untried, and there are of course many unknowns,” Mr Johnson said.

“But if it works, we should be able to offer those who test negative the prospect of fewer restrictions.”

The idea will be trialled in Liverpool, where a mass testing pilot scheme is already underway.

If it is successful, health and aged care workers could be the next to benefit and the whole of England could be able to avoid self-isolation by the new year.

What are the risks?

Accuracy is a big concern. The mass rapid testing scheme currently being trialled in Liverpool uses a lateral flow antigen test, which can produce results in less than half an hour.

Unlike a PCR test, the so-called ‘gold-standard’ test, the rapid tests don’t need analysis at off-site labs.

However, what they gain in speed, they lose in accuracy.

A study by Public Health England and the University of Oxford found the rapid tests being used in Liverpool detected 76 per cent of COVID-19 cases overall, but that figure varied greatly depending on who was performing the test.

For example, sensitivity was 79 per cent when performed by a lab technician and 73 per cent when administered by a trained health professional.

It dropped to just 58 per cent when performed by self-trained members of the public.

Alysson Pollock, a clinical professor in public health at Newcastle University in England’s north-east, said the tests weren’t reliable enough to eliminate the need for self-isolation.

“When the sensitivity is low one can end up missing half the positive cases,” she told the ABC.

“You can end up with false reassurance.”

Professor Pollock said the rapid tests weren’t designed to be used on asymptomatic patients.

The Oxford study found the tests detected 95 per cent of cases in which patients had high viral loads.

What are the rewards?

If it works, it will mean much greater freedom for anyone who’s identified as a close contact of a COVID-19 patient.

Students won’t be forced to skip school for a fortnight, workers won’t miss out on vital income, and holidays won’t necessarily have to be cancelled.

“The scientific cavalry has arrived,” Mr Johnson said, referring to breakthroughs in testing and vaccines.

“We know in our hearts that next year, we will succeed.”

However, England’s current test and tracing operation is struggling as it is.

While nearly 400,000 tests are being processed every day, only 60 per cent of close contacts of COVID-19 cases are being reached and told to self-isolate.

Boris Johnson says COVID-19 contacts won't have to self-isolate. How is that possible?Boris Johnson says COVID-19 contacts won't have to self-isolate. How is that possible?
England’s test and trace system has come under severe stress during the pandemic, with long waiting lines for tests and issues with contact tracing.(Reuters: Hannah McKay)

“The Government needs to get the basics right,” Professor Pollock said.

While welcoming more mass testing, Opposition Leader Keir Starmer also criticised the performance of the existing test and trace system, which has so far cost the government 15 billion pounds ($27b) and is likely to blow out to 22 billion pounds by the year’s end.

The percentage of contacts traced for the system to adequately work needs to be about 80 per cent, he said.

“It’s currently nowhere near that level.

‘We have turned a corner’

Britain’s month-long national lockdown appears to be working.

On Monday, 15,450 infections were recorded, and cases have been trending down for a week.

Mr Johnson has announced a reintroduction of the tiered regional restrictions for England when the national lockdown ends on December 2, albeit stricter ones than those previously in place, but he also said an escape route was “in sight”.

“This will be a hard winter, Christmas cannot be normal and there’s a long road to spring,” he told Parliament.

“But we have turned a corner and the escape route is in sight.”

Under Mr Johnson’s winter COVID plan, councils under tier 3 restrictions — the toughest tier — will be offered the mass testing program.

Non-essential shops and gyms will be allowed to open regardless of the tier, and pubs will be allowed to reopen until 11:00pm instead of 10:00pm, but under the toughest tier they will only be allowed to serve takeaway food, along with restaurants and cafes.

Boris Johnson says COVID-19 contacts won't have to self-isolate. How is that possible?Boris Johnson says COVID-19 contacts won't have to self-isolate. How is that possible?
Pubs, along with restaurants, hairdressers and shops selling non-essential items, will remain closed in England until December 2.(AP: Alberto Pezzali)

The tiers for each region will be announced on Thursday and be up for review every 14 days, with Mr Johnson indicating the measures will last until at least March.

Coming out of lockdown

Earlier on Monday Health Secretary Matt Hancock said the UK would begin its vaccination program from next month, and that things would “be able to start to get back to normal” after Easter next year.

The UK Government has ordered 100 million doses of the AstraZeneca/Oxford University vaccine, to be rolled out from December pending approval by the independent Medicines and Healthcare products Regulatory Agency.

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Boris Johnson says COVID-19 contacts won't have to self-isolate. How is that possible?Boris Johnson says COVID-19 contacts won't have to self-isolate. How is that possible?

UK Health Secretary Matt Hancock says AstraZeneca’s news is “encouraging”.

“The bulk of the vaccine rollout program will be in January, February, March,” Mr Hancock told the BBC.

“And we hope that sometime after Easter, things will be able to start to get back to normal.”

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