COVID-19: Government issues revised guidelines for discharge of patients
Following the easing of restrictions of the nation-wide COVID-19 lockdown in India, there have been a sharp and alarming spike in positive cases. Considering the fact that there is no cure or vaccine for this disease as yet, we may have to live with it for some time to come. So, we need to fall back on preventive measures and social distancing rules. The government is also doing its best to contain the spread of the disease. But COVID-19 has a way of defying all efforts to subdue it. In light of all these developments, the government of India has come out with revised guideline for the discharge of patients from health care facilities across the country.
REVISED DISCHARGE POLICY FOR COVID-19
These guidelines are different from the previous rules. According to the earlier guidelines, a positive case had to be tested on day 14 once and then again in a span of 24 hours. If both the results are negative, only then is the patient fit to be discharged from the health care facility.
For mild/very mild/pre-symptomatic cases
Such cases admitted to a COVID Care Facility will undergo regular temperature and pulse oximetry monitoring. The patient can be discharged after 10 days of onset of symtoms and provided that he ahs no fever for 3 days. There will be no need for testing prior to discharge. At the time of discharge, the patient will be advised to follow home isolation for further 7 days. If at any point of time, prior to discharge, the patient’s oxygen saturation dips below 95 per cent, he or she will be moved to a dedicated COVID health centre. After discharge from the facility, if the patient develops any symptoms like fever, cough or breathing difficulty, he will have to contact the COVID care centre or state helpline or 1075. Healthcare professionals will then follow the patient’s health via tele-conference on 14th day.
For moderate cases
This includes patients whose symptoms resolve within 3 days and who maintains oxygen saturation above 95 per cent for the next 4 days. Such patients will undergo monitoring of body temperature and oxygen saturation. If the fever goes down within 3 days and the patient maintains saturation above 95 per cent for the next 4 days without oxygen support, he or she will be discharged after 10 days of symptom onset in case of absence of fever without antipyretics, resolution of breathlessness and no oxygen requirement. There will be no need for testing prior to discharge. At the time of discharge, the patient will be advised to follow the home isolation for 7 days.
On the other hand, patients on oxygenation whose fever does not resolve within 3 days and whose demand of oxygen therapy continues will be discharged only after resolution of clinical symptoms and when they display the ability to maintain oxygen saturation for 3 consecutive days.
For severe cases including immunocompromised (HIV patients, transplant recipients, malignancy)
Discharge criteria for severe cases will be based on clinical recovery and only if the patient tests negative once by RT-PCR after resolution of all symptoms.
REVISED DISCHARGE POLICY FOR COVID-19
These guidelines are different from the previous rules. According to the earlier guidelines, a positive case had to be tested on day 14 once and then again in a span of 24 hours. If both the results are negative, only then is the patient fit to be discharged from the health care facility.
For mild/very mild/pre-symptomatic cases
Such cases admitted to a COVID Care Facility will undergo regular temperature and pulse oximetry monitoring. The patient can be discharged after 10 days of onset of symtoms and provided that he ahs no fever for 3 days. There will be no need for testing prior to discharge. At the time of discharge, the patient will be advised to follow home isolation for further 7 days. If at any point of time, prior to discharge, the patient’s oxygen saturation dips below 95 per cent, he or she will be moved to a dedicated COVID health centre. After discharge from the facility, if the patient develops any symptoms like fever, cough or breathing difficulty, he will have to contact the COVID care centre or state helpline or 1075. Healthcare professionals will then follow the patient’s health via tele-conference on 14th day.
For moderate cases
This includes patients whose symptoms resolve within 3 days and who maintains oxygen saturation above 95 per cent for the next 4 days. Such patients will undergo monitoring of body temperature and oxygen saturation. If the fever goes down within 3 days and the patient maintains saturation above 95 per cent for the next 4 days without oxygen support, he or she will be discharged after 10 days of symptom onset in case of absence of fever without antipyretics, resolution of breathlessness and no oxygen requirement. There will be no need for testing prior to discharge. At the time of discharge, the patient will be advised to follow the home isolation for 7 days.
On the other hand, patients on oxygenation whose fever does not resolve within 3 days and whose demand of oxygen therapy continues will be discharged only after resolution of clinical symptoms and when they display the ability to maintain oxygen saturation for 3 consecutive days.
For severe cases including immunocompromised (HIV patients, transplant recipients, malignancy)
Discharge criteria for severe cases will be based on clinical recovery and only if the patient tests negative once by RT-PCR after resolution of all symptoms.
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