New Delhi: The government has issued new discharge guidelines for the patients of COVID-19. The policy is formulated with the 3 tier COVID facilities. as per the new policy patients are classified based on the intensity of the infection- mild, moderate, and severe. The 3 types of COVID facilities in which the patients are kept are the COVID Care Centres (CCC), Dedicated COVID Health Center (DCHC), and the Dedicated COVID Hospital (DCH). The containment of the patients in each of these facilities depends on their extent of infection.
For very mild, mild, or pre-symptomatic cases, regular temperature monitoring and pulse oximetry checking will be carried out regularly. These are admitted in the COVID Care Centres. They can be discharged 10 days after the appearance of symptoms and are found to afebrile for 3 days. Testing before discharge won’t be required and the patient will be advised to adopt self-isolation at their homes for 7 days following the discharge. Post-discharge, if the patient develops breathing problems, fever or cough, he/she are advised to get in touch with the COVID Care Centre or the state helpline at 1075. The progress will be checked through video and audio calls on the 14th day.
Nevertheless, if the oxygen saturation of a patient falls below 95% anytime during his stay at the COVID Care Centre before getting discharged, he will be shifted to the Dedicated COVID Health Centre.
Moderately infected patients will be categorized under two types. The first category includes the patients whose symptoms will fade within 3 days and the oxygen saturation stays above 95% for the following 4 days. These patients’ temperature is regularly monitored. The discharge is allowed after 10 days of symptom onset only after the required boxes have been checked which include- the absence of fever without antipyretics (Anti-fever drugs), complete remission of breathlessness, and no support of oxygen masks required. Such patients also need not be tested before discharging and home-isolation is to be practiced for 7 days after discharge.
The second category of moderately infected cases comprises of the patients whose symptoms do not subside within 3 days and the requirement of oxygen therapy persists. Such patients will only be discharged after their clinical symptoms disappear and they maintain their oxygen saturation for 3 successive days.
Severely affected cases also include immunocompromised patients (HIV, organ transplant recipients, cancers). For such patients, clinical recovery will be the major criteria for discharge along with testing. He needs to be tested negative at least once by RT-PCR for given the nod to get discharged.
The RT-PCR test stands for the real-time Reverse Transcription Polymerase Chain Reaction which is an indirect method to detect the infection taking samples from the infected person’s nasal, nasopharyngeal or oropharyngeal swabs, sputum, lower respiratory tract aspirates, bronchoalveolar lavage, and nasopharyngeal wash/aspirate or nasal aspirate. Although it cannot find the virus, it can perceive as to whether the immune system of a person has come across the virus or not. This was taken up as the protocol test after the rapid anti-body tests were found to be unreliable.
