Explained: Revised discharge policy by health ministry for COVID-19 patients

The Ministry of Health and Family Welfare on Friday (May 8) issued a revised policy for the discharge of patients infected by COVID-19.

The revised advisory has given distinct instructions according to the severity of the infection in patients. The policy has been revised for the three categories of infections — mild/very mild/pre-symptomatic cases, moderate cases, and severe cases.

Discharge policy for mild/very mild/pre-symptomatic cases

Those who are suffering from mild or very mild symptoms of COVID-19 or have not shown any symptoms of COVID-19 yet can be discharged from hospitals without testing, ten days after they begin to show symptoms, and if they do not have a fever for at least three days.

In the previous advisory, COVID-19 patients could be discharged only after receiving a chest radiograph clearance, viral clearance in respiratory samples, and if two of the patient’s samples tested negative within a period of 24 hours.

However, according to the revised guidelines, patients should be in home quarantine for seven days after being discharged.

If the patient’s oxygen saturation drops below 95 per cent before being discharged, the patient will be moved to a COVID-19 Health Centre.

It is crucial that the patient maintains oxygen saturation at the required level, since a drop in oxygen levels below 90 per cent could result in lethargy, mental disruptions or confusion.

Discharge policy for moderate cases admitted to COVID-19 Health Centre

COVID-19 patients who are diagnosed under the moderate category will be monitored to check their body temperature and oxygen saturation. If the fever is cured within three days and the patient maintains an oxygen saturation level above 95 per cent for four days without ventilator (oxygen) support, he/she will be discharged after ten days.

If they do not have fever, have no issues with respiration (like breathlessness), and do not require oxygen support, these patients also need not be tested before being discharged.

However, they will be required to be in quarantine at their houses for seven days.

For moderate cases whose fever is not cured within three days and require oxygen support, they will be discharged only after the three symptoms mentioned above are handled, and if they are able to maintain oxygen saturation for three consecutive days without external support. No RT-PCR tests will be required for these patients.

Discharge policy for severe cases

The discharge policy for severe cases is based on clinical recovery. This list of cases includes includes immunocompromised patients with HIV or transplant recipients. These patients will have to be tested by RT-PCR after they are cured of the three clinical symptoms.