Centre issues revised policy for coronavirus patients, only severe COVID-19 patients to be tested before discharge

New Delhi: The Union Health Ministry on Saturday issued its revised discharge policy for coronavirus patients, saying only severe COVID-19 patients will undergo clinical tests before being discharged from hospital.

 In its advisory, the Health Ministry said coronavirus infected patients developing severe illness or having compromised immunity will have to test negative through RT-PCR test before being discharged by a hospital. Moderate cases of COVID-19 and pre-symptomatic, mild and very mild cases need not undergo tests before being discharged after resolution of symptoms.

According to the rules till now, a patient was considered fit to be discharged if he or she tested negative on day 14 and then again in a span of 24 hours. "The revised discharge policy is aligned with the guidelines on the 3 tier COVID facilities and the categorisation of patients based on clinical severity," the Ministry said.

The death toll due to COVID-19 rose to 1,981 and the number of cases climbed to 59,662 on Saturday, registering an increase of 95 deaths and 3,320 cases in the last 24 hours, according to the Union Health Ministry.

The discharge criteria for severe cases, including immunocompromised like HIV patients, transplant recipients, and those having malignancy will be based on clinical recovery and of patient tested negative once by RT-PCR (after the resolution of symptoms), the revised policy stated.

Cases clinically classified as "moderate" will undergo monitoring of body temperature and oxygen saturation.

If fever resolves within three days and the patient maintains saturation above 95 per cent for the next four days (without oxygen support), such a patient 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," the Ministry said.

At the time of discharge, the patient will be advised to follow home isolation for seven days as per the guidelines. Patient on oxygenation also falling under a moderate category, whose fever does not resolve within three days and demand of oxygen therapy continues, will be discharged only after resolution of clinical symptoms and when they are able to maintain oxygen saturation for three consecutive days.

Mild, very mild and pre-symptomatic cases admitted to a COVID care facility will undergo regular temperature and pulse oximetry monitoring. 

"The patient can be discharged after 10 days of symptom onset and no fever for three days. There will be no need for testing prior to discharge," the revised discharge policy stated. At the time of discharge, the patient will be advised to follow home isolation for further seen days as per the prescribed guidelines.

At any point of time, prior to discharge from COVID Care Centre, if oxygen saturation dips below 95 per cent, a patient will be moved to Dedicated COVID Health Centre.

After discharge from the facility, if he/she again develops symptoms of fever, cough or breathing difficulty he will contact the COVID Care Centre or state helpline or 1075. His or her health will again be followed up through teleconference on day 14, it said.