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Concerned about new discharge protocols by ICMR: Covid-19 hospital CEO
Dr Vijay Natarajan says that the recommendation of enforcing 14 days home quarantine “is very impractical in most Indian small-sized households”.
PUNE: The Union health ministry’s revised discharge guidelines for coronavirus disease (Covid-19) patients has evoked concern from the chief executive of a prominent hospital in Pune engaged in the treatment of Covid-19 patients.
“The recommendations suggest that we should discharge such patients (mild/very mild/pre-symptomatic cases) by the 10th day without doing the virus swab test. We have seen patients who are swab positive even on the 14th and 15th days and some extending up to the 25th or 30th days. Premature discharge of such patients from the hospital will lead to a continuing spread of the virus within the community,” cardiothoracic surgeon, Dr. Vijay Natarajan said.
Chief executive officer (CEO) of the Symbiosis University Hospital and Research Centre, Lavale, he noted that the recommendation of enforcing 14 days home quarantine “is very impractical in most Indian small-sized households”.
The hospital at Lavale, has devoted a separate five storey building for the Covid-19 pandemic with a capacity of 500 isolation beds which includes 30 beds in the ICU (intensive care unit) with four ventilators. It has a dedicated staff of 200 nurses and 150 doctors, including faculty and resident doctors. C
On May 9, the Union health ministry revised its discharge guidelines for coronavirus disease (Covid-19) patients stating that mild/very mild/pre-symptomatic cases admitted to a Covid-19 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 3 days. 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 further 7 days as per guidelines available at (https://www.mohfw.gov.in/pdf/GuidelinesforHomeIsolationofverymildpresymptomaticCOVID19case s.pdf),” the guidelines said.
The government’s previous rules said a laboratory-confirmed case had to be tested on day 14 once and then again in a span of 24 hours. If both the results were negative then the patient was fit to be discharged from the health care facility.
Dr. Natarajan noted that while the government machinery was doing its best within the limited resources of manpower, infrastructure and equipment, “it is extremely important that policies be guided by scientific evidence rather than administrative convenience.”
At the hospital, Covid-19 patients are being admitted since April 8 and the average occupancy has been varying from around 150 to 200 patients and about 8 to 10 patients in the ICU. Till date a total of 415 patients have been treated in the hospital of which 285 have been discharged.
The CEO expressed satisfaction that all the necessary precautions were being taken and his hospital did not have a single case of infection among the healthcare staff.
