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PMC implements new discharge protocol; 500 beds freed up for Covid cases
As per the protocol, patients who completed 10 days of isolation and not showing any strong symptoms can be discharged immediately and undergo isolation at home.
With the new discharge protocol coming into effect in Pune on Monday, after the Centre issued guidelines for the same on May 9, the Pune Municipal Corporation (PMC) believes it will have 500 beds freed on an immediate basis for Covid-19 patients.
According to civic commissioner Shekhar Gaikwad, there are currently 1,350 Covid-19 positive patients in various Pune hospitals.
“Of these 1,350 patients, 500 have completed 10 days in isolation while undergoing treatment. These patients can be released immediately if they do not have strong symptoms and can undergo isolation at home. This means PMC can have up to 500 beds freed on an immediate basis, even as we have decided to follow the protocol on a case-to-case basis,” Gaikwad said.
Pune divisional commissioner Deepak Mhaisekar said, “The new protocol has been implemented in the division and all the guidelines of the Centre are being followed while discharging patients with no, or mild symptoms after 10 days.”
The earlier protocol demanded a Covid positive patient, irrespective of symptoms, to be isolated in hospital for 14 days and discharged after two consecutive tests, within a gap of 24 hours, returned negative.
The new protocol states that those with mild symptoms can be discharged in 10 days based on a single negative test, if, there is no fever for three days. There is no repeat test.
For those with moderate symptoms, if the fever is resolved within three days and the oxygen saturation is maintained without support, then, the patient can be discharged in 10 days.
Those with moderate symptoms who need oxygen therapy, can be discharged only after the resolution of clinical symptoms, and the ability to maintain oxygen saturation for three days.
The Indian Council of Medical Research (ICMR) changed the discharge protocol of Covid-19 patients stating that those with mild, very mild and pre-symptomatic positive patients can be discharged after 10 days since the onset of symptoms, and with no fever for three days, without a repeat test.
City doctors have responded to the changed protocol by saying that while it might reduce the load on hospitals and staff, who can now focus more on severe patients, the risk of community transmission cannot be ignored.
Dr Vijay Natarajan, chief executive officer (CEO) of Symbiosis University Hospital, said, “ICMR and NIV, based on their studies, state that the virus stays in the body for only 10 days. We, in our experience, have found that even on the 14th day, almost 15%-20% of patients test positive. This means we are letting 15%-20% of the carriers to go out in the community which risks community transmission. Although the viral load may be less on the 10th day leading to no symptoms, no study states that less viral load prevents transmission.”
Dr Natarajan added, “Home quarantine will be extremely difficult in slums. A healthier infected person may infect someone with a comorbidity, who otherwise could have been safe.”
However, Indian medical association (IMA) president for Maharashtra, Dr Avinash Bhondwe, says, “With limited testing kits and a staff crunch, the changed discharge protocol will be of great help. Also, it is not usually seen that the symptoms reoccur and if home quarantine and social distancing is strictly followed then it might help.”
IMA has also written to the state government that all passengers arriving in the state should undergo a swab test RT-PCR, on arrival, and be sent into quarantine. The association has also demanded that people from the other states should be transported in a non-air conditioned vehicles, because the central AC may spread the coronavirus.
