Govt revises Covid-19 patient discharge rules. Here’s what you need to know

The revised guidelines are different from the government’s previous rules which said a laboratory-confirmed case had to be tested on day 14 once and then again in a span of 24 hours.

The Union health ministry on Friday revised its discharge guidelines for coronavirus disease (Covid-19) patients.

People waiting for a consultation with a doctor at MMG Hospital in Ghaziabad. (Sakib Ali /Hindustan Times)

The revised guidelines are different from the government’s previous rules which 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 are negative then the patient is fit to be discharged from the health care facility.

Coronavirus outbreak: Full coverage

“The revised discharge policy is aligned with the guidelines on the 3 tier COVID facilities and the categorization of the patients based on clinical severity,” the document said.

Here is the revised guideline:

1. Mild/very mild/pre-symptomatic cases

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).

After discharge from the facility, if they again develop symptoms of fever, cough or breathing difficulty they will contact the Covid-19 Care Centre or state helpline or 1075. Their health will again be followed up through teleconference on the fourteenth day.

2. Moderate cases admitted to dedicated Covid-19 Health Centre (Oxygen beds)

* Patients whose symptoms resolve within 3 days and they maintain saturation above 95% for the next 4 days

Cases clinically classified as “moderate cases” will undergo monitoring of body temperature and oxygen saturation.

If the fever resolve within 3 days and the patient maintains saturation above 95% for the next 4 days (without oxygen support), such patient will be discharged after 10 days of symptom onset in case of:

* Absence of fever without antipyretics

* Resolution of breathlessness

* No oxygen requirement

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 7 days as per guidelines available at (https://www.mohfw.gov.in/pdf/GuidelinesforHomeIsolationofverymildpresymptomaticCOVID19cases.pdf).

* Patient on oxygenation whose fever does not resolve within 3 days and demand of oxygen therapy continues.

Such patients will be discharged only after the resolution of clinical symptoms and after they are able to maintain oxygen saturation for 3 consecutive days

3. Severe cases including immunocompromised (HIV patients, transplant recipients, malignancy)

Discharge criteria for severe cases will be based on clinical recovery and patient tested negative once by RT-PCR (after the resolution of symptoms)