BMC says new testing protocol will free up more beds when cases peak

With the Centre’s new guidelines for testing and discharge of Covid-19 positive patients being implemented, the Brihanmumbai Municipal Corporation (BMC) expects

With the Centre’s new guidelines for testing and discharge of Covid-19 positive patients being implemented, the Brihanmumbai Municipal Corporation (BMC) expects to free up more Covid-19 care beds at quarantine centres and hospitals. This will also help ration available testing kits and reduce the amount of time needed for test results after a swab is collected.

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The Centre on Friday revised pre-discharge testing rules for Covid-19 patients, eliminating the need for a double negative test result (two consecutive test results show negative for a patient). According to these guidelines, patients showing mild to moderate symptoms no longer need to be tested before they are discharged from the hospital, and patients showing severe symptoms need to record only one negative test result.

Patients are discharged provided they show no fever for three consecutive days and oxygen saturation above 94% for four days. In the case of patients with severe symptoms, and those with co-morbidities, they will not be discharged until complete resolution of symptoms and clinical recovery.

Daksha Shah, Deputy Health officer with BMC said, “These guidelines have been communicated with all hospitals and covid-care centres, and implementation is starting soon.” As per guidelines, once released, patients are required to go through mandatory isolation at home, and follow up tele-conference health check-up.

“We may be able to free up beds three to four days earlier. It is reducing the stress on testing capacity. With reduced testing burden, results of those who need it are coming sooner,” said a senior civic official. Presently, it takes anywhere between 12 to 24 hours for a test result to arrive after a swab is given.

Two to three weeks ago, BMC had already started testing asymptomatic patients and patients showing mild and moderate symptoms, only once before discharge.

“A per the task force recommendations, BMC on May 1 had already begun discharging asymptomatic patients and those showing mild symptoms on the results of one test being negative before discharge. This has helped considerably in patient-bed management,” said Shah.

Even as experts have given mixed reactions to the new development, BMC believes it will reduce the burden on Covid care centres and hospitals and will be most useful when cases peak in Mumbai and demand for beds increases.

Suresh Kakani, additional municipal commissioner in charge of the health department, said, “There is a scientific rationale to this decision. It is not meant for reducing the load. That is only a collateral benefit. Whatever symptoms are to be developed, in more than 70% of the patients, symptoms develop on the sixth or seventh day. As per those guidelines, if on the seventh, eighth, or ninth day no symptoms are developed, then on the 10th day, the patient can be discharged without testing.”

However, Rajendra Dhage, a city-based health activist, said, “There is no proof that asymptomatic persons do not spread the virus. Without testing, if you let people go out, there is going to be a problem.”

Sanjay Pattiwar, another public health expert, said, “There is a boon in this and a small catch. The government was not able to cope with the high number of tests, viz-a-viz availability of kits. There is a small issue as some patients may be positive even after 14 days, but the government is not testing them before discharge. However, the government is asking them to quarantine at home, so the responsibility of their health will be taken by the patient. In turn, the load on public beds is reduced and tests are rationed.”

Experts have also pointed to the need of local governments to tweak the policy for slums and high population density areas, where patients remain in institutional quarantine.