The government on 9 May revised the discharge policy for covid-19 patients, indicating that positive cases having mild symptoms can be managed without hospitalization. The decision to revise the discharge policy was based on evidence, Lav Agarwal, joint secretary, Union health ministry, said on Wednesday. The government had recently said that 80% of the cases are asymptomatic.
“The new discharge policy is based on evidence where we have found that presymptomatic, mild symptomatic cases, or moderate cases for that matter not having fever for 10 days will not be able to spread the infection to others,” said Agarwal. “However, we have directed that even after a patient leaves the covid facility, s/he should self-quarantine himself/herself for at least seven days and also must take all necessary precautions. They should not go out.”
The health ministry in its revised discharge policy said mild, very mild, and pre-symptomatic cases admitted to a covid care facility will undergo regular temperature and pulse monitoring.
The patient can be discharged after 10 days of symptom onset if there has been no fever for three days for mild/very mild/pre-symptomatic cases. For moderate cases admitted to dedicated covid health centre, such patients will be discharged after 10 days of symptom onset in case of absence of fever without antipyretics, resolution of breathlessness, and no oxygen requirement, according to the revised discharge policy. There will be no need for testing prior to discharge in both these cases.
As India has gradually scaled up its testing for covid-19, the Indian Council of Medical Research (ICMR) said that till date 2,536,149 samples have been tested. In the past 24 hours, over 107,609 tests had been conducted at 555 labs, including 391 government and 164 private labs.
“We have ramped up testing and the daily figure for last two days is going above one lakh. Out of 107,609 tests, 89,466 tests were conducted at the ICMR laboratories while 18,143 tests were conducted at private labs,” said Dr Raman Gangakhedkar, head scientist of epidemiology and communicable diseases at ICMR.
India’s rate of testing, at 1,852 per million population, however, remains among the lowest in the world.
The total tally of covid-19 cases on Wednesday reached 111,536, but the government claimed that India has been able to slow the pace of covid-19 infections. “Compared to the global scale, where there are 62.3 cases per lakh, India still has only 7.9 cases per lakh population. Similarly, for mortality per lakh population, while the global average rate is 4.2, India’s figure is pegged at 0.2. The relatively low death figures represent timely case identification and clinical management of the cases,” said Agarwal.
“The focus on clinical management and recovery has resulted in the improvement in the recovery rate. More than 39.6 % of the confirmed cases have recovered bringing the total to 42,298 recoveries, as of today,” he said. This shows that the disease is curable and the clinical management protocols adopted by India are effective.
The government said the recovery data of active cases under management shows that about 2.9% of these patients require oxygen support, about 3% need intensive care unit support, and 0.45% need ventilator support.
India has concurrently been focusing on upgrading covid-dedicated health infrastructure, Agarwal said. However, the 15th Finance Commission pointed out that there is an immediate need to reassess the requirement of health manpower, medical and paramedical, and estimated requirement of resources for 2021-22 to 2025-26 in relation to the health infra-gap, including hospital infrastructure, medical equipment, and personal protective equipment.