Karnataka is not keen to adopt the new discharge guidelines that allow sending COVID-19 patients home without testing if they are admitted for 10 days, with no fever seen for three previous days from the 10th day, and no requirement of oxygen support for four days.
The Union Health Ministry recently revised its guidelines for COVID-19 patients, stating that only those with severe illness need to be tested and discharged after a negative report. Other categories of patients, including very mild, mild, pre-symptomatic, and moderate cases, need not be tested before discharge, the new guidelines stated.
However, with more than 76% of patients in Karnataka being asymptomatic and also some patients testing positive after 14 days of hospitalisation, the COVID-19 expert committee, which is tasked with analysing how the disease infects people, has observed that it may not be feasible to discharge them without a test.
The committee has recommended to the government that the existing practice of discharging a patient only after he/she tests negative twice in a gap of 24 hours should be continued.
V. Ravi, Senior Professor and Head of Neuro Virology at NIMHANS, who is part of the expert committee, said when patients are testing positive even after 14 days it is advisable to ensure they test negative twice before discharge. People sent back untested may spread the virus in the community, he said. Also with a few patients in the country showing signs of relapse, it is risky to discharge without tests, he said.
On May 11, a 50-year-old in Belagavi tested positive again after recovering and being discharged. He had tested negative twice and was under quarantine after discharge.
Adequate beds
Jawaid Akhtar, Additional Chief Secretary, (Health and Family Welfare), said Karnataka was is not following the new guidelines now, as it has adequate number of beds and hospital infrastructure. “As our bed occupancy is not more than 4%, there is no need for the State to discharge patients without testing,” he said. “We are not following the new guidelines on discharge without tests. All COVID-19 patients in Karnataka will be treated in designated hospitals and discharged only after testing negative twice,” he said.
C.N. Manjunath, director of Sri Jayadeva Institute of Cardiovascular Sciences, who is the nodal officer for lab testing in the State COVID-19 task force, said testing before discharge is a morale booster for the patients and their families. “If a patient is discharged without tests, there will be so much stress on the family and the patient. Some of them may opt to get tested at private labs by paying the charges,” he said.
He also pointed out that the new guidelines may be feasible in States with high case load and poor infrastructure. “In Karnataka, we have over 27,000 beds with a mere 491 active cases. Moreover, our lab capacity is also high with over 7,000 tests being done daily in the 38 labs,” he added.