Focusing on the positives in a bleak scenario is sometimes useful in avoiding fatigue from a prolonged campaign. That the total number of discharged people with COVID-19 , from the time the first ever case was recorded in India, has exceeded the number of active cases is definitely a milestone. As of Thursday, a total of 1,46,716 people have recovered, while the number of active cases was 1,42,697. The steady increase in the number of people discharged is to be expected, especially given that the disease is now known to have a case fatality rate that is just about 2.8%. At that figure, the rate of recoveries has no other way to go but steadily upwards, unless there is gross mismanagement of the health system. Nevertheless, for the warriors on the front lines, and for the people who run the health system in the country, this is one metric that is a direct measure of the success of their interventions. However, it must be remembered that the Indian government revised its discharge policy, as have some other nations. No longer does a patient have to test negative twice over an interval of 24 hours; any patient who does not show any symptom over three days is allowed to go home now. And patients who were on critical care require only one negative test to be discharged. Discharge is likely to be followed up with home isolation for a period of seven days or two weeks, with restrictions on movement outside the home.
While the natural path of this curve is upwards, any slackening here will have disastrous consequences. The focus on health care must not be lost at any point in the continuum of fighting this epidemic, especially at a time when the number of people testing positive for COVID-19 in the country is rising steadily. The threat of this epidemic reaching a peak and overwhelming stretched health-care resources and facilities is clear and present; in some States it is possibly already happening. In this scenario, a proper triage at the first instance, to distinguish people with mild symptoms or none, from sick patients, is essential to ensure that the health system remains responsive to the really sick, and helps them recover. Providing adequate facilities and easy access to emergency care services are important in the COVID Care Centres and COVID Health Centres, and adequate monitoring of home quarantined people, possibly in association with local bodies and voluntary organisations, is essential. Everything the government does here on must be to allow the recovery rate reach its natural proportion of the total number of cases, and to keep the case fatality rate down.
