The government on Tuesday issued fresh advisories on testing individuals who have recovered from Covid-19 and are awaiting discharge from hospitals. The Indian Council of Medical Research (ICMR) said no testing is required for COVID-19 recovered individuals at the time of hospital discharge in accordance with the discharge policy of Union Health Ministry. The ICMR further said the need for RT-PCR test in healthy individuals undertaking inter-state domestic travel may be completely removed to reduce the load on laboratories. It issued an advisory stating that it is imperative to optimise the RTPCR testing and simultaneously increase the access and availability of testing to all citizens of the country.
Following is a list of measures recommended by the ICMR to optimise testing:
- RT-PCR test must not be repeated in any individual who has tested positive once either by RAT or RTPCR.
- No testing is required for COVID-19 recovered individuals at the time of hospital discharge in accordance with the discharge policy of MoH&FW
- The need for RTPCR test in healthy individuals undertaking inter-state domestic travel may be completely removed to reduce the load on laboratories.
- Non-essential travel and interstate travel of symptomatic individuals (COVID-19 or flu-like symptoms) should be essentially avoided to reduce the risk of infection.
- All asymptomatic individuals undertaking essential travel must follow COVID-appropriate behaviour.
- Mobile testing laboratories are now available on GeM portal.
- States are encouraged to augment RTPCR testing through mobile systems.
The health ministry also issued guidelines based on clinical severity of patients.
Following is a detailed list of the revised policy:
- For mild/very mild/pre-symptomatic cases: Such patients admitted to a COVID 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 isolate himself at home and self-monitor their health for further 7 days. At any point of time, prior to discharge from CCC, if the oxygen saturation dips below 95%, patient is moved to Dedicated COVID Health Centre (DCHC). After discharge from the facility, if he/she again develops symptoms of fever, cough or breathing difficulty he will contact the COVID Care Centre or State helpline or 1075. His/her health will again be followed up through tele-conference on 14th day.
- Moderate cases admitted to dedicated COVID health centre (oxygen beds): Patients whose symptoms resolve within three days and maintains saturation above 95% for the next four days (without oxygen support) 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 isolate self at home and self-monitor their health for another seven days.
- Patient on oxygenation whose fever does not resolve within three days and demand of oxygen therapy continues will be discharged only after
• resolution of clinical symptoms
• ability 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
• Patient tested negative once by RT-PCR (after resolution of symptoms)