A COVID-19 patient who gets a negative result in an antigen test several days after the first positive result (in an RT-PCR test) will now be discharged, according to the revised discharge guidelines in Kerala, released on Monday.
“The COVID-19 pandemic is evolving and clinical research data is revealing new information about the epidemiology of the disease. Based on the recent analysis of the epidemiology of the patients in Kerala and considering the guidelines of the World Health Organisation (WHO) and the Union Ministry of Health and Family Welfare, this revised discharge guideline is issued,” says the advisory on the amendment to the guideline.
The Union Ministry of Health and Family Welfare guidelines stipulate discharging asymptomatic patients on the tenth day, it says.
Dr Amar Fettle, state nodal officer for COVID-19, says that the problem with the earlier strategy was the risk of having a huge backlog when asymptomatic people had to get a second RT-PCR test, days after the first. Priority (for the RT-PCR test) always went to newly detected cases and new admissions. “So these people who were in hospital for so many days had to get another RT-PCR test done. They would be pushed to wait and there’d be delay and the backlog would get bigger. That’s very problematic,” he says.
According to the new guidelines, an asymptomatic COVID-19 patient who gets a negative result in an antigen test, 10 days after the first positive result, can be discharged.
If the result is positive on the tenth day, the test is to be repeated every alternate day till the result is negative and the person can then be discharged.
The advice for the discharged persons is to remain in quarantine and avoid non-essential travel and social contact for 7 days after discharge.
Category A patients (those with mild symptoms) would get the antigen test done on the tenth day (since the onset of symptoms) if there are no symptoms or one day after the resolution of symptoms. If the result is negative, the person will be discharged provided they have either completed 10 days since the onset of symptoms or have had no symptoms for the last 3 days.
If the result is positive, the process will be repeated every alternate day till the result is negative.
After discharge patients need to follow 7 days of quarantine, avoiding non-essential travel and social contact with adequate rest.
Category B patients (those with fever and breathlessness) will be given the antigen test on the 14th day since the onset of symptoms if they don’t have any symptoms, or one day after the resolution of symptoms. If the result is negative, the person will be discharged provided they have either completed 14 days since the onset of symptoms or have had no symptoms for the last 3 days.
If the result is positive, the process will be repeated every alternate day till the result is negative.
After discharge patients need to follow 7 days of quarantine, avoiding non-essential travel and social contact with adequate rest.
Category C patients (those with fever, breathlessness and pneumonia) or patients who are immunocompromised (those who are HIV positive, transplant recipients, those with malignancy) will be given the antigen test on the 14th day since the onset of symptoms if there are no more symptoms, or one day after the resolution of symptoms, or as per the doctor’s orders.
If the result is negative, the person will be discharged provided they have either completed 14 days since the onset of symptoms or have had no symptoms for the last 3 days or else if they are clinically stable.
If the result is positive, the process will be repeated every alternate day till the result is negative.
After discharge they need to follow 7 days of quarantine, avoiding non-essential travel and social contact with adequate rest.