T.N. revises discharge policy for COVID-19

T.N. revises discharge policy for COVID-19

Comprehensive guidelines issued for managing pandemic

20/05/2020, SPECIAL CORRESPONDENT,CHENNAI

The State Health Department has revised the discharge policy for COVID-19 patients and has issued comprehensive guidelines for the management of the pandemic.

As per the revised policy, patients with mild or very mild symptoms, and those in the pre-symptomatic stage who have been admitted to COVID-19 Care Centres (CCCs), can be discharged after 10 days from the date of testing positive, or the date of the start of home isolation, or the date of admission to a CCC, provided that they have no fever for three consecutive days.

Those categorised as moderate cases should be asymptomatic for three consecutive days, and oxygen saturation should be maintained without support. “They can be discharged after 10 days of symptom onset — absence of fever without antipyretics, resolution of breathlessness and no oxygen requirement,” the guidelines said.

In case symptoms persist and the demand for oxygen therapy continues, they can be discharged only after clinical symptoms are resolved and they have the ability to maintain oxygen saturation for three consecutive days.

In line with the Government of India’s guidelines, the Department has said that there is no need for testing for both categories of patients prior to their discharge, and that patients should be advised to undergo home isolation for seven days after their discharge. Earlier, patients had to test negative twice to be discharged. For severe cases, discharge depends on clinical recovery. The patients should test negative for COVID-19 once under the RT-PCR testing method, after the symptoms are resolved.

Reiterating the guidelines issued by the Tamil Nadu government for containment zones, the Department has said that containment operations would be considered to be over in 14 days, if there are no active cases in the zone during this period, starting from the date on which a positive case was last confirmed. A containment zone is formed around areas where a cluster of cases or clusters of cases emerge. A cluster is an area where more than five index cases have been reported or five or more families have been affected by COVID-19.

If more than five index cases or five households are affected, then, in the case of a village, the entire village is demarcated as a containment zone, while the affected street or part of the street is demarcated in a Corporation or a Municipality. In the case of a multi-storey building, either the entire building or a part of it will be demarcated. In case of slums, families of positive cases, and their neighbours, could be shifted to institutional quarantine, if necessary, due to the factors of crowding and difficulty in maintaining physical distancing.

All inter-state and international passengers arriving in Tamil Nadu, all symptomatic — Influenza-like illness (ILI) symptoms — individuals with a history of international travel in the last 14 days, all symptomatic contacts of laboratory-confirmed cases, all symptomatic healthcare workers/frontline workers involved in containment and mitigation of COVID-19, and all patients with severe acute respiratory infection (SARI) would be tested.

Asymptomatic direct and high-risk contacts of a confirmed case would be tested once, between day 5 and day 10 of coming into contact with the patient. All hospitalised patients who develop ILI symptoms and all symptomatic ILI cases among returnees and migrants would be tested within seven days of developing the illness.

An ILI case is defined as one with acute respiratory infection with fever of more than 38 degree Celsius and cough, while a SARI case is one with acute respiratory infection with fever of more than 38 degree Celsius and cough, and requiring hospitalisation.