As the number of Covid-19 patients in the city continues to rise, health professionals have adopted the new guidelines for recovery issued by the ICMR and Ministry of Health and Wellness (MOHW).
Dr Amit Kumar Mandal, Director, Pulmonology, Sleep & Critical Care, Fortis Hospital Mohali, says a patient, who has been symptom-free for three days is considered recovered.
As for the confusion around testing, patients are no longer being tested before they are discharged or deemed recovered. Dr Mandal says, “We go as per the ICMR guideline of 17 days after onset of symptoms and minimum of 10 days being symptom-free. So there is no testing at the time of discharge.” While in home isolation a patient is ought to be monitored for 17 days, in a hospital, three days of stability is the protocol.
“Earlier the protocol of recovery was based on retesting and now it is based on the MOHFW guideline of 10 days of asymptomatic period. While those who tested positive must indicate 10 days of being asymptomatic, for the asymptomatic cases, it is 17 days from being detected positive, with a mandatory quarantine period of 17 days,” the doctor adds.
Dr Pankaj Malhotra from the Department of Internal Medicine, PGIMER, who had also set up the COVID Hospital here, has an interesting point to make regarding the issue, when he says that after 10 days, when a patient has no symptoms, he is considered recovered and discharged. So that means the patient is not infective, but in biological terms, nothing is absolute, he says. And that’s why a mandatory minimum period of 14 days of quarantine is important.
According to the ICMR guidelines, when admitted to a hospital, a patient with symptoms and in need of oxygen is considered recovered when he\she is symptom-free for three days. As for the confusion regarding symptomatic and asymptomatic cases, data, adds the doctor, reveals that in symptomatic patients, the viral load is more, as compared to those who are asymptomatic, and then comes the issue of how much contact we have had with a symptomatic patient. Chandigarh is now seeing a steady and sharp rise in COVID-19 cases, and according to Dr Malhotra, every part of the country will face a peak, though here we have not yet reached a peak and are heading towards it.
Social conditions, adds a senior doctor at a government hospital, are also responsible for the steady rise in cases, with many who may be carrying the infection, forced to work to earn their daily bread, and many even if tested positive not revealing to others, for the fear of loss of business and money. Both awareness and social responsibility go hand in hand, adds the doctor, if we have to stop the spread of the infection.
“More testing is definitely better, provided the patient follows the guidelines, or else it is a lost cause. Also, when we talk of patients who are home isolated, yes, I totally agree there are practical issues of monitoring, regular checks and making sure that they are being given proper advice and care, and for that, it has to be a collective effort of the Administration and healthcare workers,” she adds.
Another senior doctor, a private practitioner, agrees there is confusion and chaos regarding guidelines on testing and recovery, as earlier the patients who were admitted were tested twice before being deemed recovered.
“The quarantine period was reduced from 14 to 10 and now at some places it is seven days. People in home isolation must be advised and guided properly regarding testing and the quarantine period and those who have someone in the family tested positive for COVID-19 must be tested, even if the patient is recovered. There are so many patients who have symptoms, but are not getting tested, because of fear and social isolation, and this will lead to a spread of disease. I had two patients walk in today, one with fever and cough, who got angry with me when I suggested a COVID test, for he said, I know it is a viral infection, for I was caught in the rain. The other one had tested negative once after her husband was tested positive and now has headache, pain in shoulder and fatigue, but doesn’t want to be tested again. So apart from confusion, there is a lack of responsibility. Our desire to eat out, socialize, not follow guidelines of wearing masks, avoid crowds and public places, is costing us, as we see a rise in cases daily.”
Demands of PGIMER’s nurses body under consideration, says administration
Chandigarh: PGI Administration, in an official release, announced that it has given due attention to the safety, security and comfort of the healthcare workers during the war against the pandemic of Covid-19. Professor Ashok Kumar, spokesperson of PGI said the administration understands the fact that nurses make the heart of any healthcare system and are the most essential in these challenging times. In this light and after detailed discussions, the genuine demands of the Nurses Association have already been given due consideration, which include six hours duty for seven days, followed by an off of five days and provision of transport during duty period. Director PGI has confirmed that orders regarding duty at NHE and off days would be reviewed and that cooperation from all quarters is needed during these tough times. ENS