COVID-19 isolation, discharge criteria discontinued

LAHORE: The Primary and Secondary Healthcare Department (P&SHD) has ordered to discontinue isolation and hospital discharge criteria for COVID-19 patients.

The P&SHD, on the recommendations of the Corona Expert Advisory Group (CEAG) and Technical Working Group (TWG) on COVID-19, issued “revised criteria for discontinuation of isolation and discharge from hospital for COVID-19 patients”, which was communicated through a notification on Tuesday to the director general Health Services, all chief executive officers of District Health Authorities and all medical superintendents of DHQ/THQ hospitals in Punjab.

As a basic principle, the P&SHD stated that COVID-19 is highly contagious droplet infection requiring careful management of suspected and confirmed patients in isolation at public hospitals, authorized private hospitals or approved home setting. The patient can be discharged or allowed to end isolation in conformance with approved criteria to prevent spread of COVID-19 infection in the community.

The viral RNA shedding in COVID-19 declines with resolution of symptoms and may continue for days to weeks. However, the detection of RNA during convalescence does not indicate the presence of viable infectious virus. Isolation precautions can therefore be discontinued without an RT PCR test to document cure.

As per isolation precautions for various patients, the asymptomatic confirmed COVID-19 patients will continue to adhere to isolation precautions for at least 10 days from the date of COVID-19 test result. The symptomatic patients must continue isolation for at least 10 days from the start of symptoms and 3 days after resolution of symptoms including fever without antipyretics, and no or improved respiratory symptom e.g. dry cough and shortness of breath.

However, there are some exceptions as certain categories of patients will require two consecutive negative PCR tests 24 hours apart in order to discontinue isolation. These categories of patients include healthcare workers involved in patient's management, immune-compromised patients, and people living in congregations (hostels, community livings, madrasas, prisons).

For explanatory discharge criteria, the P&SHD explains that for those patients with seven days of resolution of symptoms will be discharged on 10th day, those with resolution of symptoms on 8th day will be discharged on 11th day, those with resolution of symptoms on 9th day will be discharged on 12th day, and those with resolution of symptoms on 10th day will be discharged on 13th day.