COVID-19: Doctors' body urges Centre to reconsider revised discharge policy

Kolkata: An association of doctors in West Bengal has shot off letters to the Union health ministry and Chief Minister Mamata Banerjee, making a case for a relook at the revised policy for discharge of coronavirus patients and setting up dedicated critical care units in COVID-19 hospitals of the state.

Noting that different strains of the coronavirus are prevailing across the country with non-identical morbidity and mortality profile, the Left-backed Association of Health Service Doctors (AHSD) said in its missive to Union health minister Harsh Vardhan that the Centre’s discharge guidelines cannot be uniformly exercised everywhere.

The revised discharge policy for COVID-19 cases announced by the ministry in consultation with the Indian Council of Medical Research (ICMR) had said coronavirus- infected patients developing severe illness or having compromised immunity will have to test negative through the reverse transcription-polymerase chain reaction (RT-PCR) before being discharged by a hospital.

However, moderate cases of COVID-19 and pre- symptomatic, mild and very mild cases need not undergo tests before being discharged after resolution of symptoms.

“As Gujarat, Maharashtra, Delhi are flooded with cases with a perceived scarcity of beds and apparatus, and too high bed occupancy rate, the ICMR’s recent most discharge protocol and advisory on quarantine stay may be applicable there having no other alternative. But in West Bengal and many other states where the geographical spread is not yet established, discharging confirmed cases without…. sampling can’t be the choice. Asymptomatics may potentially transmit the virus,” the letter, dated May 10, said.

According to the previous set of rules, a COVID-19 patient was considered fit to be discharged upon testing negative on day 14 and then again in a span of 24 hours.

The AHSD urged the central government to take up a state-specific focused intervention with the ICMR.

In its communication to Banerjee, the association voiced concern that the coronavirus situation may spin out of control in the state if appropriate steps such as dedicated critical care units (CCUs) for serious coronavirus patients are not developed in all COVID-19 hospitals.

“COVID hospitals in Kolkata and Howrah are already overflowing with patients. Reports are coming that not enough space is available for even properly keeping the corpses,” the letter said.

While “lack of infrastructure and human resources” in the district-level COVID-19 hospitals is worrying, “The CCU for serious patients has not been developed in most of the hospitals except Beleghata ID and MR Bangur Hospital. The number of beds in these two hospitals is limited, too,” the government service doctors’ body said.

The association said that non-COVID services in hospitals have almost collapsed with OPDs, cancer and dialysis treatment having “practically stopped” or continuing “on a meagre scale.”

The AHSD, in its letter to the Union health ministry, added that “it has been experienced that coronavirus patients with mild symptoms or no symptoms are not encouraged for home isolation by their family and close relatives”.