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To free up beds for critical care, Kerala to discharge moderate patients without rapid test

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With Covid-19 cases surging in Kerala putting stress on the health infrastructure, the state has decided to allow discharge of mild and moderate category patients without rapid antigen test (RAT).

As per the new discharge norms, which comes into effect from Monday, a patient in the mild category can be discharged without RAT if the patient has been asymptomatic for 72 hours. However, they have to remain in home isolation for 17 days from the day of onset of symptoms. Patients in the moderate category can be discharged without RAT if they don’t have any symptoms for three days. The guidelines say they should go into home isolation.

Regarding patients in critical condition, the new guidelines said the RAT should be done on 14 day from the onset of symptoms. If negative, such patients can be discharged if no symptoms for three days. Besides, if the patients are clinically stable before 14 days from the onset of symptoms, they can be shifted from hospitals to first line treatment centres. The RAT of such clinically stable patients can be done in such first line treatment centres. RAT needs to be repeated until the patients turn negative.

So far, the discharge guidelines had demanded RAT on the tenth day after a patient tested positive. Patients could be discharged only if they turned negative.

What prompted the government to water down its strict discharge norm is the increasing number of active cases in hospital care. As per the new discharge policy, patients in the mild and moderate categories can be discharged soon, making the hospital facility available for an increasing number of patients in the critical category.

As on April 26, the state has 2.18 lakh active cases, of which 19,565 patients are in hospitals. Of them, 1312 are in ICU and 419 are on ventilator support. On April 7, the state had only 4,725 in hospitals or Covid-19 treatment centers. Then, only 533 patients were in ICU with 137 on ventilators.

Among the 14 districts, the worst affected are Ernakulam and Kozhikode, which together have 65,000-odd active cases.

Health department sources said only 1,095 beds are available in Ernakulam district for Covid-19 treatment. Of the 2181 beds set aside for Covid-19 treatment, 1,086 occupied by the patients. To take care of patients in the serious category, the district has only 149 beds remaining.

In Kozhikode district, out of 858 government hospital beds for Covid-19 treatment, 544 beds are already occupied. In private sector, out of the 1446 beds for covid, 1014 have patients.

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