City’s recovery rate touches 63%
FROM 55% LAST WEEK Experts ask if patients are being discharged early; BMC chief says following ICMR guidelines
MUMBAI: The recovery rate of Covid-19 in Mumbai has jumped to 63% from 55% within a week. As of Friday, of the 82,074 total Covid-19 cases, 52,392 patients have recovered and have been discharged. On Thursday, over 5000 patients were discharged in Mumbai, the highest in a single day.
Brihanmumbai Municipal Corporation (BMC) commissioner IS Chahal said on Friday morning, “Despite a cumulative figure of 80,600 positives in Mumbai today, our discharged patients are now 50,600 – a staggering 63%. We have only 9,500 patients on hospital beds, including 874 suspected walk-in patients.”
Experts and doctors have posed questions about whether patients are being discharged early and need to continue with institutional quarantine or hospitalisation longer. On the other hand, they have stressed the need to keep hospital beds available at all times. Keeping mild or moderately symptomatic patients on beds in hospitals or Covid health centres longer than the present time prescribed by Indian Council of Medical Research (ICMR) may lead to Mumbai facing a shortage of beds, according to public health experts.
Chahal said, “Mumbai’s discharge policy for Covid-19 patients is strictly as per ICMR guidelines, with zero exceptions.”
According to the current discharge policy of the state government, mild and very mild Covid-19 patients can be discharged on the 10th day, if they have not shown any fever for three days in a row. Moderate symptomatic patients can be discharged after 10 days provided they have oxygen saturation above 95% for four days; if not, such patients can be discharged after their symptoms have resolved and oxygen saturation is maintained for three days in a row. For severely ill patients, discharge is allowed after complete recovery and a negative result on a Covid-19 test. Asymptomatic patients can opt for home quarantine, or are discharged from institutional quarantine facilities on the 7th or 8th day.
According to a member of the task force of doctors appointed by the state government in April to curb rising fatality, Covid-19 patients have died after being discharged too and health workers must follow up with patients for 14 days after discharge.
However, IS Chahal denied that this holds true for Mumbai.
Madhav Sathe, retired professor of microbiology at Nair Hospital,, said, “It is better if a patient stays in a hospital for 14 days. After recovery, even though Covid-19 is cured, whatever immune modulation has taken place remains. Patients are hence afflicted by a phenomenon called cytokine storm that leads to formation of clots in blood vessels. This is called intra-vascular coagulation and can be fatal. In such cases, it is better to keep the patient in the hospital.” Sathe said, “When a patient is being discharged, it should be done after giving him medicines for 10 to 12 days, and follow up is needed for all patients because medicines have to be chosen with a lot of precision.” Sanjay Pattiwar, a citybased public health consultant, said, “Considering the work load and patient load, it is necessary to follow the guidelines for discharge. The criterion is whoever can manage at home with counselling for seven days can follow home quarantine. Those who do not show symptoms can be discharged, so that beds are made available for new patients.”
Mumbai on Friday registered 1,338 new Covid-19 cases and 73 deaths. The total number of cases in Mumbai is now 82,074 after adding 37 cases recorded earlier; and total deaths are 4,762. The growth rate of cases in Mumbai is 1.72%, and the doubling rate is 41 days.
The city has 13,422 Covid-19 beds in hospitals for serious and critical patients with other health complications, of which 3,871 were vacant as of Friday morning. Civic officials said 127 ICU beds and 67 ventilator ICU beds are vacant.