10-Day Quarantine Enough Instead Of 14 Or 28 Days?

THIRUVANANTHAPURAM, 5 MAY 2020:

 

Revised and less rigorous guidelines for monitoring and isolation of Covid-19 patients published on Sunday by the US's Centers for Disease Control and Prevention (CDC) has caught the attention of Indian Council of Medical Research. It is reliably learnt that ICMR, which issues Covid-19 guidelines in India, has sought permission from the Union government to amend the Indian guidelines in tune with the new CDC guidelines.

 

The CDC formulated the new guidelines after studying the pattern of disease progression and recommends only three days of isolation for patients after the symptoms are no longer there. Asymptomatic patients can end their isolation in 10 days and that too without a further RT-PCR test, suggests CDC. For Covid suspects, like travellers from infected regions, the observation period needs to be 14 days. In Kerala, the health department suggests a 28-day home isolation for suspects even if there are no symptoms.

 

If the CDC guidelines are implemented, the huge demand for testing kits, PPEs and other manpower can be reduced. The financial benefits, not to mention less stress and suffering for patients, are obvious. A shorter quarantine period and one negative test also becomes more practical considering the imminent NRK influx into the state and Kerala's current shortage of testing kits.

 

Experts point out that these CDC guidelines should be adopted in the country post lockdown.

 

"In a video conference that state officials had with Union health ministry officials on Sunday, it came up for discussion. The ICMR officials said they are awaiting the Centre's nod for it. If it is approved, the time for hospitalisation could be considerably reduced and unnecessary repetition of tests can be avoided," said a senior health department official who preferred anonymity.

 

"Studies have pointed out that the viral burden on a patient declines after the onset of illness. It shows that if the patient has no symptoms then there is lesser chance of infecting others. After the recovery from clinical illness many patients will no longer have detectable viral RNA," said Dr Arun N M, an internal medicine expert.

 

Repeated attempts to contact ICMR deputy director Dr Raman Gangakhedkar and senior Kerala health authorities on the matter drew a blank.

 

The CDC found that in some patients, PCR will test positive up to six weeks after turning positive first. Recently, a 62-year-old woman patient at Pathanamthitta had to stay in hospital for 48 days as the test repeatedly showed positive though she had no symptoms after the initial days.

 

‘Infectivity period is between third day and 13th day’

 

There is no need for conducting repeated tests when a person is tested positive. Without symptoms, the latest finding is that a maximum of ten days of isolation or quarantine is only needed. The infectivity period is between the third day and the 13th day is what the latest study says. World over now the patients are discharged on the 14th day. There is no need for continuing with the tests for the 30th and 40th day,” says Dr A Althaf, associate professor of community medicine, Govt medical college, Manjeri.

 

At present Kerala is discharging patients only after testing negative in two successive tests. “This has been totally withdrawn by many countries. Only in the ICMR guideline that it mandates two successive negative results for discharge,” said Dr Althaf.

 

The CDC has pointed out that in the context of community transmission where continued testing is impractical, available evidence at this time indicates that an interim strategy based on time-since-illness-onset and timesince-recovery can be implemented to establish the end of isolation. Practical application of a symptom-based strategy cannot prevent all infections. ET Healthword