MOH Updates Covid-19 Patient Discharge Protocol

By CodeBlue | 12 June 2020

Non-symptomatic Covid-19 patients do not need to be retested prior to discharge from hospital, says the Health DG.

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KUALA LUMPUR, June 12 — The Ministry of Health (MOH) has changed its hospital discharge protocol for Covid-19 patients, comprising two categories: patients who display symptoms and those who don’t.

Symptomatic patients can be discharged if they have been fever-free for at least three days or 72 hours without the aid of fever medications and have recorded improvements on respiratory symptoms such as cough and shortness of breath, and only after at least 14 days since the onset of symptoms.

Non-symptomatic patients will be discharged 14 days from the date of a positive Covid-19 diagnostic test, assuming they had no symptoms after their positive test. Covid-19 screening will not be required before the patient’s discharge from the infectious disease ward.

Health director-general Dr Noor Hisham Abdullah said the change in Covid-19 patient discharge protocol came after monitoring by MOH and evidence from international studies, emphasising that MOH’s decision is in line with the World Health Organization’s (WHO) guidelines “Clinical Management of Covid-19 Interim Guidance, May 2020”.

“Based on the monitoring of MOH in the management of Covid-19 patients, the Covid-19 rt-PCR test for most cured patients still shows positive results over the long term even when they are cured.

“The rt-PCR test is indeed very sensitive in detecting the presence of virus proteins. Although they are still positive, they do not have symptoms, do not get sick or spread the disease to the immediate family.

“Repeated culture studies showed that Covid-19 virus failed to propagate. Thus, the MOH concluded that the positive results of Covid-19 in patients recovering were due to dead viruses or fragments of the virus (deoxyribonucleic acid or DNA),” Dr Noor Hisham told a press conference today.

He further added that similar findings were found in several countries, including South Korea, China, Singapore, and Germany.

“Studies in China show that the infection occurred 2.3 days before the onset of symptoms and was at the highest level of 0.7 days before the patient is symptomatic. The infection decreases to a very low level after seven days.” Dr Noor Hisham reported.

“While another study in Taiwan found that after five days of patients being infected with Covid-19, they did not spread the infection to close contacts exposed to this patient,” he added.

MOH also reported findings in South Korea revealed that although 25.9 to 48.9 per cent of former Covid-19 patients were suspected to be positive again after discharge, tests conducted on 790 close contacts of 285 former Covid-19 patients revealed that they were not infected with the coronavirus, which means that there was already no coronavirus infection among the former Covid-19 patients.

“This monitoring is consistent with the results of the investigation that found that the infectious period begins two to three days before the symptoms begin and is at the peak one day before the symptoms. The period of infectivity is also found to decline to a very low level seven days thereafter,” said Dr Noor Hisham.

MOH today recorded 33 new Covid-19 cases. Of the number of new cases, 17 were local transmissions including 14 foreigners, and 16 imported cases. This brings the total number of Covid-19 cases in the country to 8,402.

A total of 103 Covid-19 patients were discharged today, bringing the total number of recovered cases to 7,168. The number of active cases was reported at 1,115. One death from Covid-19 was reported today, which brings the Covid-19 death toll in the country to 119.

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