From his hospital bed, doctor pens reality check on discharge policy, treatment of coronavirus patients
From his hospital bed, a member of Maharashtra’s Covid-19 task force has penned down his own experience of treatment protocols. The member, a doctor, is being treated for the novel coronavirus himself.
In his proposal titled, ‘This is Future: Friends and Colleagues from Healthcare’, the doctor has suggested longer hospitalisation and administration of life-saving medicines to patients at an early stage.
According to his note, Covid-19 is a disease for 28 days and not 14 days as is being perceived until now.
Discharge of patients from the hospital on Day-10, if they are showing symptoms as per the ICMR guidelines, should be discouraged, the doctor asserts. I had a relapse on Day-14 in spite of taking Remdesivir, he added.
The doctor has further advised the medical community that Remdesivir must be administered immediately after a patient tests positive for Covid-19. It should be prescribed for ten days and not five as is being done currently.
While suggesting a change in the discharge procedure, the doctor recommended a six-minute walk test. “If there is a discernible change in voice, muffled voice, cough, or any shortness of breath, the patient must not be discharged,” he said.
Prior to discharge, patients must undergo cardiac enzymes test, ECG, and 2D-Echo, the doctor suggests while adding that these results should be documented.
“2 per cent of the patients who have died were discharged from the hospital. Hence, hospitals need to do rigorous follow-ups for weeks after a patient is discharged,” said the member of Maharashtra’s Covid-19 task force in his note.
In addition, the doctor has also recommended the use of steroids in a full dose of 40 mg total dissolved solids (TDS) with proper antibiotic cover.
He also wrote about plasma therapy and said that it works in the early stages of infection when combined with Remdesivir. “So, it is a combo of active antiviral drug and passive neutralising antibody,” the doctor added while stating that steroids can be deferred if plasma is being considered.
