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BMC issues new guidelines, no Covid test during discharge for those with mild symptoms

In case of asymptomatic patients, the laboratories have been directed to test only those identified by fever clinics or outpatient sections of private and government hospitals.

Updated: May 14, 2020 10:45 IST

By Mehul R Thakkar, Hindustan Times Mumbai

BMC has also asked laboratories to not inform the patients about test results without informing the civic body. (Satish Bate/HT file photo )

The newly appointed municipal commissioner Iqbal Singh Chahal issued new testing protocol on Wednesday wherein patients who have mild symptoms of Covid-19 do not require testing at the time of discharge, further adding that testing is mandatory only for discharging the patients who were critical.

In case of asymptomatic patients, the laboratories have been directed to test only those identified by fever clinics or outpatient sections of private and government hospitals.

Further, the Brihanmumbai Municipal Corporation (BMC) has said that no emergency surgery can be denied to patients by the doctors for want of Covid-19 testing. The BMC chief has also allowed home testing only in emergency cases. BMC, in a circular, said that it is issuing revised guidelines of testing by superseding all earlier circulars in light of the government of India and the state government issuing their revised discharge policy as per the categorisation of patients.

In a circular issued on Wednesday, BMC stated, “Testing of mild/very mild /pre-symptomatic cases shall not be required before the discharge if there are no symptoms seen on seventh, eighth and ninth days consecutively. In case of moderate symptomatic patients, testing shall not be required if the patient recovered clinically. Testing is required once before discharge in cases of critical patients and immune-compromised patients when they have no symptoms for three days.”



In the context of not denying urgent surgeries, the BMC circular has stated, “Only if there is a strong suspicion of Covid-19 in persons requiring elective surgery or surgery which can wait for 48 hours, a doctor can ask for Covid-19 test. No emergency surgeries should be denied to the patient for want of Covid-19 test.”

BMC has also asked laboratories to not inform the patients about test results without informing the civic body. The laboratories have been asked to report all positive cases immediately, within one hour of results so that contact-tracing may be initiated at the earliest.

For patients on regular haemodialysis, BMC has said that the test should not be asked as a routine before every procedure (dialysis). Contrary to the earlier directions by BMC last week, standard operating procedure issued by Chahal stated that only symptomatic patients who are tested have to be institutionally quarantined. Further, tests for all symptomatic patients can be done only if they have been referred by a registered medical practitioner. The circular mentions that pregnant women, even if asymptomatic, should be tested. The circular read, “Asymptomatic pregnant women should be tested in the facilities where they are expected to deliver .” Dr Sanjay Pattiwar, a public health consultant, said, “The revised guidelines will be helpful as the resources for testing and the infrastructure required are limited. However, considering the density and the parameters of Mumbai, I feel the Central government can also think of having specially dedicated testing for Mumbai in order to flatten the curve.”

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