As Trinidad COVID cases surge, new discharge policy announced

Roshan Parasram
Roshan Parasram

 (Trinidad Express) With more Covid-19 cases and fewer available hospital beds, the Ministry of Health’s admissions and discharge policy for COVID-19 patients has changed.

At-home quarantine will now be used in treating new cases and discharging patients. Additionally, patients will no longer be asked to produce two negative tests before discharge. This according to Chief Medical Officer Roshan Parasram who spoke at a virtual media conference on Wednesday.

Parasram indicated that last week, the decision to discharge on producing one negative test was taken by the Ministry. This has since been altered, completely eliminating the need for a diagnostic criterion before discharge.

“The discharge from our step-down facilities as you would have noted about a week ago, we took a decision to go down to one negative swab upon discharge. That has been further updated. We are going to do a clinical criteria for discharge which is recommended by WHO. So there is no diagnostic criteria so you won’t be getting a negative swab upon discharge,” he said.

As a result, asymptomatic and symptomatic patients will now be asked to quarantine at home for seven days.

Symptomatic patients, he said, would be asked to spend ten days from the onset of displaying symptoms in a state facility, three days without symptoms in the facility and a further seven days at home. Asymptomatic patients will now spend 10 days in a facility from the onset of a positive result, and seven days at home. The seven day at home quarantine will be mandated by a quarantine order.

“So the first category for symptomatic persons, if you spend 10 days from the date of onset of your symptoms, plus three days with no symptoms at all, we will discharge you to your home, giving you a quarantine order that you stay for a further seven days at your home without a diagnostic test being done. You can be assured after that period that you won’t be able to transmit the virus to anyone else.”

“So, persons who are in step down facilities we will be able to discharge you quicker that should happen between today and tomorrow. You’ll be asked to quarantine for a further seven days at home and after your seven days quarantine is finished you can continue to go about your daily activities after that seven-day period. In terms of asymptomatic persons, persons with no symptoms at all those persons will now be asked, the criteria is very similar but your ten day period will start at the point that you had a positive test, rather than at the point you began to have symptoms. Ten days plus the seven days at home for those individuals that had no symptoms throughout the process,” he said.

The admission of new cases into the hospital setting, he said, will be reduced to reserve bed space for the moderate to severely ill patients. County Medical Officers of Health, he said, would now oversee the monitoring positive cases who are quarantining at home. This will be done in conjunction with the TTPS.

Positive cases will be contacted twice daily by the CMOH. During this period, should severe symptoms be developed, these patients will be transferred to the Caura or Couva Hospitals.

“What is going to happen is the CMOH offices will have a list of all the positive persons in the country and they will call those individuals twice a day and do interviews to determine signs and symptoms like if it has worsened, if it is better, if it has stayed the same. They will also ask you about your household, if the persons in your household have any signs and symptoms of disease. If they do, we can send someone out and have those persons swabbed to see if they are positive or negative as well.”

“In terms of the persons from high risk groups, persons who are moderately or severely ill and experiencing difficulty in breathing, vomiting, lethargy, very tired, those persons will be picked up by the CMOH. We will call the ambulance and get you either to Caura or Couva in the first instance. If of course in between those calls persons have worsening symptoms you can take yourselves to any of the emergency departments or call the service on your own. The hotlines are also available to call at any point in time.” he said.

All patients will be required to fill a 20-day period of isolation from the public to avoid any potential spread. He also outlined the conditions of at home quarantine. These include staying at home while isolating oneself from the rest of the household.

“Stay in your home or accommodation. Do not go to work, school or any public areas. Do not have visitors in your home or accommodation. Wash your hands before and after contact with your pets. Use separate facilities if sharing, these should be cleaned before and after use by others. Separate yourself from others in your home or accommodation, wear a mask when you are around others even in your home. This pertains to people that have flu like symptoms or are diagnosed as COVID positive. Have food, medication and other supplies delivered to you if appropriate. These two documents that we have available on our website,” said Parasram.