The Nigeria Centre for Disease Control (NCDC) says that a negative laboratory test is no longer required to discharge a COVID-19 patient.
The centre stated that symptomatic patients would be discharged earlier than usual after they have stopped showing symptoms of the disease and asymptomatic patients would be discharged 14 days after their first positive test to the virus.
This is based on new data from Singapore that shows that RNA detected beyond 10 days is no longer infectious as no viable virus is grown by viral culture. Therefore, such patients will be discharged but advised to continue self-isolating at home one week after discharge.
The Director-General of the NCDC, Dr. Chikwe Ihekweazu, announced this at the daily briefing of the Presidential Task Force on COVID-19, in Abuja on Thursday.
Ihekweazu said, “There have been new science emerging about the duration of infectivity of individual patients. It led to the WHO issuing new clinical guidelines.
“We then convened colleagues across our organisation, the department of hospital services of the Federal Ministry of Health, as well as other colleagues with whom we work, to review our guidelines and issue new guidelines for the country and of course adapting it to local circumstances.
“The key thing is that the management of COVID-19 will be made primarily supportive; we don’t have any treatment so far that has any proven impact on morbidity.
“One of the major changes that have happened is the discharge criteria. While these guidelines are obviously and primarily targeted at physicians managing patients, it is important that patients and people know. There are two groups of patients – symptomatic and asymptomatic patients.
“For symptomatic patients, they may now be discharged at least 10 days after symptoms onset and at least 3 days without symptoms. If your symptoms last for longer, we will wait for longer managing you supportively.
“If you are asymptomatic, you can be discharged 14 days after your first positive test. So, we no longer have to wait for a negative test to discharge. This way you can go home with confidence that you are no longer infective and you’re not putting your family and friends or anyone else at risk.
“We are not encouraging that people be discharged while they are still symptomatic. We are talking about discharging people that are asymptomatic and have recovered. That is, you are symptomatic and have recovered or you are completely asymptomatic throughout your clinical episodes.
“At that point you really don’t need more clinical interventions, even at home; you just need time to recover. It is just like you recover from any other illness. You don’t need any special intervention once you have been discharged.
“Change is difficult because we have been saying you have to have the negative test. Even though we have published these results, many physicians are still not using them. We can assure them and everyone managing cases that 14 days after, in fact, 10 days is what the evidence says.
“But we have added 14 days to make it two weeks for people to then implement discharge for patients that are asymptomatic.”
He further added: “In addition, we have also removed the use of antivirals from our treatment guidelines. The trial for Chloroquine and Hydroxychloroquine will go on.
“We are asking that we limit the use of these medicines to those trial settings and not use them casually around the country. Let us reduce the use of Chloroquine and Hydroxychloroquine and all the other antiviral previously on our guidelines to contexts where clinical trials are going on.
“So, we have withdrawn them from the guideline from management. However, we have kept them within the clinical trial so that we can study and see whether they work or not. That is really the rational approach to this.”