Official Dispatch 548/SYT-NVY Khanh Hoa 2022 on the implementation of Decision 250/QD-BYT 2022

To:

- Hospitals in the Province;

- Health centers of districts, towns and city.

On January 28, 2022, the Ministry of Health issues the Decision No. 250/QD-BYT promulgating the Guidance on COVID-19 diagnosis and treatment that takes effect from its signing date and replaces the Minister of Health’s Decision No. 4689/QD-BYT dated October 06, 2021 and the Decision No. 5666/QD-BYT dated December 12, 2021 on amending and supplementing a number of contents of the Guidance on COVID-19 diagnosis and treatment issued together with the Decision No. 4689/QD-BYT dated October 06, 2021, the Department of Health requests units to implement the following tasks:

1. Organize dissemination, training and implementation of the Ministry of Health’s Decision No. 250/QD-BYT dated January 28, 2022 in conformity with functions, tasks and actual conditions at the units. In which, pay attention regulations on hospital discharge criteria and post-discharge monitoring:

a) Hospital discharge criteria:

• Criteria for termination of the quarantine applied to COVID-19 patients under home-based management and care

For an asymptomatic COVID-19 patient or a COVID-19 patient with mild symptoms eligible for at-home quarantine and treatment as prescribed, the at-home quarantine and treatment shall be terminated if:

+ The patient’s quarantine and treatment duration is full 7 days and the patient has a negative result of rapid antigen test for SARS-CoV-2. The test must be conducted by a health staff or by the patient under the supervision of a health staff directly or indirectly through remote devices.

+ In case the test result is still positive after 7 days, a quarantine of full 10 days is required for patients who have received the full doses of COVID-19 vaccines; 14 days for those who have not got the full doses of COVID-19 vaccines as specified.

+ The health station managing the patient shall be responsible for certify the patient’s recovery.

• Hospital discharge criteria for COVID-19 patients being treated at COVID-19 collection and treatment establishments

* For patients only infected with COVID-19

+ The patients’ quarantine and treatment duration at COVID-19 collection and treatment establishments is at least 5 days, clinical symptoms are greatly improved, fever is completely resolved (without using antipyretics) 3 days or more before the hospital discharge date; and:

• If the patients have a negative SARS-CoV-2 test result by Real-time RT-PCR method or have a low viral load (CT ≥ 30, for any specific genes) or have a negative SARS-CoV-2 rapid antigen test result, the patients shall be discharged from hospitals.

• If the patients have a positive SARS-CoV-2 test result by Real-time RT-PCR method or have a high viral load (CT < 30, for any specific genes) or have a positive SARS-CoV-2 rapid antigen test result, the patients shall continue to comply with the quarantine of full 10 days (without another SARS-CoV-2 test required).

+ After hospital discharge, the patients must self-monitor their health at home for the next 7 days and check their body temperature twice a day. If the body temperature is higher than 38°C at two consecutive checkings or there are any abnormal clinical signs, the patients must notify the grassroots health agency for timely medical examination and handling. The compliance with the 5K messages is required.

* For COVID-19 patients with underlying medical conditions or accompanying diseases

+ The patients’ quarantine and treatment duration at COVID-19 collection and treatment establishments is at least 5 days, after clinical symptoms are greatly improved, fever is completely resolved (without using antipyretics) 3 days or more; and:

• If the patients have a negative SARS-CoV-2 test result by Real-time RT-PCR method or have a low viral load (CT ≥ 30, for any specific genes) or have a negative SARS-CoV-2 rapid antigen test result, the patients shall be discharged from hospitals or be transferred to another establishment or other departments for treating accompanying diseases or underlying medical conditions (if necessary) for continuing treatment and scanning, monitoring in accordance with regulations, for in-patients; or be transferred to their home for home monitoring and care as specified.

• If the patients have a positive SARS-CoV-2 test result by Real-time RT-PCR method or have a high viral load (CT < 30, for any specific genes) or have a positive SARS-CoV-2 rapid antigen test result, the patients shall continue to comply with the quarantine of full 10 days (without another SARS-CoV-2 test required).

* For patients treated at intensive care units who have recovered from COVID-19 and being in a serious or critical condition due to other medical conditions

+ If the patients’ quarantine and COVID-19 treatment duration is at least 14 days and they have a negative SARS-CoV-2 test result by Real-time RT-PCR method or have a low viral load (CT ≥ 30, for any specific genes), the patients shall be determined to recover from COVID-19.

+ They shall be transferred to another intensive care unit or a suitable treatment department for continuing treatment and care.

b) Post-discharge monitoring

- Notify the grassroots health agencies and local Centers for Disease Control for information and coordination: COVID-19 collection and treatment establishments shall notify in writing the list of people who are eligible for hospital discharge (with at least the information of their phone number and/or email, address of accommodations and copies of relevant papers) to the Departments of Health of the provinces or cities where the patients comes to stay after recovering from COVID-19.

- After hospital discharge, the patients must self-monitor their health at home for the next 7 days and check their body temperature twice a day. If the body temperature is higher than 38°C at two consecutive checkings or there are any abnormal clinical signs, the patients must notify the grassroots health agency for timely medical examination and handling. The compliance with the 5K messages is required.

2. The Department of Health assigns the Hospital for Tropical Diseases to act as the focal point, train, guide and support relevant health units in the implementation process.
3. Any difficulty and problem arising in the course of implementation should be promptly reported to the Department of Health for coordination in handling./.

(The Ministry of Health’s Decision No. 250/QD-BYT dated January 28, 2022 is enclosed and also posted on the website of the Department of Health syt.khanhhoa.gov.vn/ at the section of Documents of the Department of Health).