The Ministry of Health has applied a new regimen in the treatment of Covid-19, which corrects the classification of patients, reduces the duration of treatment, and changes the conditions for discharge.
Guidelines for the diagnosis and treatment of Covid-19 was issued by the Ministry of Health on July 14, replacing the treatment regimen applied in April until now. This is the 6th time to correct the Covid-19 treatment regimen in Vietnam, since the outbreak appeared.
According to the assessment of the Ministry of Health, in this epidemic, more than 80% of patients only had mild fever, cough, fatigue, no pneumonia and recovered after about a week. Some cases have no clinical symptoms.
Nearly 20% of patients develop severe disease, the average time from initial symptoms to severe development is about 5-8 days. The previous treatment regimen, this time is 7-8 days.
Severe manifestations include pneumonia, severe pneumonia requiring hospitalization… Of which about 5% need treatment in the intensive care unit with acute respiratory manifestations (rapid breathing, shortness of breath, cyanosis). …), acute respiratory distress syndrome (ARDS), coagulopathy, microvascular injury causing thrombosis and embolism, myocarditis, septic shock, organ failure including damage kidney damage and myocardial damage, leading to death.
After the full-blown period 7-10 days, if there is no respiratory failure, the patient will have no fever, clinical signs will gradually return to normal and recover from the disease.
Based on the pathological developments, this time, the Ministry of Health still classify Covid-19 patients into 5 levels: Asymptomatic, mild with acute upper respiratory tract inflammation; moderate severity with pneumonia; severity when pneumonia is severe and critical.
In the general treatment principle, the Ministry of Health agreed that all F0 with positive results or without symptoms should be treated in common wards. Severe and critical cases require treatment in the intensive care unit. Because Covid-19 disease currently has no specific drug, support and symptomatic treatment are mainly on an individualized basis for each case, especially severe cases.
Points worth noting in the new regimen, The Ministry of Health divides hospital discharge standards into 3 levels, the shortest duration of treatment is 10 days. Specifically, the patient is discharged on the 10th day from the time of having a positive test if 2 conditions are satisfied. First, no clinical symptoms within 10 days of testing. Second, 2 consecutive negative tests (minimum 24 hours apart) by RT-PCR or low viral load (Ct ≥ 30). The time from taking the last specimen to hospital discharge was no more than 24 hours.
In case the patient has clinical symptoms, they will be discharged from the hospital on the 14th day or longer depending on the condition until they meet 2 conditions such as the 10-day group.
The Ministry of Health also changed the way of monitoring after discharge from the hospital. According to the new regimen, after returning home, patients self-monitor their temperature at home twice a day. If it is higher than 38 degrees in 2 consecutive measurements or there are any abnormal clinical signs, it is necessary to immediately notify the medical facility for timely examination and treatment.
In the previous 5th protocol, the Ministry of Health qualified patients to be discharged from the hospital when they had been treated for at least 14 days, had 2 negative tests, 48-72 hours apart each time. The time of the last sampling was not more than 24 hours before the time of discharge from the hospital.
When returning home, the patient will continue to take samples for RT-PCR testing on the 7th and 14th day. Particularly, the re-positive patient will continue to isolate at home for an additional 1 week (total of 21 days) and take samples for testing. 3rd trial on day 21.
Following 400 cases of re-positive, the Ministry of Health has not recorded any cases of community transmission. Therefore, the Ministry of Health believes that there is no need to isolate people who re-test positive and handle the outbreak as before.
The Ministry of Health also decided to reduce isolation time, pilot F1 medical isolation at home, shorten treatment time for asymptomatic F0 patients. These changes were made in the context of the rapid increase in the number of infections in many localities, creating great pressure on the collection and treatment.
Hospitals are facing a shortage of medical and protective equipment when recording thousands of new infections every day. To support the frontline, individuals and businesses can accompany the program “Powering the epidemic center”. See details here.