Ini merupakan salah satu pertanyaan yang banyak ditanyakan di tengah masa pandemi ini.ย Hal ini seiring dengan jumlah kasus COVID-19 yang masih terus meningkat. Sehingga tidak perlu heran bila ada yang menanyakan “kapan keluarga boleh keluar dari ruang isolasi?”
Dulu, ketika masa pandemi baru dimulai, pemulangan pasien harus berdasarkan hasil tes Swab Tenggorok. Hasil menunjukkan dua kali negatif barulah pasien boleh dipulangkan. (Dua kali pemeriksaan, minimal dengan jarak waktu 24 jam).
Sekarang? Mengapa ada pasien COVID-19 yang sudah dipulangkan meskipun hasilnya masih positif?
Pasien COVID-19 positif tanpa gejala boleh isolasi mandiri di rumah saja. Dengan catatan, yang bersangkutan harus melakukan protokol isolasi yang benar serta memonitoring gejala secara berkala. Sementara, perawatan di ruang rawat isolasi ditujukan pada mereka yang bergejala, berfaktor komorbid dan berusia lanjut usia.
Kebijakan atau pedoman “memulangkan pasien COVID-19” terus berkembang
Dan perlu diketahui bahwa tidak ada kebijakan yang benar-bebas risiko. Artinya, kebijakan apapun yang dipilih pasti selalu akan ada risiko atau konsekuensinya.
Kriteria pemulangan pasien COVID-19 tidak lagi mempertimbangkan hasil tes Swab Tenggorok PCR. Sebab hasil tes swab PCR dapat memberikan hasil positif palsu. Bukan berarti tidak akurat. Tes swab PCR berguna untuk mendeteksi RNA Virus Corona. Namun tidak dapat membedakan RNA virus yang masih aktif dan yang sudah inaktif.
Sehingga sebenarnya hasil tes Swab PCR tidak dapat dijadikan acuan untuk memulangkan pasien, meskipun beberapa negara ataupun instansi kesehatan tertentu masih menggunakan hasil tes swab PCR sebagai kriteria pemulangan pasien.
Lalu kapan pasien COVID-19 boleh keluar dari ruang isolasi?
Saya mengutip pedoman “Criteria for releasing COVID-19 from isolation” yang telah dirilis oleh WHO. Kriteria pemulangan ini tergantung pada kondisi pasiennya apakah bergejala atau tidak. Pasien yang bergejala, boleh dipulangkan setelah 10 hari pasca muncul gejala ditambah 3 hari bebas gejala. Sementara pasien tanpa gejala dipulangkan setelah 10 hari pasca hasil positif tes swab PCR.
Contoh:
Misalkan seorang pasien memiliki gejala batuk dua hari, maka si pasien boleh dipulangkan setelah 13 hari (10 + 3 hari) dari hari pertama gejala muncul.
Contoh lain: pasien yang telah bergejala batuk dan sesak napas selama 20 hari maka pasien boleh dipulangkan setelah 23 hari. Dengan syarat 3 hari terakhir si pasien telah bebas dari gejala.
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