It has been the policy of the Malaysian Medical Association (MMA) since its formation 60 years ago to be supportive of the government in efforts towards the improvement of healthcare in the country. We acknowledge and are pleased with the government’s efforts so far in fighting the COVID-19 pandemic in the country.
However, as a national medical body, we feel it is our responsibility in the best interest of the people, our healthcare system and our country, that we bring to light any matters of great concern.
Recently, a flip flop in policies with no clear-cut guidelines on the testing of the workforce before businesses resume operations under the Conditional Movement Control Order (CMCO) has left business owners, employees and even the GPs in the country confused and frustrated.
Since the announcement on using antibody Rapid Test Kits (RTK) for screening employees, employers had been calling clinics to arrange for screening of their employees, but GPs could not conduct the screening without the necessary guidelines.
Proper guidelines for GPs are a safety requirement to conduct the tests or even GPs and their staff can be at risk of infection.
However, it was reported in the media yesterday that the Social Security Organisation (SOCSO) with whom we have been working closely with for many years have said that it was discontinuing the use of rapid test kits (RTK) for the mandatory screening of workers for Covid-19.
We received a call from MOH informing us some three weeks ago that Socso would be launching the RTK Antibody tests for our workers with the participation of our GPs. Even 4 days ago during the meeting with Socso’s top management,we were told that the above screening of workers would be initiated for the workers through the GP clinics who are on their HSP panel.
Now we have been informed that under the Socso screening programme, only the Reverse Transcriptase — Polymerase chain reaction (RT-PCR) method of screening will be used. The public must be aware that the test results using this method should typically take 24hours to obtain. Depending on the volume of test samples and other logistics, it may take longer.
It must be noted that the RT-PCR test results received after 3 days will not have any clinical value. Results must be received between 48 to 72 hours after testing or the results may not reflect the current health status of the person tested. Currently, testing capacity nationwide in the private sector is around 9,000 per day. It must also be noted that the laboratories testing these samples also test non-covid-19 cases.
Aside from this, as it has now been established by MOH that RT-PCR remained the “Gold Standard” for Covid-19 detection, MOH must also be clear on the purpose of RTK antibody (still used in some applications) to clear up any doubt or confusion. What will RTK be used for now?
MMA has advised the GPs not to perform antibody RTK without clear guidelines on the usage of antibody RTKs, infection prevention and control protocols, interpretation guidelines & quarantine criteria that are yet to be received from MOH.
The local validation report of the antibody rapid test kits that have been allowed for commercialisation should also be published by MOH. The public must be aware as the safety of our fellow-Malaysians must never be compromised.
Adding further to the confusion concerning testing of workers, was the announcement by the Ministry of International Trade and Industry (MITI) two days ago that Companies may resume business operations from May 4, 2020 without an approval letter from MITI and that Covid-19 screening of workers is not mandatory.
This, as opposed to its earlier announcement for a requirement to screen all workers. Stakeholders are confused now as to why the screenings were needed at first and no longer needed now; feeling unsafe knowing that the threat of Covid-19 is still very much around.
The government must also be clear on the screening of foreign workers. MMA supports the government’s targeted approach in screening foreign workers, however which sectors will be targeted and who will be screening them must be made clear.
We wish to appeal to the government for more clarity and proper guidelines for the smooth implementation of the SOPs as many are in the dark over the next steps to be taken. Proper coordination between ministries are also needed.
We believe this confusion concerning the testing of workers would not have happened if the announcement to test workers was made after receiving the guidelines from MOH. Healthcare is highly regulated. Guidelines must be in place before the announcement of such an extensive programme.
MMA also feels it is important for the public to be aware that COVID-19 tests are part of precautionary measures but not a guarantee against COVID-19 infection. Test results that are “negative” must not in any way give the impression that the person tested is protected from COVID-19 infection. People can still be exposed to risks of infection even after testing “negative” if preventive measures are not observed.
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