More emphasis should be given on safe physical distancing, the wearing of face masks and personal hygiene among the workforce with testing focused on foreign workers in line with MOH’s (Ministry of Health) targeted approach to testing.
While testing is an important measure against Covid-19, there are concerns that testing of the workforce can give employers and their staff a false sense of security. There is a danger that workers may feel they are “in the clear” when in fact, they are not.
A person may receive a negative test result and still be exposed to infections the very same day after testing if preventive measures such as physical distancing and personal hygiene are not observed.
Some employers may also feel that testing might be a waste of money if any of their staff are down with Covid-19 after initially receiving a negative test result. More emphasis should instead be placed on preventing exposure to risks of infections.
However, with the increase in the number of Covid-19 infections among foreign workers (legal, illegal and undocumented) being reported in the media, it is necessary to test this group with data entered into a registry.
It will be important to determine the status of this group as monitoring and contact tracing efforts have proven to be extremely challenging.
MMA agrees with the Health Ministry’s targeted approach to testing of identified risk groups and existing clusters. The groups targeted by the MOH for Covid-19 tests include the tabligh group, tahfiz group, enhanced movement control order (EMCO) areas, markets, senior citizens, foreign workers, healthcare workers and existing clusters.
While testing of foreign workers will be necessary, steps must be taken to address the living conditions of foreign workers in the country. There will be no point in testing if they are to return to their cramped living conditions.
The majority of foreign workers in the country stay in overcrowded, cramped dormitories, construction site cabins, shop lot rooms, terrace houses or apartments where physical distancing may be almost impossible to observe. An SOP alone for foreign worker accommodation may be needed along with random checks by the authorities.
The recent reports of clusters at Immigration depots are also a major concern. Ways to avoid crowding in these depots will need to be looked into. Hygiene issues in these centres must also be addressed.
MMA reiterates that an amnesty may also be needed for illegals and undocumented foreign workers, or it will be increasingly difficult to get these workers tested or their employers to cooperate.
Some may flee from the authorities while some of their employers may even resort to hiding them for fear of action being taken against them. These issues will need delicate handling to be managed more effectively.
The RT-PCR test results must also be obtained within 3 days or the results will not have any clinical value. Currently there are patients receiving their Reverse Transcriptase — Polymerase chain reaction (RT-PCR) tests results beyond 3 days. Some have even received their results 7-10 days after being tested!
While RT-PCR is recognized as the “Gold Standard” to detect COVID-19 infection, the government must also now be clear on what the RTK antibody will be used for in a General Practitioner setting. Antibody RTKs are also widely used in some European countries and USA.
Apart from being faster and cheaper, MMA feels the RTK can be useful in studying prevalence for certain sectors. This data may be of great use to the government. The GPs being closest to the community they serve should be better engaged by MOH.
Dr N. Ganabaskaran is president of the Malaysian Medical Association.
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