Proper planning, coordination and a review of SOPs will ensure the smooth implementation of the compulsory Covid-19 screening of foreign workers from all sectors in several states.
If well implemented, this Public-Private Partnership initiative with the 7,000 MOH trained General Practitioners (GPs) nationwide that also enables data sharing can effectively complement the Ministry of Health’s (MOH) efforts in controlling the spread of Covid-19 in the country as Malaysia’s high migrant worker population has been identified as a priority group for Covid-19 screening.
It is a good move by the government. However, issues currently faced by GPs in the SOPs for the RTK (rapid test kit) antigen swab testing will need to be ironed out to ensure the additional large-scale testing can be carried out smoothly. For a seamless implementation, the MOH should review the SOPs for conducting the RTK antigen screening.
The current SOP where a patient confirmed Covid-19 positive is isolated at the clinic and made to wait for pick-up by an ambulance or the Pejabat Kesihatan Daerah (PKD) officers is not practical. There have been cases where patients were made to wait for hours for transportation to arrive due to the heavy workload at the PKDs. A proper transport arrangement for Covid-19 positive patients will need to be put in place.
The current SOP where Covid-19 positive samples need to be sent to the admitting hospital also causes delays and increases red tape. As the RTK antigen tested positive patient will eventually need to undergo an RT-PCR swab test at the admission hospital, we feel it is unnecessary process to send the samples.
The inconsistency in the implementation of the quarantine criteria and notice of closure on private clinics is also an issue repeatedly faced by private GPs that must be addressed immediately.
MMA has highlighted these issues to MOH on a number of occasions and it is hoped that urgent attention will be given to this matter. MMA had recently highlighted that clinic staff had to undergo quarantine even when they did not fulfill the criteria of being a close contact. As a result, a number of clinics had to close as there were no staff to run the clinic.
Employers should also be made aware that only RTK antigen kits that have special import approval and access by the Medical Device Authority (MDA) can be used. The GP clinics must also conduct a pre-assessment and keep medical records of the patients who are being screened for Covid-19.
Each patient that has undergone the RTK antigen swab test must be registered under Sistem Maklumat Kesihatan Awam (SIMKA), where certificates are generated and given to the patient with stringent Infection Prevention and Control (IPC) maintained throughout the process.
The issue of widespread commercialisation of Covid-19 screening must also be given a more serious view by the government. MMA had recently raised its concerns about organisations providing Covid-19 swab tests that are not registered with the health authorities.
There are many middlemen and non-healthcare related agents involved in the screening, as well as swab tests being conducted by facilities that are not self-declared with the MOH. The Covid-19 swab tests must be performed by trained healthcare professionals or patients can face the risk of injuries, health issues and even a false negative result if the swab tests are performed incorrectly.
MMA urges employers to insist on swab certification and proof from the facility that they are registered with MOH. The public can also check if the facilities are registered with MOH.
Only GPs, specialist clinics and ambulatory care centres are allowed to conduct on-site screening as it is part of primary care and not secondary or tertiary care. MMA is currently working with MOH on training more GPs to conduct the swab tests. We anticipate another 500 will be registering for training in the next two weeks.
Apart from reporting and issuing complaints to the relevant authorities, the public and employers can also write to [email protected] on any queries or complaints.
Dr Subramaniam Muniandy is president of the Malaysian Medical Association.
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