GPs Angered By Blame Over Covid-19 Reporting Delay

The Malaysian Medical Association says that all RT-PCR tests are processed in laboratories and that MOH guidelines oblige the person conducting laboratory processing of samples to report the result via SIMKA.

KUALA LUMPUR, Feb 1 — Private general practitioners (GPs) have demanded an apology for being accused of reporting Covid-19 cases late, after more than 5,000 daily infections were reported the past three days.

The Ministry of Health (MOH) said yesterday that the surge of reported coronavirus cases was due to the late reporting of infections to the national Crisis Preparedness and Response Centre (CPRC), which included cases detected last year.

MOH blamed private laboratories, clinics, and hospitals for delay in reporting to the Public Health Laboratory Information System (SIMKA) and state health offices.

Selangor Mentri Besar Amirudin Shari said Saturday that the high number of reported Covid-19 cases was due to a backlog and that the state health department (JKNS) would issue fines to private clinics and hospitals who fail to report positive Covid-19 cases on the same day to SIMKA.

“MMA finds the accusation made in the said report deeply troubling,” MMA president Prof Dr Subramaniam Muniandy said in a statement.

He pointed out that all RT-PCR tests are processed in laboratories, unlike rapid antigen tests that can be processed at private medical facilities, and that MOH guidelines oblige the person conducting laboratory processing of samples to report the result via SIMKA.

“Therefore, how can anyone claim that the delay in reporting confirmed cases via SIMKA is due to the failure of reporting by private practitioners when in reality, 100 per cent of RT-PCR processing is done in laboratories?” said Dr Subramaniam.

“I think it is only fair for the private practitioners to be given an apology. We are all in this together. If MOH and Selangor Health Department (JKNS) particularly, truly believe in working as a team and in wanting to enhance public-private partnership, MMA implores all parties to stop the blame game.”

Dr Subramaniam told JKNS to provide statistics on the number of coronavirus cases reported by private health facilities each month, the number of cases found to be unreported by private clinics or hospitals, action taken by JKNS against these facilities, and when MOH standard operating procedures (SOPs) would be revised.

“We believe that it is only rightful for private practitioners to demand the answers to the questions above. The JKNS cannot be given a free hand in making accusations without providing facts.”

MMA highlighted complications in reporting Covid-19 test results to state health offices (PKD) through two systems: SIMKA and a separate “e-notification” system.

“To set up an account for the e-notification system, the GPs are required to communicate with the PKDs. But as ordinary citizens are finding difficulty reaching the PKD via phone, the GPs are also finding it near impossible to contact them. We understand, the system is strained. Still, GPs have made the effort to notify the PKDs on any Covid-19 case using other means as listed in its guidelines issued earlier,” said Dr Subramaniam, referring to methods like email, phone call and fax to the PKDs.

“Then there is the Sistem Informasi Makmal Kesihatan Awam (SIMKA) reporting system which requires the GP to report all RTK antigen tests that are being done. All RT-PCR cases are reported using this SIMKA system by labs approved by MOH to conduct RT-PCR. Private health care facilities are only required to notify RT-PCR and RTK antigen positive cases via the e-notification reporting system.”

Dr Subramaniam noted that MOH has never made results from rapid antigen testing public as it is not a confirmatory test for Covid-19 diagnosis; MOH’s daily Covid-19 case reports are only based on RT-PCR positive tests.

MMA urged MOH to integrate the e-notification to the PKD and SIMKA reporting into one system.

“If five minutes can be saved on administrative work per patient, an hour can be saved on 12 patients allowing more patients to be seen and tested.”

Dr Subramaniam also complained that private laboratories were conducting drive-through and on-site RT-PCR testing even though MOH only allows such tests to be carried out at a private medical clinic, ambulatory care centre, or private hospital.

“Private laboratories are not classified as a health care facility. However, MOH has closed one eye.”

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