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PETALING JAYA: Current Ministry of Health Standard Operating Procedures (SOPs) for Covid-19 Case Management for General Practitioners (GPs) in Clinics Are Impractical and Should Be Re-analyzed, Says Malaysian Medical Association (MMA) .
MMA President Datuk Dr. Subramaniam Muniandy said there was an urgent need for proper planning, coordination and review of standard operating procedures in clinics, especially with the recent Covid-19 mandatory screening opinion for foreign workers in all sectors.
“The Ministry of Health must review the standard operating procedures for detecting the RTK antigen.
“Current SOPs in which a patient confirmed as positive for Covid-19 is isolated at the clinic and made to wait for an ambulance or district health officials to pick them up is not practical.
“There have been cases where patients had to wait hours for transportation to arrive due to the heavy workload in the district’s health departments. A proper transportation arrangement will need to be established for Covid-19 positive patients.
“The current SOP in which Covid-19 positive samples need to be sent to the admitting hospital also causes delays and increases red tape.
“Since the RTK antigen positive patient will eventually have to undergo an RT-PCR swab test at the admitting hospital, we believe it is an unnecessary process to send the samples.
“The inconsistency in the implementation of the quarantine criteria and the closure notice in private clinics is also a problem repeatedly faced by private GPs and which must be addressed immediately.
“MMA has highlighted these issues to the Ministry of Health on several occasions and is expected to receive urgent attention,” said Dr. Subramaniam on Sunday (November 22).
He added that MMA had recently highlighted that clinic staff had to self-quarantine even when they did not meet the criteria of being a close contact.
“As a result, several clinics had to close because there were no staff to run the clinic,” said Dr. Subramaniam.
He also pointed to the need for employers whose workers are screened to be informed that only RTK antigen kits that have special import and access approval from the Medical Device Authority (MDA) can be used.
“GP clinics are also required to pre-screen and maintain medical records of patients who are being screened for Covid-19.
“Every patient who has undergone the RTK antigen smear test must register with the Public Health Information System (PHIS), where certificates are generated and delivered to the patient with strict infection prevention and control (IPC) protocols they are maintained throughout the process, “said Dr. Subramniam.
He said the Health Ministry must also address the widespread commercialization of Covid-19 detection.
“MMA had recently expressed concern about organizations offering Covid-19 swab tests that are not registered with health authorities.
“There are many intermediaries and non-health-related agents involved in the detection, as well as in the swab tests that are performed in facilities that do not self-declare with the Ministry of Health.
“Covid-19 swab testing must be performed by trained healthcare professionals or patients may face the risk of injury, health problems, and there could even be false negative results if swab testing is performed incorrectly.
“MMA urges employers to insist on certification of the swab and proof of the facility that they are registered with the Ministry of Health.
“Only GPs, specialized clinics and ambulatory care centers can perform on-site screening, as it is part of primary care and not secondary or tertiary care. MMA is currently working with the Ministry of Health to train more GPs to perform smear tests.
“We anticipate another 500 to register for training in the next two weeks,” said Dr. Subramaniam.
The public can also verify if the facilities are registered with the Ministry of Health at: www.medicalprac.moh.gov.my.
On November 20, the government made it mandatory for all foreign workers in all sectors to undergo COVID-19 screening.
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