Rapid test kit approval urgently needed for mass screening

LETTER | In his midday nationwide address yesterday, the prime minister expressed the possibility of carrying out mass testing among the high-risk communities but there was no clear plan revealed.

I would like to urge the federal government to have a clear guideline for the utilisation of rapid Covid-19 Ig M and Ig G test kits and approve their usage as soon as possible. 

These rapid test kits need to be available in the market among the primary health care workers, especially government health clinics and private general practitioners, to better screen and triage any suspected cases more efficiently when the usage of RT-PCR reagents might be over-constrained and eventually run out if more suspected cases need to be tested.

In the midst of this crisis, the USA's Food and Drugs Administration has just approved rapid test kits for screening suspected Covid-19 cases. Our government should take swift action to that effect. 

There are recent studies suggesting that it is estimated up to 31 percent of Covid-19 infected persons show mild or no symptoms who could be super-spreaders and infect others especially the susceptible groups like the elderly and those with co-morbidity.

Due to the difficulty in clinical diagnosis, the World Health Organisation (WHO) has recommended more readily available testing to be done on suspected cases to establish early confirmation and intervention such as quick quarantine measures, specific and supportive treatment, curbing the spread of the disease and improve the prognosis of the patients.

Even though the sensitivity and specificity of various rapid Covid-19 Ig M and Ig G tests need to be further established with bigger data, certain countries have started testing the rapid tests by tallying their results with RT-PCR tests on a daily basis to establish their reliability. 

Their reliability could be assessed on a daily basis by our local experts who would review the triage daily too as to who should be referred to hospitals for immediate RT-PCR testing and who could be quarantined immediately and followed up by primary care doctors.

Therefore, I urge the government to approve and make available rapid screening tests. On the other hand, RT-PCR testing should be more readily available and affordable to the public via collaboration with the private sector to cope with an expected increase in the numbers of Covid-19 infections. 

The prime minister also expressed that 34 percent of 3,585 public hospital beds are already occupied. According to JP Morgan, it is estimated that by mid-April the infected persons in Malaysia may reach approximately 6,300 - almost double the existing capacity of public hospitals.

There are 153 public hospitals, nine public specialist hospitals, and 210 private hospitals which are mainly manned by various specialists. Private hospitals, specialists and laboratories should fulfil their social responsibilities and work with public health officers to combat Covid-19. 

Private hospitals and specialists should be more willing to offer their assistance in testing and managing patients than turning away suspected cases to public hospitals.

I also urge the government to ensure private insurance companies and Socso cover the costs of care for Covid-19 patients. 

All private hospitals and specialists, including GLC-run private hospitals, should be roped in to help battle the pandemic. The Ministry of Health should direct the private hospitals to set up their own infectious disease units, isolation wards and ICUs for this Covid-19 battle. 

The relevant military units should also be mobilised to set up temporary hospitals and temporary mass screening centres when civilian medical facilities reach the stage where they cannot cope with the sudden surge of Covid-19 cases.

I would also like to use this opportunity to convey my solidarity to all medical colleagues at the frontlines.

DR BOO CHENG HAU is a medical doctor and Johor DAP state committee member.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.