JOHOR BARU, March 25 — An outspoken Johor DAP leader today urged the government to urgently approve the use of Covid-19 rapid test kits as an effective measure in containing the pandemic.
Johor DAP state committee member Dr Boo Cheng Hau urged Putrajaya to have clear guidelines for the utilisation of rapid Covid-19 rapid test kits.
“The government needs to approve their usage as soon as possible and make them available in the market among the primary healthcare workers, especially government health clinics and private general practitioners, to better screen and triage any suspected cases more efficiently.
“The usage of the Real-Time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) technique might be over-constrained and eventually run out if more suspected cases need to be tested,” said Dr Boo in a statement issued today.
Dr Boo, who is the former Johor DAP chief and Opposition leader, said that in the midst of the crisis, the United States Food and Drugs Administration (USFDA) has just approved Covid-19 rapid test kits for screening suspected cases.
“Our government should take swift action to that effect as there are recent studies suggesting that it is estimated as much as 31 per cent of Covid-19 infected persons show mild or no symptoms and could be super-spreaders and infect others especially the susceptible groups like the elderly and those with co-morbidity,” said the popular grassroots politician.
Dr Boo said this in response to Prime Minster Tan Sri Muhyiddin Yassin’s earlier midday address that 34 per cent of 3,585 public hospital beds are already occupied in the midst of the Covid-19 pandemic.
According to JPMorgan, it is estimated that by mid-April the infected persons in Malaysia may reach approximately 6,300 which almost doubles the existing capacity of public hospitals.
The 55-year-old general medical practitioner, with more than 30 years of experience, said that the current Covid-19 rapid test kits will screen for Immunoglobulin G (IgG) and M (IgM) antibodies, similar to those in dengue fever.
“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 of cases and early intervention such as earliest quarantine measures, specific and supportive treatment, curbing the spread of the disease and improving the prognosis of the patients.
“Even though the sensitivity and specificity of various Covid-19 IgM and IgG rapid tests need to be further established with bigger data, certain countries have started testing the rapid test kits 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 (grouping of patients based on the severity of their condition and the likelihood of their survival) 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,” explained Dr Boo when contacted further by Malay Mail.
Dr Boo added that from his personal conclusion after researching various documents and statements issued by the Health Ministry and WHO, the USFDA urgently approved one Covid-19 rapid test kit by Bioscience because the usual health system just cannot cope.
“Certain states in the US and Europe have run out of rRT-PCR tests reagents.
“We have to prepare for the worst case scenario from now,” he said, adding that in the United Kingdom (UK), Covid-19 rapid test kits are being tallied with rRT-PCR testing on a daily basis to conclude the latest sensitivity and specificity of a rapid test kit.
Yesterday, the Health Ministry said there was no need for the public to use any rapid test kit in order to diagnose whether they are infected with Covid-19.
The Health Ministry urged the public not to take the rapid test kit test arbitrarily without consulting a medical practitioner, as it has the potential to cause misunderstanding and frustration over its test results.
Dr Boo suggested that Malaysia’s Institute of Medical Research (IMR) and university labs should be roped in for such research.
He also agreed with Health director-general Datuk Dr Noor Hisham Abdullah that rapid test kit results must be interpreted by a doctor.
“My virologist source told me a positive test is almost 100 per cent certain and treated as one until proven otherwise. The Covid-19 rapid test kits give results within 10-30 minutes and Singapore has tested on two Chinese made test kits with a sample of about 200 patients showing sensitivity and specificity of about 99 per cent.
“The challenge is how to deal with the 10 per cent false positive and false negative- clinical signs. Frontline health workers should be tested regularly with Covid-19 rapid test kits plus a complete blood count that should be able to triage quite accurately,” explained Dr Boo.
He also urged the government to ensure private insurance companies and the Social Security Organisation (Socso) cover the costs for the care of Covid-19 patients.
“All private hospitals and specialists, including government-linked companies-run private hospitals, should be roped in to help battle the pandemic. The Health Ministry should direct the private hospitals to set up their own infectious disease units, isolation wards and intensive care units (ICU) for combating the Covid-19 infection,” said Dr Boo.
On the other hand, he also suggested that the relevant military units should be mobilised to set up temporary hospitals and mass screening centres when it reaches the stage where civilian medical facilities can no longer cope with the sudden surge of Covid-19 cases in time to come.