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Covid-19 new protocols: GPs welcome call for asymptomatic patients to stay home, but say some would insist on getting tested at clinics

SINGAPORE — General practitioners (GPs) here welcomed a move by the Ministry of Health (MOH) encouraging Covid-19 patients to stay at home if they have no symptoms, although some were skeptical as to whether people will heed the new protocol.

A man undergoing a swab test.

A man undergoing a swab test.

  • MOH announced on Saturday sweeping changes to Covid-19 protocols, including a call for asymptomatic Covid-19 patients to not rush to GPs to get tested 
  • One GP said that he received five to eight patients who are asymptomatic a day, and hopes the new protocol will reduce these numbers 
  • For patients who have symptoms, some doctors said they prefer the more accurate PCR test over ART testing
  • Ultimately, doctors hope that testing can be a thing of the past if Covid-19 is to be treated as endemic

 

SINGAPORE — General practitioners (GPs) here welcomed a move by the Ministry of Health (MOH) encouraging Covid-19 patients to stay at home if they have no symptoms, although some were skeptical as to whether people will heed the new protocol. 

And while doctors will have more flexibility over which Covid-19 test to administer — antigen rapid tests (ART) or the more accurate polymerase chain reaction (PCR) tests — they hoped that testing could be done away with altogether, as is the case with influenza.

Their comments come as MOH announced on Saturday (Oct 9) sweeping changes aimed at simplifying Covid-19 protocols, which have been described as confusing and frustrating by the general public as well as healthcare workers

Among the changes is a 72-hour home isolation period for asymptomatic patients without the need to see a doctor.

These patients can resume normal activities with a negative ART taken at home at the end of 72 hours. 

The GPs that TODAY spoke to said they hoped to see fewer asymptomatic cases with the new protocol, as over the past months, such patients had been turning up at their clinics with a positive ART, asking for a PCR test.

This has led to a backlog in testing capacity, as well as extra manpower having to be deployed.  

Dr Sunil Kumar Joseph, a GP who runs Tayka Medical Family Clinic in Jurong, said that he sees about five to eight such patients a day come to his clinic for a PCR test, with each taking about 10 to 20 minutes to be assessed and swabbed. 

“When I tell (asymptomatic patients) they don’t need to be tested, then they will tell me that they have a cough,” he said. “We have been dealing with this for very long.” 

Agreeing, Dr Philip Koh, a GP at Healthway Medical clinic at Tampines, said that he welcomes the new protocol as it could lead to a reduction in the caseload. 

“For these people, whether or not they see the doctor, they don’t need medical help,” he said. “It will reduce the amount of interaction that we need to have with asymptomatic positive ART (patients).” 

“If there is more public awareness, we can reduce the workload in treating those patients,” he said. 

However, Dr Sunil said he is doubtful as to whether people will heed the Government’s protocol. 

“At the end of the day, they can be asymptomatic, but once they test ART positive, they die-die want to know the PCR test result, to know their viral load,” he said. “They will want to see where they are at in their recovery (process).” 

GPS HOPE TESTING WILL SOON BE A THING OF THE PAST 

Under MOH’s new protocols, which take effect on Monday, those who are unwell with Covid-19 symptoms will need to visit a doctor for an ART. 

If the test is positive, they should stay at home and wait for instructions from MOH. It will be up to the doctor to assess if a polymerase chain reaction (PCR) test may be more suitable.

However, some GPs said that if testing is still compulsory for those with Covid-19 symptoms, they would prefer to continue using PCR tests given their accuracy. 

Dr Vincent Chua, a GP who runs Chua & Partners Family Clinic, said that the clinic has been doing both ART and PCR tests and that he would rather do both if the ART returns positive. 

“ART offers you speed but not accuracy,” he said. “The PCR is a bit slower but it offers you accuracy.” 

He added that ART test kits are widely available and can be administered at home, which defeats the purpose of having the test done in the clinic. 

“If you do ART on your own, and you’re coming to see me for an ART, what’s the point? Why do we want to do double work, and at the same time spend unnecessary money on that?” 

The GPs added that ultimately they hoped that testing could be done away with completely for patients with Covid-19 symptoms. 

“If we are going (to treat Covid-19 as) endemic, it has to be a procedure where the patient can diagnose the illness on their own,” said Dr Koh.

“It’s just like for the flu, we don’t go one extra step to test for influenza, you can always see a doctor just for symptomatic treatment." 

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Covid-19 general practitioners endemic testing

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