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'I want to be in the system': Patients with Covid-19 mild symptoms bog down GPs, polyclinics after self-test

Patients waiting outside a clinic on Feb 10, 2022.
Patients waiting outside a clinic on Feb 10, 2022.
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  • On Feb 5, the Government said GP clinics have reported a surge in Covid-19 patients, many with no or mild symptoms
  • Some GPs said many patients were confused about what to do after they test positive with self-test kits
  • Some just wanted a test to confirm, others sought to be officially logged as Covid-19 patients 
  • This is because being logged “in the system” has implications for travel, vaccine boosters and vaccine-related infection controls, GPs said

SINGAPORE — When Mr Ridhwan Anuar, 34, experienced a bout of high fever, diarrhoea and vomiting last week, it was so bad that he had to visit his nearby general practitioner (GP) for treatment. A self-administered antigen rapid test showed that he did not have Covid-19.

The financial technology executive was given medication for his symptoms and told to rest for a few days with a medical certificate (MC) from the GP. 

On Thursday (Feb 10), he developed a fever again, as well as a runny nose and body aches. Even though his symptoms were milder this time, he tested positive for Covid-19 with an antigen rapid test.  

“At that time, I was at a loss as to what to do next,” Mr Ridhwan said.

Should he go to the doctor again or stay home? Does the doctor need to do a confirmatory test for him? And what about the MC?

Protocol 1 under the Ministry of Health (MOH) Covid-19 guidelines states that patients who are feeling unwell should see a doctor, while Protocol 2 states that low-risk individuals with mild symptoms can recover at home.

Yet, how mild are “mild symptoms”? If a patient has a fever and a cough, are they “unwell”?

For many people who have self-tested positive for Covid-19 in the past few weeks, it is not clear whether they should see a doctor.

For others, they make a dash to the doctor because they want to be registered in the public healthcare system as being infected and to skip getting a vaccine booster, among other reasons.

Speaking to TODAY, some GPs said that there have been many patients who have been choking up the queues at GP clinics, regardless of their symptoms, because they want to be recognised officially as Covid-19 positive.

This is because recovered Covid-19 patients will be able to delay their booster shots, be exempt from certain vaccine-related policies and infection controls, or be subject to fewer travel restrictions.

They want it noted down in the system because of various reasons. One is that they don’t want to have the booster.
Dr Alvina Nam from Clinic@Costa

The GPs also said that they have received a greater number of enquiries in recent weeks from people who have tested positive via a self-administered antigen test and did not know whether they should go to the clinic or stay home.

They added that for some, it is the lack of confidence in their self-test kits, which leads them to seek confirmatory tests by a qualified professional even though they feel fine.
On Feb 5, three government ministries and the Early Childhood Development Agency issued a joint statement, saying that ​​many people with no or mild symptoms are visiting clinics just to obtain a letter or memo certifying that they have recovered from Covid-19 to support their return to work or to school. 

“These visits are not necessary and risk compromising the standard of care for other patients who genuinely require medical attention,” they said.

The next day, the ministry reiterated on Facebook that people who tested positive for Covid-19 can safely recover at home if they are low risk and have mild or no symptoms. It added that for these cases, there is "no need to see a doctor and get an MC (medical certificate)", and employers and schools will accept positive antigen rapid test result as proof of infection. 

However, they stopped short of recommending that all who get positive results with antigen test kits but have mild symptoms should stay home and not see a doctor. 


In any case, some GP clinics and polyclinics continue to be inundated with patients who exhibit mild symptoms and require minimal treatment, ever since MOH roped in primary care doctors early last month to diagnose low-risk patients with mild symptoms using rapid test kits, and for them to continue caring for patients under Protocol 2. 

Dr Philip Koh, a GP from Healthway Medical clinic in Tampines, said that since then, around half of all the patients he sees are related to the coronavirus. None of them have had serious symptoms of Covid-19.

To prevent infection, these patients wait for Dr Koh to swab them outside of the clinic and cannot set foot inside. So, he would have to enter and exit his clinic repeatedly in order to do the swab.

It takes more than 15 minutes for Dr Koh to see each patient who goes to his clinic for confirmatory testing. Since they are all mild cases, the medical treatment that he gives is minimal.

“Last time, if we had a flu case, my time with the patient (consists of) just the consultation and that’s it… Now, it’s different. Besides swabbing, we have to tag the patient under Protocol 1 or 2, fill in the required forms, et cetera,” Dr Koh said. "Most of it is administrative."

Another GP told TODAY that because the wait to get a supervised swab outside his clinic would take some time, he would ask them to wait at the mall opposite the clinic as his place is too small to accommodate a crowd. 

On the ground, patients are not sure when to see a doctor and when not to. People are confused — the rules keep changing after all.
Dr Yeo Suan Aik from Yeo's Clinic

For finance manager SJ Tay, 32, who tested positive for Covid-19 at a polyclinic on Monday, the two-hour waiting time for her to see a doctor for her confirmatory test was an unnerving experience, because she was asked to wait in an area with other people who also had positive self-tests.

She visited the clinic because she is in the second trimester of her pregnancy and is considered a high-risk patient, but there were others who did not appear to be from a high-risk group who were also waiting for their turn.

“I can empathise with them, because I feel that as long as they have symptoms, mild or serious, it’s natural to want to see the doctor,” she said.

Dr Yeo Suan Aik from Yeo's Clinic in Clementi said: “On the ground, patients are not sure when to see a doctor and when not to. People are confused — the rules keep changing after all.

"Sadly, there are still some people who do not know that if they feel completely well, there is no need to come to the clinic (just because they have a positive antigen rapid test result).”


What makes the waiting times unnecessarily long are those who feel well, and want official confirmation of an infection in order to circumvent the need for Covid-19 vaccine boosters or to be excused from certain regulations, some GPs said.

Dr Alvina Nam, a GP from Clinic@Costa in Upper East Coast, told TODAY: “They want it noted down in the system because of various reasons. One is that they don’t want to have the booster. 

“Strangely, there are others who say that if they had an infection before… they can get a memo and seemingly excuse themselves from testing (when they travel).”

Current rules stipulate that people who have recovered from Covid-19 and have completed their two-dose primary series vaccination do not require a booster dose for the time being. From Feb 14, they will continue to be considered fully vaccinated even after it has been more than 270 days (or nine months) since their last jab.

From Jan 1, those who recover from Covid-19 and have not completed their primary vaccinations are also exempted from vaccination checks for entry to various places and other such regulations for a 180-day period after their infection.

And from Jan 23, travellers into Singapore who are fully vaccinated and have a past infection less than 90 days ago will be exempted from all testing and quarantine requirements if they are able to provide documentary proof.

Dr Koh agreed that many who go to his clinic do so just to be “recorded in the system”.

“It is because there are implications. If their positive antigen test is recorded in the system, it has an effect on whether they need a booster or not,” he said.


Despite the confusion and bottlenecks, it would be counter-productive for the authorities to discourage anyone with mild Covid-19 symptoms from seeking medical help, the doctors said.

For one thing, the common mild symptoms — fever, cough, sore throat and tiredness — could very well be symptoms of another illness that requires attention as well.

“Even before Covid-19, people came to the clinic with mild symptoms like a cough… We do not want to stop people from coming to the clinic, otherwise the very serious ones end up not coming here,” Dr Nam said.

Another reality with Covid-19 is the inexact nature of testing and diagnosis, which is not always immediately obvious from the symptoms. 

For Mr Ridhwan, for example, his first rapid test result was negative, even though his symptoms were more severe than the following week when he tested positive.

In the end, Mr Ridhwan’s GP told him over the phone that heading to the clinic was not necessary unless his symptoms became worse, since he already had the medicine from the previous visit.

In any case, Dr Vincent Chua, a GP from Chua and Partners Family Clinic near Tiong Bahru, stressed that doctors should not second-guess why patients are seeing them.

“For us, the workflow has slowed down a bit because of the (Covid-19-related) paperwork. But patients who come to see me for mild symptoms are also genuine patients,” he said.

Even before Covid-19, people came to the clinic with mild symptoms like a cough… We do not want to stop people from coming to the clinic, otherwise the very serious ones end up not coming here.
Dr Alvina Nam from Clinic@Costa

For now, the workload with Covid-19 is still bearable, especially since the Chinese New Year peak period has mostly passed, Dr Chua added.

During this period, clinic visits went up possibly because people were more cautious about passing the disease to relatives during home visits, some doctors said.


The GPs then suggested ways in which the authorities could help take some of the load off primary care doctors further, such as by easing the administrative demand needed to register someone as a Covid-19 case. 

Some proposed having a system where people can submit their positive self-test results and for a contractor to carry out confirmatory testing after that.

Dr Sunil Kumar Joseph, a GP who runs Tayka Medical Family Clinic in Jurong, said that such an idea would surely help alleviate the load.

He said that he has been running “flat out”, as his Swab and Send Home clinic can see more than 100 patients who need to be swabbed in recent days. This is twice the usual number and Dr Joseph is the only one doing the swabs on most days.

“I’m 50 years old already, and it’s not like my capacity to increase my workload is unlimited. I’m okay for a while, for maybe a month or two, but let’s hope the Omicron virus strain goes away and no new Greek alphabet variant comes into play,” he added.

CORRECTION: An earlier version of this report incorrectly stated that Dr Philip Koh worked at The Heart Clinic at Mount Elizabeth Medical Centre. He practises at Healthway Medical clinic in Tampines. We are sorry for the error.

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