By Professor Datuk Dr Subramaniam Muniandy
We refer to the report titled “COVID-19: Bukan Masa Kaut Untung, Pihak Swasta Perlu Duduk Sebaris Bantu Kerajaan – MCCF” published on www.astroawani.com on Feb 1.
Firstly, we wish to state that the cost for Real-Time Reverse Transcription-Polymerese Chain Reaction (RT-PCR) tests are inherently high not due to profit margins but instead due to the various resources required to run them.
A single RT-PCR test requires not only the test kit but also PPE (personal protection equipment) for the doctors and their team, sanitisation and proper clinical waste disposal as well as high level laboratory costs.
In addition, there is significant time and resources needed in terms of the reporting of all completed tests, notification of positive cases via e-notification, e-mails, fax or call within 24 hours in compliance with the Health Ministry’s (MOH) standard operating procedures (SOPs) and guidelines.
The communication challenges between the private sector and public sector often demands many man hours when handling multiple cases.
This does not include the real risk of acquiring COVID-19 infection by the healthcare staff performing the sampling and its untold costs to their physical or mental health and the viability of their practices.
Risk to health and income
When a private doctor is infected in the course of his or her duties, and is either hospitalised or quarantined, he or she may suffer financial difficulties as income immediately drops to none but running cost of their practice are ever present.
There are no grants or donations from any third parties or public unlike governmental facilities.
Despite these concerns, it is the duty of all private clinics and hospitals to do their utmost best in fighting the pandemic and certainly the detection of many cases by the private sector leads to greater national efforts of containing COVID-19 spread and its associated clusters.
Unfortunately, by simply lowering the costs without taking all real and hidden costs into consideration may lead to the unsustainability of many private facilities.
As a tool for mass screening, RT-PCR tests have the disadvantage of high costs and the longer time required to run them.
Consequently contact tracing will be prolonged which may defeat the purpose of mass screening and isolation. Typically in an area with high COVID-19 infection prevalence, RT PCR may require a turnaround time of three to five days.
A much more suitable course of action is to employ the Rapid Antigen Test Kit (RTK-Ag). It is not only more suitable because it is fast and accurate but also because the RTK-Ag kits also indicate an individual’s infectivity which will aid in combatting the spread of COVID-19.
Private hospitals and clinics are in the forefront of the fight against the COVID-19 pandemic since its start in early 2020.
All private hospitals and clinics act as a triage for COVID-19 patients when they turned up at these facilities, sharing the burden of disseminating public information to patients, COVID-19 screening, shouldering the non COVID-19 patient load, contributing to fund raising efforts, coordinating with MOH and many other acts which go beyond their normal duties.
The Malaysian Medical Council code of ethics explicitly states that every doctor is required to treat patients regardless of race, creed or religion, and it goes without saying that is the standard expected of every single registered doctor in this country.
The MMA will never condone any less and hopes that all in society will try to attain a deeper understanding of the issues involved with the trust that all parties are working towards the common goal of making our country COVID-19 free. – Feb 3, 2021
Professor Datuk Dr Subramaniam Muniandy is president of the Malaysian Medical Association (MMA).
The views expressed are solely of the author and do not necessarily reflect those of Focus Malaysia.
