EXPERTS are divided over the Health Ministry’s move to limit close-contact testing to symptomatic individuals only. 

According to a ministry circular dated January 13, Covid-19 tests will be done only on symptomatic individuals identified as close contacts of a positive case. 

The samples will be based on the cohort size, which is the number of individuals exposed to the positive case. 

The circular said it is sufficient for up to 20 samples to be taken for a cohort size of fewer than 50 people. 

“If it is more than 50 people, 10% or 30 samples – whichever is lower – will be sufficient,” it said. 

However, all close contacts or persons under surveillance who are negative for the virus will still have to quarantine for 10 days. A second test will not be done on the 10th day. 

Malaysian Public Health Physicians’ Association president Dr Zainal Ariffin Omar told The Malaysian Insight that vigorous contact tracing, testing and isolation are needed to break the chain of infection in the community. 

“These are vital elements to reduce and stop community transmissions,” he said. 

There is no scientific evidence to support the ministry’s revised procedure in relation to test samplings, he said.

Meanwhile, Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said the decision is wise given the critical situation the health sector is in as resources are overstretched and cases mounting. 

Asymptomatic cases are also currently placed under home quarantine and treated due to shortage of beds at hospitals and low-risk quarantine and treatment centres, as well as logistical issues. 

Commenting on this, Malina said the healthcare system will now have to prioritise the more severe cases. 

“We have to trust our physicians who are now struggling to treat all those symptomatic patients. We know the numbers are 15 times more than the highest figure we had last year during the first movement-control order,” she said. 

“Our healthcare system now has to prioritise those who are sick, to prevent more deaths due to Covid-19,” she added. 

Malaysian Medical Association president Dr Subramaniam Muniandy said some countries have already adopted the ministry’s move. 

“In some countries, like Europe, asymptomatic patients or patients with mild symptoms of Covid-19 are sent home to isolate and recover. As our public hospitals and quarantine centres are hitting full capacity, we may be left with this option,” he said. 

Italy, the United States and the Philippines have placed asymptomatic and mildly symptomatic patients under home quarantine. 

“However, a proper system with a detailed standard operating procedure will need to be in place to manage patient care, safety and monitoring for patients on home quarantine.

“Stricter enforcement, including heavier penalties, may also be needed to prevent a quarantine breach,” said Subramaniam. – January 18, 2021.