THE Health Ministry director-general has said that the recently introduced self-test kits are not meant to replace RT-PCR tests but would rather enable the public to conduct self-screenings in order to find out whether they are Covid-19 positive immediately.

Then, Health Minister Dr Adham Baba said it is the consumers’ responsibility to report to the ministry, regardless of whether the results are positive, negative or invalid, through the MySejahtera application.

Even though the self-tests are meant to supplement government measures to control Covid-19, if protocols on readings from rapid tests are acted upon, false negatives could seed new outbreaks, while false positives could add strain to the hospital system and patients’ pockets.

Because of its low cost, self-tests appear to be more suited and should be employed in the manufacturing and construction sectors, where it is less traumatising for the workers who are, likely, to be required to undergo routine testing two or three times a week in the new normal.

In a statement released by the head of the Greater Klang Valley Special Taskforce on 24 July 2021, the ministry said the self-test and home isolation policy would result in lower total case numbers as it would no longer capture asymptomatic contacts.

Essentially, the self-tests are for those who are asymptomatic or with light symptoms who will be asked to undergo home isolation for 10 days and report themselves to the virtual CAC using digital home assessment tools (HAT) such as mySejahtera. If the condition of those under self-isolation deteriorates, HAT will assess whether they need to be referred to a CAC for assessment

With the above policy, it now appears that MOH is passing the responsibility towards the people to self-regulate and be responsible for their own behaviour. With the self-test, the onus is on the individual to report to the Health Ministry regardless of whether the results are positive, negative or invalid through the MySejahtera application.  

What is the likelihood that those who self-test report themselves through the MySejahtera application?  Getting Malaysians to comply with the self-regulation would be a tall order and impossible for foreign workers. Already, it was acknowledged that it is Malaysians’ non-compliance with rules that are pushing Covid-19 cases up of late. Before the Delta variant hit us, not wearing face masks properly and a half-hearted attitude towards physical distancing contributed to the high number of cases.

How will the ministry monitor and have visibility over the movement of those individuals during their home isolation period?

In July 2020, when the cumulative numbers were just around 9,000 cases with 200 active and infective cases, the government reimposed compulsory quarantine due to non-compliance of home quarantine.

As would no longer be a requirement for them to wear a pink tag, those under home isolation would be able to roam unimpeded during this period. They only have to ensure they do not enter premises that require them to scan their MySejahtera or premises which only require visitors to write their details down.

It has been suspected that infected persons who remain asymptomatic play a significant role in the ongoing pandemic even though their relative number and effect have been uncertain.

A study conducted by JAMA Network Open, a monthly open access medical journal published by the American Medical Association, found that transmission from asymptomatic individuals was estimated to account for more than half of all transmission.

This suggests the identification and isolation of persons with symptoms alone will not control the ongoing spread as the virus appears to have greater potential than previously estimated to spread silently and deeply through human populations.

And, so far, it appears that the ministry has yet to distinguish between asymptomatic and pre-symptomatic cases in its data collection. A pre-symptomatic individual is infected but will eventually develop symptoms. According to a study published in the journal Science, these two groups of individuals are crucial drivers of transmission. Transmission by these two groups makes identifying the infectious timeline and potential exposures a big challenge to health authorities everywhere.

The experience aboard an aircraft carrier in the United States last year suggests that a pre-symptomatic individual might be able to transmit the virus to others for longer than 14 days. Since they do not know they’re infected, they mingle with others, promoting virus spread by not adhering to masking, distancing and hand hygiene.

If asymptomatic transmission is indeed common, testing only those with symptoms is a folly. Our lack of testing and this policy of self-tests and home isolation of asymptomatic cases could result in surging cases. – July 25, 2021.

*FLK reads The Malaysian Insight.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.