Friday 29 Mar 2024
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This article first appeared in The Edge Malaysia Weekly on June 28, 2021 - July 4, 2021

GETTING every Malaysian to vaccinate is the key to resuming our pre-pandemic way of life. At the same time, we must put in place measures that require regular and mass testing, so that positive cases can be quickly identified and isolated — to break the chain of infection before another outbreak happens.

The government should make it mandatory for businesses with more than a certain number of employees to conduct regular Covid-19 testing. The country has ample capacity for an expanded testing regime, beyond what is currently being undertaken. For instance, laboratories in the country can currently perform up to around 105,000 RT-PCR tests daily, as compared with the actual seven-day average of 54,000 (as at June 6).

The process can be made even easier and faster with RTK Antigen test kits. Since this method of testing does not require lab work, its use is not limited by lab capacity. As at June 21, there were 1,309 private clinics registered under the Ministry of Health that can offer on-site Covid-19 testing. The cost of an antigen test ranges from RM70 to RM150. For its part, the government must look at ways to substantially reduce this cost. For instance, it can approve larger companies to administer tests on-premise by a dedicated medical officer. This would lower costs, increase convenience as well as ensure regular testing. In other words, self-compliance.

To be sure, weekly testing at workplaces will add to businesses’ operating costs. However, the cost of more start-stop of economic activities and workforce restrictions in the event of future outbreaks and lockdowns will certainly be even more damaging. Businesses can, and will, adapt to the additional expenses — the same as they always do with any other challenges.

There are three main types of Covid-19 tests, namely the polymerase chain reaction (PCR) test, antigen test and antibody test. Each test is based on different elements in the body to detect the presence of the virus.

For instance, the PCR test detects genetic material of the Covid-19 virus while antigen tests detect the outer protein of the virus. The antibody test, on the other hand, looks for antibodies developed by the immune system in response to the coronavirus.

PCR tests are widely regarded as the gold standard, with the highest accuracy. The drawback is its high cost and waiting time, as the sample has to be analysed in a lab. On the other hand, antibody tests have the lowest accuracy — it may not be able to diagnose an active infection given that antibodies can take days to develop and could remain in the body long after one has recovered.

Antigen tests offer a good compromise — its results are reasonably accurate and, more importantly, can be had within an hour. They are also relatively inexpensive, even for regular use. Timeliness is important in many circumstances — for instance, screening visitors before entering a premise, employees prior to starting work and students entering schools.

The key downside of the antigen test is a false positive result. But this can be easily rectified — when the person is asymptomatic and the prevalence of Covid-19 in a community is low — by confirmation with a subsequent PCR test. The cost of an erroneous (false positive) result is definitely lower than a potential outbreak scenario, if an infected person goes untested and undetected.

 

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