1 in 4 patients with acute respiratory infection declined Covid-19 swab test: MOH

From a nasal swab test administered by a robot to a throat swab, Straits Times journalist Timothy Goh goes through four different swab tests and shares his experience.
People receive swab tests for Covid-19 at Marine Drive on Sept 19, 2020.
People receive swab tests for Covid-19 at Marine Drive on Sept 19, 2020.ST PHOTO: KELVIN CHNG

About a quarter of patients aged 13 and above diagnosed with an acute respiratory infection (ARI) from July 1 to Aug 16 declined a Covid-19 swab test, with some citing fear of discomfort.

Since July 1, it has been a policy for all patients aged 13 and above who are diagnosed with ARI to be offered the swab test for the virus when they first see a doctor, as part of efforts to support more active case-finding in the community.

Responding to queries from The Straits Times, the Ministry of Health (MOH) said that patients who decline the swab test are given a five-day medical certificate, during which they are legally required to stay at home.

If a doctor assesses that a patient meets the suspect case definition of Covid-19, or has prolonged ARI at the end of the five-day period, the patient is legally required to go for a swab test.

MOH said it understands that some patients have concerns about being swabbed, such as fearing the discomfort that might occur during the process. "We will continue to work with healthcare providers to explain to patients that the swab is quick and causes only slight discomfort," said the ministry.

MOH had previously said it was assessing the use of saliva testing to detect Covid-19 here. It added that most samples for Covid-19 testing are collected through nasopharyngeal (back of the nose) or oropharyngeal (back of the throat) swabs, which can be pooled, thus allowing for high volumes of tests to be efficiently processed daily.

Preliminary findings have shown that saliva testing may be slightly more comfortable for some individuals, though mechanisms to scale up testing in laboratories, including pooled testing, are still being developed.

MOH added that it also provides SMS reminders to patients of upcoming swab appointments, and works with general practitioner clinics to call patients to reschedule their swab appointments if patients miss them.

The ministry said it urges everyone to be socially responsible, and that those who are unwell - particularly those with mild symptoms of fever, cough, sore throat, runny nose and loss of smell - should see a doctor promptly, and go for a swab test when their doctor tells them to do so.

MOH added: "It is important to test for Covid-19 early for early disease management, because in some patients the disease becomes more severe in the second week.

"Early diagnosis also allows for early detection and containment to prevent further spread, to help protect loved ones and vulnerable members of the community from getting infected."

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A version of this article appeared in the print edition of The Straits Times on September 22, 2020, with the headline '1 in 4 patients with acute respiratory infection declined swab test: MOH'. Print Edition | Subscribe