GPs taking on bigger role in fight against Omicron

General practitioners (GPs) are taking on more responsibilities in Singapore's Covid-19 fight against the highly contagious Omicron variant.

There are around 1,800 clinics run by private GPs.

The variant is expected to spread, and GPs will play a bigger role in deciding which Covid-19 patients require closer supervision and those who can safely recover at home, the Ministry of Health (MOH) said at the start of the year.

Some clinics, such as the Healthway Medical ones, are already handling more cases.

Dr Nelson Wee, deputy head of primary care at Healthway Medical Corp, said its 70 GP clinics have seen a significant rise in the number of cases this year, compared with the November to December period last year.

"Thankfully, most of the Covid-19 patients that we encounter have mild symptoms and can be safely managed at home," he said. He attributed this largely to the high vaccination rates among the general population.

Ninety-one per cent of Singapore's eligible population have completed the full vaccination regimen, and 54 per cent of the population have received a vaccine booster shot.

At Parkway Shenton, which has 31 GP clinics, each branch now sees an average of five to seven Covid-19 cases a week. "This is a slight drop from the number of cases seen in the last quarter of 2021 and is likely the effect of the (tweaked rules regarding) VTL travel," said the group's medical director Edwin Chng.

Singapore froze new ticket sales for vaccinated travel lane, or VTL, flights and buses entering Singapore from Dec 23 last year to last Thursday because of the spread of Omicron.

During this Omicron wave, the testing processes and management of patients are unchanged, said Dr Chng.

"Any persons with suspected Covid-19 infection should be isolated from other patients and seen by the doctor first so that they don't have to linger in the clinic unnecessarily for extended periods of time," he added.

Student Hannah Lee, 21, who recently saw a GP after developing a sore throat and testing positive twice on self-administered antigen rapid tests, said she was asked to sit outside the clinic before and after seeing the doctor, while waiting for her medication and the bill.

She had expected to do a polymerase chain reaction (PCR) test but, instead, the GP gave her another antigen rapid test, and told her to stay at home and take the test 72 hours after the visit.

"My sense of taste and smell is still around... It doesn't even feel like I am sick," said Ms Lee, who has received her booster jab.

Today, only patients with risk factors or significant symptoms will be administered a PCR test, doctors said.

These include high-risk patients who are unwell - these are people with a weakened immune system, those aged 80 and above who are inoculated, and those aged 50 and above who are unvaccinated - as well as those at intermediate risk, said Dr Chng.

The latter group includes children who are too young to be vaccinated, elderly folk aged 70 and above, pregnant women, those with poorly controlled diabetes and those who weigh more than 100kg or have a body mass index of above 35kg/m2.

The PCR test will be administered to these patients if they are deemed unsuitable for MOH's health protocol 2, said Dr Chng.

Protocol 2 is for those with no symptoms or mild symptoms - they have to isolate at home for the first 72 hours, and test negative on an antigen rapid test before they can exit isolation.

Protocol 1 is for those who are unwell, while protocol 3 is for those who have been identified by MOH as a close contact of an infected person. This last group may not have been infected and can go out if they test negative on an antigen rapid test.

These revised health protocols took effect on Jan 6. The authorities said last Friday that they are preparing to progressively include more patient groups and settings under protocol 2 in the next few weeks.

Dr Chng said patients in an unstable condition or who exhibit worrying signs and symptoms should be sent to hospital. Some symptoms and signs include shortness of breath, chest pain, persistent diarrhoea and/or vomiting, and a very fast heart rate, he added.

Patients who are in a stable condition and assessed to be ineligible for home recovery may be taken to a community treatment facility, he said. These include those who do not have a single room with an attached toilet at home, and foreign workers living in dormitories.

Dr Quek Koh Choon of Bedok Life Clinic said: "Generally, those of us in the public health preparedness clinics have been monitoring patients and looking out for Covid-19 cases."

He added: "Also, we now have influenza cases which may mimic Covid-19 infections."

The good thing is that "the patients are less stressed now, knowing that the situation is still under control".

The Omicron variant has proven to be highly contagious but less dangerous than the previously dominant Delta one. Last Friday, the Government said 12,078 individuals had been confirmed to have the Omicron variant, and 34 of them required oxygen supplementation. Most needed oxygen for a day.

However, the actual number of infected people is higher and Omicron cases are expected to continue rising sharply, with the impact on healthcare services and absenteeism as yet unclear.