SINGAPORE - General practitioners (GPs) are seeing an uptick in Covid-19 patients requesting medical certificates (MCs) to cover their absence from work, despite official guidelines indicating no need for one.
This comes amid growing caseloads at their clinics as GPs grapple with a larger role in Singapore's fight against the highly transmissible Omicron variant, which is spreading through the community though leaving most of the infected with mild to no symptoms.
Experts told The Straits Times that aside from heeding tripartite recommendations, employers should set aside an insistence on MCs and consider giving time off when needed.
The Manpower Ministry (MOM) first issued an advisory in September last year on work and leave arrangements for employees who test positive for Covid-19 but are mildly symptomatic or physically well.
It suggests that such employees should self-isolate at home and not report to the workplace regardless. Those who are physically well should be allowed to work from home; if that is not possible, employers should treat the period of absence as paid sick leave without requiring an MC.
Despite these guidelines, "unfortunately many employers are either unaware or still insistent on MCs… especially for workers who cannot work from home", said Dr Tan Teck Jack, chief executive of Northeast Medical Group.
Dr Yan Shi Yuan, director of Edgedale Medical Clinic, said he has seen Covid-19 patients who, while able to work from home, feel unwell and go to his clinic to obtain an MC to rest and be excused from work.
"It really depends on whether their bosses take ART (antigen rapid test) positive results as confirmation of Covid-19 infection," he added, noting that his own company's policy is for staff to stay home with no need to take MC, even if it is just their family members who are ART-positive.
Dr Leong Hoe Nam, an infectious diseases specialist at Mount Elizabeth Novena Hospital, said a positive ART should suffice as "documentation" if the employee needs time off from work.
This would help reduce the workload at clinics and prevent them from becoming "MC-issuing centres", he added, calling it an unnecessary distraction and waste of resources.
The Ministry of Health had announced at the start of the year that GPs would take on more responsibility in deciding which Covid-19 patients require closer supervision and which can safely recover at home.
Dr Quah Soon Wee from the Crossroads Family Clinic in Tampines told ST he has since seen a definite rise in Covid-19 cases among his patients.
Dr Yan said that since reopening his clinics after the Chinese New Year holiday, more than half of patients have arrived with acute respiratory infections (ARI), of which up to 40 per cent were ART-positive.
Last week, the proportion of ARI cases at his clinics was some 30 per cent to 40 per cent, an increase from the usual load of around 10 per cent to 20 per cent.
On Wednesday, ST reported that some clinics have seen up to three times more Covid-19 cases since the start of the year.
These spiking caseloads are in tandem with a rising daily community infection rate, with experts anticipating numbers to further hit 10,000 to 15,000 a day in coming weeks.
"GPs are struggling," said Dr Yan. "There's also a lot of back-end paperwork, counselling, phone calls coming through with regard to what to do during home recovery… A lot of the burden has been pushed to GPs."
He is also seeing more Covid-19 cases among children walking in at his clinic.
Dr Carol Tan, medical director at The Good Life Medical Centre, stressed that family leave, for people who need to take care of vulnerable kin, was as important an issue as medical leave.
"I have many family members juggling the needs of their elderly parents and their jobs."
She also pointed to the need to better support the likes of gig workers who do not have paid medical leave and cannot afford to take time off even after contracting Covid-19.
Mr Sim Gim Guan, executive director of the Singapore National Employers Federation, said: "Employers generally understand that it would be worse if their employees who are Covid-19-positive turn up for work and infect their colleagues."
Dr Tan from Northeast Medical said progressive human resource policy and empathy from employers was the way forward.
When employees come down with illnesses like Covid-19 - which require prolonged recovery - employers should think about factors such as longer-term company loyalty and retention of talent, he noted.
Said Dr Leong: "If the person needs time off from work, give the person time off. There should be trust in the staff. If you cannot have this trust, perhaps it is time to change staff."