The Government has made clear that to enable the economy and society to reopen safely in Phase Two of the circuit breaker exit and beyond, it will expand the nation’s Covid-19 testing strategy and the testing capacity to 40,000 per day. 

The current testing focuses on active case finding among the community and active surveillance testing amongst the more vulnerable groups. 

However, as a doctor directly involved in the fight against Covid-19, I have concerns about the testing criteria among the student population.

Five secondary school students had tested positive for Covid-19 as part of the Ministry of Education’s proactive testing of school staff members and students aged 13 and above diagnosed with acute respiratory infection (ARI).

This testing strategy is commendable and enables early detection of cases so that they can be isolated to prevent further spread.

The testing should be extended to primary school students, who are currently not covered.

Instead, students aged 12 and below with ARI will be assessed by a doctor on whether a Covid-19 test is required.

The students are issued a five day medical certificate (MC) and will be required to stay at home. If they are still displaying respiratory symptoms after five days, they are advised to return to the same doctor for a follow-up check and the doctor may then refer them for a Covid-19 test.

The rationale cited for not making testing compulsory for younger students with ARI is that the swabbing might be uncomfortable for them and require healthcare professionals with special expertise.

While this may be true, swabbing is still a fairly non-invasive process.

Apart from the nasopharyngeal swab, there is also the option of an oral swab, although the yield may not be as high. 

I have personally administered the swab to my toddler when she developed a prolonged respiratory tract infection without her crying or struggling.

The current strategy of delayed swabbing of students below 13 carries a certain risk of them cross-infecting their family members during their five-day MC period should they be already infected with the coronavirus.

An early swab on day one of symptoms would mitigate such a risk and also enable appropriate quarantine of exposed staff and students.

I am encouraged to hear that the authorities are in the process of ramping up its testing capacity and understand the challenges involved in targeted swabbing of various sectors of the economy.

I would however strongly urge the authorities to consider swabbing primary school students as soon as they develop symptoms rather than wait for a prolonged illness.

With the country now in Phase Two and the economy opening up, early detection and isolation would be even more important in keeping all of us safe.

ABOUT THE WRITER:

Dr Shanaz Matthew Sajeed is a consultant in emergency medicine and intensive care medicine involved in the care of Covid-19 patients at a local healthcare institution.

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