GPs shoulder greater responsibilities in battle against Covid-19 Omicron variant

91% of Singapore's eligible population has completed the vaccination regimen, and 54% of the population has received the booster shot.

Joyce Teo

Joyce Teo

The Straits Times


GPs will play a bigger role in deciding which Covid-19 patients require closer supervision, and those who can safely recover at home. PHOTO: ST FILE

January 25, 2022

SINGAPORE – 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, like the Healthway Medical ones, are already handling more cases.

Dr Nelson Wee, deputy head of primary care at Healthway Medical Corporation, said its 70 GP clinics have seen a significant rise in the number of cases this year, compared with the November-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 noted. He attributed it largely to the high vaccination rates among the general population.

Ninety-one per cent of Singapore’s eligible population has completed the full vaccination regimen, and 54 per cent of the population has received the 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 Dr Edwin Chng.

Singapore froze new ticket sales for Vaccinated Travel Lane or VTL flights and buses entering Singapore from Dec 23 last year till Jan 20, due to the spread of Omicron.

In 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.

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

She had expected to do a PCR test but instead, the GP gave her another rapid test, and told her to stay at home and take the test 72 hours from the visit. “My sense of taste and smell is still around… it doesn’t even feel like I’m sick,” said Ms Lee, who has taken her booster jab.

Today, only those patients with risk factors or significant symptoms will be administered a polymerase chain reaction (PCR) test, doctors said.

These include high risk patients who are unwell – these are the immunocompromised, those aged 80 and above if they are inoculated, and those aged 50 and above if they are unvaccinated and those with an intermediate risk, said Dr Chng.

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

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

Protocol 2 is for those who are asymptomatic or have mild symptoms; they are to isolate at home for the first 72 hours, and test negative on a rapid test to end this.

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 is the group who may not have been infected and they can go out if they test negative on a rapid test.

These revised health protocols took effect from Jan 6. The authorities said on Friday (Jan 21) that they are preparing to progressively include more patient groups and settings under Protocol 2 in the next couple of weeks.

Dr Chng said unstable patients or those who exhibit worrying signs and symptoms should be sent to the hospital. Some examples of symptoms are shortness of breath, chest pain, palpitations, persistent diarrhoea and/or vomiting, while the signs can include a very fast heart rate, fast respiratory rate, low oxygen saturation, or low blood pressure, he added.

Stable patients assessed to be ineligible for home recovery may also be conveyed to a community treatment facility, he said. They include those who do not have a single room with attached toilet at home and foreign workers living in dormitories.

Dr Quek Koh Choon from 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.”

“Also, we now have influenza cases which may mimic Covid-19 infections,” he added.

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 existing Delta one. On Friday, the Government said 12,078 individuals have been confirmed to have the variant, and 34 of them require oxygen supplementation. Most needed oxygen for a day.

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

Not long after the new variant’s arrival was flagged by South African scientists in November last year, it started to spread like wildfire in various parts of the world.

Singapore prepared for its arrival by ordering all those who were suspected of having the new variant to be isolated at the National Centre for Infectious Diseases. They were to remain there until doctors were confident they were no longer infectious through repeat testing.

By Dec 27, the initial fear over Omicron had largely dissipated and those suspected of having it were allowed to recover under the home recovery programme, or managed at community care facilities and hospitals.

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