Should community pharmacies provide COVID-19 screening services?
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COMMENTARY
Should community pharmacies provide COVID‑19 screening services? Ching Siang Tan1 Published online: 14 August 2020 © Springer Nature Switzerland AG 2020
Introduction As of 3 June 2020, the World Health Organization (WHO) has reported more than 6 million confirmed cases of coronavirus disease 2019 (COVID-19) and 373,548 confirmed deaths in 216 countries around the world [1]. Recognising the shortage of healthcare facilities in low- and middle-income countries (LMICs) compared with developed countries, LMICs are likely to experience high mortality rates and detrimental effects on the economy [2]. To date, Malaysia has seen the number of COVID-19 cases increase to 7877, with a death toll of 115 [3]. Since its beginning in December 2019, the manifestations of pneumonia-like symptoms were confirmed to be caused by a novel type of coronavirus closely resembling the viruses that cause severe acute respiratory syndrome and Middle East respiratory syndrome. COVID-19 patients can develop rapidly worsening respiratory failure and acute respiratory distress syndrome [4].
Handling of the COVID‑19 pandemic in Malaysian health facilities Since 30 January 2020, the Malaysian Ministry of Health (MOH) has upgraded public hospitals and public health laboratories throughout the country to have the capacity to carry out real-time reverse transcriptase-polymerase chain reaction (RT-PCR) tests to detect COVID-19 [5]. As of 29 March 2020, the laboratory capacity in the country was expanded to 25 laboratories nationwide, including 18 MOH laboratories and 7 private laboratories [6]. Recently, the Ministry of Higher Education and the Ministry of Science, Technology and Innovation have set up 10 additional * Ching Siang Tan [email protected] 1
School of Pharmacy, KPJ Healthcare University College, Lot PT 17010 Persiaran Seriemas, Kota Seriemas, 71800 Nilai, Negeri Sembilan, Malaysia
diagnostic laboratories at institutions of higher learning and university teaching hospitals to enhance COVID-19 testing capacity [6]. As of 4 April 2020, there are 43 laboratories and 18 hospitals available across the country that can conduct COVID-19 RT-PCR tests [7]. In Malaysia, RT-PCR tests for COVID-19 are only conducted in symptomatic patients, with samples for testing being taken at health care centres by qualified physicians, which are then transported to the nearby laboratories appointed by the MOH for further testing. To detect lower respiratory tract infection, samples are collected from the sputum, tracheal aspirate and bronchoalveolar lavage; for upper respiratory tract infection, nasopharyngeal and oropharyngeal swabs are taken. A single negative test result, particularly if the sample was collected from an upper respiratory tract, does not exclude COVID-19, and repeat sampling and testing are required. Taking samples from the lower respiratory tract is strongly recommended in patients with severe or progressive disease [8]. If samples are transported to nearby laboratories for testing for the presence of COVID-19 within 72 h
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