Following the latest information from the World Health Organisation (WHO), Malaysia will change its Covid-19 treatment protocol and discharge patients after 14 days even if they test positive for the virus.

Patients will then be advised to undergo home quarantine for 14 days.

The reason for this new protocol is as patients’ infectivity levels have been found to plunge to zero after two weeks, Health Ministry director-general Dr Noor Hisham Abdullah said today.   

“According to a WHO report, those who have been infected for more than 14 days will have zero infectivity.

“Therefore, based on this new information, we can discharge patients after 14 days even if they test positive using an RT-PCR test.

“This is the new action we will take based on the latest information. We will change our protocol with regards to positive patients,” he said during his daily briefing this evening.

He added that a positive RT-PCR test result after 14 days was possibly due to the detection of “dead virus” or a “fragment of the virus RNA”.

“The test will show a weak positive. A weak positive means a patient can’t infect others anymore. And their infectivity level has dropped to almost zero,” he explained.

For the record, a number of studies have shown that Covid-19 patients could test positive for weeks even though they have long recovered from their symptoms.

This is partly because the RT-PCR test detects the presence of the virus through the presence of certain genetic markers thought to be unique to the virus. It is incapable of distinguishing between a 'live' virus from one that has already been inactivated.

Attempts to grow the virus on Petri dishes using samples taken from such patients are unsuccessful when the samples are collected more than about nine days after symptoms appear, which suggest the virus is no longer viable past that point although it would still give a positive result in RT-PCR tests.

This is backed by other studies that looked at the timing of when infected people pass on the infection to other people, which found Covid-19 patients are most infectious just before symptoms appear but the infectivity declines rapidly over the course of about a week afterwards.

Presently, Malaysia discharges Covid-19 patients after they test negative once using RT-PCR no matter how long they have been in treatment.

As for WHO’s decision to pause trials into using hydroxychloroquine to treat Covid-19, Noor Hisham said Malaysia will continue administering the anti-malaria drug with caution.

Doctors will continue to monitor patients for side effects which include irregular heartbeats, headaches, blurred vision, muscle tenderness and gastrointestinal symptoms like diarrhoea.

“We will still use it but carefully,” he said, adding that such treatment would be stopped once side effects are detected.

Previously, the top official said the hydroxychloroquine had helped prevent asymptomatic Covid-19 patients and patients with mild symptoms from worsening due to its anti-inflammatory effect of the lungs.

The WHO previously cautioned against using the drug to treat Covid-19 but still included it as one of the four treatments being tested under its global Solidarity Trial programme.

This week, the body suspended testing hydroxychloroquine following research that associated its use with lower chances of survival.

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