ABU DHABI // Hospitals in the capital are charging patients up to Dh1,000 for often unnecessary swine flu tests, a practice banned in Dubai. Patients have been demanding the tests after hearing of the side-effects of Tamiflu, in order to avoid taking the antiviral drug unless they are definitely infected.
However, in most cases even this is unnecessary. The World Health Organisation (WHO) recommends that otherwise healthy patients who have flu-like symptoms but no other complications need not be treated with antivirals or tested for the virus. It says most patients infected with the virus will recover fully within a week without taking antivirals. It also advises doctors in areas where the virus is widespread to assume that patients with flu-like illnesses have H1N1, rather than waiting for laboratory confirmation before beginning treatment.
The elderly, very young, pregnant women and people with chronic diseases should also be treated immediately without waiting for test results, the WHO says. Some private hospitals are offering tests for anyone willing to pay between Dh250 (US$68) and Dh1,000, and are charging up to Dh180 for Tamiflu. The Gulf Diagnostic Centre charges Dh1,000, plus a Dh300 consultation fee, while the New Medical Centre charges Dh250 for the laboratory test. Al Noor Hospital said it would not do the swine flu test and advised people to go to a government hospital.
The Dubai Health Authority (DHA), meanwhile, has told hospitals not to charge for the test. Dr Ali al Marzouqi, the head of public health affairs at the authority, said it had instructed private hospitals in the emirate to provide the H1N1 swab tests free of charge, but only when necessary under international guidelines. He added that if the DHA learnt of any violation it would "take the necessary action". This could include financial penalties.
In line with WHO guidance, not everyone would be tested for swine flu. "It will be decided on a case-by-case basis. We will test those with severe illness or high-risk. For others, if anyone is suspected of having the disease we either give them the medication or do not give them anything at all," Dr al Marzouki said. In the latter case, the patient would normally be told to rest at home and avoid social contact.
The Welcare Hospital in Dubai also said the decision to test was made on a case-by-case basis, and there would not be a charge for it. However, patients must pay a consultation fee of Dh450. Tamiflu would cost Dh180, a cashier said. Some patients have expressed concern about the side-effects of Tamiflu, which include nausea and vomiting, and therefore want to be tested for the H1N1 virus before taking it. One mother said she did not want to give it to her 10-year-old daughter, who had influenza-like symptoms, unless she was confirmed as a positive swine flu case. One of the two pregnant women who have died in the UAE of swine flu complications had refused to take Tamiflu out of fear for her unborn baby.
Yesterday Dr Ashraf Mahmoud Elhoufi, head of intensive care at Dubai Hospital, said it was very important for people in the high-risk groups - very young, elderly, pregnant women and those with chronic diseases - to take Tamiflu if they had flu-like symptoms. Otherwise healthy people did not always need to be tested or given antivirals. "If you are high-risk or very ill, take Tamiflu," he said. "People should not be afraid to take it."
The Health Authority-Abu Dhabi and Ministry of Health did not respond to queries about testing and regulations yesterday. Several attempts to call the HAAD's 800800 customer service number were unsuccessful. In Sharjah, Al Zahra Private Hospital said it did not perform the test but would prescribe Tamiflu for Dh180. The Central Private Hospital said it would charge Dh110 for the laboratory test which would be carried out after an evaluation of the patient's symptoms.
A source at the National Committee to Combat Swine Flu said the body had met late on Sunday to try to develop a unified approach to testing across all the emirates. It is understood that the central laboratory in Dubai, which takes samples from both public and private hospitals, does not charge the facilities for testing for the H1N1 virus as it is a public health issue. According to the same source, the bill for a two-week period, to be paid by the DHA, was more than Dh2 million.
munderwood@thenational.ae
