Wuhan virus: Public hospitals in Singapore in 'outbreak response mode'

All medical staff dealing with suspected cases are well protected with personal protective equipment and powered air-purifying respirators - to filter out any possible virus.
The Straits Times

SINGAPORE - All public hospital emergency departments here are on "outbreak response mode" as Singapore raises its defences against a mysterious virus that is spreading in China.

"We cannot rule out the possibility that the new (Wuhan) virus will reach Singapore," Professor Leo Yee Sin, executive director of the National Centre for Infectious Diseases (NCID), told The Straits Times. The stakes are higher now that the virus has started spreading from human to human.

All patients at emergency departments are screened, and those with fever and travel history are isolated. All general practice doctors have also been told what to look out for and given a number to call if there are any suspected patients.

Any such call from a doctor will activate a special ambulance which will transport the suspected patient straight to the NCID. This is to nip the spread of the virus in the bud. The ambulance will then be properly cleaned before it is used again.

At the NCID, the patients will be placed in special negative-pressure isolation rooms, where air flows only into the rooms, not out of them.

The air in the rooms is sucked out through high-efficiency particulate air, or Hepa, filters.

Prof Leo said the NCID has "high-end" Hepa filters in 124 negative-pressure isolation rooms which clean 99.999 per cent of contaminants, including viruses.

As an extra precaution, even after it has gone through the filters, the air is further cleaned with ultraviolet rays.

It will take the laboratory between four and eight hours to determine if the patient is infected with a coronavirus. If that test proves positive, genetic sequencing will be done to confirm that it is the new bug. That takes 24 hours.

Prof Leo said there are a lot of coronaviruses but only seven, including this new one, that spread from human to human.

Four types cause the common cold and are mild. The other two are the more dangerous Sars (severe acute respiratory syndrome) and Mers (Middle East respiratory syndrome).

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A negative-pressure isolation room at the National Centre for Infectious Diseases. ST PHOTO: DESMOND FOO
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The negative-pressure ward at the National Centre for Infectious Diseases. ST PHOTO: DESMOND FOO

Fifteen medical staff in Wuhan have contracted the bug, currently called the 2019-nCoV.

Prof Leo said that it is not yet known whether this virus is as dangerous as Sars.

But Singapore is not taking chances. All medical staff dealing with suspected cases are well protected with personal protective equipment (PPE) and powered air-purifying respirators - to filter out any possible virus.

Prof Leo said Singapore has a stockpile of the disposable PPE as well as the powered air-purifying respirators - enough to supply all hospitals, should a major outbreak occur here. "Yes it is expensive, but protection of staff is the most important thing," said Prof Leo, a veteran of the Sars outbreak in 2003, when medical staff caring for infected patients were among the 238 people infected and the 33 who died.

The 330-bed NCID, which opened slightly over a year ago, has more than 100 "surge beds", which are kept empty and on standby for national emergencies.

 
All medical staff dealing with suspected cases are well protected with personal protective equipment and powered air-purifying respirators - to filter out any possible virus. ST PHOTO: DESMOND FOO
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Professor Leo Yee Sin, executive director of the National Centre for Infectious Diseases. ST PHOTO: DESMOND FOO

Although the flu vaccine does not protect against the Wuhan bug, she said it is a good idea to get vaccinated. On a national level, it will "cut down on the background noise".

She added that should there be a positive case of the Wuhan bug here, people will be told.

"We need to be able to share the information and be able to guide the public, as well as the entire public healthcare system, to be able to handle the situation," she said.


Measures put in place in Singapore

WIDER DEFINITION

Singapore's Ministry of Health has widened its definition of suspect cases, and it will now include anyone with pneumonia who had been to China - not just Wuhan - within 14 days of the start of the illness. Anyone with acute respiratory infection who has been to any hospital in China within a fortnight of getting ill will also be treated as a suspect case.

MORE SCREENINGS

From today, Changi Airport will conduct temperature screening for all flights from China, and not just those from Wuhan. So far, all seven suspected cases in Singapore have proven not to have the Wuhan bug.

SUSPECT CASES

All patients at emergency departments are screened, and those with fever and travel history are isolated. At the National Centre for Infectious Diseases (NCID), the patients will be placed in special negative pressure isolation rooms, where air flows only into the rooms, not out of them.

The air in the rooms is sucked out through high-efficiency particulate air, or Hepa, filters. As an extra precaution, even after it has gone through the filters, the air is further cleaned with ultraviolet rays.

GP DOCS ON THE WATCH

All general practice doctors have been told what to look out for and given a number to call if there are any suspect patients.

SPECIAL AMBULANCES

Any such call from a doctor will activate a special ambulance which will transport the suspected patient to the NCID. This is to nip the spread of the virus in the bud. The ambulance will then be properly cleaned before it is used again.


Precautions for the public

• Avoid contact with live animals, including poultry and birds. Do not eat raw or undercooked meat.

• Avoid close contact with people who are sick.

• Observe good personal hygiene.

• Wash hands with soap frequently, such as before eating, after going to the toilet, or if dirtied through sneezing or coughing.

• Wear a mask if you have a cough or runny nose.

• Cover your mouth with a tissue when coughing or sneezing, and dispose of the soiled tissue paper in the rubbish bin immediately.

• Seek medical attention promptly if you are feeling unwell.

This article was first published in The Straits Times. Permission required for reproduction.