Steps taken in hepatitis C outbreak need explanation

I read with concern about Singapore General Hospital’s (SGH) hepatitis C outbreak (“4 dead after 22 infected in SGH hep C outbreak”; Oct 7). Several questions spring to mind about the timeline, which I hope the health authorities will clarify.

Why did SGH take 1.5 months after the 19th and 20th cases were detected, between July 7 and 15, to inform the Ministry of Health (MOH) of the hepatitis C cluster, in late August?

Are 20 cases of hepatitis C within three months, April to July, insufficient cause to inform MOH immediately about the matter? When MOH was informed, did it ask SGH about the delay? If so, was it satisfied with the response provided?

After learning of the outbreak, why did MOH not inform the public immediately? What did MOH and SGH consider in deciding to withhold this information? Was it because they had not ascertained the exact cause of the outbreak, or because investigations by SGH were not fully completed?

The exact cause of the outbreak has still not been ascertained, so what made SGH decide to make the matter public now versus waiting for the independent review committee to complete its work in two months’ time?

If MOH and SGH are able to provide comprehensive answers, it would help the public understand the rationale for their decisions and provide reassurances that they are acting in the interests of patients and the public.