Threat of epidemic is ever-present, Gan warns

SINGAPORE — It is not a matter of if but when the world will be hit by the next global health scare, and Singaporeans should draw on the successful fight against the Severe Acute Respiratory Syndrome (SARS) a decade ago in making sure that the country is ready to cope with it, Health Minister Gan Kim Yong said yesterday.

“The ever-present threat of infectious diseases remains a concern worldwide ... surely it will come one day,” said Mr Gan, who was speaking at a SARS commemorative ceremony held at Tan Tock Seng Hospital (TTSH).

Urging Singaporeans to “remain vigilant and be prepared all the time”, Mr Gan added: “In our highly globalised world, where cities are well connected by air travel, the transmission of infectious diseases has become much harder to control. There is a real risk of epidemics or outbreak of a new infectious disease spreading to Singapore, given our global connectivity.”

He noted that the World Health Organization recently sounded a global alert for a new virus which has emerged in the Middle East and has killed nine people so far. The Novel Coronavirus belongs to the same family as the SARS virus, which killed 33 people here — including five healthcare workers who died in the line of duty — and 774 worldwide in the outbreak a decade ago.

“We have raised the level of vigilance for this disease in our medical community, so that suspect cases can be detected, isolated and investigated quickly. So far, there have been no confirmed cases reported in Singapore,” said Mr Gan.

Speaking to reporters on the sidelines of the commemorative ceremony - which was attended by about 200 people, including nurses who were infected while caring for SARS patients - TTSH Chief Executive Officer Philip Choo said he was confident that Singapore would be ready to face another “moderate sized outbreak” like SARS.

“If you are talking about a true pandemic, for example H1N1, it spreads very easily... can’t be prevented actually, from person to person. Can the country protect itself against a pandemic the way we did for SARS? It will be difficult, but the smaller outbreaks, yes we can.”

Still, Singapore is “probably one of the better prepared countries for most outbreaks including a pandemic, because we are small enough, and also because we are rich enough for pay for things (to fight the outbreak)”, Professor Choo said.

He added that since the SARS crisis, a lot of processes have been put in place and tested in major exercises every year. For instance, medical doctors go through conversion courses so that they will be able to also treat patients in intensive care units. Newly-hired staff go through mask-fitting within the first month of work.

In his speech, Mr Gan also cited the “valuable lessons” which have translated into established work processes at hospitals. For instance, patients with symptoms of infectious diseases are segregated and managed differently. Hospitals now also practise visitor registration.

Mr Gan added that the number of isolation rooms in hospitals has increased to almost 400. During the SARS crisis, there were insufficient rooms and makeshift facilities had to be built. Singapore now also has 48 infectious disease physicians, a three-fold increase compared to 2003, he said.

At the commemorative ceremony at TTSH - which was designated as the sole screening and treatment centre for SARS on March 22, 2003 - a minute of silence was observed for SARS victims. An exhibition was also set up to educate visitors about the Republic’s three-month fight against the disease.

At National University Hospital, a commemorative ceremony and exhibition were also held yesterday.

The SARS crisis saw cluster outbreaks in TTSH, NUH and the Singapore General Hospital. Out of 283 people infected in total during the SARS crisis, 40 per cent were healthcare workers.

TTSH Senior Staff Nurse Ashirdahwani Asmawi, 34, was one of the healthcare workers who were infected while caring for SARS patient.

Recounting her ordeal, Ms Ashirdahwani said that she feared that she would die alone. Nevertheless, the experience has motivated her to be a better nurse, she said. “Previously, some things were just a task. Now I give my best, doing it because I want to do it. I’m very particular about cleanliness now, especially hand hygiene and protective wear, which prevents infections going around. I reinforce this point to my students too,” said Ms Asmawi, who is also a clinical instructor.

Paying tribute to healthcare workers, Mr Gan described SARS as “one of the darkest moments in Singapore’s history and yet, is remembered as one of our finest triumphs – when the nation banded together with resilience, determination and compassion”.

He said: “Our healthcare workers especially fought a valiant war and the episode brought a renewed appreciation for the nobility and importance of their profession.”

Thanking Singaporeans who had given their support to the healthcare professionals, Mr Gan said: “We did not face the crisis alone but as one people. Generous donations, from bottled drinks and herbal tea to fruits and food of all kinds, poured in abundantly from members of the public to keep our healthcare workers going. There were also numerous messages and handmade cards to encourage and thank these unsung heroes.”