'SWAT team' may be set up to tackle disease outbreaks
By Audrey Tan, The Straits Times, 29 Dec 2015
A Ministry of Health (MOH) task force is considering setting up a national-level "SWAT team", comprising infectious disease experts who can be mobilised at short notice to respond to outbreaks in any healthcare institution here.
Such a team will strengthen Singapore's capabilities to respond to outbreaks, said Minister of State for Health Chee Hong Tat, as it is not feasible for every healthcare facility to have a full-fledged infection control response team that can respond to complex and unusual outbreaks.
The "SWAT team" is one of four measures being considered by the task force set up earlier this month to help Singapore better respond to unusual infections, in the wake of the hepatitis C outbreak at the Singapore General Hospital (SGH) earlier this year.
Mr Chee, chairman of the task force, gave the update at Tan Tock Seng Hospital yesterday at the launch of an SG50 book and video about Singapore's experience in overcoming infectious diseases.
Other measures being considered include reviewing standard operating procedures, making better use of technology and reviewing the list of notifiable diseases under the Infectious Diseases Act.
Mr Chee said: "The 'SWAT team' members can come from different institutions in Singapore (in) both public and private sectors.
"There could be a few full-time members while the rest are experts from our hospitals, universities and government agencies who MOH could call upon and activate during an outbreak."
To date, 25 patients who were warded at SGH have been diagnosed with the same family of hepatitis C virus. Eight patients have died, with the hepatitis C virus infection "a likely contributory factor" in seven of the deaths.
By Audrey Tan, The Straits Times, 29 Dec 2015
A Ministry of Health (MOH) task force is considering setting up a national-level "SWAT team", comprising infectious disease experts who can be mobilised at short notice to respond to outbreaks in any healthcare institution here.
Such a team will strengthen Singapore's capabilities to respond to outbreaks, said Minister of State for Health Chee Hong Tat, as it is not feasible for every healthcare facility to have a full-fledged infection control response team that can respond to complex and unusual outbreaks.
The "SWAT team" is one of four measures being considered by the task force set up earlier this month to help Singapore better respond to unusual infections, in the wake of the hepatitis C outbreak at the Singapore General Hospital (SGH) earlier this year.
Mr Chee, chairman of the task force, gave the update at Tan Tock Seng Hospital yesterday at the launch of an SG50 book and video about Singapore's experience in overcoming infectious diseases.
Other measures being considered include reviewing standard operating procedures, making better use of technology and reviewing the list of notifiable diseases under the Infectious Diseases Act.
Mr Chee said: "The 'SWAT team' members can come from different institutions in Singapore (in) both public and private sectors.
"There could be a few full-time members while the rest are experts from our hospitals, universities and government agencies who MOH could call upon and activate during an outbreak."
To date, 25 patients who were warded at SGH have been diagnosed with the same family of hepatitis C virus. Eight patients have died, with the hepatitis C virus infection "a likely contributory factor" in seven of the deaths.
An independent review panel found that while there were solid reporting procedures for well-known infectious diseases and epidemics, these were not effective in catching an unusual and unfamiliar outbreak like the hepatitis C infections.
Associate Professor David Lye, senior consultant at Tan Tock Seng Hospital's Infectious Diseases Department and Institute of Infectious Diseases and Epidemiology, said a "SWAT team" is a fantastic idea. "We are small and we do not have the same number of experts in every institution. The 'SWAT team' allows us to get experts from different areas together very rapidly and work together on an emergent issue," he said.
Task force studying measures to tackle disease outbreaks
By Audrey Tan, The Straits Times, 29 Dec 2015
Clearer guidelines and a simplified process for reporting cases of infectious diseases are among the measures being considered by a task force set up to boost Singapore's ability to tackle infectious disease outbreaks.
The task force was set up earlier this month by the Ministry of Health (MOH) in the wake of lapses revealed by the hepatitis C infections at the Singapore General Hospital (SGH) earlier this year.
"What we want is to encourage and enable medical professionals to report cases which they come across by providing clearer guidelines and simplifying the reporting process where possible, for example, by having a direct link from the laboratory to MOH on positive cases," said Minister of State for Health Chee Hong Tat, who chairs the task force.
He said the task force will look at the "modes of notification, timelines and escalation process" of infectious diseases, but be mindful about not adding to the workload.
"The task force will be careful about the downsides of adding more reporting and administrative burden for our healthcare institutions and medical professionals," he said, citing a need to keep standard operating procedures simple and help medical professionals "focus on their core responsibilities and to comply with existing infection-control protocols".
The task force will also relook the list of notifiable diseases under the Infectious Diseases Act, and have a national-level "SWAT team" of infectious disease experts who can be mobilised at short notice.
By Audrey Tan, The Straits Times, 29 Dec 2015
The task force was set up earlier this month by the Ministry of Health (MOH) in the wake of lapses revealed by the hepatitis C infections at the Singapore General Hospital (SGH) earlier this year.
"What we want is to encourage and enable medical professionals to report cases which they come across by providing clearer guidelines and simplifying the reporting process where possible, for example, by having a direct link from the laboratory to MOH on positive cases," said Minister of State for Health Chee Hong Tat, who chairs the task force.
He said the task force will look at the "modes of notification, timelines and escalation process" of infectious diseases, but be mindful about not adding to the workload.
"The task force will be careful about the downsides of adding more reporting and administrative burden for our healthcare institutions and medical professionals," he said, citing a need to keep standard operating procedures simple and help medical professionals "focus on their core responsibilities and to comply with existing infection-control protocols".
The task force will also relook the list of notifiable diseases under the Infectious Diseases Act, and have a national-level "SWAT team" of infectious disease experts who can be mobilised at short notice.
It also plans to make better use of data analytics and information technology systems to boost the detection of potential outbreaks.
"Our current system depends too heavily on human judgment to process large amounts of information and decide whether the risks are significant enough for escalation and further investigation," said Mr Chee, who is also Minister of State for Communications and Information, at the launch of an SG50 book and video about Singapore's experience in overcoming infectious diseases.
Currently, most measures to prevent and control infectious diseases here come under the Infectious Diseases Act, which includes provisions for the director of medical services of MOH to get patient information from doctors to investigate an outbreak, for instance.
To date, 25 patients who were warded at SGH have been diagnosed with the same family of hepatitis C virus. Eight patients have died, with the hepatitis C virus infection "a likely contributory factor" in seven of the deaths.
Professor Paul Tambyah, secretary-general of the Asia Pacific Society of Clinical Microbiology and Infection, said the measures identified were a good starting point.
But he said Singapore could also look at adopting a "one health" approach, which looks at human and animal health together. This could be an area of interest, especially with the recent outbreak of Group B Streptococcus infections linked to raw freshwater fish.
Professor Leo Yee Sin, director of the Institute of Infectious Diseases and Epidemiology at Tan Tock Seng Hospital, said the measures were critical areas for the task force to follow up on. One area of interest is how to improve the notification system, she said, adding that she thought Singapore was in a good position to do this, as a lot of the recording is done electronically.
"The trick is how to take the electronic information and make sense of it using electronic and big data analysis," she said. "But recognising the amount of data is not enough. Step Two would be to identify and analyse the data, and (take) response action."
Outbreak response unit 'a good idea'
MOH idea to set up infectious diseases 'SWAT team' gets thumbs up from healthcare experts
By Audrey Tan, The Straits Times, 30 Dec 2015
The idea to have a quick-response "SWAT team" to tackle outbreaks of infectious diseases in Singapore is a good one, experts have said.
The idea had come from a Ministry of Health (MOH) task force set up in the aftermath of the outbreak of hepatitis C at the Singapore General Hospital, which was linked to several deaths earlier this year.
The experts said that such a team would provide healthcare institutions with the expertise needed to deal with complex and unusual outbreaks.
The "SWAT team" would also be able to provide an "unbiased assessment" of the situation, said Dr Leong Hoe Nam, an infectious diseases specialist from Mount Elizabeth Novena Hospital.
MOH idea to set up infectious diseases 'SWAT team' gets thumbs up from healthcare experts
By Audrey Tan, The Straits Times, 30 Dec 2015
The idea to have a quick-response "SWAT team" to tackle outbreaks of infectious diseases in Singapore is a good one, experts have said.
The idea had come from a Ministry of Health (MOH) task force set up in the aftermath of the outbreak of hepatitis C at the Singapore General Hospital, which was linked to several deaths earlier this year.
The experts said that such a team would provide healthcare institutions with the expertise needed to deal with complex and unusual outbreaks.
The "SWAT team" would also be able to provide an "unbiased assessment" of the situation, said Dr Leong Hoe Nam, an infectious diseases specialist from Mount Elizabeth Novena Hospital.
"Doctors within the hospital... may be under inappropriate pressure to report findings that are less truthful but better for the hospital's reputation," he said.
On Monday, Minister of State for Health Chee Hong Tat said that the MOH task force was considering setting up a national-level "SWAT team". It would comprise infectious disease experts who can be mobilised quickly to respond to outbreaks in any healthcare institution here.
On Monday, Minister of State for Health Chee Hong Tat said that the MOH task force was considering setting up a national-level "SWAT team". It would comprise infectious disease experts who can be mobilised quickly to respond to outbreaks in any healthcare institution here.
The "SWAT team" is one of four measures being considered by the task force, which was set up earlier this month.
Other measures include reviewing standard operating procedures, making better use of technology and reviewing the list of notifiable diseases under the Infectious Diseases Act.
Associate Professor David Lye, senior consultant at Tan Tock Seng Hospital's Infectious Diseases Department and Institute of Infectious Diseases and Epidemiology, said that similar response units have been implemented overseas.
He said: "An example of this would be the Epidemic Intelligence Service (EIS), part of the United States Centres for Disease Control and Prevention (CDC).
"The US has a lot of small hospitals and there are outbreaks every year, everywhere. The EIS attends to some of these outbreaks in smaller hospitals, as well as overseas. That is definitely a great idea and should be developed further."
For instance, the CDC last year sent EIS officers to West Africa in response to an Ebola outbreak there, in the largest international outbreak response in the CDC's history.
Professor Paul Tambyah, secretary-general of the Asia-Pacific Society of Clinical Microbiology and Infection, said that while it is not yet clear what form the Singapore "SWAT team" will take, the EIS was "very effective". He said: "They get sent anywhere, and investigate anything - community outbreaks, hospital outbreaks."
But Dr Leong pointed out that for the "SWAT team" to be effective, it must be given access to cutting-edge laboratory research.
"Science has changed over the last five years, and we can now get genetic signatures of the viruses concerned ," he said.
"This is often a research tool not available to hospitals. Yet, it is crucial and should be considered a country resource."
"This is often a research tool not available to hospitals. Yet, it is crucial and should be considered a country resource."
* MOH Taskforce On Strengthening Outbreak Detection And Response Completes Its Review - 8 Jul 2016
Changes to boost disease-outbreak control
They include letting healthcare staff report outbreaks anonymously, beefing up IT systems that track incidents
By Linette Lai, The Straits Times, 9 Jul 2016
Healthcare professionals will soon be able to anonymously report infectious disease outbreaks, and IT systems used to track these incidents will be beefed up.
These are some of the changes made at the recommendation of a task force set up last December to strengthen outbreak detection and response in Singapore.
The eight-member team's 15 recommendations also included measures to improve how the Ministry of Health (MOH) monitors infectious diseases, as well as establish a clear decision-making structure.
The team also proposed changes to boost communication between healthcare institutions and ensure such outbreaks can be properly handled even outside acute hospitals.
The task force, headed by Minister of State for Health Chee Hong Tat, was established in the wake of the hepatitis C outbreak at the Singapore General Hospital last year.
Then, 25 kidney patients admitted between January and September were diagnosed with the viral infection. Eight of them died.
Following this, an independent review committee was set up to probe the causes behind the outbreak. It concluded that poor infection control practices and a slow response time were to blame.
Changes to boost disease-outbreak control
They include letting healthcare staff report outbreaks anonymously, beefing up IT systems that track incidents
By Linette Lai, The Straits Times, 9 Jul 2016
Healthcare professionals will soon be able to anonymously report infectious disease outbreaks, and IT systems used to track these incidents will be beefed up.
These are some of the changes made at the recommendation of a task force set up last December to strengthen outbreak detection and response in Singapore.
The eight-member team's 15 recommendations also included measures to improve how the Ministry of Health (MOH) monitors infectious diseases, as well as establish a clear decision-making structure.
The team also proposed changes to boost communication between healthcare institutions and ensure such outbreaks can be properly handled even outside acute hospitals.
The task force, headed by Minister of State for Health Chee Hong Tat, was established in the wake of the hepatitis C outbreak at the Singapore General Hospital last year.
Then, 25 kidney patients admitted between January and September were diagnosed with the viral infection. Eight of them died.
Following this, an independent review committee was set up to probe the causes behind the outbreak. It concluded that poor infection control practices and a slow response time were to blame.
The team comprised experts in infectious diseases, systems engineering and data science.
For example, MOH said in a statement yesterday, healthcare professionals will be able to anonymously report outbreaks "to encourage a culture of open reporting".
"People on the ground sometimes have a better sense of what is going on," said Adjunct Associate Professor Lim Poh Lian, who heads the infectious diseases department at Tan Tock Seng Hospital.
"Doing so takes away some of the barriers to why people might not want to come forward, because they might not want to cause trouble."
The ministry has designated its Communicable Diseases Division as the unit in charge of overseeing surveillance of all infectious diseases and outbreak reporting.
MOH has also expanded the list of notifiable infectious diseases, which doctors are required by law to report to the authorities, from 43 to 49.
The list, which originally included diseases such as dengue and Ebola, will now also include botulism, tetanus, leptospirosis, murine typhus, rabies and Japanese encephalitis.
On the technology front, the task force recommended that MOH improve its data analytic capabilities to monitor the situation and trigger alerts if abnormalities are detected.
MOH said it will consolidate data from different sources and design the system to trigger alerts if needed. It will also share the data collected with healthcare institutions, after putting in safeguards to protect individuals' privacy.
"This two-way information flow will help to improve surveillance and early detection, enhance situational awareness across institutions, and encourage sharing within the healthcare system for better infection prevention and control," it said.
MOH had previously announced the initial recommendations of the task force in March. These included setting up a new National Outbreak Response Team, as well as simplifying the process of notifying the authorities of infectious diseases.
Professor Leo Yee Sin, who is director of the Institute of Infectious Diseases and Epidemiology and chaired the independent review committee, said the changes show a conscious effort to continue improving our healthcare system.
"This is quite a major change," she said. "Although the entire system in Singapore is well known to be good internationally, we have to look into continuing to improve all our processes."
"This is quite a major change," she said. "Although the entire system in Singapore is well known to be good internationally, we have to look into continuing to improve all our processes."
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