Wednesday, 11 March 2020

Singapore COVID-19 spread caused by socially irresponsible behaviour

1 in 5 patients went out or carried on with work despite being ill

Social activities for seniors organised by government agencies will be suspended for 14 days from 11 March 2020

Health Minister Gan Kim Yong urges people not to go out or doctor-hop if unwell
By Goh Yan Han, The Straits Times, 11 Mar 2020

One in five confirmed coronavirus patients here went out despite being unwell, said Health Minister Gan Kim Yong yesterday.

One in four also consulted more than one doctor, he said at a press conference, giving an update on the COVID-19 situation.

Urging Singaporeans not to go out or doctor-hop if they are unwell, he said: "I am very concerned that many of the locally transmitted cases resulted from the socially irresponsible actions of a few individuals who continued to go to work, and attended events, and participated in activities despite being unwell, and went on to spread the disease to their family, friends and other contacts."

About 35 of the 160 earlier confirmed cases did not minimise social contact despite developing fever or respiratory symptoms, or consult a doctor early when unwell.

More than a fifth continued to work or carried on with their daily routine despite being sick.

The dinner at SAFRA Jurong, for example, was attended largely by seniors who took part in singing classes and activities like line dancing and qigong at some community clubs and residents' committee centres.

Many were in multiple groups across the island. One person who was unwell attended the event on Feb 15 and later tested positive for the coronavirus.

This could have led to 18 additional cases that were also at the dinner and later tested positive, Mr Gan noted.

Of the 18, 10 continued with daily activities despite feeling unwell, spreading the virus to another 17 people who were not at the dinner.

Meanwhile, the Wizlearn Technologies cluster had three staff members who continued with their daily activities despite feeling unwell. One of them spread the virus to a family member who also continued with daily activities while ill.

This resulted in an extra four cases that did not work for the company.

Mr Gan also said that of the confirmed cases, 38 had gone to more than one general practitioner.

In fact, eight of the 38 visited three or more GP clinics.

The minister urged the public to refrain from doctor-hopping so that the same doctor can follow up on each case, and make the appropriate assessment if a patient needs to be tested for COVID-19.

Separately, the Ministry of Education said yesterday that the student passes of two international students will be terminated for breaching 14-day leave or stay-home rules.

One is an international postgraduate student at Nanyang Technological University's National Institute of Education (NIE), who breached his stay-home notice repeatedly and provided false information on his movements to the institution and NIE's board of discipline.

The other, a National University of Singapore international exchange student, was found to have breached the requirements of her leave of absence and made a false travel declaration to the university.

Social activities for seniors on hold for 14 days as precaution
Singapore looking at a fuller range of social distancing measures to curb spread of virus
By Lim Min Zhang and Goh Yan Han, The Straits Times, 11 Mar 2020

All social activities for seniors organised by government agencies will be suspended for 14 days from today, 11 March, as Singapore ramps up measures to protect a group particularly vulnerable to COVID-19.

More permanent steps will help combat threats over the long haul.

The precautions come amid a growing number of infections linked to a dinner at SAFRA Jurong - now Singapore's largest coronavirus cluster with 39 cases - attended by many senior citizens.

The suspension will affect courses and activities at community and residents' committee centres in areas like music, drama, dance, exercise, basic IT and career development.

The People's Association (PA) said the suspension will affect 2,600 classes and 11,000 activities attended by about 290,000 participants. PA defines seniors as those aged 50 and above.

Care services for seniors such as those at nursing homes and inpatient and day hospices, senior care centre services and home-based care services will continue to run, but with additional precautions.

Health Minister Gan Kim Yong, who co-chairs a multi-ministry task force to fight the coronavirus, said yesterday: "While we encourage seniors to be active, there is now evidence of COVID-19 transmission among the seniors participating in such social activities, because some individuals who were unwell had continued to participate in them."

Mr Gan said he is "very concerned" that many of the locally transmitted cases resulted from the socially irresponsible actions of a few individuals, young and old, who continued to go to work and socialise despite being unwell.

The new measures are the most extensive social distancing efforts to date, and could be extended even further.

National Development Minister and fellow task force co-chair Lawrence Wong noted that as the virus "spreads to countries everywhere", Singapore's approach must shift - maintaining basic surveillance at borders but doubling down on measures within the country.

The coronavirus has so far infected more than 114,000 people worldwide and killed over 4,000.

As of noon yesterday, Singapore had 166 confirmed cases, with 93 patients discharged.

Mr Wong said the Republic will look at a fuller range of social distancing measures, including for public events, community activities, school closures, religious services, workplaces and schools.

But the task force is mindful that such measures can be disruptive. Mr Wong said that for moves that are likely to be more disruptive, sufficient lead time would be given so Singaporeans can prepare well in advance. He likened the moves to "circuit breakers", where Singapore tries to "stop the transmission chain and flatten the epidemic curve".

Some will be implemented on a temporary basis, or over a discrete period of time, but there will also be permanent measures put in place.

One example is the SG Clean campaign, Mr Wong said: "That's something we should do, not just with this particular outbreak, but in fact we should adopt better hygiene standards at the personal level, at the public level."

Other measures that the Government will continue to stress include washing hands frequently with soap and using common serving utensils rather than double-dipping.

"It's critical to implement the right measures at the right time," said Mr Wong.

Coronavirus outbreak: Singapore mindful of need to calibrate social distancing measures, says Lawrence Wong
By Choo Yun Ting, The Straits Times, 11 Mar 2020

Even as Singapore intensifies social distancing measures to deal with the coronavirus outbreak, it is mindful that this has to be done in a calibrated manner, National Development Minister Lawrence Wong said yesterday.

Social activities organised by government agencies for seniors have been suspended for 14 days.

The authorities could ramp up such measures over time, said Mr Wong.

He noted that as the virus spreads worldwide, Singapore's approach must shift - maintaining basic surveillance at borders but doubling down on measures within the country, including social distancing.

"Increasingly, this is spreading everywhere in the world, and the possibility of shutting ourselves out is, I think, not something we want to contemplate, so border controls will become less relevant and effective," he noted, adding that the focus would be what to do within Singapore.

More extensive measures could also be implemented for public events, community activities and schools, for instance, and could include staggered hours or telecommuting.

"We have a range of social distancing measures that we are continuing to study, and whether they apply to events, to gatherings, to cruises... we will look at what's appropriate as the situation evolves, and whether or not we should apply tighter measures along the way," said Mr Wong.

He likened the measures to "circuit breakers" where Singapore tries to "stop the transmission chain and flatten the epidemic curve".

"We are very mindful that these measures can be very disruptive to the lives of Singaporeans.

"If we were to do all of them at one time, we will literally have to shut down our city and everything will grind to a halt."

Health Minister Gan Kim Yong stressed that the coronavirus situation remains unpredictable, given the rapid developments globally and experts saying the outbreak could last till the end of the year.

Singapore needs to be prepared for the long haul, he said, adding that the heightened hygiene measures that have been introduced are good for society, regardless of the COVID-19 outbreak.

Mr Wong said that the Government "will provide lead time" for social distancing measures that will have significant impact on Singaporeans, such as school closures.

The Government is constantly reviewing measures, including the current advisory on large-scale events, and the downstream implications that the tightening of these measures would have on future events such as the National Day Parade, said Mr Wong.

Mr Gan, who co-chairs the multi-ministerial task force on COVID-19 with Mr Wong, emphasised the importance of responsible behaviour to limit the spread of the virus in Singapore.

Noting that several confirmed cases had continued to engage in social activities even after developing respiratory symptoms, Mr Gan said that their irresponsible behaviour poses a risk to all Singaporeans.

"Measures we've implemented will only work if individuals operate and behave in a socially responsible manner," he said.

His comments were echoed by the Health Ministry's director of medical services Kenneth Mak, who said that maintaining social responsibility is key and stressed that those who are ill should follow doctors' advice to stay home and prevent further spread of the virus.

Ring-fencing close contacts remains an important strategy for Singapore, he added.

"We will continue to be safe in the community if we continue to maintain good personal hygiene," said Associate Professor Mak.

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