SINGAPORE: Singapore is preparing for various scenarios of how the global outbreak of a novel coronavirus could evolve, said Health Minister Gan Kim Yong in Parliament on Monday (Feb 3) as he warned of risks ahead and the need to “plan for the worst”.
“There could be a long road ahead,” he said in a ministerial statement delivered in response to six parliamentary questions filed about the latest virus outbreak, which first emerged in the Chinese city of Wuhan last December and has since spread to 23 countries around the world.
READ: In full - Gan Kim Yong's ministerial statement on whole-of-Government response to novel coronavirus
He referred to how it took about eight months from the first detected case of the Severe Acute Respiratory Syndrome (SARS) before the World Health Organization (WHO) declared it to be contained in July 2003.
How the current virus outbreak would turn out is unsure, Mr Gan said.
“Therefore, we must stand ready to respond to new developments as the situation evolves.”
First, he said there could be community spread in more Chinese cities beyond Wuhan or in other countries.
If this happens, there may be a need to roll out additional measures to prevent the importation and to contain the virus, said the minister, who described this as not an easy decision to make.
“We have to do what is necessary to protect the health and safety of our people and those who travel to Singapore,” he added.
The second scenario, according to Mr Gan, is local community spread.
“Despite our best efforts, this is a possibility that we must be ready for,” he said, while adding that the key to managing this is quick detection and limiting further spread, which calls on social responsibility from all Singaporeans.
“If the infected Singaporean wears a mask to protect others, and promptly sees a doctor and gets triaged for testing, the risk of further spread could be greatly reduced. Even if there is spread, quick action will help to limit its extent,” Mr Gan elaborated.
Once tested positive, the Government can also contact trace quickly, helping to reduce further spread to their close contacts, he added.
“If the community spread becomes very extensive, we will need to consider measures to reduce human to human interactions, such as cancelling mass gatherings, suspending schools, paring down non-essential care services and introducing further infection control and monitoring measures, to slow the spread,” said the minister.
In the third scenario, the virus could mutate to become more infectious and spread widely, resulting in a pandemic.
“This is the known unknown, and we have to assess what best to do, depending on how the virus mutates,” he told Parliament. For example, the virus may also become less infectious or less severe.
On the healthcare front, Mr Gan, who also co-chairs a multi-ministerial task force to direct the Government’s response to the new infectious virus, said Singapore is stepping up preparations for these potential scenarios.
This includes increasing the capacity of isolation beds by around 100 in the past two weeks.
Singapore has also been increasing its testing capacity to more quickly confirm suspect cases.
“Overall, we must stay calm but cautious. Our early intervention efforts have helped to contain the spread so far, but while we hope for the best, we must plan for the worst,” he said.
In a wide-ranging speech, Mr Gan also shared what is known about the novel coronavirus thus far, such as how it is most likely transmitted via droplets from an infected person and individuals can best protect themselves by practicing good hygiene.
The medical consensus at the moment is that the novel coronavirus is “more transmissible but appears less deadly than SARS”, he said, adding that available evidence also suggests a possible higher rate of human-to-human transmission than that of SARS.
He clarified that there is no evidence currently to suggest the virus is airborne. Nor is there a known curative treatment.
The development of a successful cure may take time, months or years, he added. The current approach is to provide good supportive care for the patients to reduce complications and to allow time for the patient to recover, he said.
Mr Gan also said that the current case fatality rate stands at around 2 to 3 per cent, with majority of the deaths among those with underlying medical conditions.
This is lower than the fatality rate of SARS, which was around 10 per cent. But this remains the initial stages of the outbreak, added the minister, noting that the actual severity “can only be assessed after some time”.
The Government has been following the situation in Wuhan closely since last December and responded rapidly with a series of measures to reduce the risk of import and spread of the virus since early January.
These include the implementation of temperature screening at the airport and the set-up of a multi-ministerial task force on Jan 22 as the confirmed cases in Wuhan increased significantly.
READ: Wuhan virus in Singapore: The first 7 days
READ: Wuhan coronavirus: Singapore to widen travel restrictions to all new visitors who recently travelled to mainland China
As the global and local situation evolves, the task force has since stepped up measures accordingly, such as a widening of travel restrictions to bar all new visitors of any nationality with recent travel history to China from entering Singapore and the suspension of new visas to those with Chinese passports.
There is also good surveillance systems in place to help identify cases, said Mr Gan, citing healthcare providers, especially polyclinics and GPs, that are on heightened alert and stand ready to deal with cases as they emerge.
Individuals also have a part to play by exercising social responsibility to prevent or stem any possible spread of the virus in the community.
Mr Gan said: “We had set up multiple lines of defence to reduce the risk of imported cases and local community transmission. We have been stepping up our posture and efforts at each line of defence.”
On their own, none of these measures are fool-proof, he added. “But when taken together, they will improve our resilience and ability to respond to this disease.”
In an update on the current situation in Singapore, Mr Gan said the number of confirmed cases here has remained at 18.
All of the confirmed cases are being treated in isolation rooms and the conditions of most of these confirmed cases are improving, he said.
Meanwhile, as of Sunday noon, 43 recently admitted suspect cases are pending test results, while 240 suspect cases were tested and cleared.
“To date, there is no evidence of local community transmission. However, we should not be complacent and we must be prepared for this scenario,” said the Health Minister.
GOVERNMENT WILL ACT SWIFTLY: GAN
Noting that Singaporeans may feel anxious given the many unknowns about the novel coronavirus, Mr Gan said: “Here, I want to reiterate the Government’s firm commitment that we will spare no efforts in protecting our people.
“We will act swiftly and share information on the novel coronavirus openly and as soon as possible,” he added.
“We have overcome several challenges as a nation in the past, such as SARS, H1N1, and Zika. In the face of this novel coronavirus, we have built up our defences, our capabilities, and we are stronger and more prepared."
Describing the need for a "whole-of-Singapore" response, Mr Gan added: “This is a fight that calls on every individual to do our part. We are confident that we can manage and overcome this situation as a nation, and emerge stronger together."
Mr Gan, in his speech, also acknowledged the healthcare workers on the frontlines and commended them for their bravery and selflessness.
"They have worked tirelessly over the past few weeks, missing their holidays or reunion dinners. They worked very hard so as to keep Singapore and Singaporeans safe," he said.
He also noted that the outbreak of the novel coronavirus is not just a problem for China, but for the world.
As such, Singapore will be putting together an assistance package to help the communities in China severely affected by the novel coronavirus, with more details to be provided later.