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Wuhan virus: Infectious diseases centre Singapore's first line of defence

SINGAPORE: The National Centre for Infectious Diseases (NCID) is poised to be the first line of defence against the Wuhan virus, should it land in Singapore.

The centre, which opened in September last year, has begun conducting pre-screening for patients and designated a special precaution area for suspected cases. 

On Tuesday (Jan 21), the Ministry of Health broadened the criteria for suspected cases, a day after announcing temperature screening for all travellers arriving at Changi Airport from China.   

A notice placed outside the National Centre for Infectious Diseases.

Travellers with pneumonia who were in China within the two weeks before symptoms started showing will be isolated. Those with acute respiratory infection who have been to any hospital in China in the 14 days before symptoms surfaced will also be isolated.  

NCID has more than 330 isolation rooms within its Jalan Tan Tock Seng facility, where suspected cases may be housed until they are determined to no longer be infectious. 

There is no specific medication or treatment for the novel coronavirus, but patients can expect to receive all necessary supportive treatment such as oxygen therapy to support the lungs. 

NCID executive director Professor Leo Yee Sin said the centre is working closely with MOH to monitor and prepare for the situation.

The negative pressure isolation room at NCID.

“Singapore is very well-connected regionally as well as globally. We need to be ready, because we cannot confidently rule out the possibility of receiving a case of this novel coronavirus. 

"So the healthcare system is now being put on alert… We have such capacity in terms of the availability of the isolation beds, as well as trained individuals to be able to step up to the role, to be able to support the ministry in outbreak readiness ... We will do our best," said Prof Leo.

READ: Wuhan virus - Death toll rises to 6 as number of cases climb past 300 

READ: China confirms human-to-human transmission of Wuhan virus

China has confirmed the virus can spread between humans and Prof Leo noted there have been other interesting observations.

“We have received reports indicating that there are more male than female (individuals) coming down with this novel coronavirus, and those older individuals as well as those with comorbidities tend to have more severe disease," she said.

The NCID is also key in determining and confirming if a patient has the virus, which it does by looking for distinct sequencing patterns in a laboratory. 

The seven suspected cases in Singapore had their respiratory secretion samples sent there and all were tested negative for the Wuhan virus.  

Testing for the virus is done in-house under strict protocol.

The testing is done in-house at the National Public Health Laboratory under strict protocol to ensure staff are well-protected. Any staff testing for the virus will need to wear the full personal protective equipment (PPE), which include double-layer gloves, and breathe through a Powered Air-Purifying Respirator.

"The novel coronavirus shares certain things that are common to other coronaviruses like the SARS coronavirus, the MERS coronavirus from the Middle East and actually even from our normal common colds. We must find that part of virus that is unique to the new coronavirus and then we design our test to target only that," said laboratory director Associate Professor Raymond Lin. 

READ: Singapore to isolate all travellers from China with pneumonia

READ: Wuhan pneumonia outbreak - Asia ramps up defence against coronavirus

Assoc Prof Lin said this testing technique is common around the world, but because it is a new virus, various institutions may design the test slightly differently.

“Which is the best design, we can only tell with time … or whether there’s a need to improve or refine the test,” he said.

Community doctors including general practitioners (GPs) and polyclinic doctors are also on alert, especially since patients usually seek help from them first.  

Dr Chung Wing Hong, a GP at Finest Health Medical Centre in Toa Payoh, said the standard protocol would be to check the patients' travel history. Symptoms such as high fever and breathlessness are also tell-tale signs of suspected cases.

NCID employees wear protective gear before carrying out in-house testing for the virus.

"If the patient is stable enough, then a dedicated ambulance service will be called upon to divert these patients to the relevant hospitals. If the patient is unstable, means (they are) in very severe respiratory distress, then the SCDF 995 will be activated," he said.

Patients above 16 years old will be taken to Tan Tock Seng Hospital’s emergency department, while children below 16 years will be taken to the emergency department at KK Women’s and Children’s Hospital. 

If necessary, they will then be transferred to NCID. 

Dr Chung said most clinics will stock up on PPE for staff, including items like N95 masks, surgical gowns and gloves. These will likely be deployed when a confirmed case is reported. 

As for the general public, Prof Leo said defence against the virus really comes down to maintaining good personal hygiene. 

"For those individuals who need to travel overseas, it is important that they first do adequate homework to find out the situational changes in locations they are going to go to and avoid crowded areas as well as at-risk areas such as markets," she said. 

MORE: Our coverage on the Wuhan virus and its developments

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Source: CNA/hs


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