SINGAPORE, June 12 — It is not a question of if but when the first Middle East Respiratory Syndrome (MERS) case is detected here and the country is well-prepared for the eventuality, Prime Minister Lee Hsien Loong said yesterday during a visit to Tan Tock Seng Hospital (TTSH) to assess its preparedness in the event of an outbreak.
Yesterday, South Korea reported another MERS death, as well as 14 new patients. To date, 10 people have died from the virus there while 122 have been infected. Meanwhile, Hong Kong, which issued a “red alert” advisory on Tuesday against non-essential travel to South Korea, were testing two more suspected cases.
Lee noted that every month, 15,000 to 20,000 people travel from the Middle East to Singapore, and 40,000 arrive here from South Korea.
Adding that it is “a matter of time” before the republic has its first MERS case, Lee said Singaporeans should take the health scare seriously but there is no need to panic because preparations have been made.
Writing on Facebook after his visit to TTSH, Lee added: “I wanted to be sure that the medical team and facilities are well drilled and ready.
It’s not just the medical team. The public too must be psychologically prepared, so that we won’t panic.”
TTSH, which has been designated as the hospital for MERS, is raising its vigilance, and proactively screening of patients. It is also making sure that staff are more aware of what they need to do and how to identify cases, given that healthcare professionals are at a higher risk of contracting infectious diseases. The hospital has also stepped up simulation drills, and healthcare professionals are being reminded of protocols that have been in place since 2012, when MERS was first reported in Saudi Arabia.
Over the last three years, TTSH has tested 180 cases and all turned out negative.
In South Korea, all known infections have taken place within healthcare facilities. Healthcare workers, patients who were being treated for other ailments and caregivers were among those who contracted the virus.
TTSH said that when attending to suspected cases, its healthcare workers will be in protective gear such as boot covers, an N95 mask, two layers of gowns, a cape hood and visor mask, and two layers of gloves.
Associate Professor Thomas Lew, who chairs the medical board at TTSH, said the staff were “on constant alert.” “What is important is that the staff understand what is the level of protection that they have to ensure in order to protect themselves, and also to ensure they understand the questions and the clinical science that is consistent with the need to do further testing on suspected cases,” he said.
The hospital has contingency plans to scale up areas for screening and admissions if the situation escalates here. It has made plans to deploy an additional 100 beds outside of its main facility, and it is also working with the Health Ministry to ensure it has manpower support from other hospitals, should the need arises.
Assoc Prof Lew said systems and procedures were also in place for ambulances to transport suspected cases, and to be decontaminated afterwards. At TTSH, patients typically arrive via two entry points — the Emergency Department and the specialist outpatient clinics. There, patients are proactively asked for their respiratory symptoms and travel history. If, for instance, they have visited an affected country and developed symptoms within two weeks of return, they will be immediately given a mask and attended to in isolation rooms.
More serious cases will be transferred into an isolation room at Ward 81 at the CDC2 — an intensive care unit ward set aside for MERS suspected and confirmed cases. There are 16 beds in the ward which are on standby for activation within eight hours. The facilities and equipment there are specially dedicated for MERS patients, to reduce chances of contamination.
Suspected cases from other hospitals will also be referred to TTSH’s Emergency Department for assessment. Patients in isolated admission may be observed for further diagnostic tests, which take up to 48 hours.
Prof Leo Yee Sin, director of TTSH’s Institute of Infectious Diseases and Epidemiology, said the medical staff have gathered valuable lessons from the severe acute respiratory syndrome (SARS) outbreak in 2003. The two viruses share similar characteristics, she said. As both are respiratory illnesses, the healthcare workers know how to identify the cases, and they also know that patients need to be isolated quickly to reduce the human-to-human transmissions, she added. — TODAY
