Angry Doctor

Tuesday, April 28, 2009

We are now at...

Alert Yellow:

Inefficient human-to-human transmissions of flu caused by a novel virus, requiring close and sustained contact to an index case. Further spread can be prevented through public health measures to isolate cases and quarantine contacts.

Risk of import into Singapore elevated. Isolated imported cases may occur but there is no sustained transmission.

Strategy is to prevent further import of cases, and to ring fence and isolate cases to prevent spread. The focus will be to provide treatment of all cases, and antiviral prophylaxis to contacts including exposed healthcare workers.


Alert Green action apart, institute home quarantine for close contacts of cases.

Institute temperature screening and impose restriction on hospital and clinic visitors.

Restrict inter-hospital movement, except in emergencies.

Healthcare workers to take temperature twice a day.

Institute temperature screening for passengers arriving from affected countries at border control checkpoints.

Travellers from affected countries given Health Alert Notices (HANs) and advised to monitor their temperature daily for 1 incubation period.

Keep safe, my friends.



  • Hi there,i am in New york at the moment and i work at a hospital in Queens, where the index cases were reported.

    There are currently the usual infectious disease precautions in place, wash hands and mask when seeing patients with respiratory symptoms. But that's about it.

    I strongly feel that Singapore is over-reacting to this epidemic, and it is probably a knee-jerk reaction from SARS. The deaths have been well-publicised, but there are very few cases of confirmed DEATHS from H1N1 or any of the strains.

    Perhaps we are being our usual KIASU selves and want to appear to the entire world that we are "prepared" for "war". Even though it may be life and death we are talking about here, as a healthcare professional here i strongly feel that it does not warrant the hard-handed actions taken by the Singapore government.

    What do you think?

    By Anonymous Anonymous, At April 29, 2009 12:38 pm  

  • Certainly I agree that much of the response is for show - I personally am not convinced that routine twice-daily temperature measurement of healthcare workers will pick up cases earlier than if we waited for them to report symptoms.

    As for temperature screening at airports I think it is a reasonable measure. Even if we can't catch every case, every case we catch is a case that is not spreading it around.

    Overall I think the response needs to be knee-jerk initially, and then modified as we learn more about the disease.

    I won't panic until the first death outside Mexico occurs, and Singapore has her first confirmed case though.

    By Blogger angry doc, At April 29, 2009 12:58 pm  

  • First death outside Mexico just reported - a child in Texas..

    Still mainly a community disease.

    Very very few hospital infections

    By Anonymous Paul Ananth, At April 29, 2009 11:44 pm  

  • Hi

    Scarily, it comes when it comes right? Unfortunately nothing to prevent someone from bringing it to Singapore unknowingly. The Predator-like fever sensors at the airport can't detect a carrier if there is no fever symptom.

    On being paranoid, better safe than sorry. The risk is that the government's paranoia might start an unnecessary public panic though. Delicate trade-off.

    By Anonymous The Void Deck, At April 29, 2009 11:55 pm  

  • Prof,

    I think hospitals are the safest places to work in right now! You told me once that knowing that a patient you are dealing with has or may have an infectious disease allows you to take the necessary precautions - it's not knowing that will get you.


    It really depends on what the kill-rate of the flu is like outside of Mexico. If it's very low then it may be just a case of getting it, surviving it, and then getting on with your life.

    If it's high, then maybe it's better to spread panic than to spread disease...

    By Blogger angry doc, At April 30, 2009 8:55 am  

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