OTGV #28 - SARS Lessons
Broadcast Date: 05/05/03
It's nearly two months.
Gradually the initial suffocating fear loosens its grip somewhat as the world learns to deal with a new disease, SARS.
Hi Welcome to On the Grapevine as I take a look back at Singapore's fight against SARS.
In the beginning there was SARS and nothing much at all.
There's no information, there's no experience in dealing with an infectious outbreak involving an entirely new disease.
In fact, most ministries, including the Health Ministry, are not prepared at all says Minister of State for Education and Manpower, Ng Eng Hen.
"Indeed any other ministry was not geared to fight this. Even the Ministry of Health. Because this disease, the last time was polio in 1950s. I mean, all our systems were not geared for infectious disease and therefore the set-up of ministerial committee where all the ministers put their resources together."
A lot of the fear is generated by the fact that there is no cure or vaccine against SARS.
There may not be a cure for a very long time if the fight against AIDS is anything to be compared against.
But what's even more crucial is that there isn’t a lab-based diagnostic kit accurate enough to detect the new virus.
This means the fight against SARS so far isn't an entirely medical one says Dr Ng.
Each branch of the government is drawn into battle and their expertise and knowledge challenged.
The learning curve is very steep and quick, assured actions are crucial and absolutely necessary.
National Development Ministry was drawn in by the unexpected closure of the Pasir Panjang Wholesale Market that disrupted Singapore's supply of leafy veggies for a while.
This lesson of having just one distribution centre is swiftly learnt says National Development Minister Mah Bow Tan.
"We are now in the process of building redundancies. In other words, duplicating the facilities that we currently have but we have to be careful that beyond a certain point, the additional points involved will have to be factored in. But yes the answer is we will be building redundancies. The main idea is to protect our sources of supplies to make sure our food supply coming in whether it is fish meat vegetables eggs whatever is safe, is protected."
Pasir Panjang also brought in an interesting lesson for the Health Ministry.
How can a relatively small team of people do contact tracing for an estimated group of some two thousand people and still hope to have the Home Quarantine orders out as soon as possible?
Dr Ng Eng Hen who's also part of the SARS combat Unit says this taught the lesson that getting help to the Health Ministry is very important.
"The second tipping point was allocating resources to MOH because it was not geared up to fight this national crisis. Because if you think about it, how have we fought this war? Not with drugs at all. It's not a medical war, its a logistical war. So putting 9 Div commander contact tracing, what is contact tracing? Asking who you've been in contact, there's nothing medical about it. Doctors are never meant to do that."
But contact tracing by authorities isn't enough.
Singaporeans are urged, begged or even cajoled to be forthcoming and honest about their health status and do self-assessment of their own risks.
In his dialogue session with the grass-roots leaders, Prime Minister Goh Chok Tong was asked if the government should name people who are home quarantined so that his or her neighbours can take the necessary pre-cautions.
Mr Goh turned the question back to the floor.
"Now should we tell the neighbours about the family that's been quarantine? In other words, do you agree that we should in fact be quite open about this? What do you think? Those who support there should be more openness please put up your hand."
Not enough hands up.
So Mr Goh clarifies what he actually means.
"My own view is there's nothing shameful about being quarantined and I will let people know. Mrs Lee was quarantine and we knew. And SM told everybody. So I think if you take that attitude, your neighbours know, well we’re just a little careful that there's somebody being quarantine but there's nothing, really embarrassing about it. So can ask those who support a more open stance, please put up your hands. Those at the top? I think there's a clear majority."
As the PM proves, people will even accept radical measures that may compromise their confidentiality if they can understand why these measures are being undertaken.
Of course they mustn't feel singled out and ostracised by the community.
After all, a person on quarantine isn't even sick so why should they be treated as lepers?
Senior Minister of State for Transport and incoming Acting Minister for Health Khaw Boon Wan says more can be done to the current system to rid it of stigma.
"I also get some anecdotes on why people are reluctant to call 993. Because... ambulance will come and the whole neighbourhood is be shuttered you know, we are trying to look into this whole process, whether we could humanised it. Most of this contacts who developed fever are mobile. There's actually no need to move them in ambulance or whatever. there could be other means. So a few of us have been thinking about how to make it more user friendly. Less frightening to the person and to the whole community. And I have an idea. You could come in one of those beautiful SQ tour coach, you know, and we will send to Tan Tock Seng!"
Mr Goh Chok Tong says it is imperative that all must their part because the best reactive system in the world will crumble to naught if even the most minute population doesn't play ball.
"While we do in controlling the problem, we cannot allow one selfish act, one selfish individual to destroy the lives of all of us. So that is my simple message."
It is still early days yet but the world and Singapore has learnt so much about SARS and so much more.
It's been a quantum leap of experiential learning that may well equip Singaporean leaders and population to deal with the next curve ball nature decides to throw at them in the form of another new infectious disease.
This is Chong Ching Liang for Newsradio 938. (Now 938Live)
==========================
Related Links:
Newsradio938 (now 938Live)
http://www.938live.sg/
Ministry of Health SARS website
http://www.moh.gov.sg/corp/sars/index.html
Hong Kong University SARS Fund website (with links and info)
http://www.hku.hk/sarsfund/
World Health Organisation SARS website
http://www.who.int/topics/sars/en/
National Development Ministry's News Release on Pasir Panjang Wholesale Market
http://www.mnd.gov.sg/Newsroom/newsreleases/2003/news280403.htm
It's nearly two months.
Gradually the initial suffocating fear loosens its grip somewhat as the world learns to deal with a new disease, SARS.
Hi Welcome to On the Grapevine as I take a look back at Singapore's fight against SARS.
In the beginning there was SARS and nothing much at all.
There's no information, there's no experience in dealing with an infectious outbreak involving an entirely new disease.
In fact, most ministries, including the Health Ministry, are not prepared at all says Minister of State for Education and Manpower, Ng Eng Hen.
"Indeed any other ministry was not geared to fight this. Even the Ministry of Health. Because this disease, the last time was polio in 1950s. I mean, all our systems were not geared for infectious disease and therefore the set-up of ministerial committee where all the ministers put their resources together."
A lot of the fear is generated by the fact that there is no cure or vaccine against SARS.
There may not be a cure for a very long time if the fight against AIDS is anything to be compared against.
But what's even more crucial is that there isn’t a lab-based diagnostic kit accurate enough to detect the new virus.
This means the fight against SARS so far isn't an entirely medical one says Dr Ng.
Each branch of the government is drawn into battle and their expertise and knowledge challenged.
The learning curve is very steep and quick, assured actions are crucial and absolutely necessary.
National Development Ministry was drawn in by the unexpected closure of the Pasir Panjang Wholesale Market that disrupted Singapore's supply of leafy veggies for a while.
This lesson of having just one distribution centre is swiftly learnt says National Development Minister Mah Bow Tan.
"We are now in the process of building redundancies. In other words, duplicating the facilities that we currently have but we have to be careful that beyond a certain point, the additional points involved will have to be factored in. But yes the answer is we will be building redundancies. The main idea is to protect our sources of supplies to make sure our food supply coming in whether it is fish meat vegetables eggs whatever is safe, is protected."
Pasir Panjang also brought in an interesting lesson for the Health Ministry.
How can a relatively small team of people do contact tracing for an estimated group of some two thousand people and still hope to have the Home Quarantine orders out as soon as possible?
Dr Ng Eng Hen who's also part of the SARS combat Unit says this taught the lesson that getting help to the Health Ministry is very important.
"The second tipping point was allocating resources to MOH because it was not geared up to fight this national crisis. Because if you think about it, how have we fought this war? Not with drugs at all. It's not a medical war, its a logistical war. So putting 9 Div commander contact tracing, what is contact tracing? Asking who you've been in contact, there's nothing medical about it. Doctors are never meant to do that."
But contact tracing by authorities isn't enough.
Singaporeans are urged, begged or even cajoled to be forthcoming and honest about their health status and do self-assessment of their own risks.
In his dialogue session with the grass-roots leaders, Prime Minister Goh Chok Tong was asked if the government should name people who are home quarantined so that his or her neighbours can take the necessary pre-cautions.
Mr Goh turned the question back to the floor.
"Now should we tell the neighbours about the family that's been quarantine? In other words, do you agree that we should in fact be quite open about this? What do you think? Those who support there should be more openness please put up your hand."
Not enough hands up.
So Mr Goh clarifies what he actually means.
"My own view is there's nothing shameful about being quarantined and I will let people know. Mrs Lee was quarantine and we knew. And SM told everybody. So I think if you take that attitude, your neighbours know, well we’re just a little careful that there's somebody being quarantine but there's nothing, really embarrassing about it. So can ask those who support a more open stance, please put up your hands. Those at the top? I think there's a clear majority."
As the PM proves, people will even accept radical measures that may compromise their confidentiality if they can understand why these measures are being undertaken.
Of course they mustn't feel singled out and ostracised by the community.
After all, a person on quarantine isn't even sick so why should they be treated as lepers?
Senior Minister of State for Transport and incoming Acting Minister for Health Khaw Boon Wan says more can be done to the current system to rid it of stigma.
"I also get some anecdotes on why people are reluctant to call 993. Because... ambulance will come and the whole neighbourhood is be shuttered you know, we are trying to look into this whole process, whether we could humanised it. Most of this contacts who developed fever are mobile. There's actually no need to move them in ambulance or whatever. there could be other means. So a few of us have been thinking about how to make it more user friendly. Less frightening to the person and to the whole community. And I have an idea. You could come in one of those beautiful SQ tour coach, you know, and we will send to Tan Tock Seng!"
Mr Goh Chok Tong says it is imperative that all must their part because the best reactive system in the world will crumble to naught if even the most minute population doesn't play ball.
"While we do in controlling the problem, we cannot allow one selfish act, one selfish individual to destroy the lives of all of us. So that is my simple message."
It is still early days yet but the world and Singapore has learnt so much about SARS and so much more.
It's been a quantum leap of experiential learning that may well equip Singaporean leaders and population to deal with the next curve ball nature decides to throw at them in the form of another new infectious disease.
This is Chong Ching Liang for Newsradio 938. (Now 938Live)
==========================
Related Links:
Newsradio938 (now 938Live)
http://www.938live.sg/
Ministry of Health SARS website
http://www.moh.gov.sg/corp/sars/index.html
Hong Kong University SARS Fund website (with links and info)
http://www.hku.hk/sarsfund/
World Health Organisation SARS website
http://www.who.int/topics/sars/en/
National Development Ministry's News Release on Pasir Panjang Wholesale Market
http://www.mnd.gov.sg/Newsroom/newsreleases/2003/news280403.htm
posted by CHONG Ching-liang | 11:23 AM
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