SINGAPORE: Following several cases of novel coronavirus without any links to previous cases or travel history to mainland China, Singapore on Friday (Feb 7) raised its Disease Outbreak Response System Condition (DORSCON) level to Orange from Yellow.

With immediate effect, schools will suspend inter-school and external activities until the end of the March holidays, said the Ministry of Health (MOH). These include the national school games, learning journeys and camps.



All schools and teachers will also continue to implement already announced enhanced measures such as classroom-based assemblies.



“I understand that Singaporeans are anxious, concerned and there’s much that we do not yet know about the virus,” said Health Minister Gan Kim Yong at a media briefing on Friday afternoon.



“New information is emerging daily, we expect that this is likely to take time to resolve, maybe months, life cannot come to a standstill but we should take all the necessary precautions and carry on with life.”

He added: “We will do our best to contain the situation and keep Singaporeans safe.”

Health Minister Gan Kim Yong, Feb 7, 2020. (Photo: Marcus Mark Ramos)

The way Singapore deals with outbreaks like the novel coronavirus is guided by DORSCON.

The colour-coded system - which has Green, Yellow, Orange and Red categories - shows the current situation. It also indicates what needs to be done to prevent and reduce the impact of infections.

DORSCON Orange means that the disease is deemed severe and spreads easily from person to person, but has not spread widely and is being contained.

"This is not the first time which we've actually changed our DORSCON level and reached DORSCON Orange," said Associate Professor Kenneth Mak, director of medical health services, MOH.

"On the previous occasion (it was) in relation to the H1N1 influenza outbreak which actually occurred in many countries in the world, we had done the same as well."

He added: "As we had a better understanding of that illness and realised that in fact, its behaviour was very similar to what other forms of influenza was, it provided us with the opportunity to reassess the risk associated with this infection to our population and then lower our DORSCON accordingly, and then eventually back to normal."

National Development Minister Lawrence Wong, who was also at the briefing, said the authorities may have to adopt a different strategy based on how the virus evolves.

“There is another scenario – which in a way (Assoc Prof Mak) alluded to: Because if you look at the situation now, the mortality rate in China is 2 per cent but outside of Hubei province, the mortality rate for this virus is 0.2 per cent. It is much lower than SARS (severe acute respiratory syndrome),” said Mr Wong.

“And if the mortality rate remains low or even continues to fall further, depending on the evidence and depending on how it evolves, then I think we are dealing with something quite different and we may well have to consider a different approach."

He added: “So these are two scenarios of how the situation may unfold. It is too early to tell right now what the strategy will be, but I am just sharing possibilities of how things may unfold in the future.”

This announcement follows the confirmation of three new cases on Friday, all of which do not have links to previous cases or travel to mainland China.

This brings the total number of confirmed cases to 33.

With the “heightened risk posture” of DORSCON Orange, MOH said it will be introducing new precautionary measures.

“We have planned for such a scenario that involves community spread,” MOH said.

Organisers of large events should take necessary precautions such as carrying out temperature screening, looking out for respiratory symptoms such as cough or runny nose and denying entry to unwell individuals. Individuals who are unwell, on leave of absence or have recent travel history to mainland China should not attend such events.

MOH also urged organisers to cancel or defer non-essential large-scale events. At workplaces, employers should require their employees to conduct regular temperature taking and check whether they have respiratory symptoms.

PRECAUTIONS AT WORKPLACE

Temperatures should be taken at least twice a day and anyone with a fever or who is unwell should leave the office immediately to see a doctor. Workplaces should also step up their business continuity plans and prepare for widespread community transmission, added MOH.

Such plans can include allowing telecommuting or dividing the workplace into segregated teams. MOH will be implementing temperature screening and closer controls for entry points into the hospitals.

People were seen wearing a mask at Orchard Road, Singapore on Feb 3. (Photo: Gaya Chandramohan)

Hospitals will introduce measures to care for patients with pneumonia, separately from other patients to reduce the risk of transmission.

Pre-schools and social and eldercare services will also limit the number of visitors to their premises, said MOH.

“Since last month, the Government has implemented a series of defensive measures to reduce the risk of imported cases and community transmission. We have strengthened these progressively as the situation escalated, both globally and in Singapore,” said MOH.

DORSCON takes into account the current disease situation overseas, how transmissible the disease is, how likely it is to arrive in Singapore and what impact it may have on the local community.

This crisis management plan did not exist in 2003, but was drafted after SARS and refined again in the wake of the swine flu (H1N1) pandemic in 2009.

At its most severe, the H1N1 pandemic in 2009-2010 was at Orange status. According to the National Library Board’s Infopedia, an estimated 415,000 people were infected with H1N1 influenza in Singapore, and there were at least 18 fatalities.

Singapore on Saturday widened travel restrictions to stop all new visitors of any nationality with recent travel history to mainland China from entering Singapore. These visitors are also not allowed to transit in Singapore.

The virus, believed to have originated in the central Chinese city of Wuhan, has killed more than 600 people and infected more than 30,000, the vast majority of them in China.

The World Health Organization (WHO) has declared the virus outbreak a global emergency.

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