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SINGAPORE: There are three new confirmed cases of novel coronavirus in Singapore and none of them are linked to the existing cases or have been in China recently, said the Ministry of Health (MOH) on Friday (Feb 7).

This brings the number of cases in the country to 33. There are now at least four patients with no recent travel history to China or links to the other cases.



A teacher was among the three new cases announced, while one of the cases went visiting during Chinese New Year after developing symptoms, said MOH.



Health Minister Gan Kim Yong said that authorities are now expanding their case definition and doing "proactive case finding".

"This means never mind a connection to China. When they have pneumonia, I want to know if this is novel coronavirus. We are investigating more cases, so we are discovering more cases," said Mr Gan.

At a press briefing on Friday, Singapore authorities raised the DORSCON (Disease Outbreak Response System Condition) code to Orange from Yellow.

This means the disease is deemed severe and spreads easily from person to person, but has not spread widely and is being contained. Moderate disruption is expected, due to measures such as quarantine and visitor restrictions at hospitals.

Seventeen of the 33 confirmed patients in Singapore were visitors from China, while another four are Singaporeans who were evacuated from Wuhan on Jan 30.

Twelve are locally transmitted, of which nine can be traced back to a group of Chinese tourists from Guangxi.

Two patients are now in critical condition, said MOH. They are on breathing support and do not have any other significant medical problems, said MOH director of medical services Kenneth Mak.

Two patients have been discharged, while the remaining cases are stable or improving. The second discharged patient is a woman from Wuhan who was the second confirmed case in Singapore.

Mr Mak said that experts around the world are working towards understanding the nature of the new coronavirus and its transmission patterns.

"All of us still recognise that the main form of spread remains by droplets and it is very important for us to recognise that most spread can occur through touch," he said.

Ministry of Health's director of medical services Kenneth Mak, Feb 7, 2020. (Photo: Marcus Mark Ramos)

This means touching contaminated surfaces and then touching the face, mouth or eyes with contaminated hands.

He added that there have been some reports of spread from people who have yet to develop symptoms but that the evidence today shows the rate of transmission is "very low".

THREE NEW CASES

On Friday, MOH said that two of the new cases had been to Malaysia prior to their diagnosis.

Case 31, a 53-year-old Singaporean man, had been in Malaysia on Jan 6, 11 and 17, said MOH.

He reported having symptoms on Jan 23, and visited two clinics before being admitted to Changi General Hospital (CGH) on Feb 1. He is currently warded in an isolation room at CGH.

He lives at Tampines Street 24 and had been to the Life Church and Missions Singapore in Paya Lebar. He had visited friends and family during Chinese New Year.

People with masks on walks at Orchard Road, Singapore on Feb 3. (Photo: Gaya Chandramohan)

Case 33, a 39-year-old Singaporean woman, had also been in Malaysia from Jan 22 to 29. She is in isolation at Sengkang General Hospital (SKH).

She reported having symptoms on Jan 30 and went to the emergency department on SKH on Feb 2 where she was admitted.

JUNIOR COLLEGE TEACHER 32ND CASE

The 32nd case, a 42-year-old Singaporean woman, reported symptoms on Sunday and was admitted to Parkway East Hospital on Wednesday.

She works at Victoria Junior College but did not interact with colleagues or students after onset of symptoms as she was on medical leave.

The last day she was at school was Jan 31, said Ms Liew Wei Li, director of schools at the Ministry of Education (MOE).

The teacher stays at Elias Road and had visited Changi Airport and the Singapore Zoo.

She is currently warded in an isolation room at the National Centre for Infectious Diseases (NCID).

Tests for all three confirmed their 2019-nCOV infections at about 11pm on Thursday.

Ms Liew added that a few colleagues and students who have been in close contact with the teacher will be given 14 days of leave of absence since last day of contact with her.

The college will be thoroughly disinfecting the staff room, pantry and teaching rooms that the teacher was in and co-curricular activities will be suspended for 14 days, among other measures to prevent large-group gatherings.

UPDATE ON CASE 30

In an update on case 30, which was announced on Thursday, MOH said that the 27-year-old man reported having a fever on Jan 21 and visited a general practitioner clinic on Jan 28.

The Singapore citizen, who had attended a conference in Singapore linked to a few other cases, went to another clinic for treatment on Feb 3 before being admitted to the National Centre for Infectious Diseases on Thursday.

He lives at Shunfu Road and had been to Far East Square and Junction 8 shopping malls.

Guests are seen at the Grand Hyatt Singapore lobby. (Photo: Jeremy Long)

The business meeting at the Grand Hyatt was attended by more than 100 people, including participants from the Chinese province of Hubei.

The new coronavirus that emerged in Wuhan, Hubei province at the end of last year has killed more than 630 people and spread around the world.

The latest figures from China show there are more than 30,000 people infected in the country.

A Chinese doctor who was punished after raising the alarm about the virus died from the pathogen on Friday, sparking an outpouring of grief and anger in China over the worsening crisis.

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Editor’s note: This story has been updated following corrections sent in by MOH on the address of Life Church and Missions Singapore and on where Case 32 is being treated.