SINGAPORE - Singapore has moved up its response to the coronavirus outbreak to code orange because of "heightened risk", said the Ministry of Health (MOH).

This is because there are now four cases of infection with no known links to China or people already infected, which means the disease may be spreading in the community.

It is only the second time Singapore has activated code orange. The first was for swine flu (H1N1) in 2009. The coding system was set up after Sars (severe acute respiratory syndrome) in 2003. The outbreak then would also have been orange, had the classification existed.

Under the Disease Outbreak Response System Condition or Dorscon, orange means the outbreak is deemed to have moderate to high public health impact.

With Singapore now in code orange, MOH said on Friday (Feb 7) that it is introducing additional measures "to minimise the risk of further transmission of the virus in the community".

The emphasis will now be on "aggressively trying to stop or limit further spread", according to MOH's pandemic readiness and preparedness plan.

Measures to be implemented:

* Event organisers are advised to cancel or defer non-essential large-scale events. Those that choose to continue should take additional precautions:

- Carry out temperature screening.

Related Story Coronavirus: 3 new Singapore cases include Victoria JC teacher

- Look out for respiratory symptoms such as cough or runny nose, and deny entry to people who are sick.

- Remind participants to declare travel history to China.

- Ensure the venue is well ventilated, with enough facilities for hand washing.

- Increase frequency of cleaning of commonly used areas.

- Maintain a registration list of participants, if possible.

People who are on Leave of Absence (LOA) should not attend such events.

* Employers are urged to require staff to conduct regular temperature taking, at least twice a day. Anyone with a fever should see a doctor immediately. If their temperature is above 38 deg C, they should not be at work.

Staff should also be checked for cough or runny nose.

Companies should step up their business continuity plans, which includes asking employees to telecommute, or segregating them into teams.

* MOH will implement temperature screening and closer controls of entry points into hospitals. Patients with pneumonia will be separated from other patients to reduce risk of transmission.

* Schools will immediately stop all inter-school and external activities till the end of the March school holidays. These include national school games, learning journeys and camps.

Primary school teachers will take pupils to toilets to wash their hands before recess and snack breaks. Secondary school students will be reminded to do so.

Pre-schools and eldercare facilities will limit the number of visitors to their premises.

Related Story Coronavirus cases in Singapore: What we know so far

Related Story Interactive: How coronavirus is spreading across the world

MOH said that all its measures will be effective only if everyone plays their part.

Since the virus can be spread through direct contact with individuals as well as via contaminated surfaces, it is critical to ensure good hygiene.

Hands should be washed regularly with soap and water, or failing that, using sanitisers. People should avoid touching their faces unnecessarily.

These were all measures Singapore had implemented during the Sars outbreak.