SINGAPORE: The Ministry of Health (MOH) is investigating the possibility that there was transmission of COVID-19 within a ward at the Singapore General Hospital (SGH), the health authority said on Friday (Mar 6).

Case 109, a 70-year-old Singaporean man, and a new case announced on Friday - Case 126 - had been at the same ward at SGH from Feb 29 to Mar 1, before Case 109 was confirmed to be infected with the coronavirus on Mar 2.



Having gone to SGH with respiratory symptoms, they were both put in a three-bed acute respiratory isolation ward, said Associate Professor Tan Thuan Tong, head of infectious diseases at SGH, during a press conference on Friday.

When asked if Case 126, a 77-year-old Singaporean man, was infected in hospital, MOH director of medical services Assoc Prof Kenneth Mak said: "We are investigating for that possibility, but that is obviously a concern that we have, when two patients in the same ward are diagnosed with the infection over a short period of time."



SGH ASKED TO CHECK FOR LAPSES

This is why the ministry has asked SGH to look into its processes to make sure that there were no lapses, no breaches of hospital processes and to make sure that patient safety is not compromised, he said.

The patients who were warded were not bed-bound, Assoc Prof Mak added.

"While every due diligence could have been made by staff in the ward to advise them not to move around, to mix, there’s always a theoretical possibility that they could have mingled,” he said.

“Somewhere therefore in that period in time when they were admitted in the same ward, possibly, some sort of transmission could have taken place.”

However, he cautioned that this is speculation at this point in time.

“The instruction given to the hospital is to investigate this further, to examine their processes and we hope that as they complete their review, we would then be able to have more information,” he said.

PATIENTS HAVE NORMAL RESPIRATORY TRACT INFECTIONS

Patients who are placed in this ward have normal respiratory tract infections, and do not meet any case definition for COVID-19, Assoc Prof Tan said.

The beds are put far apart, 3m from each another, patients have to put on masks and practise social distancing, he added.

Case 109 went to SGH with a “series of symptoms”, including respiratory symptoms, but he did not have risk factors for COVID-19, Assoc Prof Tan added.

The ward is “in some way” considered isolation, because patients with respiratory symptoms would not be able to pass on any respiratory infections they have, he said, adding that it is not the same kind of isolation required for COVID-19 patients.

"The case is still being investigated, but we do tell patients upfront they should not mingle, they should not go around.”

The third patient who was in the ward with cases 109 and 126 is well and has no symptoms, he added. MOH said he will be on home quarantine.

For patients who have respiratory symptoms, MOH has asked all hospitals to exercise a higher degree of suspicion and therefore test these patients, particularly if they pneumonia, to make sure no cases of COVID-19 are missed, Assoc Prof Mak said.

“So I understand in that context, perhaps the first patient (Case 109) was tested. The second patient (announced) today did not fulfill even those circumstance, so was therefore not originally tested,” he said.

Case 109 is not known to have links to any clusters or cases other than Case 126. He works at Fish Mart Sakuraya but did not serve customers or handle food, MOH had said.

MOH said that Case 126, who has no recent travel history to affected countries and regions, was quarantined from Mar 4 and confirmed to have COVID-19 on Mar 5.

No other details have been given about the case for now.

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