14th Feb 2020

The Ministry of Health (MOH) is re-activating the Public Health Preparedness Clinics (PHPCs) to focus our primary care efforts to better detect and manage COVID-19 infections. MOH has also observed that many of the local confirmed cases had continued to circulate in the community or gone to work when they were already ill. This is why MOH had earlier given guidance to doctors to provide medical certificates (MC) of five days for patients with respiratory symptoms so they could stay home to recover.



2. Based on the COVID-19 cases in Singapore so far, the National Centre for Infectious Diseases (NCID) has observed that a significant number of them have mild symptoms in the initial phase of infection. Similar to influenza, these patients typically experience mild flu-like symptoms such as fever and cough. And similar to influenza, they can be infectious during this initial period of mild symptoms. The risk of their infecting others can be reduced with appropriate measures.



3. In fact, most patients with respiratory symptoms are not infected with COVID-19.But we must take extra precautions. It is therefore important that anyone with respiratory symptoms (such as fever, cough, sore throat and runny nose) seek medical treatment early, and stay home throughout their illness. We urge all individuals and employers to cooperate, and follow strictly the five-day MC regime that has been put in place. In addition, we will be taking further pre-emptive measures to reduce the risk of community transmission.



Re-activation of Public Health Preparedness Clinics

4. We currently have about 900 general practitioner (GP) clinics designated as PHPCs. They were activated previously to deal with haze and the H1N1 influenza pandemic. These preparedness clinics provide subsidised treatment, investigations and medications during outbreaks, and play an important role during public health outbreaks.



5. From 18 February, the preparedness clinics will be progressively activated to care for patients with respiratory symptoms, such as fever, cough, sore throat and runny nose. Patients suspected to have pneumonia will be referred to the hospitals for further tests and care.



6. The preparedness clinics will provide special subsidies for Singapore Citizens and Permanent Resident diagnosed with respiratory illnesses. Patients with respiratory symptoms can also go to the polyclinics, where the subsidies will also apply.(Please refer to the Annex for the subsidies.)



7. PHPCs have been guided on the appropriate care protocols according to the assessed risk and diagnosis of each patient, and will be supplied with the necessary Personal Protection Equipment to carry out their role. Please refer to flugowhere.gov.sg for the updated list of PHPCs. Members of the public can also identify these preparedness clinics from the PHPC decal at these clinics.



8. The activation of PHPCs and polyclinics will allow us to enhance and tighten disease surveillance. We would be better able to detect the virus earlier, and reduce the risk of further transmission.



Extended medical certificates

9. Healthcare professionals have been advised to provide medical certificates of five days for their patients with respiratory symptoms. Patients will be referred for further medical assessment and tests if they do not recover within five days. Should their symptoms persist or deteriorate, patients are advised to return to the same doctor to seek further treatment.



10. Patients must recognise the importance of staying home when unwell. Mixing in large crowds, or continuing to go to work or school when ill, even with mild symptoms, will put others at risk.



Exercising good social responsibility



11. With the enhanced detection and surveillance, we expect to see more confirmed COVID-19 cases in the coming days. The measures we are putting in place will allow us to intervene early in the infection. Activating the PHPCs is a proactive step to reduce the risk of further community spread of the virus.



12. These measures will only be effective if everyone plays their part, and exercises social responsibility. The most effective method to prevent transmission remains through good personal hygiene of regular hand washing with soap and water, and the use of hand sanitisers when soap and water are unavailable. We should avoid touching our face with our hands unnecessarily. Those who are unwell should see a doctor early and stay home to prevent further spread of their illness to others.

Annex