HOME RECOVERY PROGRAMME FOR MONKEYPOX CASES

From 22 August 2022, monkeypox cases will be able to recover safely at their place of residence under the Home Recovery Programme (HRP), if they are assessed to be clinically stable by a doctor and their place of residence is suitable for home recovery. Cases assessed to be at higher risk of complications will continue to be managed in hospitals.

2.             All confirmed cases will be issued with an Isolation Order and are required under the Infectious Diseases Act to remain isolated until they are medically assessed to be non-infectious.

3.             Local and international data continues to show that monkeypox is typically a mild and self-limiting illness where the majority of patients recover within two to four weeks without requiring hospitalisation. As the transmission of monkeypox requires close physical or prolonged contact, including face-to-face and skin-to-skin contact such as sexual contact, the risk to the general public remains low.

4.             Currently, all confirmed cases assessed by public hospitals to be clinically stable recover with telemedicine support at a Monkeypox Isolation Facility (MIF). From 22 August 2022, confirmed cases may recover at home with telemedicine support if they are assessed to be clinically stable by a doctor and their place of residence is deemed suitable by the Ministry of Health (MOH) for fulfilling the following conditions:

a.    The case can self-isolate in a bedroom with an attached bathroom, and there is an additional bathroom for other household members’ use.

b.    None of the other household members are (i) pregnant; (ii) children aged below 12 years; (iii) seniors aged 80 years and above; (iv) individuals who are undergoing dialysis, immunocompromised or on immunosuppressants; or (vi) individuals at higher risk of being infected (e.g. with caregiving needs).

c.     There are no pets at home. This is to avoid any animal-to-human transmission which may occur when an animal contracts monkeypox from an infected person and then spreads to other persons through bites, scratches or through direct contract with skin, mucosa, blood, and bodily fluids.

5.             Cases may continue to recover in the MIF if their place of residence is not suitable for home recovery.

6.             Cases on HRP will receive regular telemedical consultations to assess their state of recovery, and may be conveyed to the National Centre for Infectious Diseases (NCID) for additional reviews if necessary. They can also call a dedicated MOH hotline if they require any assistance during the period of recovery. In the event that cases experience any shortness of breath, chest pains, severe headaches, stiff neck, changes in mental state (e.g. mood, behaviour), or unusual symptoms with their nerves (e.g. numbness, weakness, changes in speech or vision, abnormal movement of the arms or legs), they should call 995 immediately and inform the operator that they are monkeypox patients.

7.             At the end of the isolation period, cases will be conveyed to NCID to undergo a discharge review. If they are medically assessed to have fully recovered, they will be able to exit isolation. If they have not recovered, they will continue to be isolated until the next appointed discharge review.

8.             In line with the shift to home recovery, suspect monkeypox cases who are assessed to be clinically well will no longer be required to isolate in the hospital while awaiting their test results. They may instead isolate themselves at home if they are able to do so. Those who are unable to self-isolate in their home will be isolated at an isolation facility while awaiting their test results. Suspect cases who are assessed to require admission for clinical care will continue to be managed in hospitals.

9.             MOH will continue to monitor the monkeypox situation closely and calibrate our preparedness and response measures as needed. Members of the public are encouraged to exercise personal responsibility by monitoring their personal health, maintaining good hygiene, and avoiding high-risk sexual activity, such as having multiple sex partners or casual sex, especially during travel. They should also avoid close contact with individuals known or suspected to have monkeypox infection.