Singapore's response to potential infectious diseases outbreaks

17 Oct 2005

Question No:  237  

Question

Name of the Person: Dr Geh Min, Nominated MP

To ask the Minister for Health in the light of a likely increase in the foreseeable future of global and regional epidemics and Singapore's increased vulnerability to these diseases due to its dense urban population and global positioning, what long-term strategy does the Ministry have or will develop for the prevention, early detection, effective control and treatment of infectious diseases?

Question No:  255  

Name of the Person: Mdm Halimah Yacob , MP for Jurong GRC

To ask the Minister for Health (a) what is the likelihood of an avian flu epidemic breaking out worldwide; (b) what will be the impact on Singapore and how is Singapore prepared for this; and (c) are enough funds and resources being invested to develop Singapore's capabilities to deal with the avian flu?

Reply

Reply From MOH

Global and regional epidemics are immense challenges. The world had a taste of such challenges during SARS. Past flu pandemics also provided valuable lessons. The current bird flu outbreak may trigger the next global flu pandemic. Mdm Halimah asked the likelihood of it happening. The World Health Organization (WHO) has warned repeatedly that it is not a question of whether it will happen but when it will happen. However, no one knows when that time will be. What is certain is that a major disease outbreak such as a flu pandemic will be very costly in terms of human lives as well as economic losses. International cooperation is the key to avoiding such calamities, or when they occur to minimize the damage. 

That is why we maintain strong links with health authorities in other countries and with key international health agencies such as the WHO and the US Centers for Disease Control. This facilitates the rapid exchange of critical information and expertise and will help us better prepare ourselves or deal with any outbreaks. With globalization and jet travel, we are all vulnerable to global epidemics and must collaborate with one another to manage any outbreak. 

Domestically, we are progressively gearing up for such major outbreaks. Preparations can never be complete as it is not possible to know the nature or the extent of the next outbreak. With more funds and resources, we can certainly do more. But the major pieces are in place. Let me briefly outline what those pieces are. 

First, we have established the organizational structure to deal with such crises. There is a Ministerial Committee chaired by DPM/ Minister for Home Affairs, of which I am a member. The Committee is supported by an Executive Group comprising Permanent Secretaries and chiefs of key government agencies. My Permanent Secretary heads the Crisis Management Group for Health which reports to the Executive Group. This command and control structure will ensure a coordinated government response to any major health threat. It was tested during SARS and further refined after that crisis. 

Second, we have formulated various outbreak scenarios and planned our specific response strategies. This exercise can never be exhaustive but by thinking through them, we develop useful insights into our strengths and our weaknesses. We can then try to enhance our capabilities. 

The response strategy to each disease outbreak would depend on the nature of the disease ' how it is transmitted, availability of diagnostic tests and whether there are treatments or vaccines. Mdm Halimah asked specifically about our flu pandemic preparedness and response plan. We have recently reviewed and refined it. It is published on our website, both to inform as well as to consult. It is based on what we know about past pandemics, nature of the flu virus, and availability of drug treatments and vaccines. We will continue to review and strengthen the pandemic plan. 

Third, we have learnt extensively from the SARS experience and have significantly strengthened our capabilities and capacity. In particular, we have augmented our surveillance and response systems, operational and emergency preparedness capabilities. This has been done through increasing manpower and other resources such as isolation facilities in hospitals. 

Fourth, we have constituted our various response strategies into a Disease Outbreak Response System (DORS). Briefly, the DORS framework comprises (a) an effective surveillance system and (b) a rapid response system. 

Our surveillance system has external and internal components. External surveillance continuously scans foreign and international news and health websites and information exchange networks on infectious diseases. Our internal surveillance comprises continuous evaluation of atypical pneumonia cases, laboratory surveillance of influenza viruses and through the implementation of new IT systems to rapidly capture, analyse and monitor cases of infectious disease of concern. 

Under the DORS framework, my Ministry will mount a rapid response to major disease outbreaks by mobilizing teams to investigate the outbreak, analyse epidemiological findings and then contain the outbreak as quickly as possible through appropriate control measures such as contact tracing and quarantine, treatment or vaccination. 

Fifth, we regularly exercise our plans. This is important to ensure that the players know what to do when a real crisis happens. It also allows us to learn from the exercises to refine our plans. 

Finally, we must involve Singaporeans in our preventive and response strategy. What can Singaporeans do? When there is a specific outbreak, we will seek specific actions from the people. But meanwhile, I think Singaporeans can do a lot on the preventive front. Aim for a much higher standard of public and personal hygiene. 

Let's go back to basics. Do not spread germs: so don't spit, wear masks when unwell, wash hands thoroughly and often. Keep public toilets clean and dry and do not litter. Simple acts like these can go a long way to minimize the spread of infectious diseases.