SINGAPORE — Six additional cases of the Wuhan coronavirus were confirmed by the Ministry of Health (MOH) on Tuesday (4 February), four of whom are the country’s first confirmed cases of local transmission.
This brings the total tally of confirmed cases to 24, making Singapore the country with the second highest number of such cases outside mainland China, behind Thailand.
Three of the locally transmitted cases can be traced to contact with recent travellers from mainland China, while the fourth is a close contact of one of the three cases, said MOH at a media briefing chaired by a multi-ministry taskforce on the virus on Tuesday.
The other two cases are from a group of 92 Singaporeans who were evacuated from Wuhan, where the virus originated, last Thursday.
“Though four of these cases constitute a local transmission cluster, there is as yet no evidence of widespread sustained community transmission in Singapore,” said the ministry.
Health Minister Gan Kim Yong stressed, “This is a scenario that we have prepared for and we are ready to manage it. As the situation evolves, we will step up our posture accordingly.”
Two colleagues, tour guide among locally-transmitted cases
One of the four locally-transmitted cases is a 28-year-old female Singapore permanent resident who works at Yong Thai Hang at 24 Cavan Road, a complementary health products shop that primarily serves Chinese tourists.
She reported developing sore throat and fever last Wednesday (29 January) and sought treatment at a general practitioner clinic on the same day.
She went to Tan Tock Seng Hospital’s emergency department the next day, and was discharged when her chest x-ray came back negative for pneumonia.
She reported that she had not left her home at Jalan Bukit Merah from 31 January to 2 February.
On Monday, she went to Singapore General Hospital (SGH) and was diagnosed with pneumonia. She was later classified as a suspect case and was immediately isolated.
Her results came back positive for the virus on Monday, past 11pm, and she is currently warded in an insolation room at the hospital.
The other case is a 48-year-old female Singaporean, a colleague of the 28-year-old, who resides at Hougang Street 61.
She reported the onset of symptoms on 25 January. On Monday, she went to the National Centre for Infectious Diseases (NCID) and was classified as a suspect case and immediately isolated. She tested positive for the virus on Tuesday morning.
The third case is a 44-year-old female Indonesian national, a foreign domestic worker who works for the 28-year-old and resides at the same place.
She reported the onset of symptoms on Sunday and was admitted to the SGH emergency department the next day.
She tested positive for the virus on Tuesday afternoon and remains warded in an insolation room at the hospital. She reported that she has not left her place of residence since the onset of symptoms.
The fourth case, a 32-year-old female Singaporean, is a tour guide who had brought tour groups to Yong Thai Hang where two of the locally-transmitted cases work.
On Monday, she was asymptomatic when she went to the NCID, where she is currently warded in an insolation room. She was confirmed to have the infection on Tuesday afternoon.
While she had previously reported that she was asymptomatic when she went to the NCID, she subsequently informed the NCID on the night of her test results that she had developed a fever earlier last Thursday
Prior to her hospital admission, she stayed at her home at Buangkok Green and worked at Jalan Besar. She visited Hougang Polyclinic last Thursday and went to a supermarket near her home.
“The four cases of local transmission were identified as a result of enhanced surveillance at our hospitals,” said the MOH.
“Three of the four cases can be traced to contact with recent travellers from mainland China, and prolonged interactions with these travellers. Pending confirmation from the Chinese authorities, the travellers are from Guangxi, and at least two have been confirmed with 2019-nCoV infection,” the ministry added.
According to a timeline relating to the cluster, a tour group from China arrived in Singapore at 8pm on 22 January. The next day, the tour group visited Yong Thai Hang among other places.
From 24 to 26 January, the tour group went to Malaysia. It re-entered Singapore via Woodlands at 3am on 27 January and departed at Changi Airport at 6am.
Evacuees from Wuhan
The remaining two new cases are Singaporeans who were among the 92 evacuated from Wuhan last Thursday. The two Singaporean men, aged 41 and 17 respectively, showed no symptoms while onboard the flight and were put under quarantine once they landed in Singapore.
These two cases tested positive on Monday despite continuing to show no symptoms and are currently warded in isolated rooms at the NCID.
The ministry noted a confirmed case that was reported in Malaysia on Tuesday, involving a 42-year-old Malaysian man who was in Singapore from 16 to 23 January for a business meeting at Grand Hyatt Hotel with Chinese nationals.
The man, the first Malaysian to be confirmed in his home country, displayed the onset of symptoms after his return to Malaysia and tested positive for the virus on Monday.
The MOH said it has initiated epidemiological investigations and contact tracing to identify individuals who had close contact with the cases.
Contact tracing has begun for the new confirmed cases, which MOH’s director of medical services Kenneth Mak warned is a “laborious process” that will take days or even weeks.
As of Tuesday, 12pm, test results for 20 suspect cases are pending while MOH has identified 311 close contacts.
Of the 239 close contacts who are still in Singapore, 234 are being quarantined or isolated. Efforts are ongoing to contact the remaining five close contacts.
524 individuals quarantined
In Parliament on Monday, co-chair of the multi-ministry taskforce Lawrence Wong, Minister for National Development, said that a total of 524 individuals are currently quarantined in the Republic. Of that figure, 222 are being housed in government quarantine facilities, with the remaining at home.
The minister also revealed that since Saturday, more than 200,000 face mask packs – or 15 per cent of the total – have been distributed by the government. The decision to release masks directly from the national stockpile – built up over the years thanks to crises like the SARS epidemic – to the general public was taken thanks to a “rapid consumption rate” by the public, he added.
Same family of coronaviruses as SARS
The novel strain belongs to the same family of coronaviruses as Severe Acute Respiratory Syndrome (SARS), which killed nearly 800 people globally during a 2002-2003 outbreak and also started in China.
On Monday, China's death toll from the coronavirus epidemic soared past 420, exceeding the 349 mainland fatalities from the SARS outbreak.
The coronavirus has also spread to 27 territories beyond mainland China, sickening over 20,000 people worldwide. The World Health Organization declared a global emergency over the new virus last Thursday (GMT), after initially downplaying the threat posed by the disease.
The new strain likely originated from Wuhan’s Huanan Seafood Market, where live animals or products – such as foxes, wolf puppies, giant salamanders, snakes, porcupines, and camel meat – are sold.
Patients suffering from the new strain may exhibit fever and symptoms of lower respiratory illness – such as coughing or difficulty in breathing –, as well as pneumonia-like symptoms like a runny nose, sore throat, and headache.
However, some who have died from it have not displayed symptoms of fever, according to details released by China’s National Health Commission, potentially complicating global efforts to check for infected travellers as they arrive at airports and other travel hubs.
This means that temperature screening, the most common measure being used at transport links and airports to check travellers, may not identify some infected people.