New Coronavirus threat

John Fedup

The Bunker Group
China has just announced huge travel restrictions (CNN report) around the Wuhan area effecting almost 20 million people. The death toll now stands at 17 and cases have been reported in Saudi Arabia and one case in Singapore. It will be interesting to see what international travel restrictions and screenings emerge. as well as how civil aviation is affected.
 

John Fedup

The Bunker Group
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This article discusses the apparent lack lustre performance of China’s PLA so far wrt the coronavirus outbreak. The civil response has been more visible and Alibaba certainly stepped up with their efforts, both financially and logistically. Could be some political blowback for Xi and the PLA if this crisis takes an even worse downturn.
As Coronavirus Spreads, China’s Military Is Largely MIA
 

OPSSG

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Post 1 of 3: Orange alert & SG backgrounder
Case Summary in Singapore (as of 07 Feb 2020, 1200h)

  • Confirmed cases 33*
  • Cases tested negative - 363
  • Cases pending test results - 181
*Cases 30 to 33 were confirmed at about 2pm, 07 Feb. See press release.
1. The ‘Disease Outbreak Response System Condition' (DORSCON) is a colour-coded framework that shows Singaporeans the current disease situation. Read more here.
2. Shortages in-stores in Singapore have also compelled the government to supply mask packs for free to all households. All Singapore households from Saturday (1 Feb 2020 to 9 Feb 2020) will be issued with 4 masks as a one-time government release. Personnel from the Ministry of Health (MOH), Ministry of Defence (Mindef), Ministry of Trade and Industry (MTI) and People’s Association said at an inter-ministry briefing on the Wuhan virus outbreak that a pack of four surgical masks will be distributed to each of the 1.37 million Singapore households. Read more at Govt to distribute masks to all 1.37 million Singapore households amid Wuhan virus outbreak

3. Speaking in Davos on 24 Jan 2020, Prime Minister Lee Hsien Loong urged Singaporeans to be calm but watchful, adding that the Government is well prepared to deal with the new coronavirus. PM Lee pointed to the establishment of a multi-ministry task force co-chaired by Health Minister Gan Kim Yong and National Development Minister Lawrence Wong. Singapore is well prepared for this new coronavirus, having learnt and implemented systems from the last SARS outbreak. Numerous plans to curb the risk of spread have since been stood up, including the set-up of quarantine facilities, increased border checks and a compulsory leave of absence for students and teachers from China.

4.WHO’s director general Tedros Adhanom Ghebreyesus said on 7 Feb 2020 that demand for PPE was 100 times higher than normal, The Guardian reports. As result, global stocks of masks and respirators were now insufficient to meet the needs of WHO and its partners.

5. "Following the Singapore Ministry of Health's Feb 7 declaration of a Code Orange health alert, we consulted with the US government and our medical teams and decided not to participate in the Singapore Airshow" [that starts on 11 Feb 2020], Lockheed Martin said in a statement. Business jet manufacturers Bombardier, Textronand General Dynamics's Gulfstream division are among other companies that have withdrawn from the airshow. Despite the fact that Ellen Lord (the Pentagon's chief weapons buyer), will no longer attend the event, USMC F-35Bs and USAF F-22 will continue to be at the air show. Experia Events told CNA that the Ba Yi team was cleared to perform after careful consideration and medical assessment by relevant Government authorities. The Singapore airshow will continue next week, but organisers might look to limit public visitors.

6. According to David Boey, whom I quote below:

“SARS arrived on Singapore shores like a silent killer in the night. Although the first case broke in China in November 2002, the World Health Organization (WHO) issued an alert only in March 2003. It was unclear at first what the virus was, how bad it was and how long the crisis would grip Singapore. Face masks and common cold medication were wiped off shelves. People started to stay away from public spaces. The WHO declared Singapore SARS free on May 30, 2003. The relief in the air then was palpable. David Boey has an excellent post on the eight measures last seen during the 2003 Severe Acute Respiratory Syndrome (SARS) that are likely to make a comeback (some already have).

I. Contactless greetings
The 2003 fight against SARS popularised contactless greetings where people acknowledged one another without shaking hands. A nod and a smile, palms pressed together were all widely-accepted substitutes that prevented inadvertent cross contamination. We didn't have wide screen smart phones and clever memes back in 2003. Probably won't take long for some creative minds to think of something people could flash digitally to say Hi or Bye.

II. Threat velocity
SARS struck suddenly and caught many Singaporeans unprepared. I covered my first SARS story one quiet weekend when I was asked to interview passengers from a Singapore Airlines flight that was quarantined in Frankfurt, Germany, after reports that some passengers were stricken by a mysterious illness. I remember the gaggle of Singaporean reporters at Changi Airport Terminal 2 joking that we should interview the passengers from behind the arrival terminal glass panels by writing questions on pieces of paper or using an extra long boom mike (the kind used by TV studios that hang a microphone on a long pole). Seventeen years on, I don't recall ever having met those passengers as they were taken for checks by health authorities. From a slow start, SARS soon turned deadly in Singapore. Looking at the novel coronavirus, we must be prepared for a steep escalation in threat velocity.

III. SARS deaths
The first SARS patient was hospitalised on 1 March 2003. On 25 March, Singapore had its first SARS death - Patient Number 1's father. Singapore reported its first Wuhan novel coronavirus case on Thursday 23 Jan 2020. We pray for a good outcome (25 days from 23 Jan is 17 Feb 2020).

IV. Split office
Business continuity was the buzzword during SARS. Companies did so by splitting the workforce and having staff work from separate locations. I was one of the journalists who covered the SARS crisis in 2003. Our newsroom was separated into three teams: work from News Centre in Toa Payoh North, work from the SPH office in Genting Lane and work from home. You can imagine the news editor's utter dismay when she learned that journalists from different papers who worked from Toa Payoh North and Genting Lane inevitably met one another at press conferences. Worst, some continued to meet after work - which defeated the whole idea of preventing the spread of the SARS virus by isolating the work force.



V. Travelling with windows down
During SARS, some commuters who travelled in taxis did so with windows wound down for better ventilation. When I saw a taxi on the way to Changi Airport last Saturday with a window half down, it brought back memories of SARS 2003 when people wound down taxi windows to avoid breathing in recycled air-conditioned air inside enclosed car cabins. In today's context, you might see private hire vehicles moving around with windows slightly down too.

VI. Dialects made a comeback
Ever since the Speak Mandarin Campaign took root, one hardly heard local dialects on national television in Singapore. SARS changed this. I recall local celebrities on TV translating health advice to dialects like Hainanese, Teochew and Hokkien to maximise the effectiveness of public health messages. We may soon need to do the same again. Oh, and we had a SARS Hotline too.

VII. Sticky problem
Some places like hospitals and government buildings gave coloured stickers to visitors to indicate that the walk-ins had been checked for signs of fever (which could indicate SARS). Pedestrains could tell they were near a place with SARS checks as traffic lights and lamp posts were plastered with dozens of discarded stickers, making them look measle-like especially when round red stickers were used. Some of the stickers that indicated the wearer was OK were nicely done. I might have kept a sheet or two of these SARS stickers. I hope my collection will not expand in 2020.

VIII. South Korea and Japan
Proving that SARS wasn't an Asian disease, South Korea and Japan were relatively untouched by SARS. My colleagues and I wondered why. Kimchi? Wasabi? Genetics? Who knows? Those who had been to these countries believed that good hygiene may be a reason why they beat SARS. [I had yet to visit S Korea and Japan in 2003. Only did so in 2015 and 2016 respectively. Yes, the Koreans and Japanese generally practice very good hygiene.]”
 
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OPSSG

Super Moderator
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Post 2 of 3: Global update
7. Mainland China had its deadliest day in the coronavirus outbreak on 7 Feb 2020, with authorities reporting 86 fatalities from the pneumonia-like illness that is paralyzing much of the country. A total of 722 people had died from the virus and 34,546 were infected in mainland China. To combat this virus, a 60,000-square-metre hospital with space for 1,000 beds and 30 intensive care wards, all built in just 10 days by China in Wuhan.

8. Coronavirus: Which countries/cities have confirmed cases?
  • Australia - 1
  • Belgium - 1
  • Cambodia - 1
  • Canada - 5
  • China - 34, 546
  • Macau - 10
  • HK - 25
  • Finland - 1
  • France - 6
  • Germany - 14
  • India - 3
  • Italy - 3
  • Japan - 25 + 61 (quarantined on cruise ship)
  • Malaysia - 16
  • Nepal - 1
  • The Philippines - 3
  • Russia - 2
  • Singapore - 33
  • South Korea - 24
  • Sri Lanka - 1
  • Sweden - 1
  • Taiwan - 17
  • Thailand - 32
  • United Arab Emirates - 7
  • UK - 3
  • United States - 12
  • Vietnam - 12
United Arab Emirates - 7
9. Unlike in previous outbreaks, research for a vaccine to help stem this outbreak got under way within hours. Chinese officials released its genetic code very quickly, in mid-Jan. That information helps scientists determine where the virus probably came from, how it might mutate as the outbreak develops, and how to protect people against it. In the past few days several papers from China describing the illness have been published or posted on preprint websites (sites that share papers before they have been peer-reviewed or published in journals). Scientists are publicly sharing an ever-growing number of full sequences of the virus from patients—53 at last count in the Global Initiative on Sharing All Influenza Data database. Many analyses of 2019-nCoV’s sequences have already appeared on virological.org, nextstrain.org, preprint servers like bioRxiv, and even in peer-reviewed journals. The sharing of the sequences by Chinese researchers allowed public health labs around the world to develop their own diagnostics for the virus. These viral genomes are being intensely studied to try to understand the origin of 2019-nCoV and how it fits on the family tree of related viruses found in bats and other species. Notably, 2019-nCoV was closely related (with 88% identity) to two bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, collected in 2018 in Zhoushan, eastern China, but were more distant from SARS-CoV (about 79%) and MERS-CoV (about 50%). With greater commitment from governments to fund research, research facilities were able to spring into action fast. At Inovio's lab in San Diego, scientists are using a relatively new type of DNA technology to develop a potential vaccine. "INO-4800" - as it's currently called - with plans for it to enter human trials by the early summer. Moderna, and Novavax are also reported to be developing coronavirus vaccines. A total of 30 therapies are planned to be tested. Scientists from the School of Biotechnology and Food Technology under Hà Nội University of Science and Technology in Vietnam have developed a novel coronavirus test kit which provides results in 70 minutes instead of 1.5 to 3 hours under the current polymerase chain reaction method. Another team of researchers at Hong Kong University of Science and Technology (HKUST) have invented the world’s fastest portable 2019-nCoV diagnostic device. From sampling to testing, the device is apparently able to detect the novel coronavirus in just 40 minutes. US CDC has a Q&A (see link provided for full list of Qns):

Q: How can I help protect myself?​

A: Visit the 2019-nCoV Prevention and Treatment page to learn about how to protect yourself from respiratory illnesses, like 2019-nCoV and for people who have had close contact with a person confirmed to have, or being evaluated for, 2019-nCoV infection available online.​

Q: Does CDC recommend the use of facemask in the community to prevent 2019-nCoV?​

A: No. CDC does not currently recommend the use of facemasks among the general public. While limited person-to-person spread among close contacts has been detected, this virus is not currently spreading in the community in the United States.​
 
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Ananda

The Bunker Group
Lembaga Eijkman pastikan kemampuan deteksi virus corona di Indonesia - ANTARA News Aceh

This is an interview with the head of Eijkman Institute in Jakarta as leading Molecular and Biology Institute in Indonesia. Basically he denied report from Sydney Morning Herald and few other Foreign Media that report the reason why still no Corona virus case in Indonesia due to Indonesia inability to identify This particular Corona virus.

Indonesia already have capabilities on identified any virus strain since several laboratories (including his) already have PCR and DNA Sequencing capabilities. He just explain that on early weeks the specific Reagen/Reactant for this particular Virus is not available in Indonesia yet, but this week those Reactant already available. This Chemical Reactant will help to identified this particular Coronna virus strain faster than using PCR and DNA Sequencing. He said that all suspect cases in Indonesia after isolation in several hospital, already refer to his Labs, and they already determine their virus is not the particular Coronna virus from Wuhan.

Thus the reason why so far why no cases yet in Indonesia, mostly due to luck. Granted Thailand, Malaysia, Singapore, Japan, Vietnam has more Chinese Tourist or Business travelers from or to China, however Indonesia also have significant people interaction to or from China too.
By luck several hundred Indonesian students in Wuhan that already back to their home during holiday (before lock down), so far did not shown any Viral infection from this particular Coronna virus.

How long our luck can hold, hopefully with already several action being taken including closing flight from and to China will hold, but nothing can certain. According to Chinese consulate in Bali, several thousand Chinese Tourist in Bali now opt to stay in Bali, rather than go home at this moment. Chinese consulate working with Indonesian Imigration to extend their visa until end this month.

WHO already stated that more than 80% of current Corana cased especially the new ones can be considered light case, around 20%+ consider mild, and only few percentage can be considered critical. Usually this kind of trend shown that prevention is working, thus many early stages of Infection can be identified. Hopefully this can be a sign that the peak period already surpassed.
 

OPSSG

Super Moderator
Staff member
Post 3 of 3: Keeping track of the science behind the viral fight

10. On 29 Jan 2020, researchers at the Peter Doherty Institute for Infection and Immunity in Melbourne, Australia have successfully developed a lab-grown version of coronavirus, the first to be recreated outside of China.

11. On 30 Jan 2019:
  • 92 Singaporeans were evacuated on Scoot flight TR121 from Wuhan, Hubei and the arrived in Singapore at 11.40am.
  • Scientists from Duke-NUS Medical School (Duke-NUS), in close collaboration with clinicians and scientists from SingHealth Duke-NUS Academic Medical Centre, SGH, National Centre for Infectious Diseases and Ministry of Health (MOH), have successfully cultured the coronavirus from an infected patient’s clinical sample. This makes Singapore the third country in the world outside China to culture the virus, and the development will certainly aid efforts in diagnosis.
Indonesia already have capabilities on identified any virus strain since several laboratories (including his) already have PCR and DNA Sequencing capabilities. He just explain that on early weeks the specific Reagen/Reactant for this particular Virus is not available in Indonesia yet, but this week those Reactant already available. This Chemical Reactant will help to identified this particular Coronna virus strain faster than using PCR and DNA Sequencing. He said that all suspect cases in Indonesia after isolation in several hospital, already refer to his Labs, and they already determine their virus is not the particular Coronna virus from Wuhan....

How long our luck can hold, hopefully with already several action being taken including closing flight from and to China will hold, but nothing can certain. According to Chinese consulate in Bali, several thousand Chinese Tourist in Bali now opt to stay in Bali, rather than go home at this moment. Chinese consulate working with Indonesian Imigration to extend their visa until end this month.

WHO already stated that more than 80% of current Corana cased especially the new ones can be considered light case, around 20%+ consider mild, and only few percentage can be considered critical. Usually this kind of trend shown that prevention is working, thus many early stages of Infection can be identified. Hopefully this can be a sign that the peak period already surpassed.
12. On 8 Feb 2020:
  • It was announced that a made-in-Singapore diagnostic test kit that can detect the presence of the novel coronavirus (2019-nCoV) with high accuracy has been rolled out at some public hospitals. Plans are in place to scale up their production so such kits can be deployed at other hospitals and laboratories which are not currently offering 2019-nCoV tests, said the Agency for Science, Technology and Research (A*Star), whose scientists developed the pre-packed reagents. The test kit, which has been approved for use by the Health Sciences Authority, was developed by scientists at A*Star's Experimental Drug Development Centre and Bioinformatics Institute.
  • Vivian Balakrishnan, Singapore’s Minister for Foreign Affairs just shared an update, as follows:
Just launched our second Scoot flight to Wuhan. It is extra special because today marks ‘Chap Goh Mei’, a day for family reunion in Chinese tradition. This flight will bring our Singaporeans and their family members back home from Wuhan.​

We also gave some diagnostic test kits and medical supplies for the novel coronavirus to China this afternoon through PRC Ambassador Hong Xiaoyong. We must credit the Chinese for sequencing and releasing the full genome of the virus by mid-January, which enabled multiple research centers across the world, including A*STAR in Singapore, to rapidly develop test kits for specific identification of the 2019-nCov.​

Infectious diseases do not stop at the border. We can only overcome this global challenge by working together, at both the national and international level. Singapore will continue to work closely with China and the international community to tackle the challenge.
13. Singapore is gearing up to increase production of test kits for 2019-nCoV and have sent test kits capable of testing 10,000 samples, together with three polymerase chain reaction (PCR) machines, to China, today. In a few days, Indonesia will also be able to source more tests kits from Singapore. Infectious diseases experts from Hong Kong University said they believe the virus is now transmitting person-to-person, in a sustained way, in all major cities in mainland China. When the first cases of infected Chinese visitors to Singapore surfaced in late January, a 140-strong team of government contact tracers set to work interviewing patients and identifying and quarantining those close to them. A close contact is defined as anyone who has been within two metres and spent 30 minutes with an infected patient. Finding these contacts has involved asking airlines to hand over flight manifests, tracking patients’ movements on security cameras and roping in police investigators for the search, health ministry officials said.

14. To date, Singapore has quarantined nearly 2,593 people. Epidemiologists who use mathematical modeling to calculate disease spread have been looking at how many cases have been found in other countries.
  • Researchers at Johns Hopkins University in Baltimore, Maryland, are visualizing global infection data in real time. A flurry of models of the 2019-nCoV outbreak have been shared and attempt to do far more than just sharpen hunches about where infected air travelers are going to land. Models can forecast the rate at which an outbreak will grow and help predict the impact of various interventions. “When you start to include disease dynamics and population information, there’s more information than just intuition,” says Alessandro Vespignani, an infectious disease modeler at Northeastern University. There are formulas that give you an idea of how many infections probably occurred in China before a case was exported.
  • The centerpiece of many outbreak/infectious disease/pathogen models is the “basic reproduction number”, or Ro (pronounced “R zero” or “R naught”). It’s essentially how many people each infected person can infect if the transmission of the virus is not hampered by quarantines, face masks, or other factors.
  • In a paper posted to bioRxiv, scientists from Guangdong province estimated the incubation period — the time from infection to symptoms — to average between four and five days, which was also the case with SARS. There is clearly a range, though; Ma Xiaowei, director of China’s National Health Commission, announced that researchers believe the viral incubation period—the time it takes for an infected person to develop symptoms—could last up to 14 days for infections of the novel coronavirus 2019-nCoV.
Modelers also look at the incubation time, which is how long it takes for the virus to cause symptoms. The serial interval factors in the time between a person developing symptoms and a contact becoming ill. In this young outbreak, unknowns riddle every model.
 
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OPSSG

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Post 1 of 2: Mitigation measures of a city under DORSCON Orange
Viking and De Havilland have joined other vendors and canceled plans to attend the Singapore Airshow.

Dash 8 and Twin Otter manufacturers pull out of Singapore Airshow
1. Sensible. DORSCON Orange means the 2019-nCoV virus is probably already circulating in Singapore’s population and this affects, my family and me, directly. My family has decided not to wear masks in public, unless we are sick and have chosen to wash our hands more frequently instead. A lady teacher (Case 32) from Victoria Junior Collage (VJC) has not been to China, has caught the novel coronavirus, locally. VJC staff and students who have been in recent contact with her are put on a 14-day leave of absence. In addition, co-curricular activities have been suspended for 14 days, and the school will conduct more tutorial-size classes, rather than larger lectures. There are also 3 cases (Cases 29, 35 & 37) where the infected person(s) whose infection is not traced and have also not been to China. Other transmissions in 3 clusters, as follows:
  • Yong Thai Hang health products store in Cavan Road: It was visited by a tour group from Guangxi, China, on Jan 23. So far, 10 patients have traceable links to that visit (Cases 19, 20, 21, 24, 25, 27, 28, 29, 34 & 40)
  • Grand Hyatt business meeting on Jan 20-22: So far, 3 Singapore residents and 4 foreigners who have since left - at the meeting have the virus (Cases 30, 36 & 39)
  • The Life Church and Missions in Paya Lebar: 5 people linked to it have tested positive (Cases 8, 9, 31, 33 & 38)
2. The total number of people infected in Singapore has grown to 40, as at 8 Jan 2020. If the number of cases of infection continues to grow, Singapore will have to reconsider its strategy, said PM Lee Hsien Loong, as it is "futile to try to trace every contact" if the virus is widespread. Hospitals would be overwhelmed if every suspect case is hospitalised and isolated, he said. At that point, provided the fatality rate is low, Singapore could shift its approach to encourage those with mild symptoms to see their family GP instead of going to the hospital. This way, he said, hospitals and healthcare workers would be able to focus on the most vulnerable patients instead. However, Singapore is not at that point yet, said PM Lee. "It may or may not happen, but we are thinking ahead and anticipating the next few steps," he said. "And I am sharing these possibilities with you, so that we are all mentally prepared for what may come."

3. “In this single-center case series of 138 hospitalized patients with confirmed novel coronavirus–infected pneumonia in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and [the] mortality was 4.3%. SARS had a fatality rate of 9.6% compared to the fatality rate of 2.1% so far for this new 2019-nCoV strain of coronavirus...” wrote Quentin Fottrell of MarketWatch on 8 Feb 2020. Globally, more than 810 have been killed, mostly in China, with more than 37,000 infected worldwide. Currently, the mortality rate of the virus in China is 2 percent, but outside Hubei province, the mortality rate is 0.2 per cent.

4. During the 2009 influenza pandemic, the earliest reports listed 59 deaths from approximately 850 suspected cases, which suggested an extremely high case fatality of 7%. However, the initially reported information of 850 cases was a gross underestimate. This was simply due to a much larger number of mild cases that did not report to any health system and were not counted. After several months — when pandemic data had been collected from many countries experiencing an epidemic wave — the 2009 influenza turned out to be much milder than was thought in the initial weeks. Its case fatality was lower than 0.1% and in line with other known human influenza viruses.

5. Amongst the ASEAN-10, the Singapore Government is the best prepared to deal with a pandemic outbreak. At the heart of Singapore's response plan is the Disease Outbreak Response System (DORS), a crisis management plan which did not exist in 2003, but was drafted after SARS and refined again in the wake of the swine flu (or H1N1) pandemic in 2009. The last SARS outbreak showed that as a country, Singapore has a disciplined population, plus we can trust systems and processes, put in place to mitigate against the spread of disease. During SARS, the Singapore Armed Forces helped to place 1,500 people under quarantine after the outbreak of Sars. Professor Ooi Eng Eong, an infectious diseases expert and virologist at the Saw Swee Hock School of Public Health, noted that a multi-ministry taskforce on the Wuhan coronavirus was formed on 22 Jan 2020, several hours before the first suspected case came to the attention of the authorities at 10pm the same day. The patient - a 66-year-old Chinese national tourist from Wuhan - tested positive the next day, becoming the first confirmed case in Singapore. “If you look at the response time, it is a fact that the ministerial committee formed before the case appeared, and we can see that a lot of systems are already in place, occurring across ministries and not as siloed as back then when SARS caught us all by surprise,” said Prof Ooi, who is also deputy director of the Emerging Infectious Diseases Programme at Duke-NUS Medical School.

6. In terms of capacity, Singapore has already beefed up its healthcare and isolation capacity since 2003. This includes the 330-bed National Centre for Infectious Diseases that opened in 2019, and new hospitals such as Khoo Teck Puat Hospital in 2010, Ng Teng Fong General Hospital in 2015, and Sengkang General Hospital in 2018. Nanyang Technological University (NTU)’s Graduate Hall 1 and Blocks 9, 10 and 11 at Hall 2, as well as Block 83 at the Prinsep Street Residences of the Singapore Management University (SMU) and the Civil Service Club@Changi were also activated as quarantine facilities. 4 blocks of Prince George’s Park Residences at the National University of Singapore (NUS) said that chaos ensued after they learnt that they had to move out to make way for quarantine facilities for the novel coronavirus outbreak. Further, there are the many enhancements to the Infectious Diseases Act over the years since 2003, which give the authorities greater powers to enforce orders that were issued in the fight against a gazetted outbreak. The Act allows people who break home quarantine orders to be arrested without a warrant and to be jailed or fined on conviction. It was amended last year to allow officers to use “physical means” to enforce the order by bringing an absconder back to the place of isolation, in lieu of arrest.

7. As a result of SARS, policies and procedures regarding risk stratification, contact mapping, contact tracing, quarantine and others were developed on the fly as the epidemic erupted, Dr Tan Yia Swam, First Vice-President of the Singapore Medical Association said. “Today, all of the above have been developed and tested before in exercises and they are now put into action. Of course, these plans, policies and procedures must be modified in line with the epidemiology of the disease, but we are not working from scratch, unlike the past experience with SARS,” Dr Tan added. Army officers have been brought in to help with contact tracing and the administration of quarantine measures. Contact tracing for the confirmed cases is ongoing in Singapore. Once identified, the Ministry of Health (MOH) will closely monitor all close contacts. As a precautionary measure, they will be quarantined for 14 days from their last exposure to the patient. In addition, all other identified contacts who have a low risk of being infected will be under active surveillance, and will be contacted daily to monitor their health status. As of 4 Feb 2020, 12pm, MOH has identified 311 close contacts. Of the 239 who are still in Singapore, 234 have been contacted and are being quarantined or isolated. Efforts are ongoing to contact the remaining five close contacts.

8. Writing in an MOH journal on SARs, Professor Chee Yam Cheng, recalled the Singapore Army's contributions in 2003: "They worked in shifts from 7 am to 11 pm, and their sole objective was to trace within 24 hours (and this is vitally important) of receiving the name of a SARS patient, everyone who had been in close contact with him. This meant every name (and address – in order to serve the Home Quarantine Order) of every person that the SARS patient (be he highly suspect or probable) could remember having met from the time he took ill (and maybe even while he was incubating the illness the previous 10 days, unless we can be very sure when the infectious period started in each case). "The army came to the rescue when MOH realised its battle against time to trace the 2,000 people affected by the Pasir Panjang Wholesale Centre closure could not be won without reinforcements.”
 
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John Fedup

The Bunker Group
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Singapore certainly seems to be prepared for what may come and Japan and South Korea are as well but other Asian countries not so much This virus seems to be more infectious than SARS but so far the mortality rate is lower and in fact may be much lower as many mild cases may not be included. The likely outcome is an established seasonal virus that mutates, sort of like the flu. It will be the future mutations that will be worrisome.
 

Ananda

The Bunker Group
Pangolins are possible coronavirus hosts, scientists say

After suspecting Bats and Snake as carriers of this strain of Corona Virus, new evidencen based on DNA sequencing seems suggest Pangolins is the carrier.

Whether it's Bat, Snake or Panggolins as carriers, sadly even this episode of Corona Virus will not reduce much of Wild Live meats demand. They are simply too ingrained in segments of sociaty throughout Asia on the need to get wild live meats for their health and stamina.
 

John Fedup

The Bunker Group
  • Thread Starter Thread Starter
  • #12
@Ananda ...yes, read an article about this yesterday. Even here in Canada customs agents have seized significant quantities of pangolins scales on two occasions last year. Many bears have been killed solely to collect certain organs for Asian markets. Definitely a worldwide problem.
 

OPSSG

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Post 2 of 2: Adapting to change
Singapore certainly seems to be prepared for what may come and Japan and South Korea are as well but other Asian countries not so much This virus seems to be more infectious than SARS but so far the mortality rate is lower and in fact may be much lower as many mild cases may not be included. The likely outcome is an established seasonal virus that mutates, sort of like the flu. It will be the future mutations that will be worrisome.
9. Thanks for your kind words. Living here in urbanised and crowded, Singapore, seeing the confusion and adjusting to new circumstances be it due to sudden changes in behaviour or circumstance, like:
  • hoarding of supermarket supplies, resulting in retailers like NTUC FairPrice, only allowing shoppers to buy four packs of paper products, two bags of rice, four bundle packs of instant noodles and S$50 limit for vegetables per customer from 9 Feb 2020, or
  • the confusion of the university students, who had 24 to 48 hours to move out of their hostels, or
  • neighbours living next to hundreds of families served with home quarantine orders (like food delivery riders, taxi drivers and so on), which is expected to rise to thousands, if the virus spreads,
has not been easy emotionally for all of us — regardless of the best laid plans and mitigation measures taken. We just have to bear with it. In addition, taxi and private-hire car drivers have been instructed to take daily temperature readings and will be given 300,000 surgical masks, in response to the coronavirus situation. Singapore, which has 5.7 million people, has 43 confirmed cases of the virus. That’s the second-highest outside China, excluding a quarantined cruise ship off the coast of Japan.

10. According to data from the Singapore Tourism Board, more than 3.3 million tourists from mainland China travelled to Singapore between January and November 2019. Their spending contribute significantly to tourism receipts. With travel restrictions in place to curb the spread of the virus, there will be no tourists from China during this period. In turn, businesses that will see a big dip in customers include hotels, airlines, airports, restaurants, retail outlets and land transport providers.

11. Compared to the 2003 Sars (severe acute respiratory syndrome) epidemic, experts believe the Wuhan virus crisis could have bigger impacts, since China’s economy has grown tremendously and Asian markets are now more reliant on their consumers. China's central bank has announced other economic measures in the face of a deepening coronavirus epidemic, including providing banks with 300 billion yuan to lend to affected companies. When China sneezes, to say Singapore and the rest of ASEAN catches a cold is an understatement. No one is spared from China-related disruption, either on the production or demand side. And then you add in travel. Therefore, in this light, I think that the Singapore Government has made tough decisions to protect people in Singapore from the Novel Coronavirus, with travel restrictions imposed on tourists and visitors from China — keeping in mind that Singapore's trade with China is worth more than US$50 billion, a year. Air cargo and cargo ships continue to ply between China and Singapore daily, but with air crew and sailors under stricter supervision.

12. Returning Singapore residents, work pass holders and other employees with recent travel history to mainland China within the last 14 days will be placed on Leave of Absence (LOA), where they have to stay at home and avoid social contact. Ministry of Manpower (MOM) announced that it has suspended the workpass privileges of 6 employers and revoked the work pass for 4 workers after they have found to have breached the LOA requirements in place due to the coronavirus situation. According to MOM, 4 work pass holders were repatriated within 24 hours and banned permanently from working in Singapore. The six employers will not be allowed to hire work pass holders for two years.

13. 174 Singaporeans and their family members evacuated by the Scoot TR5121, from Wuhan, the Ministry of Foreign Affairs (MFA) said, adding that its Consular Officers and medical personnel accompanied this second evacuation fight. This second flight includes passengers with fever or respiratory symptoms and will be taken to designated hospitals for further examination. The remaining passengers will be quarantined for 14 days. Foreign Affairs Minister Vivian Balakrishnan said in Parliament that Singapore will not leave any overseas citizen behind, in the wake of the novel coronavirus outbreak in China. The first evacuation flight TR121 departed Wuhan for Singapore on 30 Jan 2020 and carried 92 passengers, all Singaporeans — 4 of these 92 passengers have tested positive for the virus (Cases 15, 17, 22 and 23).

14. On 9 Feb 2020 (Sun), 3 new cases of the novel coronavirus were confirmed in Singapore, all with no recent travel history to China. This takes the total number of cases in Singapore to 43. Of these, six are in critical condition in intensive care. Unsurprisingly, travel advisories have been issued by Kuwait and Qatar for Singapore, urging citizens of both countries to defer travel plans unless necessary. South Korea and Israel have also told their citizens to defer travel to Singapore, while Indonesia and Taiwan have recommended that precautions be taken.

15. As governments in Asia struggle to reassure their populations over the coronavirus, public health experts say Singapore’s approach in communicating to the public is providing a model for others to reduce panic, rumors and conspiracy theories. In a nine-minute recorded message on Sunday, Prime Minister Lee Hsien Loong said “fear can do more harm than the virus itself” amid reports of long lines and hoarding at local supermarkets. He then laid out steps residents can take to help prevent the spread of the virus, like exercising good hygiene, while assuring them that the city had enough supplies of enough goods. The speech, posted on social media in three languages, appeared to have an immediate impact: The long queues at supermarkets throughout the city-state on Friday night returned to normal levels as of Sunday.
Prime Minister Lee’s speech proved notable in a region where governments have struggled to get the message right, spurring panic buying and confusion over how to protect themselves from the outbreak. In Hong Kong, leader Carrie Lam’s mixed messages on wearing masks and shutting the border with mainland China has stirred mistrust. Nurses have gone on strike and residents have violently opposed quarantine sites, while residents have struggled to buy toilet paper, hand sanitizer, rice and other staples for more than a week.

16. Lee's speech “was a pretty outstanding example of very good risk communication,” said Claire Hooker, a senior lecturer at the University of Sydney’s Center for Values, Ethics and the Law in Medicine, who has studied the public responses to epidemics and infectious disease for about 20 years. “It gave people very concrete actions” that “handed back a measure of control to people whose sense of control will feel threatened,” she said. Thomas Abraham, author of “Twenty First Century Plague, the Story of SARS,” and a risk communication consultant for the World Health Organization, said the speech worked because of the high level of trust Singaporeans have in the competence of the government -- as well as the transparency. Ironically, my greatest concern is not with the status of the novel coronavirus outbreak in Singapore. My greatest concern is with the spread of the novel coronavirus in Malaysia, with 16 infected — as Malaysia is much less prepared than Singapore to manage any outbreak — as more than 300,000 Malaysians travel across the Johor-Singapore Causeway every day, making it one of the busiest overland border crossings in ASEAN. Dr Wan Azizah, Malaysia’s National Disaster Management Agency (Nadma) chairman, said that Malaysia will hold discussions with Singapore on measures to protect workers from both countries.
 
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hauritz

Well-Known Member
Pangolins are possible coronavirus hosts, scientists say

After suspecting Bats and Snake as carriers of this strain of Corona Virus, new evidencen based on DNA sequencing seems suggest Pangolins is the carrier.

Whether it's Bat, Snake or Panggolins as carriers, sadly even this episode of Corona Virus will not reduce much of Wild Live meats demand. They are simply too ingrained in segments of sociaty throughout Asia on the need to get wild live meats for their health and stamina.
China and a few other counties have temporarily suspended wildlife imports. China has done this before with the SARS outbreak but the scale of this outbreak may force them to really crack down on these imports.
 

Todjaeger

Potstirrer
For those interested in better understanding the potential impact of an epidemic or pandemic, the 2011 movie Contagion, while a work of fiction does cover some of the basic concerns and protocols fairly well. Some of the important things to do was to segregate the population to attempt to prevent transmission of the disease. A basic breakdown would be the "normal" population, those who have or may have been exposed to the disease, and those who actually have the disease.

So far though, it appears that the coronavirus might either have multiple infection vectors, or the vector has not been determined from some of the potential routes. I could see this causing problems in determining who has and who has not been exposed, as well as what some effective quarantine tactics would be.
 

John Fedup

The Bunker Group
  • Thread Starter Thread Starter
  • #16
I think the next several weeks will allow a determination on what the potential threat is. Assuming the info coming out of China is correct then there is reason to be optimistic. The negative aspect is this may be yet another seasonal virus that will require annual vaccination. Important to remember, so far the flu is a way bigger problem.
 

hauritz

Well-Known Member
It will take time to assess the seriousness of this outbreak but when you look at this interview with an expert it does kind of give you a sense of impending doom.


In his own quiet laid back way he is talking about an infection rate that is doubling every 5 days, has an unknown mortality rate and we may be years away from developing vaccines to combat it.
 

ParadoxicalQ

New Member
Alarming to say the least. Who knows what the real numbers are, and how serious it really is. One thing is for certain, the Chinese are taking this very, very seriously. You don't see the flu shutting down a city of 10 million + people.

 
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John Fedup

The Bunker Group
  • Thread Starter Thread Starter
  • #19
There were reports the outbreak was slowing but this link seems to end the optimism. Lung scanning has provided a means to quickly diagnose new infections and the increased numbers are alarming to say the least.
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ngatimozart

Super Moderator
Staff member
Verified Defense Pro
There were reports the outbreak was slowing but this link seems to end the optimism. Lung scanning has provided a means to quickly diagnose new infections and the increased numbers are alarming to say the least.
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Trouble is, don't really know what to believe about anything coming out of the PRC. They are spinning the hell out of it and like Tonto used to say, "they speak with forked tongue Kemosabi". Any "independant" videos that were coming out have ceased as the reporters have disappeared, probably picked up by the security forces and will be subjected to very unpleasant conditions. We know that the local population have been angry at how the Wuhan party authorites / govt reacted at the start and since and have taken to wechat and weibo to vent. This has been allowed up until the last day or so and now the state censors are starting to clamp down again, but the security forces will have been taking note of who has been complaining and posting. Door knocking and arrests mightn't be that far away.
 
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