Press Conference chaired by Minister for Health Khaw Boon Wan
30 April 2009, 1700hrs
Key points made by Minister Khaw Boon Wan
1 The flu outbreak continues to spread. In the last 24 hours, confirmed cases have emerged in five more countries (UK, Germany, Peru, Austria and Switzerland), infecting a total of 12 countries and 237 patients. The first death outside of Mexico has now been reported in Texas, US, an imported case from Mexico.
2 While the first batch of cases outside of Mexico had travel history to Mexico, the subsequent cases include many local transmissions. This means that secondary transmission has now happened outside of Mexico, especially in US.
3 That is why WHO has further revised its alert to Phase 5. We anticipated this change and hence yesterday, I told you that although at alert colour Yellow, we have actually started to implement several Orange measures, especially in the hospitals. With the change in WHO alert, we will formally revise our colour code to Orange. In parallel, we are also gearing up for Red measures at short notice. We should not be surprised if WHO raises its alert to Ph 6 over the next few days.
4 But let me put the situation in perspective.
5 First, the whole world is at war with this Mexican swine flu. It is a global war and every country is or will be involved eventually. It is just a matter of time when cases and deaths will happen in all countries. We have been lucky so far, but I think it will not be long before patients or even deaths start to occur here. In SE Asia, we are the most globalised country, so the first cluster of cases in SE Asia may well emerge in Singapore. We must be mentally prepared for this scenario and not be shocked into panic or inaction when it happens.
6 Second, this war will be long drawn, with several waves of attack. So we must be prepared for a long war, it will not be a quick battle. We must pace ourselves carefully. We must gear up speedily but we must also not go into unnecessary overdrive and tire ourselves out even before the first wave of attack here. That is why I have advised my hospital colleagues not to over-swing. They must gear up and be mentally prepared for immediate operation when called upon. But they should not put everyone on 24-hour battle mode; that will not be sustainable for a long operation. If I may use a battle analogy: we have put some troops on the ground to guard our key installations to detect enemy intruders. We have also set up patrols and sentries in the community to watch out for intruders. But many more troops are on standby to reinforce when necessary. We need them to be well-rested and be fit for action when called upon to do so.
7 Third, we must not be trapped into the SARS battle mindset. As I said yesterday, we are now fighting a new war. What worked during SARS may not be effective this time round. For example, during SARS, the main source of transmission, in fact the only source of transmission was in hospitals. With flu virus, the main source of transmission, unfortunately will likely be in the community, besides hospitals. That is why WHO said yesterday that they had given up on containment strategy, instead they would focus on mitigation strategy, treating patients as they come. Let me try to explain this in local terms. This is like our fight against chikugunya vs dengue. When there were only a few imported cases of chikugunya, we went all out to contain it, checking every gutter, drain and flower pot, trying to prevent it from sinking roots here. But with dengue already here in large numbers and all over the place, containment strategy is no longer practical.
8 However, for countries like Singapore which hopefully are still unaffected, we must do our utmost to make containment strategy work, even though we know how difficult it is because border controls cannot be fool-proof with flu virus. But we must try. That is why we must do more to manage recent travellers from Mexico. With or without symptoms, we have to put them on home quarantine for a week. We must also strongly discourage Singaporeans from going there.
9 The containment strategy cannot fully protect us from this virus, but will buy us time to delay the attack for as long as possible. Vaccine manufacturers are rushing to produce vaccines but they need time, several months to a year. Every one month we can delay the flu attack, we enhance our chances of protecting Singaporeans.
10 Fourth, Singaporeans cooperated fully with the Government during SARS. Your cooperation is even more important now in the war against flu virus. SARS carriers were detectable through high fevers. But the Mexican swine flu carriers can look healthy like you and me and may not even know it themselves. Until a vaccine is available, there are only two effective public health measures: (a) social distancing, i.e. stay away from one another, and from big crowds; (b) very high standard of personal hygiene. That’s why we must keep on nagging Singaporeans to wash hands thoroughly and frequently, do not touch your eyes or mouth, reduce hand-shaking etc. These are simple steps that our grandmothers taught us since young, and they are effective, but you must practice it all the time. One careless mistake and the virus attack may succeed. As for social distancing, this applies to all those who are sick or recent travellers to Mexico and the affected regions: please stay away from crowds, lest you infect them. For those who are sick: stay at home, and if you must go out, please wear a mask. For example, for the Istana Open House tomorrow, please stay away if you are sick or recent travellers to the affected regions. Please do not endanger the health of fellow Singaporeans.
11 But for healthy Singaporeans or those who have not been overseas, get on with your life. Go out, exercise, bicycle, brisk walk. We all know that when we are active and sleep well, we hardly get flu. The same thing this time. Do not allow this crisis to stress you out, continue your daily exercise, have enough sleep but listen to your body. If you feel unwell, wear a mask and see your doctor immediately.