Singaporeans celebrated Chinese New Year this year under the shadow of a novel coronavirus (CoVID-19) outbreak. This outbreak originates in Wuhan in China and has since spread to many countries. The case in Singapore was confirmed on 23 January 2020, two days before the Chinese New Year [1]. By 7 February, there were 33 confirmed cases in Singapore, and there were cases without any link to previous cases or travel history to China, this has caused the government to raise the DORSCON (Disease Outbreak Response System Condition) level from Yellow to Orange. The DORSCON is a colour-coded system, which has green, yellow, orange and red categories, providing guides for the nation to prevent and reduce the impact of the infectious disease [2].
The escalation of disease outbreak measure sparked panic buying among some residents to stock up rice, instant noodles, toilet paper and sanitization products, as reported in the media [3]. Circulating pictures on social media of emptied shelves in supermarkets in Singapore continued to induce a sense of fear and anxiousness among some quarters even after reassurance from the authority that ample supply of daily essentials is available in stock. This is something never seen during the past virus outbreaks, namely Influenza A (H1N1) in 2009-2010 and SARS (Severe acute respiratory syndrome) in 2003. Clearly, the ease of dissemination of information (or disinformation) via social media is a culprit of such irrational behaviours [4].
Is CoVID-19 outbreak more serious than SARS or H1N1? The emerging fact indicates that CoVID-19 is more like H1N1 than SARS [5]. The following is a table summarising and comparing the CoVID-19 with the SARS and H1N1 outbreaks in Singapore. From this comparison, CoVID-19 appears to be not as severe and deadly as SARS, which caused 33 deaths out of a total of 238 cases in Singapore. The CoVID-19 is quite like H1N1 that most of the infected patients (80%) developed only mild symptoms [6]. Unlike H1N1 which infected mostly the youth and children, CoVID-19 appears to affect older adults aged 40 and above. Hence, older patients with weaker immune systems may potentially develop more complications that can become fatal.
[table caption=”Outbreaks in Singapore in Recent Years” colalign=”left|left|left|left”]
Outbreaks , SARS [7],H1N1 [8],CoVID-19
Time period, 1 Mar 2003 – 31 May 2003, 26 May 2009 – 12 Feb 2010, 23 Jan 2020 – present
No. of Cases, 238, Estimated 415000, 77 (as of 18 Feb. 20)
No. of Death, 33, 18, 0
Death rate,13.87%, 0.004%,~2% based on experience in China
Transmission route, Close contact,Airborne droplets,Airborne droplets
Severity,Cause severe pneumonia,Mostly mild flu-like symptoms, Causes mild disease for 80% of infected patients
Population most infected,Adults of all ages,Younger cohort below 30 years old (~80%),Most patients are aged 40 and above (90%) based on data from China
Clusters, Mainly in healthcare institutions and one in a wholesale vegetable centre,Widespread in community,Most cases traceable to contact of earlier cases or travel history to China
Last case reported, 8 September 2003 (acquired in a laboratory), Influenza activity in Singapore remains at low to moderate level until today, Currently active
Highest DORSCON Levels, Non-existence, Orange, Orange
Current status worldwide, No new cases reported worldwide since 2004, Vaccine is available but H1N1 continues to affect the world with seasonal outbreaks, Outbreak in progress with 73385 reported globally with 1873 deaths
[/table]
So, are we under threat from a super virus? Clearly not! Most people are not aware that there are an estimated 290 to 650 thousand deaths due to influenza of all types each year. There is no need for the public to become paranoia over the CoVID-19 outbreak.
It is important for every one of us to play a role in curbing the spread and contain the outbreak by practising personal hygiene through frequent handwashing and wearing a mask when feeling unwell. Follow the public health advice for protection if you need to be in contact with any potential infect. In fact, this is the same advice for seasonal flu or influenza of all types. Hence, keep healthy and be vigilance.
Beyond that, it should be life as per normal.
References
[1] Z. Abdullah, H. Salamat, Singapore confirms first case of Wuhan virus – CNA, CNA. (2020). https://www.channelnewsasia.com/news/singapore/wuhan-virus-pneumonia-singapore-confirms-first-case-12312860 (accessed February 18, 2020).
[2] M. Mohan, J.A. Baker, Coronavirus outbreak: Singapore raises DORSCON level to Orange; schools to suspend inter-school, external activities – CNA, CNA. (2020). https://www.channelnewsasia.com/news/singapore/wuhan-coronavirus-dorscon-orange-singapore-risk-assessment-12405180 (accessed February 18, 2020).
[3] M. Jamrisko, Coronavirus Latest: Singaporeans Empty Supermarkets – Bloomberg, Bloomberg. (2020). https://www.bloomberg.com/news/articles/2020-02-08/singapore-pm-says-virus-response-major-test-as-hoarding-spikes (accessed February 18, 2020).
[4] Y. Low, A. Chandra, The Big Read: Panic buying grabbed the headlines, but a quiet resilience is seeing Singaporeans through COVID-19 outbreak – CNA, CNA. (2020). https://www.channelnewsasia.com/news/singapore/coronavirus-covid-19-panic-buying-singapore-dorscon-orange-12439480 (accessed February 18, 2020).
[5] H.M. Ang, COVID-19 threat could erode with time just as with H1N1, say experts – CNA, CNA. (2020). https://www.channelnewsasia.com/news/singapore/covid-19-threat-could-erode-with-time-just-as-with-h1n1-say-12438600 (accessed February 18, 2020).
[6] More than 80% of COVID-19 patients have mild disease and recover: WHO chief – CNA, (2020). https://www.channelnewsasia.com/news/world/covid-19-coronavirus-who-china-patients-have-mild-disease-12445010 (accessed February 18, 2020).
[7] K.T. Goh, J. Cutter, B.H. Heng, S. Ma, B.K.W. Koh, C. Kwok, C.M. Toh, S.K. Chew, Epidemiology and control of SARS in Singapore, Ann. Acad. Med. Singapore. 35 (2006) 301–316.
[8] Influenza A (H1N1-2009) outbreak | Infopedia, (n.d.). https://eresources.nlb.gov.sg/infopedia/articles/SIP_1759_2011-01-28.html (accessed February 18, 2020).