AIDS, HIV AND SARS IN SINGAPORE

AIDS AND HIV IN SINGAPORE

Although the number of people living with HIV in Singapore is relatively small, the country’s status as an international travel and business hub, along with the high number of infections found in surrounding countries, make it possible that the country will experience a more serious epidemic in the future. The number of annual new infections has been rising in Singapore. In 2008, a record 456 people were newly diagnosed with HIV, compared to 357 in 2006. The majority of these new infections (50 percent) are diagnosed at a late-stage of HIV infection, by which point HIV treatment should already have started. To combat these rising figures, the government has chosen to focus on preventing mother-to-child transmission, but controversially, has rejected widespread condom promotion. Another controversial policy in Singapore is the strict law banning sex between men, which campaigners argue undermines efforts to promote safe sex among MSM. This is concerning considering the rising number of HIV infections among MSM (38 HIV infections in 2002, compared with 185 in 2008). [Source: Avert, International AIDS-HIV charity website]

HIV/AIDS - adult prevalence rate: 0.1 percent (2009 est.), country comparison to the world: 159. HIV/AIDS - people living with HIV/AIDS: 3,400 (2009 est.), country comparison to the world: 127. HIV/AIDS - deaths: fewer than 100 (2009 est.), country comparison to the world: 152 At the end of 2005, the Ministry of Health reported that 2,641 Singaporeans were infected with human immunodeficiency virus (HIV); of these cases, 1,481 had developed full-blown acquired immune deficiency syndrome (AIDS) cumulatively since 1985, 255 were new HIV cases in 2005, and 100 were new AIDS cases. [Source: CIA World Factbook 2013, Library of Congress, 2006]

At the end of 1988, the Ministry of Health reported thirty-four cases of acquired immune deficiency syndrome (AIDS) among Singaporeans; four of these cases resulted in death. The first two cases were identified in 1985. Thereafter the incidence increased; five new cases were reported in December 1988 alone. In 1987 the Ministry of Health established an AIDS Task Force to inform health professionals of research on and treatment programs for the disease. A National Advisory Committee, also formed in 1987, with representatives from the Ministry of Health, other ministries, the public media, hotels, and travel agencies concentrated on educating the public about the disease. The Ministry of Health worked with WHO, adapting its information and strategies to local circumstances. All blood donors were routinely screened for AIDS, and blood screening could be done at designated government clinics. In 1989 the Ministry of Health was sponsoring education programs on AIDS and offering confidential counseling to people worried that they might be infected. The ministry was trying to reach members of high-risk groups, but many of them refused counseling from fear of being identified and stigmatized. [Source: Library of Congress, 1989]

For a long time the Singapore government maintained a rule that required that AIDS victims in the city-state be buried or cremated within 24 hours of death. AFP reported: “The Action for Aids group had called on the government to do away with the rule saying it was outdated, having been drawn up in the 1980s when little was known about the effect of AIDS after death, the Straits Times said Thursday But the health ministry said the requirement would remain to minimize embalmers' risk of exposure to the virus. "The virus can remain infectious in body fluids and tissues after death. Without embalming, a dead body will decompose rapidly after one day because of the hot weather. "Decomposition accentuates the risk of exposure and transmission as body fluids will exude from the body. This is the basis for the requirement of cremation or burial within 24 hours," the ministry said. The World Health Organization has done away with the rule of burial and cremation of AIDS patients within 24 hours, as long as the bodies are properly handled by trained embalmers, the report said. [Source: Agence France Presse, December 9, 1999]

Expatriates with AIDS Kicked Out of Singapore

In March 2000, Singapore began testing all expatriates for AIDS and HIV and those that failed were be asked to leave the country. "This is a means to control the spread of communicable diseases to improve the health of Singaporeans," said Ministry of Health spokeswoman Aida Tay. [Source: Barry Porter, South China Morning Post, February 19, 2000 *~*]

Barry Porter wrote in the South China Morning Post, “Foreigners will also be tested for tuberculosis as part of a routine compulsory general physical medical examination for anyone wanting a long-term immigration pass, permanent residence or employment pass of over six months' duration. There are believed to be close to a million foreigners living in Singapore. Before March 2000, only unskilled workers earning under S$2000 a month - such as foreign maids and labourers - had to undergo medical examinations. *~*

“AIDS testing of foreigners is already carried out in Brunei and was later introduced in New Zealand. Brenton Wong, secretary of the non-government organisation Action for Aids, branded the ruling discriminatory and a waste of money. Singapore nationals will not be tested. "Testing this number of people is going to cost a lot of money," he said. "That money could be better spent on care and treatment of AIDS and HIV sufferers." *~*

“As of December 2000, there were 1080 registered Aids sufferers living in the island state. The number of Aids-causing HIV carriers was believed to be treble or quadruple that. This does not include foreign sufferers the government has previously come across by chance and asked to leave, like those who failed a medical test for an insurance policy. The Health Department said an average of 300 to 500 foreigners had been detected with HIV annually over the past five years. The average annual number of known foreign TB carriers was 600 to 1000 over the same period. *~*

“Action for Aids has long criticised the Singapore government for a lack of compassion towards Aids sufferers. Because of a social stigma associated with Aids, only one sufferer has gone public with the disease - Paddy Chew in 1998, who has since died. "Financially, it is quite hard to be an Aids suffer in Singapore," Mr Wong said. "There are no subsidies on medicine and less than 30 percent can afford treatment." Unlike many wealthy countries, there are no special hospices for Aids patients. "They have to either enter public hospital wards or go home to die," Mr Wong said. *~*

Family Values Trump a Tough Stand on HIV in Singapore

Alejandro Reyes wrote in Asiaweek, “In Singapore, swift reversals of policy are rare. So it was noteworthy when the Home Affairs Ministry announced on May 27 that 12 foreign spouses of Singaporeans, who have been or were about to be repatriated because they have the AIDS virus, would be allowed to return or stay in the country. The 11 women and one man had been asked to leave under laws that prohibit HIV-positive immigrants. The cases came to light recently when the local Straits Times newspaper reported how some of the expulsions had separated children from parents. The story sparked public support for the families and opposition against tough application of the rules. [Source: Alejandro Reyes, Asiaweek, June 9, 2000 ^^]

“Singapore's leaders took notice. "The law cannot just apply without thinking of the consequences to the family," Prime Minister Goh Chok Tong declared publicly. Within hours, the Home Ministry made known its decision. Later, in a letter to the Straits Times, the ministry insisted that there had been no policy reversal. The law, it explained, was never intended to affect people with family roots in Singapore. ^^

“Still, many Singaporeans saw the move as an about-face that underscored the government's more open attitude -- even on an AIDS-related issue. It "shows a greater sensitivity and humanity than expected and also accords with public sentiment," says legislator and lawyer Simon Tay. But he quickly adds that authorities remain firm that HIV-positive visitors be kept out. In no way does the u-turn signal any softening of Singapore's hardline HIV policy, says gay-rights activist Alex Au Wai Ping. The initial decision indicated how "the bureaucracy seems to be completely out of step with public opinion." ^^

“Au says that a similar gap exists between bureaucrats and citizens on the treatment of homosexuals. On May 23, the police refused to approve an application by Au to hold a public forum on gay and lesbian issues. The reason, said the rejection letter, was that such a meeting would "advance and legitimize the cause of homosexuals in Singapore. The mainstream moral values of Singaporeans are conservative, and the Penal Code has provisions against certain homosexual practices. It will therefore be contrary to the public interest to grant a license." In late 1996, Au and others applied to register an informal group called "People Like Us" so it could meet to discuss gay and lesbian issues and circulate a newsletter. The application was denied. Three appeals, including one to Goh, were turned down. In April this year, authorities explained that the law indicated refusal if a group "is likely to be used for unlawful purposes or for purposes prejudicial to public peace, welfare or good order." ^^

SARS

SARS (severe acute respiratory syndrome) is a deadly pneumonia-like disease that appeared in China in 2002 and spread across China and into Southeast Asia and North America in the winter and spring of 2003, killing several hundred people, scaring many more and disrupting economies and travel plans around the globe. SARS was given its name by the World Health Organization (WHO) after it was first reported to the organization by an Italian doctor in Vietnam.

The SARS outbreak began in southern China late 2002 and was not controlled globally until June 2003. It killed 774 people and infected at least 8,273 people in more than 30 countries, according to the World Health Organization. Higher death tolls had been listed. Investigation found some of the deaths on these lists were the result of other causes. The disease died out later in 2003.

SARS is caused by a corona virus, which is also connected to about a third of all cases of the common cold. The SARS corona virus is very deadly, killing almost 10 percent of the people who get it. About half of those who have died form it so far are over 65.

SARS turned out to be relatively easy to deal with---compared to the threat of a major pandemic presented by bird flu---because it sickened people immediately, This allowed victims to be easily identified and and contained before they infected ti many people. This allowed a prospective pandemic to be reined in relative easily and quickly.

SARS article factsanddetails.com

SARS in Singapore

Singapore had the forth highest number of SARS cases after Hong Kong, China and Taiwan. SARS killed 33 people and infected 238 in Singapore between March and May 2003. One doctor at Tan Tock Seng Hospital, were the disease spread from, told the New York Times, “We were very lucky; We got our first case before the phrase “SARS” was coined. We used no protective gear. We had her in a room with five other patients. And once the infection has taken hold in a hospital like this, it is very difficult to control.” Dozens of people at the hospital became ill. A cardiologist was among those who died.

The first SARS death in Singapore occurred in late March 2003. By that time the disease was already blamed for 10 deaths in Hong Kong, four in Vietnam and three in Canada. The disease was brought to Singapore by three local travellers who had visited Hong Kong, where they were believed to have been infected by a mainland Chinese doctor who eventually died. Most people in Singapore infected by SARS caught it while visiting or working at hospitals. [Source: Agence France Presse, March 26, 2003]

The Singapore economy was hit hard by SARS, particularly tourism related industries and airlines. Hotels had a 80 percent vacancy rate. Singapore Airlines was burdened with flight cancellations and empty planes. Businesses that rely on tourism such as restaurants and retail outlets saw a dramatic drop off in business. It took about a year for these businesses to fully recover.

Singaporeans became extremely worried about SARS. According to a Gallup Poll taken in early April 2003, when the disease was starting to take hold, 75 percent of Singaporeans feared either they would catch it or a family member would, while only 37 percent of Americans said they worried about it. In May 2003, at the height of the SARS crisis, AFP reported: “The death toll from SARS rose to 31 in Singapore after two elderly men who had battled the disease for nearly two months died, the ministry of health said. The men, aged 64 and 78, were admitted to the SARS treatment centre at Tan Tock Seng Hospital on April 6 and 7 and confirmed as probable cases a few days later. The pair were original patients at the Singapore General Hospital who were transferred to Tan Tock Seng following a cluster outbreak at the General. [Source: Agence France Presse, May 22, 2003]

A 28-year-old woman died a day earlier from SARS after being diagnosed with the pneumonia-like ailment a month before. There were no new infections reported Thursday and the number of cases remained at 206. Of these, 162 have recovered and 12 patients remain in hospital, including five in intensive care. At least 525 people were under home quarantine.

A SARS case was reported in August 2003 after the outbreak was over. The victim was a medical researcher who was studying SARS at a hospital. He caught the disease in a lab accident blamed on poor training. He was doing research with a West Nile virus sample which somehow got contaminated with SARS. His case was relatively mild. He survived didn’t infect anyone else.

Battling SARS in Singapore

Singapore was praised by the World health Organization for it handling of the SARS crisis. Schools were closed, strict quarantines were put into effect, severe restrictions on traveling in and out of Singapore were imposed, companies and banks segregated workers according to their exposure to SARS, Some companies required their employees to make their temperatures every couple of hours and report the results to their superiors. Taxi drivers were told to drive with their windows open and turn off their air conditioning.

People under quarantine were required to report regularly in front of web cameras and in some cases wear electronic bracelets so their movements could be monitored 24 hours a day. People who broke the quarantine could be fined $5,800 and imprisoned for six months. Those that didn’t obey the quarantine restrictions were placed in a drug rehabilitation center that served as a jail. People caught lying about the disease in anyway could be fined $10,000 and imprisoned for six months.

Singapore’s three main broadcasters set up an all-SARS channel, which offered nothing but news and information about the disease. Thermal scanners were used to screen new arrivals at the airport for fevers. A special tent annex was attached to Tan Tock Seng Hospital and turned into the main screening center for SARS. The hospital itself was emptied except for essential staff, many of whom were required to wear full-body protective gear. Some wore scuba-like outfits with their own breathing apparatus. Patients with the disease were kept in rooms with their own ventilation systems.

The Catholic Church of Singapore suspended confessions in booths and instead granted a “general forgiveness” to all faithful. Rumors circulated that Indian people were immune from the disease and that smoking cigarettes, drinking alcohol and abstaining from pork also helped ward off the disease.

1970's Singaporean Health Law Used to Fight SARS

Wayne Arnold wrote in the New York Times, “Though its tools were thoroughly modern — thermal scanners, Web cameras and electronic bracelets — Singapore's most potent weapon in its battle against SARS may have been a law originally designed in the 1970s to protect the island's inhabitants from old-fashioned diseases like cholera. When the first cases of severe acute respiratory syndrome appeared in Singapore, the government dusted off its powers to impose quarantine, something it had not done since independence in 1965. Faced with several potential problems, Parliament raised the penalty for violating quarantine to as much as $5800 and six months in prison. It then required those quarantined to appear regularly before Web cameras installed at their homes and to wear electronic bracelets if they failed to do so. [Source: Wayne Arnold, New York Times, June 11, 2003 //\\]

“Civil libertarians condemned the measures, but experts say it was similarly intrusive legislation, public awareness campaigns and improved sanitation and medicine that helped Singapore beat a host of older diseases endemic to its tropical neighborhood, including malaria, typhoid, hepatitis and leprosy. "In your country, individual rights always take precedent over community rights. In our country, it's the other way around," said Goh Kee Tai, chief of the communicable diseases branch at the Ministry of Health's epidemiology and disease control division. //\\

“With evidence showing that the virus that causes SARS is spread through droplets from the nose and mouth, the government has mounted a new campaign against spitting. Last month, authorities took 11 men accused of spitting in public into custody and paraded them in court before fining them $300 each. Changing the unhealthful habits of its largely immigrant population has been the purpose of much legislation. //\\

“The linchpin in Singapore's health defenses, the legal basis for its timely response to SARS, was the Infectious Diseases Act of 1976, which required physicians to report cases of certain infectious diseases to authorities. Over the years, this list of diseases has been expanded to include AIDS and now SARS. The law also allowed authorities to require testing of suspected carriers and restored the quarantine provisions adopted in the early 1900's.”

Singapore Shuts Schools, Expands Quarantines After First SARS Death

After the first SARS death was reported in Singapore, the Singaporean government suspended all classes up to the pre-university level and placed more people under home quarantine. Some 600,000 students are affected by the school closures and at least 861 people were ordered to stay home in a bid to contain the spread of the disease. [Source: Agence France Presse, March 26, 2003 ~]

“AFP reported: Concern was rising among parents, and rumors that the disease was spreading beyond control gripped the densely-populated island, where the number of SARS cases rose to 74, with 10 patients in serious condition. "As an additional precautionary measure in response to concerns expressed by parents on the recent SARS cases, the Ministry of Education (MOE) and Ministry of Health (MOH) have decided to close all primary schools, secondary schools, junior colleges and centralised institutes from Thursday 27 March to Sunday 6 April," a government statement said. "On purely medical grounds, there are currently no strong reasons for closing all schools. However, principals and general practitioners (doctors) have reported that parents continue to be concerned about the risk to their children in schools," it said. ~

“Health Minister Lim Hng Kiang described the decision to close the schools as tough. "We are very much aware of the implications of such a move but on balance even though there is no clear medical reasons to undertake this, we thought it's useful, it's important for us to allay the fears (of parents)," he said. The ministries said that "further transmission of the infection appears to be stabilising" and the control measures "appear to be working, although it is still too early to be confident of this." ~

Singapore has strongly advised against unnecessary travel to Hong Kong and Hanoi, and Guangdong province in southern China -- strongly suspected to be the origin of the outbreak. Lim said a decision by Singapore's rugby team to participate in the upcoming Hong Kong Sevens tournament was "unwise." "If I were them, I would not have gone, but they decided for themselves," he said at the news conference. Commenting on Canada's travel advisory which included Singapore along with Vietnam, Hong Kong and Guangdong as among the places to avoid, Lim also said it was possible other countries could follow suit. "Very soon, people will look at us and put us in the same category as Vietnam," he said. ~

“Lim said that the strategy remains isolation of victims and suspected cases through quarantines and restrictions on visits to hospitalised victims. Hefty fines will be imposed on those who break the 10-day quarantine, which was imposed under the rarely invoked Infectious Diseases Act, and visitors to homes of quarantined people should be limited. Lim rejected suggestions to quarantine travellers coming from Hong Kong, Hanoi or Guangdong even if they do not exhibit symptoms of SARS, saying there was no need to overreact.” ~

Singapore Nurses Fighting SARS also Battle Social Stigma

About two weeks into the SARS crisis, AFP reported: “They are shunned in trains, some have been asked by their landlords to pack up, taxi drivers speed past them and others are told by apartment neighbours to avoid taking the lift. Singapore's nurses, a multinational force of frontline troops in the battle to contain the SARS outbreak, are fighting their own war against the social stigma associated with the killer disease. [Source: Agence France Presse, April 6, 2003 ^+^]

“News of the health workers being avoided like the plague prompted a call by the Singapore Nurses Association (SNA) for their members to be allowed to shower and change out of their white uniforms before boarding public transport. Health Minister Lim Hng Kiang disagreed, saying this would bring further humiliation to the 18,000 nurses working in the affluent city-state. "I appreciate the good intentions of the SNA. I am concerned, however, that asking nurses to change before taking public transport may stigmatise them," Lim said in a statement. "The dedication and professionalism of our nurses, particularly at the frontline is exemplary. It would be unfair if Singaporeans treat them differently."I am proud of our nurses and I urge Singaporeans to treat them without bias," he said. ^+^

“But in an atmosphere of paranoia and uncertainty sparked by the mystery surrounding the SARS-causing virus, people remain wary. After all, SARS has killed” many people, including some in Singapore and “medical workers treating patients were among the first to be infected.” A 39-year-old nurse from Myanmar, M.Y. Khin, was told by her landlord to vacate her rented room even though she works at a hospital that does not treat SARS patients. "I understand their worries, but I feel hurt," she told the Straits Times newspaper. A Filipino nurse told AFP she and her colleagues are shunned at the lift of their highrise apartment.An anonymous letter was dropped in their mailbox asking them to avoid using the lift and to change clothes when they finish from work. "It's humiliating," said the 29-year-old nurse who asked not to be named, pointing out she does not even work at Tan Tock Seng Hospital, which has been roped in as the centre for warding all SARS patients in the city state. ^+^

“Nurses at Tan Tock Seng have sadder tales to tell: buses and taxis refuse to stop for them while friends have suddenly begun distancing themselves. "I feel betrayed. We are doing a job that other people do not want to do and yet we are treated like this," a nurse who works at the hospital said. Health authorities say much of the paranoia comes from the fact that a lot remains unknown about the virus, which is still unidentified. There is also scant information on how exactly it is transmitted, with initial evidence pointing to "direct close contact" such as being next to an infected person who sneezes or coughs. There is little proof it is airborne. ^+^

“A doctor and 20 nurses at a Singapore hospital treating non-SARS patients have been confined as suspected cases, officials said over the weekend, highlighting the dangers of the outbreak to medical workers. While the 21 staff of the Singapore General Hospital (SGH) were not declared part of the 103 confirmed cases of SARS, they were admitted to Tan Tock Seng Hospital handling the outbreak after they developed fever. A ministry of health statement said it suspects that a Chinese man who was admitted to SGH for gastro-intestinal bleeding and a kidney abscess could have spread the disease among SGH staff. “ ^+^

Singapore Calls out Military to Fight SARS

In early April 2003, Singapore called out the military to battle the SARS virus and bedated whether to use Internet-linked cameras to enforce home quarantine orders. Jason Szep, Reuters, April 8, 2003] Fifty Singapore Air Force (SAF) paramedics, wearing green military fatigues, medical gowns and surgical masks, joined nurses at Changi International Airport screening passengers arriving from places hit by SARS such as China and Toronto. "We have requested 100 from the SAF and we have received 50," said a spokeswoman for the Ministry of Health. [Source: Jason Szep, Reuters, April 8, 2003 ==]

“In a bid to contain the illness, the government said air passengers from SARS-afflicted regions would have their temperature taken when they arrived in Singapore. Singapore has taken aggressive steps to contain SARS beyond World Health Organisation recommendations, quarantining hundreds and stationing nurses at air and sea ports. But nine people have broken home quarantine since March 24, despite the threat of heavy fines -- exposing a possible leak in the government's strategy of isolating SARS to one hospital. ==

“Health Minister Lim Hng Kiang said government-installed "webcams" might help enforce home quarantines and halt the virus. "We are thinking of installing webcams in the houses of people under home quarantine and at certain times of the day they will have to report to the webcam," he said. Such a move might seem shocking in many countries, but Singaporeans are accustomed to a pervasive government role in society.” ==

As SARS Spreads, Singapore Life Suffers

Three weeks after the first reported SARS death, Ellen Nakashima wrote in the Washington Post, “Hotel lobbies are empty. Taxi drivers lean against their cabs, waiting in vain for passengers. Over the last month, the sometimes-deadly illness known as severe acute respiratory syndrome, or SARS, has all but halted the tourist trade in Singapore and made people fearful of being out on the street. Health officials confirmed tonight that another person had died of SARS and said the ailment was suspected in two other deaths. They also announced four new cases of people contracting the disease. [Source: Ellen Nakashima, Washington Post, April 14, 2003 <>]

“The Singapore government has instituted stringent control measures, including a 10-day quarantine for anyone in contact with a probable SARS patient. Video phones have been installed in quarantined homes to monitor compliance, officials said. Violators must use electronic wrist bracelets. Travelers arriving by sea or air are required to fill out a card indicating whether they have symptoms of the disease or have traveled to affected areas. "We are in this for the long haul," Health Minister Lim Hng Kiang said at a news conference today. "We are putting in place as many measures as we can. It's still early. . . . We have to see how this situation develops." <>

“Meanwhile, the Super Star Virgo, a Malaysian cruise ship that arrived in Singapore after being hit by a SARS scare, was scheduled to depart tonight for an undisclosed location, its 13 floors having been disinfected. Health officials acknowledged a crew member now suspected of carrying SARS checked into a Malaysian hospital last week without informing Singapore authorities. <>

“There were many signs of concern about the spread of SARS. Some people have stopped shaking hands and bow in greeting instead. An increasing number of residents were staying home, although they were not wearing surgical masks as in Hong Kong and some other affected locations. "We don't want fear to overtake us and then put on measures without a good basis," said Balaji Sadasivan, a senior health official. "We have no strong basis to require that the general public wear masks." <>

“Officials said it was too early to say the outbreak was under control, although schools in Singapore,closed since last month, were to reopen this week. Officials said they had traced a cluster of 19 cases to one elderly man whose infection was traced to a 26-year-old woman, hospitalized at Tan Tock Seng Hospital, Singapore's designated center for SARS treatment. The two unconfirmed SARS deaths were linked to that cluster, as were three of the new cases reported today, officials said. Health officials here said that all 151 cases so far appear to have occurred through close personal contact with an infected person, rather than airborne or environmental exposure. <>

“At a church not far from Tan Tock Seng Hospital, 200 worshipers today mourned the loss of three in their congregation, including the pastor and parents of the unnamed 26-year-old woman. The pastor, Simon Loh, 39, became ill while ministering to the young woman, who Singaporean authorities said infected more than 140 people, almost all of the cases reported here. The parishioners prayed for the young woman -- a former stewardess -- who infected and then lost her parents, her pastor and very nearly her grandmother. Protected by a glass partition and a mask, she watched her father die from outside his room. Though she has recovered from the illness, hospital officials were keeping her isolated to protect her privacy. Members of the congregation said they phoned and sent text messages to the woman on her cell phone. "We don't have a grudge against her," said Iris Mao, 50. "She needs a lot of encouragement. Pastor Loh died in service, praying for her.”

SARS Lockdown in Singapore

Eric Ellis wrote in the Bulletin, “Buses and the metro operate on half- loads, Singaporeans will take more convincing than that. Many of the city-state's four million people – including this correspondent – have effectively imposed home quarantine on themselves. The rare times one ventures out – to take a taxi or stock up on shopping – many cabs won't take you (and those that do smell like hospitals), while supermarket shelves suffer telling shortages of vitamins, orange juice and vinegar, the fumes of boiling vinegar being an ancient Chinese remedy of dubious effectiveness. The city's Islamic leaders, representing about 14 percent of Singaporeans, told worshippers that Muslims who die of SARS will be wrapped in traditional burial cloth and then double-bagged in plastic. [Source: Eric Ellis, Bulletin, April 9, 2003 <^>]

“Other Singaporeans are not even free to move. Invoking the Infectious Diseases Act, the government has effectively locked around 1000 people in their homes – they are suspected of having had direct contact with the 100 known SARS victims. Breaking the quarantine risks fines of up to A$20,000. Schools have shut for 10 days, a closure that's likely to be extended.

The central business district seems deserted. Anyone showing SARS symptoms has been advised to go to Singapore's Tan Tock Seng Hospital, the central command of the SARS fight. Bizarrely, when local journalists were invited to meet Prime Minister Goh Chok Tong for a briefing they were asked to complete a form which asked if they had recently visited a SARS-infected country. It seems not to have occurred to Singapore's bureaucrats that they actually live in one. <^>

“The commercial nature of Singapore has made it both a breeding ground for the spread of SARS. Changi Airport is the region's aviation hub and many of those afflicted with SARS outside Asia seem to have brought it with them from Singapore. But Singapore's relative lack of democracy also gives the government absolute powers to lock the city- state down if need be. But by week's end Singapore was confident it had contained the spread. Nevertheless economists have lopped a point off 2003 growth forecasts for the wider region.” <^>

Singaporean SARS Patient Gets to the Disease Months After the SARS Crisis

In September 2003, three months after the World Health Organization declared Singapore SARS-free in late May, a 27-year-old man was diagnosed with SARS and survived. After his release from hospital, AFP reported: “ The 27-year-old man will spend the next 14 days in home quarantine as a precautionary measure, the spokeswoman told AFP. The Singapore patient, a medical researcher, is suspected of contracting SARS while working at one of two laboratories.[Source: Agence France Presse, September 16, 2003]

"The young 27 year-old student who worked in a virology laboratory in Singapore is now considered by WHO, in keeping with laboratory results, as a confirmed case of SARS," WHO spokeswoman Fadela Chaib said in Geneva. The WHO had been puzzled by the incomplete symptoms displayed by the medical researcher in first results of tests last week but said additional tests at the CDC had confirmed he was suffering from SARS. Chaib repeated the WHO's reassurances that the isolated case did not pose a health threat. "The WHO continues to say that Singapore is a safe destination and people from Singapore do not represent any danger," Chaib said.

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Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, Lonely Planet Guides, Library of Congress, Singapore Tourism Board, Compton’s Encyclopedia, The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Newsweek, Reuters, AP, AFP, Wall Street Journal, The Atlantic Monthly, The Economist, Foreign Policy, Wikipedia, BBC, CNN, and various books, websites and other publications.

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© 2008 Jeffrey Hays

Last updated June 2015

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