Two more confirmed cases of novel coronavirus infection in Singapore

                As of 6 February 2020, 2pm, the Ministry of Health (MOH) has confirmed two additional cases of 2019 novel coronavirus (2019-nCoV) infection in Singapore. Of these, one case is a close contact of a previously confirmed case. The other case has no recent travel history to mainland China and does not appear to be linked with previous cases. This case was confirmed late last night and contact tracing is still in progress, with focus on identifying any links it may have with past cases or travellers from China. We will provide further updates tomorrow as the investigations progress.

2.             Thus far all our previously announced confirmed cases have been either PRC travellers from Hubei, or individuals with links to PRC travellers.  All such cases have been isolated and ring-fenced.  But we must be prepared for the possibility of new infection clusters involving locals within the community, not linked with recent travel to China or contact with recent PRC travellers. This has already happened in several places outside of mainland China. We had earlier stepped up significantly our precautionary measures to reduce the risk of community spread of the virus. We stand ready to ramp up our measures even more once we have some findings from the ongoing investigations.

About the confirmed cases

Cases 27 and 28 (announced on 5 February)

3.            Cases 27 and 28 are family members of Case 19[1] who were confirmed to have 2019-nCoV infection on 5 February at about 2pm.

4.            Case 27 reported that he developed symptoms on 1 February. He visited a general practitioner (GP) clinic on 2 February and was subsequently isolated at the National Centre for Infectious Diseases (NCID) on 4 February. Prior to hospital admission, he stayed at his home at Jalan Bukit Merah and worked as a private hire driver. He indicated that he had visited Tiong Bahru Plaza, Tiong Bahru Market and Beo Crescent Market and Food Centre. The risk of infection from transient contact, such as on public transport or in public places, is assessed to be low.

5.            Case 28 was cared for at home and was not in any infant care facility prior to hospital admission.

Case 29

6.            Case 29 is a 41 year-old Singapore Citizen who has no recent travel history to mainland China. He was admitted to Mount Elizabeth Novena Hospital (MEN) on 3 February. Subsequent test results confirmed 2019-nCov infection on 5 February at about 11pm. He has been transferred to NCID for further treatment and is currently warded in an isolation room.

7.            He reported that he had developed a fever on 28 January, and visited a general practitioner (GP) clinic the next day. He sought treatment at another GP clinic on 30 January before being admitted to MEN on 3 February.

8.            Epidemiological investigations and contact tracing are ongoing to identify individuals who had close contact with the case, and to establish any link he may have had with confirmed cases in Singapore or travellers from mainland China. We are interviewing the patient and his close contacts, and investigating the locations he had recently been to.

Case 30

9.             Case 30 is a 27 year-old male Singapore Citizen who has no recent travel history to mainland China. He is one of the four Singapore residents who are being investigated at NCID after attending a private business meeting at Grand Hyatt Singapore from 20 to 22 January. The meeting included participants from China, including Hubei, and the confirmed cases from Malaysia and South Korea. Subsequent test results confirmed 2019-nCoV infection on 6 February at about 2pm. He is currently warded in an isolation room at NCID.

Update on condition of confirmed cases

10.             All new cases today are stable. Amongst the earlier 28 confirmed cases, one has been discharged. Of the remaining 27, most are stable or improving. The condition of two patients has worsened. One is now in critical condition in the intensive care unit, and another requires additional oxygen support.

Update on suspect cases

11.             As of 6 February 2020, 12pm, 310 of the suspect cases have tested negative for 2019-nCoV, and 30 have tested positive (Case 30 was confirmed at about 2pm, 6 February). Test results for the remaining 147 cases are pending.

Update on contact tracing for confirmed cases

12.             Contact tracing for the confirmed cases is ongoing. Once identified, MOH will closely monitor all close contacts. As a precautionary measure, they will also be quarantined for 14 days from their last exposure to the patient. In addition, all other identified contacts with a lower risk of having been infected will be under active surveillance, and will be contacted daily to monitor their health status.

13.             As of 6 February 2020, 12pm, MOH has identified 435 close contacts. Of the 353 who are still in Singapore, 348 have been contacted and are being quarantined or isolated. Efforts are ongoing to contact the remaining five close contact.

Health advisory

14.            Singaporeans are advised to defer all travel to Hubei Province and all non-essential travel to Mainland China.

15.            All travellers should monitor their health closely for two weeks upon return to Singapore and seek medical attention promptly if they feel unwell. Travellers should inform their doctor of their travel history. If they have a fever or respiratory symptoms (e.g. cough, shortness of breath), they should wear a mask and call the clinic ahead of the visit.

16.            Travellers and members of the public should adopt the following precautions at all times:

• Avoid close contact with people who are unwell or showing symptoms of illness;

• Observe good personal hygiene;

• Practise frequent hand washing with soap (e.g. before handling food or eating, after going to toilet, or when hands are dirtied by respiratory secretions after coughing or sneezing);

• Wear a mask if you have respiratory symptoms such as a cough or shortness of breath;

• Cover your mouth with a tissue paper when coughing or sneezing, and dispose the soiled tissue paper in the rubbish bin immediately; and

• Seek medical attention promptly if you are feeling unwell.
  

17.            MOH will continue to monitor the situation closely. As medical practitioners are on the lookout for suspect cases who have recently been in China, Singapore is likely to see more cases that will need to be investigated.

[1] Case 19 is a 28 year-old female Singapore resident who has no recent travel history to China. She was tested positive for 2019-nCoV on 3 February.