Speech In Support Of The Infectious Diseases (Amendment No. 2) Bill

25 Apr 2003

By Dr Balaji Sadasivan

Mr. Speaker Sir,

I rise to speak in support of the bill,

SARS is a new disease. It hit us without warning. On Mar 12, when WHO issued its warning, we were unsure what the disease pattern was going to be or how it was transmitted or what the patient outcome was going to be. Because we are dealing with the unknown, it is natural to be afraid. In this battle against SARS and the fear that SARS induces, information is power. It helps overcome our fear and puts problems in the correct perspective. In the last 6 weeks, we have learnt much about this disease that allows us to better assess the danger that SARS poses. I want to highlight three key points that members and Singaporeans should take note of.

Most Patients Recover

The first point is that SARS is a serious disease. There is a mortality of 5-10%. But this means that 90% do recover. Of the 192 patients diagnosed with SARS, 120 have recovered and have been discharged from hospital. More will be discharged in the coming days. Since SARS is a new disease, to get a perspective of how dangerous or serious it is, let us compare SARS with other diseases. SARS is not like cancer. In cancer, even with treatment, you may not have a cure. Cancer treatment is long and difficult and you always have to worry about the cancer coming back. SARS is not like stroke, where you may recover but you may be left with a disability for the rest of your life. In SARS 90% of patients recover. They return to work as per normal without any disability. And because they have antibodies against SARS, they are immune from getting SARS again.

In fact, at Tan Tock Seng Hospital, there are 3 doctors who have caught SARS. They have been treated and have returned to work at Tan Tock Seng to look after other SARS patients. Two more doctors who are now at home will return to work next week and join them. Our research teams testing the diagnostic kits need specimens of mucus from the back of the throat. You need to be well protected to take a swab from the back of the throat of a SARS patients because when you tickle the back of the throat of a patient, he may cough into your face spraying you with a lot of SARS virus. These SARS recovered doctors can safely obtain the specimens because they are immune to the disease and cannot catch SARS again. They are helping our research teams obtain specimens from SARS patients.

Patients who have recovered from SARS are not only returning to work, they are also helping other new SARS patients fight the virus. When you recover from SARS, you have plenty of antibodies in your blood that can kill SARS virus. These patients donate their antibodies to new patients to help them fight the SARS virus. This is called serum therapy and new SARS patients at Tan Tock Seng are benefiting from this treatment.

The best place in the world to get treatment for SARS is Tan Tock Seng Hospital. They have the most knowledge and experience dealing with the disease and we have given them all the resources they need.

Last week, at my meet the people session, a young man, a technician, saw me for help. He had lost his job. He wanted his employer to re-instate him. I asked him why he lost his job. He said he went to a neighboring country for a week without applying for leave and his company terminated his services. I asked him why he did that. He replied he was scared of SARS so he went to a small town to hide. I looked at him. He was young and athletic and I asked him why he was afraid of SARS? He said he had a cough. I told him lots of people have cough. He than told me he went to Hong Kong in mid February to participate in a sporting event and so he was afraid he had SARS. So I asked the young man to review his actions. If he did not have SARS, he has lost his job because of his fear. But if he had SARS, would he be better off in a small town with no or little medical expertise or in Tan Tock Seng Hospital with the care equal to the best in the world. The young man had no answer. He realized he had allowed fear to take control of him.

The fear of SARS is more dangerous than the disease SARS itself.

SARS is controllable

The second point I want to highlight is that SARS is controllable. In looking at our cases, we find that our SARS cases caught their infection by having close contact with a person who was feeling unwell from SARS. If we can isolate SARS patients early, we can stop transmission. We need the help of all Singaporeans to do this. Singaporeans are a socially responsible people and are united in this battle. But we need the cooperation of every Singaporean. One weak link and the virus will use that link to pass on to the next person. A single person with SARS, if he is the weak link in our defense and does not behave responsibly and if he is infectious, he can pass on the infection to as many as 20 persons. Hence the need to amend the Infectious Disease Bill to get the few who may not be responsible to join us in this fight against SARS.

We Are at a Critical Point

The third point I would like to highlight is that we are at a critical point in our battle against SARS. This week, WHO downgraded Toronto's status to that of Hong Kong, Guangdong, Beijing, that is a place for travelers to avoid. We are at the brink, If we fail to contain the outbreak, we may end up joining Toronto, Beijing and Hong Kong as places that travelers should avoid. This will cost us many jobs. However, if we work together, we can move away from this brink and contain the outbreak. Hence the need for urgency and resolution in our actions.

Mr. Speaker Sir, I support the Bill