10 Reports by : Gan Yung Chyan, KUCINTA SETIA
Image : The SARS-CoV-2 infection chart by Singapore Eye shows that asymptomatic infections are more than symptomatic infections among the cases outside dormitories in Singapore from 21 July 2020. On 21 August, there are 13 asymptomatic cases. Courtesy of Singapore Eye.
News (1)
Asymptomatic infections in mainland China and Thailand from Singapore
The number of asymptomatic SARS-CoV-2 (covi, in short) infections in Singapore has risen since 21 July 2020 according to Singapore independent media "Singapore Eye". Since 14 August 2020, this is especially so among the number of Chinese migrant workers that were leaving Singapore for the People's Republic of China during the last fortnight.
On 14 August 2020, the China Eastern flight MU2070 to Xi'an Xianyang from Singapore has recorded 18 asymptomatic patients! The flight was suspended as a result for two weeks. This is followed by the unfortunate Juneyao Air flight HO1606 (on 15 August) and Scoot's Tianjin flight TR138 (on 19 August) with a total of 12 asymptomatic infections.
On 21 August 2020, Thailand, which has a cumulative number of 3390 confirmed covid cases and 58 fatalities, has 1 new imported case from Singapore. The case is a 57-year-old Thai worker who entered the country from Singapore on 7 August and tested negative at the time of entry. 11 days later, he was tested again during the quarantine on 18 August. He is diagnosed positive and confirmed.
News (2)
PRC's nucleic acid test requirement applies to 80 countries, including Singapore
On 24 August 2020, the Chinese Embassy in Singapore revealed to independent media that the recent mandate on passengers holding certificates proving negative nucleic acid test results applies to all nationals of 80 countries, not only Singapore. From 28 August 2020, passengers intending to leave Singapore for the People's Republic of Singapore(PRC) have to undergo nucleic acid tests to prove they are not suffering from covid and are fit to enter PRC.
The Chinese Embassy mentioned that the Embassy officials were liaising with the Ministry of Health(MOH) on conducting nucleic acid tests in Singapore for passengers departing for the country. According to media reports, the Ministry of Health SARS-CoV-2 testing method in Singapore is polymerase chain reaction (PCR), not nucleic acid test. Therefore special arrangements are being done to assist passengers to do the virus testing accepted by PRC.
Tentatively on 24 August 2020, the Embassy, airlines on the Singapore-PRC routes and MOH have arranged passengers on these routes to undergo nucleic acid tests on 25 and 26 August 2020 from 9 am to 10.30 am at the Regional Screening Centre(RSC) at the former Shuqun Secondary School (450 Jurong East Street 21, Singapore 609604). Passengers of Air China flight CA768 to Hangzhou are the first group to undergo nucleic acid testing at the RSC.
On 25 August 2020, past and future passengers of Scoot flight TR100 receive erroneous emails from Scoot. The same email content states that the passengers need to undergo nucleic acid test at the RSC in Jurong East on 26 August 2020 at the same timing at a cost of 186 Singapore Dollars payable via credit card.
News (3)
Update on erroneous email from Scoot
Campbell Wilson, the CEO of Scoot, forwarded a press release to the affected passengers at 10.02 pm of 25 August 2020. The whole information release as received by StayGate from Scoot CEO Campbell Wilson is as follows:-
Scoot is aware that you have received an erroneous email from us regarding new travel requirements for customers booked on one of our flights, TR100 to Guangzhou departing on 30 August 2020. Scoot sincerely apologises for this mistake and would like to provide an explanation on what happened.
The erroneous email was not a data security or hacking incident. Due to human error, an email meant only for passengers booked on TR100 from Singapore to Guangzhou departing on 30 Aug 2020, was mistakenly sent to a distribution list containing customers who have travelled with Scoot in the past, or who have a future booking to any destination.
Scoot understands the worry and concerns that you may have over the use of your personal information. To repeat, we have established that this was not a data security or hacking incident. No new booking has been created. There was also no leak of sensitive personal information; the personal information that was included in the erroneous email was limited to first name and booking confirmation ID, and the erroneous email was sent to the email address associated with the original booking. No third party has been sent an email with your personal information although, if you have previously made a booking on someone else’s behalf, you may see their first name in the email instead of yours. No current bookings can be accessed with this information.
We assure you that Scoot takes this incident very seriously and will conduct an internal review looking into how to further strengthen our internal processes. We have also informed Singapore’s Personal Data Protection Commission of the incident. Should you have questions or concerns, we welcome your feedback at https://help.flyscoot.com/s/
Once again, Scoot sincerely apologises for this oversight.
Yours Sincerely,
Campbell Wilson
Scoot Chief Executive Officer
News (4)
Discussions on nucleic acid testing in Singapore
Singapore’s Minister of Health minister Gan Kim Yong said on 21 August 2020 that some people who wanted to return to PRC were once patients with confirmed covid. Although they have recovered and been discharged from the hospital, it cannot be ruled out that their test results may be positive.
In response to China's requirement to submit a negative test for covid within 5 days before returning to China from Singapore, Mr Gan said that he was discussing the matter with the Chinese Embassy.
Gan Kim Yong stated that he will assist Chinese migrant workers returning to their hometowns for SARS-CoV-2 testing.
News (5)
Asymptomatic cases cannot be tested for covid in Singaporean clinics
Currently, Singapore’s policy has not been changed, and asymptomatic people cannot be tested for covid in clinics.
Why are there so many imported asymptomatic cases from Singapore?
In July 2020, it is often heard that there are no imported cases from Singapore. Many readers exclaimed that "there were no new cases in the community three times within 7 days." How come in August 2020 Singapore has become a major exporter of cases? What is going wrong?
The clues to the answer can be seen from a report featured in Singapore Eye on 29 May 2020.
News (6)
Singapore covid patient discharge standard
Singapore Eye published on 29 May 2020 that, after the diagnosis of covid patients in Singapore, regardless of whether they are in good health or whether they have symptoms, the patients must undergo PCR tests twice in a row. All were negative before being discharged. However, this standard has been officially changed on 28 May, and Singapore's covid patients will have a new discharge standard.
On 28 May 2020, the Singaporean health minister Gan Kim Yong stated that 21 days after the patient’s symptoms appear, as long as the patient is clinically well and no longer has symptoms, he does not need to undergo further testing and can be discharged from the hospital. Therefore, the discharge standard for Singapore's covid patients will be officially based on time, and the "double negative" standard will no longer be used. However, just in case, the patient must stay in the dormitory for 7 days after being discharged from the hospital and wait until the 29th day after the onset of symptoms before returning to work.
Mr Gan said that many foreign studies have successively confirmed that patients have the highest infectious ability one or two days before the onset of symptoms, and no longer have infectious viruses 14 days after the onset of the disease. These patients may still be "positive" in PCR tests but the ribonucleic acid (RNA) fragments of these viruses are no longer infectious.
There are two possibilities for those who have a positive PCR test but are asymptomatic. One is that they still carry the active virus in their body and can still spread SARS-CoV-2 to others. They have not yet developed covid. These are likely to occur three days before the onset of the disease, and half a day before the onset of the disease, a large amount of covi will be released and spread. Once the human coronavirus transmission power reaches its peak, the patient is classified under category A for the time being.
The other possibility is that the patients have already defeated the virus by their own immunity, and there are virus fragments in their bodies. The fragments have no virus transmission power. The positive test results are asymptomatic and positive for serum antibodies, indicating that they have recovered. These patients are classified under category B.
The Ministry of Health pointed out that only those patients whose immune system is suppressed by the virus will still have to pass two consecutive PCR tests and declare "negative" before being discharged.
Regarding discharge standards, the WHO's professional advice is: 10 days after the onset of the disease, patients with new covid can be discharged if they do not develop respiratory symptoms or fever for three days. However, Singapore adopts a more cautious approach and extends it to 21 days before allowing patients to be discharged from the hospitals.
Countries that adopt similar time-based discharge criteria include South Korea, the United States, the United Kingdom and Ireland.
News (7)
Why are there many cases originating from Singapore on the flights to PRC?
Many of those returning to mainland China at this stage are Chinese migrant workers in the construction, maritime and processing industries, living in large dormitories. As of 21 August, the infection rate in this community is 16.46%, which means that every 6 people have a confirmed diagnosis.
The discharge standard in Singapore is 21 days after diagnosis, and then seven days later, the migrant workers can leave the dormitory, or go to work, or return to their hometowns if their test prove negative. According to the "Singapore Eye", until today, there is no so-called "negative test" in Singapore that allows patients to be discharged from hospitals or for passengers that are allowed to board planes.
Singapore has no requirement for inbound passengers to prove they are tested negative before they can enter Singapore. Passengers from China, Vietnam have to isolate themselves for seven days in designated hotels while from 1 September 2020, passengers from Brunei and New Zealand have to undergo covid testing in Changi Airport and isolate themselves for two days in designated hotels before they can carry on with their Singapore tours. Crew of Singaporean airlines have to undergo covi testing after they have landed in Singapore to prove they are virus negative.
News (8)
Not every clinic in Singapore does PCR, different certification standards
Passengers who test positive after entering China and other countries have at least three possibilities: 1. He was discharged from the hospital after recovery, but with virus fragments in his body; 2. He was newly infected and has no symptoms or has not yet developed symptoms, but he does not know; 3. He is a symptomatic patient. They want to know where to get certified fit for travel.
StayGate has recently done ad hoc interviews at some clinics and polyclinics. Not many Public Health Preparedness Clinics (PHPC), basically neighbourhood clinics that can detect symptoms of covid, do PCR tests. Those that do such tests require the person to show symptoms of covid. If they are asymptomatic or do not know if they have symptoms of covid, the clinics do not test them for covid and do not certify the person fit for travel. So far, Raffles Hospital clinic branches do the PCR tests and / or certify people negative with the virus. Each certificate costs 43 Singapore Dollars and it can be collected in the morning after the first day of visit.
The PHPC that does not do PCR tests recommend people to approach polyclinics. The polyclinic staff told StayGate that the polyclinics do not accept people directly to undergo any form of testing at the door. People must show referral letters from clinics before the polyclinics accept them to undergo PCR tests. The whole process to collecting the test results takes three days. The results can only be collected in the morning of the third day before flight departure.
News (9)
Situation of Covid in Singapore on 21 August 2020
On 21 August 2020, the Ministry of Health of Singapore notified 117 newly confirmed cases (56,216 in total), including 13 imported cases, 6 community cases, and 98 migrant worker cases in dormitories.
All 13 imported cases from abroad are asymptomatic and were diagnosed when the “Home Notification” (SHN) quarantine was performed at the designated location.
Among these cases, there are two special cases. One is a 30-year-old Indian man who entered from India on August 7 (case 56242), and the other is a 50-year-old Filipino woman who entered the Philippines from the Philippines on August 9 (case 56243). They enter the country on short-term visit visas.
Singapore has implemented border control since the end of March, and basically only allows citizens, permanent residents, and workers with long-term documents to enter the country, and no longer issue short-term visas. The two were specially approved to enter the country because one’s spouse was in Singapore for medical treatment and needed care, and the other was performing project work in Singapore.
On 21 August 2020, the six notified new cases in the community is the highest since 23 July.
The situation of these cases is as follows:
1. A 14-year-old Singaporean teenager (case 56244): He developed symptoms on 15 August 15 and was diagnosed on 20 August. He was diagnosed with aspiration in a centralized isolation state. He was a close contact of the 55562 and 55804 cases. His serum antibody is positive, which means a previous infection.
2. A 61-year-old Singaporean man (case 56184): He developed symptoms on 17 August and was diagnosed on 20 August. He had worked at SLR Revolution in Excelsior Shopping Centre.
3. 47-year-old Singaporean woman (the 56200th case): She is asymptomatic and confirmed on 20 August. She was a case detected by the authorities on the front lines of the epidemic. Her serum antibody is positive, which means she has a previous infection.
The following 3 cases are the cases detected by the authorities during routine rounds of inspections of workers in the construction, maritime and processing industries:
4. A 45-year-old Malaysian man (case 56187): He is asymptomatic and diagnosed positive on August 20.
5. 27-year-old Indian man (case 56190): He is asymptomatic and diagnosed on 20 August.
6. 37-year-old Bangladeshi man (the 56269th case): He is asymptomatic and diagnosed on 20 August.
News (10)
Need to address how to test asymptomatic cases in Singaporean neighbourhoods
The Singapore government agencies and media address the mandatory importance of Singaporeans and work permit holders putting on face masks, surgical masks or the three-layer masks distributed by the government to protect the community from asymptomatic cases. Using the SafeEntry, TraceTogether applications and putting on contact tracing devices to register visits can help MOH monitor the covi spread in Singapore but do all these measures stop asymptomatic cases from emerging in the communities, given that the neighbouring community clinics do not handle such cases?
The relevant authorities need to find ways to detect asymptomatic cases better other than those in dormitories.
SARS-CoV-2 likes every human, regardless of poor or rich, political party or job position. Also with the likelihood of covi reinfection or secondary infection, everyone needs to be alert, practice continual safe distancing, proper mask usage and work in a proper air circulated environment.
Refs :
Chinese Embassy in Singapore : Changes to the procedures for visitors to mainland China from 28 August 2020, https://staygate.blogspot.com/2020/08/chinese-embassy-in-singapore-changes-to.html
Singapore exports 12 covid cases involving construction workers to Tianjin on 19 August 2020, https://staygate.blogspot.com/2020/08/singapore-exports-12-covid-cases.html
Juneyao Air claims unreported covid cases from Singapore, https://staygate.blogspot.com/2020/08/juneyao-air-claims-under-reported-covid.html
Cheryl Teh, Scores of China-bound Scoot and other passengers turn up at Jurong centre for compulsory Covid-19 testing, The Straits Times, https://www.straitstimes.com/singapore/guangzhou-bound-passengers-turn-up-for-last-minute-covid-19-testing-after-requirements
Daozi, 50 added | Singapore does not test healthy people for SARS-CoV-2, China requires a negative report to board the plane, what should I do?, Singapore Eye, https://www.yan.sg/zhifeixian15ren/
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