‘Less useful’ to advise against travel as number of cases rises

THE Health Ministry (MOH) is no longer telling Singaporeans to avoid countries where H1N1 is spreading rapidly.

Instead, its website (www.moh.gov.sg) simply lists areas which have confirmed community spread of H1N1 or which have ‘exported’ the virus – and Singapore is among those named.

Explaining the change, an MOH spokesman said yesterday that keeping the travel advisory ‘will become less useful as the whole world, including Singapore, sees more cases’.

She said the places listed are there simply to allow travellers to make an informed decision on whether to go ahead with their trips.

This is the latest change in the way the ministry treats H1N1 patients and suspect cases, and comes as it learns more about the virus and moves from a strategy of containment to one of mitigation.

The changes are a result of the shift, the MOH said yesterday. For example, the definition of who is regarded as a ‘close contact’ of an H1N1 patient has changed considerably.

When H1N1 first appeared, a close contact was anyone who had been near the infected person. Now, it is defined as anyone who has been within 2m of an infected person for an hour or more without any protection, such as a mask.

The spokesman said the changes have come about as experts now know more about the virus and also reflect how the number of local infections now outstrips that of those who caught the virus abroad.

As a result, she said: ‘We are now preparing to manage the disease in a more targeted and risk-stratified manner.’

Other countries, such as Australia and Japan, have shifted to a mitigation strategy as cases of local transmission have multiplied rapidly.

Confusion arises
THE changes have created confusion, with some saying they are not sure what to do if they return from an ‘affected country’.

Said Mr Edward Tan, a father of two: ‘It is confusing when the Education Ministry wants children who have been to affected countries to stay away for a week, but the MOH tells people to simply monitor their condition.’

The list itself has raised some eyebrows. Some have noted that Indonesia, with only two cases, is on it, but Malaysia, which has confirmed 68 cases, is not.

Yesterday, the MOH spokesman said those returning from listed areas still need to monitor their health. They should also call 993 for an ambulance if they get flu-like symptoms within a week of their return.

She said Malaysia is not on the list because it does not have sustained local transmissions.

Indonesia, she added, could have many cases, because it is not actively tracking its H1N1 cases. However, at least two people here caught the virus while they were in the country.

This is the reason it has been named.

As for including Singapore in the list, the spokesman said this was only fair to those planning to visit, because H1N1 is spreading locally.

‘Eventually, we foresee that we will also be exporting cases to other countries,’ she added.

Meanwhile, Singapore is preparing to switch to the mitigation phase of dealing with H1N1, possibly in the next few weeks.

Then, most people with H1N1 will be treated by general practitioners and at polyclinics and only the severely ill or those likely to suffer complications will be sent to hospital.

The ministry has been meeting doctors to prime them to take over the care of H1N1 patients.

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