Ebola: Should Singaporeans be worried?

As the Ebola epidemic spreads in West Africa, airports in the West have begun screening people arriving from Africa.

Some countries especially the ex-colonial powers of France, Britain and Belgium have long standing and varied institutional and historical links with these African countries. So they do see significant air traffic between their countries and thus they may have some cause for some concern.

Singapore, on the other hand, has few such links with western Africa, the epicentre of the outbreak, so air traffic to and fro is much less.

The World Health Organisation already recommends that people are screened as they exit Ebola-hit countries. But if air travel out of the affected countries could be suspended for a time, it would help contain the epidemic and break the chain of transmission.

Liberian Thomas Eric Duncan died on Oct 8, the first Ebola fatality outside Africa. He had been in Liberia and gotten into contact with an Ebola-infected woman in Liberia, then travelled back to Dallas. He had no symptoms on arrival but became sick later. In the meantime, he had had contact with over 100 people.

This chain of events shows that a traveller from any of the infected African countries, even if asymptomatic at departure or on arrival may, in fact, be already infected with the virus.

A reader had earlier asked me in the event a Singaporean got infected overseas, should we bring him or her back for treatment. What if doing so leads to an outbreak in Singapore?

Well, the answer depends on how easily the virus spreads and how well such a patient would be isolated in hospital here.

Even if a case gets imported into Singapore, we should be able to properly isolate the patient for the appropriate treatment.

There is little risk of an outbreak spreading like wildfire in Singapore because we don’t live in the same crowded and unsanitary conditions as those in Liberia.

Ebola can be transmitted only by body fluids such as blood, sweat, saliva, vomitus, urine, stools or semen of an infected person. Each patient infected with Ebola tends to spread the virus to just one or two persons, unlike the Sars virus which is airborne and spreads much more easily.

And this is also why isolation of patients and quarantine of contacts, if done meticulously, do work in containing Ebola.

Many of the developing countries in African cannot isolate cases to treat them properly or quarantine contacts as well as is needed to rein in the disease.

Still, should Singapore be concerned as the Philippines is saying it’s only a matter of time Ebola hits its shores? Well, no, for the same reasons above: the Singapore healthcare system has the institutional capacity to contain an outbreak even if some of our neighbours don’t.

To repeat, Singapore also does not have living conditions that are chaotic, crowded and unsanitary, which would enable imported cases of Ebola to trigger off a devastating epidemic.

For these reasons, Singaporeans should not be unduly worried - for now.

Perhaps a worthwhile approach is to persuade the affected African nations to bar outward air travel from their borders until the epidemic is brought under control. This would require some kind of financial aid, arranged by the developed West perhaps to help these affected countries in Africa to offset the economic impact of curbing air travel from their borders for a period of time. Helping them in this way could help many other countries as well.

Meanwhile, Singaporeans should avoid travelling to the affected nations in Africa if at all possible. If they have to anyway but come back feeling unwell, they should act responsibly and report to the health authorities immediately so that any potential outbreak can be nipped in the bud.

andyho@sph.com.sg