The Ministry of Health yesterday sent a reminder to hospitals, stressing that they must report acute hepatitis C cases within 72 hours. Its reminder came a day after the Singapore General Hospital was criticised for not reporting its hepatitis C outbreak quickly enough.
Meanwhile, experts said such incidents should be reported sooner rather than later, instead of hospitals waiting to finish their investigations or trying to solve the problem all by themselves.
"The MOH would like to remind all hospitals that acute hepatitis C is a notifiable disease under the Infectious Diseases Act. Notifications must be made within 72 hours," said the circular signed by Dr Jeffery Cutter, director of the Communicable Diseases Division (CDD), on behalf of the director of medical services.
It said a separate notification has been sent to clinical laboratories.
The call for quick reporting was echoed by others, too, including a member of the Independent Review Committee that examined the SGH outbreak.
MORE RESOURCES NEEDED
We need to put more manpower and resources into infection control related work, to recognise, identify, notify and contain. Doctors who are infection control trained are already in short supply and high demand in Singapore. They have to do their regular work and yet do outbreak investigations - this is too much.
DR LEONG HOE NAM, infectious diseases physician
"When you have a sniff that there's an outbreak, maybe we should activate the new unit in the ministry (CDD) that deals with outbreaks so that we can get together, the ministry plus the hospital, draw in experts, draw in resources to understand what was the source of the outbreak and how to deal with it in a more expedient manner," said Professor Lim Seng Gee, a senior consultant of the gastroenterology and hepatology division at the National University Hospital, at a briefing on Tuesday.
He also said that, in the future, any hospitals facing such unusual outbreaks should draw on the MOH's resources to deal with it.
But would hospitals turn to the ministry quickly enough?
One health expert suggested that since SingHealth and the National Healthcare Group had been formed, there had been a slight disconnect between the ministry and the healthcare clusters as most clinically trained staff had moved from the MOH to these clusters.
Healthcare consultant Jeremy Lim, former chief executive of Fortis Hospital who was also involved in making policy at MOH, said: "Ministries are typically designed as policy units rather than operators and the different knowledge and expertise might lead to governance challenges."
Dr Lim added that the episode could present an opportunity to strengthen the healthcare system to respond to future threats.
"We need many more doctors and nurses to be specially trained in the management of infectious diseases and public health," he said, while acknowledging that not many healthcare professionals would wish to be bogged down by compliance issues.
Infectious diseases physician Leong Hoe Nam concurred.
"For too long we have ignored infection control, and perhaps even paid lip service to the dangers of infectious diseases spread. We need to put more manpower and resources into infection control related work, to recognise, identify, notify and contain. Doctors who are infection control trained are already in short supply and there is high demand for them in Singapore. They have to do their regular work and yet do outbreak investigations - this is too much."
He also asked for a closer watch on other possible outbreaks.
"It calls to question if we should be monitoring other diseases too, besides hepatitis C. For instance, chickenpox, measles, norovirus, rotavirus in the hospitals. Perhaps they are not too threatening to life - but they are capable of causing outbreak situations."
However, Ang Mo Kio MP Koh Poh Koon, who was a colorectal surgeon before he entered politics this year, called for people not to overreact, saying: "In the larger context, it is an unusual occurrence; it is a rare incident in the long history of Singapore's healthcare system."
What matters more to patients is the hospitals' long-term performance, he said.