Singapore moved its disease outbreak response up one level to "orange" yesterday as the coronavirus spread further in the country, with three new cases announced of unknown origin, including a junior college teacher.
To date, four people here have been infected with the virus who have no known links to previous cases or any travel history to China.
Under the Disease Outbreak Response System Condition, "orange" means the outbreak is deemed to have moderate to high public health impact, though the situation is still under control. It is one step below "red", which signifies an out-of-control pandemic.
The emphasis will now be on "aggressively trying to stop or limit further spread", according to the Ministry of Health's (MOH) pandemic readiness and preparedness plan.
"We have been preparing for this scenario, and we are ready to manage the situation," said Health Minister Gan Kim Yong at a news conference yesterday.
"The key is quick detection and limiting further spread."
Globally, the situation has escalated, with nearly 32,000 people infected and more than 630 deaths. At least 320 patients are outside mainland China.
Singapore's heightened response comes as the ministry announced three new cases yesterday.
All are Singaporeans not linked to earlier clusters and who had not been to China recently.
They were discovered because hospitals here have been testing all pneumonia patients for the virus.
They are a 53-year-old man who was in Malaysia for three days last month; a 42-year-old woman who is a teacher at Victoria Junior College; and a 39-year-old woman who was in Malaysia from Jan 22 to Jan 29.
The total number of people infected here has grown to 33.
Two of the patients have been discharged, but two are now in critical condition and in the intensive care unit, said MOH.
With code orange, new precautionary measures to minimise the risk of further virus transmission to the community include schools cancelling inter-school events and external activities, companies implementing business continuity plans, limiting visits to pre-schools and eldercare services, and temperature screening in hospitals.
The Government has been ramping up its defences against the virus since last month, with many of the measures in "orange" already in place, and being stepped up now.
During yesterday's news conference, National Development Minister Lawrence Wong, co-chair of the multi-ministry task force tackling the outbreak, said the mortality rate in China is 2 per cent, but outside Hubei province, the mortality rate is 0.2 per cent.
Singapore has to be prepared for the situation to evolve in different ways. If it worsens, even more stringent measures may be adopted or, if the mortality rate remains low or falls further, a different approach could be taken, he said.
The coding system was set up after the 2003 severe acute respiratory syndrome (Sars) outbreak. Code orange was imposed during the H1N1 influenza outbreak in 2009.
After news of the raised outbreak response became public yesterday, politicians and supermarket chains asked shoppers to remain calm after items such as rice and noodles began flying off the shelves.
Some parents asked for school to be suspended, but Education Minister Ong Ye Kung said there was no need to do so. Given all the measures taken, schools may actually be one of the safest places for students, he noted in a Facebook post.
Said Mr Gan, who co-chairs the task force: "I understand Singaporeans are anxious, concerned, and there is much we don't yet know about the virus...
"Life cannot come to a standstill... We will do our best to contain the situation and keep Singaporeans safe."
• Additional reporting by Timothy Goh and Rei Kurohi