Covid-19 cluster at TTSH of concern, but no need to be overly worried: Experts

Tests of patients and staff at the ward have thrown up a preliminary confirmation of four more cases - a doctor and three patients.
Tests of patients and staff at the ward have thrown up a preliminary confirmation of four more cases - a doctor and three patients.PHOTO: THE STRAITS TIMES

SINGAPORE - The Covid-19 cluster at Tan Tock Seng Hospital (TTSH) is of concern, but there is no need to be overly worried, said several experts. 

As the pandemic rages on elsewhere, the development is a reminder that hospitals are vulnerable and infection control needs to be taken extremely seriously.

A nurse who had been fully vaccinated was diagnosed with Covid-19 on Tuesday (April 27) after coming down with a cough, body ache and sore throat.

Another eight patients and staff have been diagnosed. They are linked to the nurse (Case 62541), and were detected from proactive testing of patients and staff in the affected ward, the Ministry of Health said on Thursday afternoon (April 29).

Professor Dale Fisher, a senior infectious disease consultant at the National University Hospital (NUH), said: "We know Covid is very unforgiving. Such a cluster could have occurred anywhere and we just have to make sure that if there is a case at a hospital, it will be picked up and not allowed to spread."

Associate Professor Jeremy Lim from the National University of Singapore Saw Swee Hock School of Public Health, said the development is worrying and warrants even more prudence, but there is no need to be paranoid.

He urged people not to speculate about what happened until investigation results are out.

Prof Fisher agreed: "Until the investigation is undertaken, it won't be clear where the breach happened. But so far, all the rules have shown great outcomes and kept the hospitals transmission-free."

Associate Professor Hsu Liyang, an infectious diseases expert at the NUS Saw Swee Hock School of Public Health, said it is fortunate that the majority of hospital staff have been vaccinated.

Vaccination gives more than 90 per cent protection against severe illness and death. But people might still get infected, and could also transmit the disease, although the risk of transmission should be lower than in someone who has not been vaccinated.

However, he said, patients who have certain chronic diseases or who are immunocompromised might face more severe illness if infected.

Prof Fisher added: "This is why we give a special focus on preventing disease in hospitals. Visitors to hospitals since the pandemic began will fully understand how we screen everyone for symptoms and limit the number of visitors and their movement.

"Any patient being admitted who could possibly have Covid is isolated until their swab result comes back. Our efforts so far have worked, but now it does look like a leak has occurred - which is in reality somewhat inevitable after so long."

He added that in spite of the best efforts to minimise risks, "in reality, on occasion, breaches are somewhat inevitable".

Prof Hsu added: "It is a reminder of how difficult and challenging it is to contain such a virus when we have a healthcare cluster in the hospital that has the most experience in Singapore in dealing with major epidemics."

TTSH is next to the National Centre for Infectious Diseases, and both are part of the National Healthcare Group. TTSH was also the epicentre in the fight against severe acute respiratory syndrome (Sars) during the 2003 outbreak in Singapore.

On the Covid-19 cases detected at TTSH, Prof Fisher said: "Overseas, there are countless occasions (of hospital infections). It is a timely reminder that hospitals are vulnerable and infection prevention and control processes need to be rigidly undertaken."

Dr Asok Kurup, who chairs the Academy of Medicine's Chapter of Infectious Disease Physicians, thinks Singapore may have "inadvertently imported some cases into the country which have fallen through the cracks and infiltrated the community".

He added: "We are probably going to see more clusters. We have to be very vigilant so that a huge wave does not follow. In addition, whether these are new variant strains or potentially more infectious ones remain to be seen."