Singapore's system not set up to detect unusual, unfamiliar outbreaks like in hepatitis C episode, committee finds

Visitors at the entrance of Block 4 at Singapore General Hospital. PHOTO: ST FILE

SINGAPORE - While the Singapore General Hospital (SGH) has well-established escalation protocols in place for familiar infectious diseases and epidemics, these could not cater to the reporting of risk events in the shortest time possible for an "unusual and unfamiliar" outbreak like the cluster of hepatitis C virus (HCV) infections, an Independent Review Committee (IRC) found.

The national surveillance system was built to pick up communicable diseases in a community setting, noted the report released on Tuesday (Dec 8) afternoon.

"Some characteristics of HCV make it difficult to be detected by the current system. In addition, not all cases of HCV infections were reported by the doctors and laboratories," said the report.

Nonetheless, the committee found that there was no evidence of deliberate delays by SGH or the Health Ministry staff in escalating the outbreak or informing the Minister for Health.

"The IRC agreed that the decision of the DMS (director medical services) on Sept 3 to ask SGH to complete key aspects of the investigation was professionally valid and appropriate."

The Minister for Health Gan Kim Yong was notified only in mid September.

However, the committee found that within SGH, there was a lack of clarity on the roles and responsibilities for the management of unusual healthcare associated infections.

Furthermore, there were delays in the escalation processes within the hospital and from SGH to the Ministry of Health.

Within the ministry itself, there was also no one division with clear responsibility to oversee outbreak of such unusual infections.

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