Special report: On the front lines of the coronavirus

Insight looks at how Singapore is tackling the outbreak, the doctors, nurses and officers on the front lines, and the scientists racing to find a vaccine.


Fighting the coronavirus, with openness and information


Singapore's multi-ministry task force tackling the coronavirus addressing a press conference on Jan 27. PHOTO: LIANHE ZAOBAO

It was just before noon, but The Straits Times newsroom was deserted.

The multimedia hub - the operational nerve centre of the revamped ST newsroom - usually abuzz with activity, had fallen silent. Only a handful of my colleagues were about, staring intently at their screens.

Like in many organisations across the island, most of our staff had been told to stay at home, after we made a decision to move into a virtual, distributed mode of operations.

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Coronavirus: Teaching us a bit about disease, and a lot about ourselves


Cambodian Prime Minister Hun Sen alighting from his helicopter and waving to passengers of a cruise liner - which had been turned away from several ports over virus fears - at Sihanoukville seaport on Friday. PHOTO: AGENCE FRANCE-PRESSE

 

If, as they say, where you stand depends on where you sit, there was little doubt where Cambodian Prime Minister Hun Sen has chosen to place himself.

On Friday, he showed up at the seaport in Sihanoukville to receive the cruise liner Westerdam that had been turned away by five countries, including Thailand which dispatched a battleship to escort it out of the Gulf of Thailand.

Not a man known for softness, Mr Hun Sen, China's staunchest friend in Asean, showed up portside holding roses for the 1,455 disembarking passengers since it was Valentine's Day.

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5 turning points in Singapore’s fight against the coronavirus

Temperature screening for visitors to the Singapore Airshow 2020 yesterday at Changi Exhibition Centre.
Temperature screening for visitors to the Singapore Airshow 2020 at Changi Exhibition Centre. ST PHOTO: LIM YAOHUI

At the Criminal Investigation Department's Command Centre in Outram last Thursday afternoon, 20 police officers were hunched in front of their computers, trying to make sense of how the coronavirus is spreading in Singapore.

Working with the Ministry of Health (MOH) - which is in charge of contact tracing - as well as detectives on the ground, they are helping to piece together the movements of those infected.

People who had been in close contact with a patient will be traced. If they are well, they will be put under quarantine for 14 days. If they show symptoms, they will be treated as a suspected case, hospitalised and looked after.

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Coronavirus: All hands on deck at public hospitals

Dr Monica Chan says it was "anxiety-provoking" when the National Centre for Infectious Diseases confirmed its first coronavirus case.
Dr Monica Chan says it was "anxiety-provoking" when the National Centre for Infectious Diseases confirmed its first coronavirus case. ST PHOTO: JASON QUAH

At the heart of the outbreak battle, the National Centre for Infectious Diseases (NCID), where most coronavirus patients have been taken, senior consultant Monica Chan reflects on what it has meant to her family.

Since late last month, as the number of suspected and confirmed coronavirus cases grew, Dr Chan has managed to see her two daughters, aged nine and 11, for only about half an hour each day before they sleep.

When she is unable to do so, she stays in touch through a video call.

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Coronavirus: Top medical official's long hours in hot seat, barely a month in job

Ministry of Health director of medical services Kenneth Mak speaking to the media on Friday. Associate Professor Mak, a surgeon by training, took up the post only at the start of this month.
Ministry of Health director of medical services Kenneth Mak speaking to the media on Friday. ST PHOTO: DESMOND FOO

Talk about landing in the hot seat. Singapore's top medical authority, the director of medical services (DMS) at the Ministry of Health, is Associate Professor Kenneth Mak. And he took up the post only at the start of this month.

Prof Mak, 53, now finds himself dealing with the biggest national medical emergency since Sars: the coronavirus outbreak.

"We work every day. Even Chinese New Year was an ordinary working day for most of us," says Prof Mak, who even in the fortnight before formally taking up his position was leading the medical effort. He was previously chairman of the medical board at Khoo Teck Puat Hospital (KTPH).

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Coronavirus: 'Taking care of everybody' at centre for infectious diseases

NCID executive director Leo Yee Sin with flowers for her staff from the public. With her are (from left) director of nursing Margaret Soon and nurses Ma. Olivia Valencia Valiente and Nurul Hazirah Subari.
NCID executive director Leo Yee Sin with flowers for her staff from the public. With her are (from left) director of nursing Margaret Soon and nurses Ma. Olivia Valencia Valiente and Nurul Hazirah Subari. ST PHOTO: JASON QUAH

She is right on the front lines in the coronavirus fight, as executive director of the National Centre for Infectious Diseases (NCID) - where the bulk of patients are cared for in specially constructed isolation rooms.

This is the sort of pressure Professor Leo Yee Sin, 60, faces: There are at least twice as many patients in the wards than normal, with close to 60 from the current outbreak, and more expected.

She has "to take care of everybody", as she puts it, making sure the infrastructure - only a year old - is able to stand up to the sudden heavy load.

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Coronavirus: MOH team races against time to trace links and stop spread

Dr Vernon Lee finds it most rewarding at this time when his team's contact tracing prevents further spread of the coronavirus. He adds that encouraging messages from friends also give him strength.
Dr Vernon Lee finds it most rewarding at this time when his team's contact tracing prevents further spread of the coronavirus. He adds that encouraging messages from friends also give him strength. ST PHOTO: JASON QUAH

The highs and lows in life today for Dr Vernon Lee, 42, are tied closely to whether his team is able to find the source of coronavirus infection in patients who caught the disease locally.

As he is the director of communicable diseases at the Ministry of Health (MOH), it is his team that has to identify - and serve quarantine notices to - all close contacts of someone who is infected. They aim to do all this within 24 hours, to minimise spread of the virus.

The first cases were all visitors from Wuhan whose contacts were fairly limited. Although the visitors went sightseeing, they would only have had brief contact with people here, and so had little danger of spreading the virus to them.

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Coronavirus: Doctor treats, comforts patients in open-air 'consultation room'

Dr Dale Lim checking a child patient with suspected flu symptoms at his clinic on Thursday. Besides assuring his patients, he has also assured his family that protection measures are in place.
Dr Dale Lim checking a child patient with suspected flu symptoms at his clinic on Thursday. ST PHOTO: KUA CHEE SIONG

The open-air corridor underneath a block of Housing Board flats in Whampoa would not normally be put to use as a doctor's consultation room.

But these are not ordinary circumstances, as evidenced by the N95 mask imprints left on the face of 47-year-old family physician Dr Dale Lim, after he removes it to talk to Insight.

The mask and outdoor consultation area, where he sees patients with flu-like symptoms, are just two of the many measures in place following the spread of the coronavirus here.

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Coronavirus: GPs set aside their own fears to fight on the front line


People queueing to get their temperature taken before entering a clinic in Clementi Ave 5, on Feb 12, 2020. ST PHOTO: KELVIN CHNG

With almost 30 years of medical experience, Dr Leong Choon Kit has seen it all: Sars, Zika and H1N1.

So when the coronavirus hit Singapore's shores, he knew what he had to do. "I told my family that if I see a suspect case, that day, I'll make sure I don't come into contact with them. They must be mentally prepared," he said.

The 52-year-old family physician at Mission Medical Clinic is just one of many doctors who are Singapore's first line of defence against the virus. His years of experience allow him to take a cool-headed approach to the outbreak.

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Coronavirus: Singapore labs join global race to learn about virus


Professor Lisa Ng was part of a team at A*Star that developed a kit which could test for the Sars virus in patient blood samples in 2003. ST PHOTO: KELVIN CHNG

How does the fight against the spread of a disease begin, if the virus causing it is something that no one has seen or heard of before?

As with most mysteries, it starts with first seeking answers to the most basic of questions: What is it? How does it spread? How severe is the infection it causes?

Enter the scientists, the detectives of the microbe world.

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Coronavirus: The 'sixth sense' and long nights behind virus test kit

Dr Timothy Barkham from Tan Tock Seng Hospital and Dr Masafumi Inoue from the Agency for Science, Technology and Research worked with other scientists to develop a test kit to diagnose infections with high accuracy.
Dr Timothy Barkham from Tan Tock Seng Hospital and Dr Masafumi Inoue from the Agency for Science, Technology and Research worked with other scientists to develop a test kit to diagnose infections with high accuracy. ST PHOTO: JASON QUAH

As merrymakers ushered in the dawn of 2020 with high spirits, infectious diseases experts in Singapore were on high alert. Their radars, honed by experience, had picked up on a series of pneumonia-like cases in Wuhan, China.

By the time the Chinese authorities alerted the World Health Organisation on Jan 31 that they had an outbreak of an unknown virus on their hands, scientists here were waiting to spring into action.

On Jan 2, Dr Masafumi Inoue, a scientist at the Agency for Science, Technology and Research (A*Star), sent a text to Dr Timothy Barkham, who works at Tan Tock Seng Hospital (TTSH), saying: "How are you, Tim, how's your holiday?"

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Coronavirus: More prepared, less fearful now than during Sars

The measures taken here are based on experience and data from previous viral outbreaks which have been effective, says Professor Tan Chorh Chuan, chief health scientist at the Ministry of Health.
The measures taken here are based on experience and data from previous viral outbreaks which have been effective, says Professor Tan Chorh Chuan, chief health scientist at the Ministry of Health.ST PHOTO: KELVIN CHNG

The chief health scientist at the Ministry of Health (MOH), Professor Tan Chorh Chuan, sheds light on the measures Singapore has in place to fight the coronavirus outbreak.

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Coronavirus: Keep your hands clean and carry on


Washing your hands with soap and water will get rid of the virus if it is on your hands. PHOTO: ST FILE

Should you close all windows to prevent a spread of the coronavirus? Can a flu jab protect you from the virus?
Answers to these questions and more here.

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Sesame oil won't zap the coronavirus, and don't microwave the mask

Associate Professor Hsu Li Yang said there are viral videos on how you can steam masks. These are not recommended. The masks are meant to be used once, and microwaving or steaming is likely to damage them and reduce their protectiveness.

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All in a day's work for cool-headed nurse

Nurse clinician Priscilla Fu going through the first steps in the process of donning personal protective equipment - putting on an N95 mask, goggles and shower cap. She has to "gown up" in this way when she enters an isolation room in which a coronav
Nurse clinician Priscilla Fu going through the first steps in the process of donning personal protective equipment - putting on an N95 mask, goggles and shower cap. ST PHOTO: JASON QUAH

The close to 70 coronavirus patients here may have the whole country in a bit of a panic, but for nurse clinician Priscilla Fu, 31, it is all in a day's work at the National Centre for Infectious Diseases.

With 13 years of experience behind her, Ms Fu is unfazed even when she has to take swabs from the nose or the back of the throat of a patient confirmed to be infected with the coronavirus.

This process requires two nurses. The one going into the patient's room - which is separated from the ward by two doors, of which only one can open at a time - has to "gown up" and wear an N95 mask.

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Coronavirus: Police helping MOH in contact tracing

(From left) 2 Deputy Director Criminal Investigation Department (CID) and Senior Assistant Commissioner of Police Lian Ghim Hua
(From left) 2 Deputy Director Criminal Investigation Department (CID) and Senior Assistant Commissioner of Police Lian Ghim Hua; assistant director, analytics research and technology development, Ms Linda Teo; ASP Tan Yong Zhi and ASP Tew Meng Hwee are all pitching in to help out in the coronavirus fight. ST PHOTO: JOEL CHAN

When the Singapore Police Force was roped in to help trace contacts of coronavirus cases, officer Tew Meng Hwee put up his hand.

"I wanted to get involved because I know I can contribute," said the Assistant Superintendent of Police (ASP).

ASP Tew, the deputy officer in charge of the Specialised Crime Branch, knew that the police had been involved in contact tracing during the outbreak of the severe acute respiratory syndrome in 2003, and so was prepared to help out this time round.

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Coronavirus: More ICA officers volunteering than needed

 ARIFFIN JAMAR
Superintendent Toh Lai Keng, Deputy Commander (Ground Operations), Airport Command, with a screening officer at the checkpoint for arrivals at Changi Airport's Terminal 3. ST PHOTO: ARIFFIN JAMAR

 

The day 92 Singaporeans came home on a special Scoot flight from Wuhan, seven Immigration and Checkpoints Authority (ICA) officers were waiting to receive them at Changi Airport.

Superintendent (Supt) Toh Lai Keng, Deputy Commander (Ground Operations), Airport Command, was one of them.

He felt it was important to be on the ground with his officers, all of whom had volunteered to screen those returning with full knowledge of the risks.

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Coronavirus: Keeping the spirit alive as the battle continues in China

A doctor being disinfected by his colleague earlier this month in a quarantine zone in Wuhan, the city in China's central Hubei province that is the epicentre of the coronavirus outbreak. A People's Liberation Army medical team starting work on Jan 2
A doctor being disinfected by his colleague earlier this month in a quarantine zone in Wuhan, the city in China's central Hubei province that is the epicentre of the coronavirus outbreak. PHOTO: AGENCE FRANCE-PRESSE

In the annual Lantern Festival show on China's state television just over a week ago, doctors in white robes stood on stage with celebrities like Ulan Tuya, Qu Dan and Wei Yunxi, waving the national flag and joining in the popular patriotic song, Me And My Motherland.

In fact, one could say the true celebrities of the extravaganza were the medical professionals, who were being hailed for their bravery and sacrifice in facing down the coronavirus that had taken hold of the nation.

Since the disease began spreading like wildfire across the city of Wuhan, social and state media has been flooded with images and stories of overburdened healthcare workers whose lives have been consumed by taking care of a seemingly endless number of the ill.

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Wuhan's unseen heroes: Making meals for hospital workers



Restaurant owner Fang Zhongqin (right) with the lunch boxes his kitchen has been preparing for medical workers that are delivered to hospitals in Wuhan every day since the start of the outbreak. PHOTO: COURTESY OF FANG ZHONGQIN

Cantonese restaurant owner Fang Zhongqin never thought life in the new year would be about dishing out more than 1,000 lunch boxes to feed hungry doctors and nurses in hospitals around Wuhan every day.

When the city lockdown on Jan 23 forced him to shut his two eateries, he figured he would use up his food stock by having his kitchen produce meals for hospital workers.

That endeavour grew as more requests came in and from more hospitals - and so, there was no turning off the stoves.

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Wuhan's unseen heroes: Volunteer drives doctors, nurses to hospital


(Left) Mr Zhang Jie and his two workers have been taking medics to and from hospitals in Wuhan in his company cars. (Right) Mr Zhang with his son, then 10 years old, in a picture taken last year. PHOTOS: COURTESY OF ZHANG JIE

When the authorities locked down the city of Wuhan on Jan 23, Mr Zhang Jie was visiting his aunts in another county more than 100km away.

They insisted he stay with them, but Mr Zhang, 41, who runs a conference-organising business, made the two-hour drive back to Wuhan that night; he had two employees he felt responsible for.

By then, all public transport in the city had been suspended. The next day, taxis also stopped running. How would doctors and nurses get to the hospitals and home as more people fall ill, he thought to himself.

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Coronavirus: What next for Singapore?


PHOTO: ST FILE

More cases of coronavirus infections are emerging in Singapore with no known source of transmission. So far, of the 50 local cases, a quarter cannot be accounted for.

The numbers are still relatively small, and contact tracers are working hard to find out how the patients had been exposed to the virus.

If they succeed in identifying the sources and ring-fencing other people who might have been exposed to the virus, then the current containment measures are still working fine.

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Coronavirus crisis shows how risk is misjudged

A shopper stocking up on toilet paper at a drugstore in Hong Kong. Threats that feel out of control, like a runaway illness outbreak, lead people to seek ways to re-impose control, for instance by hoarding supplies.
A shopper stocking up on toilet paper at a drugstore in Hong Kong. Threats that feel out of control, like a runaway illness outbreak, lead people to seek ways to re-impose control, for instance by hoarding supplies. PHOTO: EPA-EFE

Shortly after the University of Washington announced that the school's fourth suspected case of the coronavirus had turned out negative, two professors, one of public policy and the other of public health, held a small dinner for students and faculty members.

Like everywhere else on campus, and in much of the world, the coronavirus was all anybody could talk about. But one of the attendees, a public health student, had had enough. Exasperated, she rattled off a set of statistics.

The virus had killed about 1,300 worldwide and infected around a dozen in the United States. Alarming, but a much more common illness, influenza, kills about 400,000 people every year, including 34,200 Americans the last flu season and 61,099 the year before.

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