Sars: 10 years on

Sars in Singapore: Race against time to battle deadly disease

This story was first published in The Straits Times on March 15, 2013

The patient was sick with pneumonia, but her doctors at Tan Tock Seng Hospital (TTSH) somehow had a feeling that it was not the garden variety.

Maybe it was bird flu, they thought, spooked by an alert in a newsletter about an outbreak in China in the first week of March 2003.

But the patient had been to Hong Kong, not China. Still, to play it safe, they isolated her anyway and alerted the Ministry of Health (MOH).

Looking back on this fortuitous decision, TTSH infectious disease senior consultant Lee Cheng Chuan, 48, gives thanks for that bird flu outbreak.

A week later, on March 12, the World Health Organisation issued a global alert on a severe form of pneumonia in Hong Kong, Guangdong in China and Vietnam. Three days later, it coined the term severe acute respiratory syndrome, or Sars, which had infected 150 people worldwide, including 16 here.

"Who knew that she had Sars?" said Dr Lee.

The deadly disease had medical administrators and doctors here scrambling.

Associate Professor Leo Yee Sin, then head of TTSH's Communicable Disease Centre, recalled the first night that the hospital knew it had a Sars outbreak here: "I was just sitting down there, writing out procedures, step by step. If this person comes in, where should he go? What to do, go in here and go out there... those kind of things."

She raced against time to equip health-care workers with the "maximum protection". This meant N95 face masks, which they had to be fitted for, and full water-impermeable gowns that they had to learn to wear and discard.

MOH made TTSH the Sars-designated hospital on March 22. Two days later, the Government invoked the Infectious Diseases Act and quarantined about 740 people at home for 10 days.

Schools were shut, and travellers were screened at Changi Airport.

On March 25, Singapore suffered its first Sars fatality - the first patient's father. Her mother, uncle and pastor died later.

At TTSH, then chief executive Lim Suet Wun held meetings up to three times a day, and sent daily updates and reminders to practise infection control to his staff. TTSH also set up a paediatric ward for Sars-hit children. The sight of so many people gowned up, with goggles, gloves and masks, frightened many of them to tears, said National University Hospital (NUH) paediatrician Chan Poh Chong, who volunteered there.

On April 7, TTSH doctor Ong Hok Su became Singapore's first health-care worker to succumb to Sars. Four others died. Associate Professor Dessmon Tai, who was leading the Sars medical intensive care unit at that time, recalled colleagues gathering there, helplessly watching Dr Ong slip away.

"I remember the atmosphere that night. Everyone was silent, speechless. Looking up on the wall and down on the floor," he said.

"When I said goodbye to my wife every morning, I was not sure if it would be the last time I would be seeing her. She told me that she would rather grow old with an ordinary man, than live with the memory of a dead hero."

Sars victims spent their final moments alone, as visitors were forbidden. Mr Isacc Steven, 49, then a porter at NUH, recalled moving the body of a dead patient to the mortuary while his family looked on 20m away. "It was very sad, they couldn't even do last rites, or have a last look at their loved ones."