Yesterday, additional precautionary measures were announced, as six more cases of 2019 novel coronavirus (2019-nCoV) infection were confirmed in Singapore.

In a joint advisory, the Ministry of Trade and Industry (MTI), Ministry of Manpower (MOM), National Trades Union Congress (NTUC), and Singapore National Employers Federation (SNEF), outlined some additional precautions for employers and employees. This includes:

Step up cleaning of workplace premises

Employers are advised to conduct more frequent cleaning of areas with high human contact, such as counters where customers are served and rooms where visitors are hosted. Additionally, general public access areas (such as lifts, pantries, toilets, and bin areas) should also be cleaned more frequently.

Businesses should also adopt sanitation and hygiene advisories disseminated by the National Environmental Agency (NEA). Interim guidelines for cleaning and disinfecting areas exposed to confirmed cases of 2019-nCoV have also been released by the NEA, and a list of companies that can carry out disinfection works have been provided.

The advisories have been disseminated to hotels, public and private transport operators, and F&B outlets, including hawker centres.

Clear guidance to frontline staff on how to handle customers who are unwell

Employers should establish clear guidance to frontline staff on how to handle customers who are unwell.

For example, frontline workers can advise customers who are visibly unwell to see a doctor. Customers could also be asked to reschedule their appointments, or be served via alternate means (such as tele-conferencing).

Proper procedures to safeguard staff and premises should be established should it be necessary to provide urgent services to customers who are unwell.

For example, having frontline workers wear a surgical mask, and serving these customers separate from other customers if possible.

Employees play an important role in taking precautionary measures

Precautionary measures that workers can take include:

  • Observing good personal hygiene, such as monitoring their temperature regularly and washing hands frequently with soap.
  • Avoiding close contact with people who are unwell.
  • Consulting a doctor promptly if unwell or suffering from respiratory symptoms.
Employees who are unwell should stay away from the workplace, and wear a mask so that they do not spread infection to others. Employees who are well do not need to wear a mask.

With the onset of the 2019-nCoV cases in Singapore, MTI, MOM, NTUC and SNEF have worked together to put place measures for workplaces. These are:

  • Precautionary measures such as obtaining a health and travel declaration from their employees on whether they have travelled to mainland China recently, or if they have any upcoming travel plans to mainland China.
  • Complying with Leave of Absence (LOA) – Employees with recent travel history to mainland China will be required to go on a 14-day LOA, where they have to stay at home and avoid social contact. Employers and employees must ensure that employees behave responsibly during the LOA. MOM may take action against the employer or employee if they do not discharge their responsibility.

Home Quarantine Orders or LOA are just precautionary measures

On the topic of the 2019-nCoV, the Ministry of National Development (MND), Ministry of Education (MOE), and Ministry of Manpower (MOM) on Persons have released a joint statement affirming the actions regarding persons placed on home quarantined orders and leave of absence.

With effect from 31 January 2020 6pm, the following returning groups have been placed on a 14-day LOA from the day of their return to Singapore from mainland China:

  • Residents (Singaporean Citizens/ PRs) with recent travel history to mainland China within the last 14 days;
  • Long-term pass holders (including Work Passes, Student Pass, Dependant’s Pass and Long-term Visit Pass) with recent travel history to mainland China within the last 14 days.
In light of this, the Ministries have advised the general public: "People placed on Home Quarantine Orders (HQO) or Leave Of Absence (LOA), who could be workers or students, are well, and that these are simply precautionary measures to protect Singaporeans from the spread of the 2019 Novel Coronavirus (nCoV).

"Those who are unwell with fever or respiratory symptoms will be sent to a hospital for assessment and isolated if they are a suspect case."

They also noted feedback received on cases of landlords evicting tenants who are placed on LOA or HQO, and based on their nationality. "Landlords found to have irresponsibly evicted their residents may face restrictions and even be barred from renting out their flats to foreign work pass holders in future," the release stated.

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According to a press release by Singapore's Ministry of Health (MOH), four of the six new cases constitute "a local transmission cluster".

That said, three of these local transmission cases can be traced to contact with recent travellers from Mainland China and had prolonged interactions with these travellers. Pending confirmation from the Chinese authorities, the travellers are from Guangxi, and at least two of them have since been confirmed with the Wuhan virus.

The fourth case is a close contact of one of the local transmission cases.

While the remaining two were from among the group of Singaporeans who were evacuated from Wuhan on 30 January.

As such, MOH noted that although the four cases constitute "a local transmission cluster", there is as yet no evidence of widespread sustained community transmission in Singapore.

Likely modes of transmission are mainly through contact

Current evidence suggests that the likely modes of transmission are mainly through contact with droplets from infected individuals, either directly or indirectly through hands that have come into contact with these droplets. The virus can also transmit through surface contact.

Hence, as an added precaution in view of the latest developments, MOH has advised individuals to observe good personal hygiene. Those who are not feeling well should also practice social responsibility (such as by wearing masks). Additionally, everyone should wash their hands regularly, avoid touching their faces, and stay home if they are unwell.

At the same time, businesses and organisations have been advised to increase the frequency of cleaning, especially high-traffic premises such as food and beverage outlets, retail shops and hotels. Individuals are also urged to play their part to keep their personal workspaces clean.

The MOH has also implemented the following enhancements:

  • A more cautious stance with vulnerable groups (young children and the elderly) For example, staggered recesses and suspension of school assemblies for schools, and suspension of external excursions and large scale gatherings in eldercare facilities.
  • Active case finding for similar cases and expanded surveillance efforts MOH is contacting individuals with profiles similar to the four cases of local transmission, who have had recent close contact with individuals with travel history to Mainland China. 2019-nCoV testing will also be conducted on all individuals with pneumonia at local hospitals since last week.
The MOH said it is closely monitoring the situation and will calibrate its posture accordingly as new developments arise.

It is possible that there could be broader community spread despite the government's best efforts. Should that happen, MOH will consider additional measures to reduce human-to-human interactions, such as cancelling mass gatherings, suspending schools, and paring down non-essential care services, to slow the spread of disease.

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On the bright side, one of Singapore's earlier confirmed cases - a 35 year old male Wuhan resident - has been discharged from NCID on 4 February. He has recovered, and has been comprehensively tested negative for the virus.

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