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Singapore COVID-19 spread caused by socially irresponsible behaviour

1 in 5 patients went out or carried on with work despite being ill

Social activities for seniors organised by government agencies will be suspended for 14 days from 11 March 2020

Health Minister Gan Kim Yong urges people not to go out or doctor-hop if unwell
By Goh Yan Han, The Straits Times, 11 Mar 2020

One in five confirmed coronavirus patients here went out despite being unwell, said Health Minister Gan Kim Yong yesterday.

One in four also consulted more than one doctor, he said at a press conference, giving an update on the COVID-19 situation.



Urging Singaporeans not to go out or doctor-hop if they are unwell, he said: "I am very concerned that many of the locally transmitted cases resulted from the socially irresponsible actions of a few individuals who continued to go to work, and attended events, and participated in activities despite being unwell, and went on to spread the disease to their family, friends and other contacts."

About 35 of the 160 earlier confirmed cases did not minimise social contact despite developing fever or respiratory symptoms, or consult a doctor early when unwell.

More than a fifth continued to work or carried on with their daily routine despite being sick.



The dinner at SAFRA Jurong, for example, was attended largely by seniors who took part in singing classes and activities like line dancing and qigong at some community clubs and residents' committee centres.

Many were in multiple groups across the island. One person who was unwell attended the event on Feb 15 and later tested positive for the coronavirus.

This could have led to 18 additional cases that were also at the dinner and later tested positive, Mr Gan noted.

Of the 18, 10 continued with daily activities despite feeling unwell, spreading the virus to another 17 people who were not at the dinner.

Meanwhile, the Wizlearn Technologies cluster had three staff members who continued with their daily activities despite feeling unwell. One of them spread the virus to a family member who also continued with daily activities while ill.

This resulted in an extra four cases that did not work for the company.



Mr Gan also said that of the confirmed cases, 38 had gone to more than one general practitioner.

In fact, eight of the 38 visited three or more GP clinics.

The minister urged the public to refrain from doctor-hopping so that the same doctor can follow up on each case, and make the appropriate assessment if a patient needs to be tested for COVID-19.

Separately, the Ministry of Education said yesterday that the student passes of two international students will be terminated for breaching 14-day leave or stay-home rules.

One is an international postgraduate student at Nanyang Technological University's National Institute of Education (NIE), who breached his stay-home notice repeatedly and provided false information on his movements to the institution and NIE's board of discipline.

The other, a National University of Singapore international exchange student, was found to have breached the requirements of her leave of absence and made a false travel declaration to the university.




































Social activities for seniors on hold for 14 days as precaution
Singapore looking at a fuller range of social distancing measures to curb spread of virus
By Lim Min Zhang and Goh Yan Han, The Straits Times, 11 Mar 2020

All social activities for seniors organised by government agencies will be suspended for 14 days from today, 11 March, as Singapore ramps up measures to protect a group particularly vulnerable to COVID-19.

More permanent steps will help combat threats over the long haul.

The precautions come amid a growing number of infections linked to a dinner at SAFRA Jurong - now Singapore's largest coronavirus cluster with 39 cases - attended by many senior citizens.

The suspension will affect courses and activities at community and residents' committee centres in areas like music, drama, dance, exercise, basic IT and career development.

The People's Association (PA) said the suspension will affect 2,600 classes and 11,000 activities attended by about 290,000 participants. PA defines seniors as those aged 50 and above.

Care services for seniors such as those at nursing homes and inpatient and day hospices, senior care centre services and home-based care services will continue to run, but with additional precautions.

Health Minister Gan Kim Yong, who co-chairs a multi-ministry task force to fight the coronavirus, said yesterday: "While we encourage seniors to be active, there is now evidence of COVID-19 transmission among the seniors participating in such social activities, because some individuals who were unwell had continued to participate in them."

Mr Gan said he is "very concerned" that many of the locally transmitted cases resulted from the socially irresponsible actions of a few individuals, young and old, who continued to go to work and socialise despite being unwell.



The new measures are the most extensive social distancing efforts to date, and could be extended even further.

National Development Minister and fellow task force co-chair Lawrence Wong noted that as the virus "spreads to countries everywhere", Singapore's approach must shift - maintaining basic surveillance at borders but doubling down on measures within the country.

The coronavirus has so far infected more than 114,000 people worldwide and killed over 4,000.

As of noon yesterday, Singapore had 166 confirmed cases, with 93 patients discharged.

Mr Wong said the Republic will look at a fuller range of social distancing measures, including for public events, community activities, school closures, religious services, workplaces and schools.

But the task force is mindful that such measures can be disruptive. Mr Wong said that for moves that are likely to be more disruptive, sufficient lead time would be given so Singaporeans can prepare well in advance. He likened the moves to "circuit breakers", where Singapore tries to "stop the transmission chain and flatten the epidemic curve".



Some will be implemented on a temporary basis, or over a discrete period of time, but there will also be permanent measures put in place.

One example is the SG Clean campaign, Mr Wong said: "That's something we should do, not just with this particular outbreak, but in fact we should adopt better hygiene standards at the personal level, at the public level."

Other measures that the Government will continue to stress include washing hands frequently with soap and using common serving utensils rather than double-dipping.

"It's critical to implement the right measures at the right time," said Mr Wong.








































Coronavirus outbreak: Singapore mindful of need to calibrate social distancing measures, says Lawrence Wong
By Choo Yun Ting, The Straits Times, 11 Mar 2020

Even as Singapore intensifies social distancing measures to deal with the coronavirus outbreak, it is mindful that this has to be done in a calibrated manner, National Development Minister Lawrence Wong said yesterday.

Social activities organised by government agencies for seniors have been suspended for 14 days.

The authorities could ramp up such measures over time, said Mr Wong.

He noted that as the virus spreads worldwide, Singapore's approach must shift - maintaining basic surveillance at borders but doubling down on measures within the country, including social distancing.



"Increasingly, this is spreading everywhere in the world, and the possibility of shutting ourselves out is, I think, not something we want to contemplate, so border controls will become less relevant and effective," he noted, adding that the focus would be what to do within Singapore.

More extensive measures could also be implemented for public events, community activities and schools, for instance, and could include staggered hours or telecommuting.

"We have a range of social distancing measures that we are continuing to study, and whether they apply to events, to gatherings, to cruises... we will look at what's appropriate as the situation evolves, and whether or not we should apply tighter measures along the way," said Mr Wong.

He likened the measures to "circuit breakers" where Singapore tries to "stop the transmission chain and flatten the epidemic curve".

"We are very mindful that these measures can be very disruptive to the lives of Singaporeans.

"If we were to do all of them at one time, we will literally have to shut down our city and everything will grind to a halt."



Health Minister Gan Kim Yong stressed that the coronavirus situation remains unpredictable, given the rapid developments globally and experts saying the outbreak could last till the end of the year.

Singapore needs to be prepared for the long haul, he said, adding that the heightened hygiene measures that have been introduced are good for society, regardless of the COVID-19 outbreak.

Mr Wong said that the Government "will provide lead time" for social distancing measures that will have significant impact on Singaporeans, such as school closures.



The Government is constantly reviewing measures, including the current advisory on large-scale events, and the downstream implications that the tightening of these measures would have on future events such as the National Day Parade, said Mr Wong.

Mr Gan, who co-chairs the multi-ministerial task force on COVID-19 with Mr Wong, emphasised the importance of responsible behaviour to limit the spread of the virus in Singapore.

Noting that several confirmed cases had continued to engage in social activities even after developing respiratory symptoms, Mr Gan said that their irresponsible behaviour poses a risk to all Singaporeans.

"Measures we've implemented will only work if individuals operate and behave in a socially responsible manner," he said.

His comments were echoed by the Health Ministry's director of medical services Kenneth Mak, who said that maintaining social responsibility is key and stressed that those who are ill should follow doctors' advice to stay home and prevent further spread of the virus.

Ring-fencing close contacts remains an important strategy for Singapore, he added.

"We will continue to be safe in the community if we continue to maintain good personal hygiene," said Associate Professor Mak.




























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COVID-19: Why was the Costa Fortuna cruise ship allowed to dock in Singapore?

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COVID-19: Why was the Costa Fortuna cruise ship allowed to dock in Singapore?

Costa Fortuna cruise ship docks in Singapore; some passengers immediately bussed to airport
By Aqil Haziq Mahmud and Tang See Kit, Channel NewsAsia, 10 Mar 2020

The cruise liner turned away from ports in Malaysia and Thailand due to COVID-19 concerns docked in Singapore on Tuesday morning (Mar 10), with some passengers immediately taken to Changi Airport by bus.

The Costa Fortuna berthed at the Marina Bay Cruise Centre as part of a scheduled call, after the ship was barred from stopping in Penang and Phuket.

This was despite the cruise operator stating there were no suspected COVID-19 cases on board.

The ship, however, was carrying dozens of Italian passengers.

Italy was placed on lockdown on Tuesday after it reported 97 more deaths from COVID-19, taking its toll to 463 - the largest outside of China. There are 9,172 confirmed cases in the country.



Speaking at a press conference on Tuesday evening, National Development Minister Lawrence Wong explained why Singapore let the ship dock here.

"The passengers were already in Singapore," Mr Wong said. "They had arrived in Singapore, and then they embarked on a cruise from Singapore with the intention to come back to Singapore.

"I don't think it would be right for us to reject the ship if it were to come back to Singapore ... so that's why we agreed to accept them.

"We took extra precautions, as we have taken for all cruise ships as well."



The minister added that there were Singaporeans aboard the Costa Fortuna. He said later in a Facebook post that two Singaporeans had been on board.

Passengers started to leave the vessel at about 9am and more than 600 had left by 12pm, the Ministry of Health (MOH), Maritime and Port Authority of Singapore (MPA) and Singapore Tourism Board (STB) said in an update on Tuesday afternoon.

In another update on Tuesday night, MOH, MPA and STB said that at 11pm, all passengers of the cruise ship have been allowed to disembark.

"By midnight, all foreign passengers would have been conveyed directly to the airport for their onward flight or to their respective hotels."

All foreign passengers will also depart Singapore within the next two days.



Passengers CNA spoke to said the mood on board was generally fine, but some said they were disappointed they could not alight in Penang or Phuket. Some passengers said they had their temperature taken before disembarking.

The passengers included those from Germany, Australia, Slovenia and Romania.

Singapore authorities said on Monday that disembarking passengers would be checked by a doctor on board to ensure they were healthy.

Passengers entering Singapore would have their temperature taken, while those who had fever and/or symptoms of respiratory illness might be required to undergo a COVID-19 swab test. Passengers with no symptoms would be taken directly to the airport for onward flights, while those who have would be taken to the National Centre for Infectious Diseases.



On Tuesday afternoon, the three local agencies said those who had recent travel history to affected regions within the last 14 days have completed enhanced one-on-one screening by doctors licensed by MOH and have been certified fit to travel.

"These passengers had entered Singapore and boarded Costa Fortuna prior to the implementation of the travel ban and/or advisory on 4 March, 2359 hrs.

"These passengers will stay onboard the ship and will be facilitated directly to the airport for their onward flights."



The cruise centre was closed to the public on Tuesday morning, as staff and security officers screened passes and prevented reporters from taking photographs.

The first batch of passengers who left the centre at about 9am were quickly ushered to a waiting coach. The coach displayed a label showing the number of a Singapore Airlines flight departing for Bangkok at 6.35pm on Tuesday.

Subsequent batches of about 30 to 40 passengers each were also taken to waiting coaches, ushered by auxiliary officers keen on preventing them from speaking to the media.

Some of the coaches had labels showing the Crowne Plaza hotel in Changi Airport. Another coach had a label that indicated it was for members of the Dutch airline KLM.

"Nobody (on board) had fear,” a passenger from Germany said. “There’s no pain for us.”



A passenger from Romania said passengers were allowed to disembark in Langkawi, but not in Penang and Phuket.

“The cruise stopped in Phuket for four hours, then (moved off),” he said, making a hand gesture of a vehicle speeding off. “They told us that it’s closed.”

Another passenger from Australia said it was “upsetting” that her holiday was “cut short” as passengers were not allowed to disembark in Penang and Phuket.

“But it is what it is, (the virus) is worldwide,” she said, adding that it was still a “lovely” holiday.

At about 12.10pm, a bus with about 12 passengers arrived at the Crowne Plaza Changi Airport. All of them are from Germany and are due to leave Singapore on Tuesday night.

Almost all foreign passengers will depart Singapore within the next two days, MOH, MPA and STB said in their joint response.



A couple said they got off the ship at about 9am and had been waiting at the cruise centre for an available coach to bring them to the hotel.

“That (took) very long and now we are waiting for our hotel rooms. We hope this will be fast so we can rest,” the man told CNA at the hotel lobby.

The couple boarded the Costa Fortuna cruise liner on Feb 25 in Singapore and said they enjoyed their two-week holiday as planned, despite not being allowed to get off the ship at Phuket and Penang.

“For me, I went to Thailand a few years ago so I know the country a little but my wife doesn’t so she is a little bit frustrated," the passenger said. "But overall, it is okay. We still had fun.”



Another two passengers from Munich – a mother and her daughter – described Costa Fortuna as a “big” and “beautiful” ship.

Both had arrived in Singapore on Feb 21 and boarded the cruise ship on Feb 25. They said they visited Pattaya, Koh Samui and Langkawi before the ship was denied entry at Phuket and Penang.

They were in high spirits when they spoke to CNA despite the long wait at the cruise centre on Tuesday morning.

“We are feeling very good. We had a good holiday for two weeks,” said the daughter, who declined to reveal her name. “What happened at Phuket and Penang was a little sad and everyone was a little frustrated, but this is the situation now so we understand.”






























Singapore will continue to accept cruise ships despite higher risk of spread
By Rei Kurohi, The Straits Times, 10 Mar 2020

Singapore will continue to accept ships that are based here, including cruise ships, said the Health Ministry's director of medical services Kenneth Mak yesterday.

He added that Singapore has had ships coming into and leaving the country since the Covid-19 outbreak began in January, just as planes have not stopped taking passengers in and out of the country.

"What's important is recognising the risk that infections may occur on ships and they can spread very easily," said Associate Professor Mak.


"What's important is that as we receive some of these ships back in Singapore, we have a high degree of vigilance to make sure that none of (the passengers) are infected, and if they are, then we must be vigilant in making sure that we're able to identify them, isolate them and control any further spread."




Prof Mak was responding to questions from The Straits Times' senior health correspondent Salma Khalik on whether Singapore should stop cruise ships from docking here as other countries have done.

Ms Khalik also asked during yesterday's panel discussion, which was broadcast on the newspaper's social media channels, if cruise ships pose a greater danger of infection compared to planes.


Prof Mak said ships and planes are similar in that passengers cannot leave halfway through a journey, but he added that the dynamics of social interaction are very different between the two.


"If you're on a plane, you're spending most of your time... in your seat," he said. "You may get out of that seat and walk down the aisle, but most of the time you're going to the toilet and back to your seat."


The interactions one has with fellow passengers on a plane is therefore very limited, Prof Mak said. Any spread that takes place would occur in the vicinity of the seat.


He said: "Conventionally, we talk about investigating and looking at people who might be seated in the same row as you are if you're sick, two rows in front and two rows behind you."


In contrast, most interactions on a cruise ship occur during social activities such as meals, Prof Mak noted. Ship passengers also interact with one another much more than plane passengers.


The possibility of a virus spreading is therefore potentially much higher in a ship, Prof Mak said.




Ms Khalik also asked the panel if it is safe to travel during the upcoming March and June school holidays.

Panellist Tikki Pangestu, a visiting professor at the Lee Kuan Yew School of Public Policy and former director of the World Health Organisation's Research Policy and Cooperation department, said it is fine to travel to countries that have not seen much local transmission.


"I think it depends on your threshold of risk taking. Even within countries (with more cases), there are higher-risk areas. In Italy, it is the northern part of the country, and in South Korea, it's mostly Daegu, not the whole country," he said.


"So I think you just have to make, let's say, a judgment based on your own individual risk levels."




Associate Professor Hsu Li Yang of the National University of Singapore's Saw Swee Hock School of Public Health said cutting back on non-essential travel and paying attention to which countries are seeing a rise in cases suggesting community spread is going to be the "new normal" for a while.

He added: "The next question is, should tourists come to Singapore? And the answer, we think, is yes, because we think we've got a handle on the situation."




Professor Leo Yee Sin, executive director of the National Centre for Infectious Diseases, said: "We also have to watch out in terms of introduction and importation.

"But, personally, I think that Singapore is the safest place."















The Corona Virus in The Middle East Will Hajj Bring it home ?


The coronavirus in the Middle East: will Hajj bring it home?








Source: Potential for the International Spread of Middle East Respiratory Syndrome in Association with Mass Gatherings in Saudi Arabia/PLOS Currents Outbreaks



On Wednesday, the World Health Organization announced that MERS -- the new coronavirus in the Middle East -- is noy yet considered a public health emergency.



But emergency or not, the situation is a serious one. To date, MERS has infected 88 people and killed 45 people -- some of whom have brought the virus to Europe and Africa.



Thus far, all confirmed cases can be traced back to one of four Middle Eastern countries: Jordan, Qatar, the United Arab Emirates, and Saudi Arabia. But the majority of cases have occurred in saudi Arabia -- the same country millions of pilgrims are now flocking to for Hajj and Umrah.



As Mecca enters its peak season for pilgrimages, there is a growing worry that visitors could get infected and scatter back to their home countries, bringing the virus with them.



But which countries are most at risk? This is the question a team of researchers -- led by Dr. Kamran Khan, a St. Michael's Hospital doctor and founder of BioDiaspora -- wanted to answer with their new study, published Wednesday in PLOS Currents Outbreaks.



The team used a web-based technology that analyzes global air traffic patterns to predict the spread of infectious diseases.



And their results are not exactly reassuring. According to a press release about the study, MERS "could spread faster and wider during two international mass gatherings involving millions of people in the next few months."



Analyzing 2012 data, the researchers found that 16.8 million travelers flew on commercial airlines out of Saudi Arabia, Jordan, Qatar and the United Arab Emirates between June (one month pre-Ramadan) and November (one month post-Hajj).



During SARS, which killed some 800 people worldwide, the majority of infected travelers turned up in high-income countries, including Canada. But with Hajj, there were 1.74 million pilgrims last year and an estimated 65.1 per cent flew home to low or low-middle income countries, according to the study.



Nearly one in four Hajj pilgrims flew to India, Pakistan, Bangladesh, Afghanistan and Nepal -- countries that spend $59, $30, $56 and $33 US per capita on health care, respectively. For comparison's sake, Canada's health expenditures per capita is $5,630 US, or $5,837 CAD.

"Given that these countries have limited resources, they may have difficulty quickly identifying imported MERS cases, implementing rigorous infection control precautions and responding effectively to newly introduced cases," Khan said in the press release.



Khan and his team also found that eight countries supply the majority (51.6 per cent) of Mecca's pilgrims: India (16.3 per cent), Egypt (10.4), Pakistan (7.8), Britain (4.3), Kuwait (3.6), Bangladesh (3.1), Iran (3.1) and Bahrain (2.9). Twelve cities also received more than 350,000 commercial air travelers from the four Middle Eastern countries affected by MERS (Cairo, Kuwait City, London, Bahrain, Beirut, Mumbai, Dhaka, Karachi, Manila, Kozhikode (India), Istanbul and Jakarta).



In the press release, Khan and his team urge health care providers to learn from SARS; we should anticipate a wider MERS outbreak, they say, rather than react to one after it happens.

Sounds like good advice.

Best response to the coronavirus? Altruism

By Richard A. Friedman, Published The Straits Times, 9 Mar 2020

Are you fearful about catching the coronavirus? Are you anxious about whether you're properly prepared for its arrival? You're in good company. In the past few days, I've had patients call or e-mail to ask me to double or even treble the dosage of their prescription antidepressant or anti-anxiety medication so that they can have a bigger supply on hand "just in case".

Throughout the United States, people are stockpiling food in anticipation of a shortage or quarantine measures. Supplies of Purell hand sanitiser flew off the shelves and are now hard to find or even unavailable online. I understand the impulse to secure one's safety in the face of a threat. But the fact is that if I increase the supply of medication for my patients, I could well deprive other patients of needed medication, so I reluctantly declined those requests.

As a psychiatrist, I frequently tell my patients that their anxieties and fears are out of proportion to reality, something that is often true and comforting for them to realise. But when the object of fear is a looming pandemic, all bets are off.

The coronavirus is an uncertain and unpredictable danger. This really grabs our attention, because we have been hardwired by evolution to respond aggressively to new threats. After all, it's safer to overact to the unknown than to do too little. Unfortunately, that means we tend to overestimate the risk of novel dangers.

I can cite you statistics until I am blue in the face, demonstrating that your risk of dying from the virus is minuscule compared with your risk of dying from everyday threats, but I doubt you'll be reassured. Just as we tend to assume the worst about novel threats - the safest, if not the most statistically justifiable, strategy - we tend to underestimate the danger of familiar risks because we are habituated to them. We are not very rational when it comes to assessing risk.

The good news is that even in the face of fear, we do have the capacity to act in ways that would help limit contagion during an epidemic. Specifically, we can behave altruistically, which benefits everyone. For example, research shows that when people are told that it is possible - but not certain - that going to work while sick would infect a co-worker, people are less willing to stay home than when they are reminded of the certainty that going to work sick would expose vulnerable co-workers to a serious chance of illness.



Stressing the certainty of risk, in other words, more effectively motivates altruism than stressing the possibility of harm. Health officials should be explicit in telling the public that selfish responses to an epidemic, such as going to work while sick or failing to wash your hands, threaten the health of the community.

There are other ways to encourage selfless behaviour. For example, another study examined the neural activity of people while they played a game in which they made either generous or selfish choices to award or withhold money. The researchers found that when subjects made selfish decisions, the brain's reward centre was activated, whereas when they made generous decisions, a region of the brain implicated in empathy lit up. This suggests that people are more likely to be altruistic if they are primed to think of others and to imagine how their behaviour might benefit them.



There is no question that we can all be encouraged to act in the interest of our fellow humans during perilous times. Specifically, public figures need to convey loudly and clearly that we should not go to work or travel when we're sick and that we should not hoard food and medical supplies beyond our current need.

But that will require morally authoritative leaders who can inspire the better angels of our nature by reminding us that we are all in this epidemic together.

NYTIMES

Richard A. Friedman is a professor of clinical psychiatry and director of the psychopharmacology clinic at the Weill Cornell Medical College.


Foreigners to pay for COVID-19 treatment in Singapore from 7 March 2020

Short-term visitors must now pay for virus treatment, tests still free
Citing rising infections, MOH says Singapore must prioritise resources at public hospitals
By Choo Yun Ting and Timothy Goh, The Straits Times, 10 Mar 2020

Tourists and other short-term visit pass holders in Singapore have had to pay for COVID-19 treatment since last Saturday, 7 March, the Ministry of Health (MOH) said yesterday.

It cited the rising numbers of infections globally and an expected rise in confirmed cases, saying Singapore will "need to prioritise resources at our public hospitals".



Singapore will still waive testing fees for short-term visit pass holders, but they have to pay for treatment if warded. The Government will continue to pay for Singapore residents and long-term pass holders - such as those on work, student's and dependant's passes - admitted to public hospitals for treatment, an MOH spokesman said yesterday.



The ministry also confirmed 10 new patients yesterday, 9 March, of whom six are linked to the Joy Garden private dinner at SAFRA JURONG on Feb 15. One is linked to The Life Church and Missions Singapore, and the remaining three are imported.

Another three patients were discharged.

The SAFRA JURONG cluster is now the largest, with 36 cases. Case 160, a five-year-old Singaporean boy, is the youngest case linked to the dinner there. He is a family member of Case 145 and is warded at KK Women's and Children's Hospital. Cases 155 to 159, aged between 47 and 59, are also linked to the SAFRA cluster.


One of the imported cases announced yesterday, Case 152, is a 65-year-old male Indonesian national. He reported the onset of symptoms in Indonesia on Feb 28, and sought treatment at a hospital in Jakarta on March 2. He arrived in Singapore last Saturday and turned up at Singapore General Hospital (SGH).

Case 153 is likely to be an imported case. The 65-year-old female Singaporean was in Indonesia from Feb 25 to Feb 28, and visited her sister who had pneumonia while there. She reported the onset of symptoms on March 3 and sought treatment at Choa Chu Kang Polyclinic that day and last Saturday. She turned up at SGH last Saturday.



Another imported case, Case 154, is a 52-year-old British man who arrived in Singapore last Friday and was confirmed to have the infection yesterday. He is hospitalised at the National Centre for Infectious Diseases (NCID). The MOH spokesman declined to identify the flight he was on.

Case 151, linked to The Life Church and Missions, was at a Jan 25 Chinese New Year gathering in Mei Hwan Drive. The 51-year-old Singaporean man reported the onset of symptoms on Feb 4, and visited a general practitioner clinic on Feb 5 and 13. He also sought treatment at Yishun Polyclinic on Feb 8 and 13. While he was ill, he mostly stayed at home in Yishun Ring Road.

He was referred to NCID to undergo a serology test on Feb 22 after he was confirmed to have attended the gathering, which has been linked to other cases. The results from the serological test, which looks for past infections by detecting antibodies in a person's blood, on Sunday confirmed that he had an earlier COVID-19 infection.



MOH also provided updates on the cases confirmed on Sunday. Among them was Case 147, Singapore's first case to be picked up at the checkpoints using a swab test. The 64-year-old Indonesian man reported the onset of symptoms on March 3 and arrived here four days later.

He had a fever when he arrived at Seletar Airport and did a swab test at the checkpoint. He was taken to NCID by ambulance on Saturday night and confirmed to have the infection on Sunday morning. Prior to hospitalisation, he mostly stayed at his rental apartment in the Oxley Road area. He will have to pay for medical treatment here, MOH said.

In a Facebook post, Second Minister for Home Affairs Josephine Teo said a test kit developed by Home Team agency HTX has been used to analyse COVID-19 swab test samples at land, air and sea checkpoints since last Thursday. It was used to detect the virus for Case 147.

Singapore has a total of 160 coronavirus cases, of whom 93 have been discharged. Ten remain in critical condition, while the rest are stable or improving.