Telemedicine can help prevent local outbreak

I was president of the Singapore Medical Association 17 years ago during the severe acute respiratory syndrome (Sars) outbreak and have some suggestions on how to better deal with the Wuhan virus situation.

It is now clear that the Sars virus and the Wuhan virus develop in very different ways despite both being coronaviruses.

With Sars, almost every patient had a fever, and until that happened, he was not at risk of infecting others. With the Wuhan virus, however, it is highly likely that during the incubation period (of up to 14 days), some infected people will experience only mild symptoms, little different from a common cough and cold.

Worse, even when without symptoms, some may spread the virus to others around them. It seems that the only reliable early differentiator is the patient’s travel history, or the fact of having been in contact with a person who has travelled to a high-risk region.

Such patients are then isolated, and subsequently confirmed as having the virus or discharged, based on the results of a blood test.

The current instruction to persons at risk is to head to their general practitioner (GP) clinic if they feel unwell. This is illogical. The GP has no exceptional means of distinguishing patients with the Wuhan virus from others with a common cough and cold.

All he can do is to ask for details of recent trips and about close contacts. No physical examination or blood test is available to help him reach a diagnosis.

Such questions about travel or contacts should not be kept to the GP visit. I suggest that the Ministry of Health urgently set up some telemedicine hotlines, manned by trained bilingual personnel.

All travellers arriving at Changi Airport can be instructed to call that number if they feel unwell.

The telemedicine hotline staff can ask the relevant questions, with the traveller in the relative safety of his hotel room.

Callers assessed as needing further evaluation can be told to wait for a dedicated ambulance to arrive. This way, the hour-long wait in a GP’s clinic is eliminated, as well as the possible spreading of the virus to many others waiting together.

Since the days of Sars, communications technology has developed tremendously. The initial screening of ill patients via telemedicine seems a perfect fit for new technology.

It may even reduce the risk of an outbreak, starting from a GP’s clinic and proceeding to the community.

 

Lee Pheng Soon (Dr)

* Letter first appeared on ST Forum and is reproduced for duscussion.

 

 

 

 

 

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21 Responses to “Telemedicine can help prevent local outbreak”

  • Bapak:

    Tomboy is passing a hint with maotai & alcohol to sanitize hands. Actually, she got the info drink alcohol (the higher the better) can kill that virus. But cannot so direct cause seems promoting drinking.

    Smokers also did not get SARS, but they cannot say cause seems like promoting smoking.

    OTOH, why small-space-can-make-love Jo so concerns about the 30,000 Chinese work pass holders cannot come back? Just fill these 30,000 jobs with Singaporeans, you idiot!

    Btw, 30,000 x 14 x $100 is how much? I failed my Maths. Why use SG taxpayers’ money, OUR hard-earned money to pay them?

    Sinkies70 you better wake up & kick the robbers out.

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  • So lousy practice?:

    “The current instruction to persons at risk is to head to their general practitioner (GP) clinic if they feel unwell. This is illogical. The GP has no exceptional means of distinguishing patients with the Wuhan virus from others with a common cough and cold.”

    Shockingly lousy practice.

    Singapore “leaders” need to learn from the good practices in other countries.

    In some country, based on travel history, the likely case will be sent a special ambulance to bring to a special hospital unit.

    No anyhow show up in a clinic, wait for hours and infect all the other patients and staff at the clinic.

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  • Experience Outweights Paper:

    Very good suggestion. That way the infected is transported by an ambulance to the hospital directly and will not pass the virus on to the taxi driver or others in the public.

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  • Harder Truths:

    Dr. Lee

    After SARS, what have you and your colleagues done to make sure that another similar type of disease can be controlled? I have seen and heard nothing since that time to ensure a system is in place for just this type of contingency.

    Now after all this time has passed – is this advice the best you can do? Do you practice preventive medicine to save lives or is this an ‘income opportunity’?

    Just asking – because listening to you my next trip may be to the voodoo doctor from Africa.

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  • Bapak:

    And most of the times, before their visit to the clinic they will make their maiden trip to queue long long time for their TOTO or 4D first as they need to place their Mon, Wed Thurs, Sat & Sun bets for their next 14 days. This queue, NO ONE complain over social media. Why such queue so special? Collect mask queue alit of kpkb.

    Btw, Sinkies70 are so selfish they don’t have time for telemedicine. Don’t waste time with such kind. Maybe some already kenna but trying out selfmedicine first cause visiting clinic is so damn expensive UNLESS THERE IS INSENTIVES LIKE $100 REWARDS FOR COMING FORWARD.

    How about many of their FTs already here may already kenna? They are fond of selfmedicine first. Did the bright 4G & Paper Generals think of this? Only know how to TKSS, boasts and one-shoot-one-kill himself.

    This country is done for. No good suggestion can help. There are only two roads forward for SG. Kick PAP out or concentration camps to all Sinkies70. These two components are the creations of one devil who was sentenced to minus-18th level, 5 years ago. Heard someone want to keep his “legacy” alive. Must be another devil.

    So lousy practice?:
    “The current instruction to persons at risk is to head to their general practitioner (GP) clinic if they feel unwell. This is illogical. The GP has no exceptional means of distinguishing patients with the Wuhan virus from others with a common cough and cold.”

    Shockingly lousy practice.

    Singapore “leaders” need to learn from the good practices in other countries.

    In some country, based on travel history, the likely case will be sent a special ambulance to bring to a special hospital unit.

    No anyhow show up in a clinic, wait for hours and infect all the other patients and staff at the clinic.

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  • Audit TB stats:

    We need to investigate if stats on TB infections in SG is accurate, let’s put it that way.

    Any self-respecting doctor or nurse who is intellectually honest should understand what I mean.

    I wonder how many have latent TB infections in SG given our highly dense population. Any virus relatively easily enter a very Foreigner-Open country .

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  • DavidNeo&IreneVanessa:Bastards:

    Common cold and everybody panicked.

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  • Experience Outweighs Paper:

    Makes good sense. This way, the infected person will not passed the virus to other patients in the waiting area or doctor’s office, who are already sick and susceptible. In any case, the GP would likely send the suspect Wuhan patient to the hospital than to take chances. Once the med-hotline can narrow the call down to a possible infection of the Wuhan virus, the person can be sent directly to the hospital in an ambulance. He/she will save on GP’s consultation fee and taxi fare as the govt has prommised to take care of all local citizens infected by the virus. Dr Lee should be considered for the position of Health Minister! Haha!

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  • MobeyNoEnufSgs:

    On both CNY days my area was semi deserted but the nearby Singapore Pools outlets (theres 2 within walking distance, imagine that!), were packed with snaking lines till outside.
    Haha so there was where all the people were! Hahaha..

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  • MobeyNoEnufSgs:

    MobeyNoEnufSgs:
    On both CNY days my area was semi deserted but the nearby Singapore Pools outlets (theres 2 within walking distance, imagine that!), were packed with snaking lines till outside.
    Haha so there was where all the people were! Hahaha..

    Error ..title should be “MoneyNoEnufSgs”

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  • Lisa Mc Bong:

    GP laugh all the way to bank everyday.
    Today, they say Pai Tan ah!!!

    They are overcharging for just simple things like giving you a medicine for fever, cough or flu.

    Nurses should be paid to do these so that we no need to pay this kind of expense.

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  • Mobile App to Track Visitors:

    Mobile phones are ubiquitous. Quickly set up a mobile app to allow visitors as well as residents concerned to update their health status every 6 hourly.

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  • here is the truth:

    Lisa Mc Bong:
    GP laugh all the way to bank everyday.
    Today, they say Pai Tan ah!!!

    They are overcharging for just simple things like giving you a medicine for fever, cough or flu.

    Nurses should be paid to do these so that we no need to pay this kind of expense.

    this is from experience.

    rental is a high part of the cost.

    para medics can do all they can except when things go wrong. this is when the expensive consultation comes in. such diagnosis comes after many hours each day working in public hospitals as cheap labour under studying bullies and cocks and hens. this understudy process is ffffingly inefficient but no bully nor cock nor hen is ever in minister position to remove it.

    so the shockingly slave like training, long hours each day at cheap labour rates permeate every level of medic life until venture into private practice.

    then a large chunk goes toward clinic rental.

    look at it this way. common cough and cold get self prescribe unless something goes wrong. then self prescribe can be fatal if things really are wrong. medic basic education 5 years. after one year of cheap about internship, specialist training minimum 6 years thereafter, with additional exams for MMed and such post training.

    if ever anything is wrong in medical scene in pap Singapore, it is the backward training system and high rental caused by pap land cost inflation. go to JB. see how truly cheaper medic costs there.

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  • Dave:

    SOMEONE SAID ‘ DO NOT PANIC’. WE ARE WELL PREPARED. AT THIS TIME THEY WANT TO SCORE POLITICAL POINTS TOO BY GETTING THEIR ‘LOSERS’ TO DISTRIBUTE THE MASKS INSTEAD OF THE ELECTED MP OF THE WARD. REPEATING AGAIN AND AGAIN THE IMPACT AND EFFECTS IT WOULD HAVE ON THE ECONOMY WITHOUT ELABORATING FURTHER WHAT MEASURES THEY WOULD IMPLEMENT TO ALLEVIATE THE SITUATION.MOST PROBABLY TRYING TO TO TELL US THEY ARE RUNNING OUT MONEY FOR THIS SITUATION.

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  • Dave:

    THE SHOW HAS YET TO BEGIN WHEN THE CHINAMAN &CHINAWOMEN COME BACK FROM THE CNY HOLIDAYS FROM ALLOVER CHINA.THE PAPIGS HAVE NOW OPEN A GATEWAY TO HELL WITH THEIR RELENTLESS FLOODING OF THIRD WORLD IMMIGRANTS TO THE TUNE OF 2.2 MILLION IMMIGRANTS AS OF 2020 FEBRUARY. THE PAPIGS THIS TIME ROUND WILL ‘RUN ROAD’. YOU CAN COUNT ON IT AND BET ON THIS PROPHECY OF MINE.

    Bapak:
    Tomboy is passing a hint with maotai & alcohol to sanitize hands. Actually, she got the info drink alcohol (the higher the better) can kill that virus. But cannot so direct cause seems promoting drinking.

    Smokers also did not get SARS, but they cannot say cause seems like promoting smoking.

    OTOH, why small-space-can-make-love Jo so concerns about the 30,000 Chinese work pass holders cannot come back? Just fill these 30,000 jobs with Singaporeans, you idiot!

    Btw, 30,000 x 14 x $100 is how much? I failed my Maths. Why use SG taxpayers’ money, OUR hard-earned money to pay them?

    Sinkies70 you better wake up & kick the robbers out.

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  • Corona Fried Chicken Rice:

    Anybody know where the stall moved to? They used to be at Bras Basah.

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  • Good job PAP!:

    Hello guys! $100 per day up to 14 days will be given out to Wuhan virus patients warded. So dun worry, got money to receive! Nearly all of them are new citizens or PRs from China. They will be happy to be warded here than in China. If allowed, China would be most happy to send all patients to Puala Tekong and each get $100. This is a good opportunity for PAP to show remorse for the military vehicles case in HKG.

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  • So easy:

    Just paylah the doctors dedicated mobile number and the doctor will wechat or whats app video call you.so simple also dunno…MOH Study too much become gong kia izzit?

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  • listen to pap, die fastest:

    So easy:
    Just paylah the doctors dedicated mobile number and the doctor will wechat or whats app video call you.so simple also dunno…MOH Study too much become gong kia izzit?

    the pap gan kim yong is useless, more useless than the rest of the useless overpaid underworked pap folks.

    btw the pap folks S$m is not legitimate. it is given via a pap parleement via ownself justify ownself S$m system which in truth not a single pap folk is even worth median wage S$3,500 pm GROSS.

    in other words, pap has abused power to legalize stealing S$m under pap ownself pay ownself S$m system via a pliant pap parleement.

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  • Nfi pap pstbs:

    Trump used corruption to shield his own as reported in all US media except Fox which in parallelism akin to SIN media which have self destruct their own profession by breaking their own spines to bootlick n despicably compliant to the filth of the regime much alike to SIN PSTBs n both worsening by the sevonds.

    BerraChan is nothing but a fake. Only fakes have no confidence n capability but to resort to threatening n needing schieding by compliant bureaucrats in singlish terribly big harem of spinrse polanpas. He should be exterminated to show SIn is ready to accept real Singaporean talents and patroits to blossom n not subject to the filth n bloated garbage of pseudos, coward nfi SIN PSTNfiBs. US presidential privileges r no difference from absolute power self gratification n glorification aided by CBs or Hplpd to be above laws effectively translated to legalizing the lillegal eg conflict of interest in public institution appointment, defiance of cConstitution Selation of Power aka the Contempt of the judicial branch, afterall all covered by lCompliant bureaucracy, confirmed by no defence in a Court of Laws else reducing LKY, GCT n LHL as DH n men eating their BIG words aka bsing.

    The reference of to GP to identify the new coronavirus is definite evidence ohf the absolute stupidity in addition to the generally oft proven nfi of the Goon 4 of PAP. They effectively r worthy even a cent n what they r reaping now is nothing less thanTrUmp favourite pasttime akin to pap. Trump gets such a long tussel with demo but still stay aflot cos of pap akin republicans. stupid, arrogant nfi PSTBs in the same cesspool as SIN PaP pstBs.

    Time to get rid of these pstbnfiBs before SIN sink to the level of no return. Singaporeans, let get rid of them n blow their lies on their own face!

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  • REGIME CHANGE is the solution:

    Telelearning can make local education cheap and affordable for all Singaporeans. Exams can be taken (twice a term) on campus to confirm identity of students taking the exam.

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