H1N1 outbreak: time for a strategy reboot

Eighty-nine more cases of novel H1N1 infections were registered today, bringing our national total up to 454. This puts us at number 17 in the world with regards to countries with confirmed cases. There are no deaths in Singapore from this infection as yet, but this is a question of "when" rather than "if" at this point in time.

Trying to get to the MOH website this evening will land one onto "http://www.h1n1.gov.sg/homepage.htm" which is a rather ironic address. The table is a couple of days out of date, and there is a list of countries for which a H1N1 travel advisory has been issued. One is just about as likely to be infected in Singapore as in the majority of these other countries, therefore a travel advisory no longer makes much sense.

Looking at various reports in both the traditional as well as the new media, one gets the sense that the healthcare system is starting to be overwhelmed by the worried well and the mildly ill cases. There now appears to be a considerable backlog in terms of epidemiologic tracing, and hospital emergency department facilities appear to be barely coping at times. Patients are being charged for the influenza A(H1N1) testing, and for the delays in testing, which has rightly been perceived as being unfair.

Moving forward, we should seriously consider doing what Japan (click on the video link on this Channelnewsasia site, just bear with the advert), Australia and US have done:

1. Keep the hospitals (and emergency departments) free for the serious cases (and accept that there will be such cases as well as deaths despite the best treatment) and patients with other diseases requiring hospitalization.
2. Patients with mild flu-like symptoms and who do not require an MC for work or school (employers and schools should also be more flexible and understanding during this pandemic situation) should stay home rather than go to a GP/polyclinic/hospital.
3. Others should go to a primary healthcare clinic, preferably one of the "Pandemic Preparedness Clinics" should these get activated.

Buckle down for the long term - and otherwise let life proceed as normally as possible. Else we will pay a much higher price in financial terms and collateral damage than if we had just let the virus run rampant through the community from day 1.