Doctor criticises MOH for discharging an infectious COVID-19 CECA patient prematurely from hospital, causing new cluster

tanahgu

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not their responsiblility
anything just arrow to expert
 

Phoooey

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Medical doctor Lim Boon Hee wrote in Straits Times Forum today criticising the Ministry of Health (MOH) for making mistakes in relying only on viral load and serology test to allow an infected COVID-19 patient be discharged from hospital prematurely (‘Forum: Don’t rely on viral load and serology test alone‘, 23 Apr).

“It takes only one positive Covid-19 case to start another wave of community infections if we let our guard down,” Dr Lim cautioned.

“I am referring to the imported case who was probably reinfected in India, infectious on return to Singapore and released into the community as he was deemed to be no longer infectious. Unfortunately he was, and thus infected two others, starting a new cluster.”

“Any person with a positive PCR, or polymerase chain reaction, swab must be assumed to be infectious and immediately isolated”, Dr Lim added.

Dr Lim was referring to a 43 year-old Indian expat on Work Pass who arrived in Singapore from India on 2 Apr and was tested positive for COVID-19 on arrival. His serology test result also came back positive suggesting that it was an old infection (‘Expat from India discharged from hospital as recovered COVID case, who later goes on to infect 2 others‘).

The authorities then deemed that the Indian expat was a recovered case based on his high Ct value indicating a low viral load. They discharged him from the hospital on 6 Apr, as he was deemed to have been shedding only minute fragments of the virus RNA, which were no longer transmissible to others.

But 10 and 12 days later, his sister-in-law and her husband who are staying together with him, were infected. In fact, just yesterday (22 Apr), it was reported that his nephew, an 11 year-old Indian national on Student’s Pass also staying with them, is the latest victim. He is a student at Dimensions International College.

After his sister-in-law was tested positive, the Indian expat was re-tested which showed that his COVID-19 viral load has increased and that his Ct value was lower than that of his earlier test. This suggests that he was exposed to a new infection which boosted his antibody levels.

Later, MOH said that the Indian expat was “probably re-infected when he was in India, and had been infectious when he returned to Singapore”.

Dr Lim commented, “The doctors who deemed him as non-infectious were probably misled by two red herrings – the low viral load, and the positive serology test, which tests for antibodies to the virus. They probably concluded the very low viral load meant he was recovering from infection.”

“But a low viral load can equally mean an early acute infection before the virus replicates,” Dr Lim explained.

“In the current situation of multiple variants of the virus, positive serology, or having antibodies to the virus, just means the patient was infected before and does not rule out a new acute infection. It could very well still be a sub-acute case and the patient could still be infectious, as this case has shown.”

Dr Lim added that relying on the viral load and positive serology test to release imported Covid-19 patients is unwise. He advised that all tested positive for Covid-19 upon entering Singapore be treated as people with acute infection, and be quarantined appropriately until proven otherwise.

“We cannot afford to have another reinfected case starting a new wave of Covid-19 in our community,” he said.

Wow, after the lawyers, the academics and now even the doctors are coming out publicly to criticise this Pinky government and his incompetent 4G leaders.

Even the intellectuals in Singapore today are tired of the government’s high horse, complacent and condescending attitudes.

Always blaming Singaporeans as xenophobic and recently racist when the root cause of the problems today are their own incompetence.
 

Yua Mikami

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same as the taiwan case they released the airline staff early then booom
 

Ohayo!

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just say no evidence, and sweep under the carpet

the gates must remain open!
 

HYHY123

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Na bei keep asking us to not let our guards down but who keep making mistakes
 

treeskull

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Everybody knows it's the CECAs that caused the P2HA
 

betking

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who the health ministar ... xia tai
 

Renzokukenz

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is it referencing to this case?

Case 61536 is Case 62045’s brother-in-law, and had been identified as a household contact of Cases 62045 and 62143. He arrived from India on 2 April, and was asymptomatic. His on-arrival swab was positive for COVID-19 infection and he was conveyed to a hospital. He was subsequently assessed to be a recovered case based on his high Ct value which indicated a low viral load, positive serology test result on 4 April, as well as negative pre-departure test taken on 31 March. He was discharged from the hospital on 6 April, without the need for further isolation as he was deemed to have been shedding minute fragments of the virus RNA, which were no longer transmissible and infective to others.​
On 17 April, as he had been identified as a close contact of Case 62045, he was tested for COVID-19 and his test result came back positive. His serology test result is also positive. The Ct value of his polymerase chain reaction (PCR) test taken on 17 April was lower than his test done on 2 April, indicating a higher viral load this time. His antibody titres are also currently very high, suggesting that he was exposed to a new infection which boosted his antibody levels. MOH, in consultation with an expert panel which comprises infectious diseases and microbiology experts, has assessed that he was likely to have been re-infected with COVID-19 recently. Our epidemiological investigations indicate that Case 61536 was probably re-infected when he was in India, and had been infectious when he returned to Singapore. He then passed the infection to Cases 62045 and 62143.​
With the emergence of new variants of concern around the world, we will closely monitor for re-infection of recovered COVID-19 cases, and are reviewing our border measures for recovered travellers. Similar imported cases suspected of re-infection will be isolated and undergo repeat COVID-19 PCR tests to monitor the trend of their viral loads, to ensure that such cases are detected promptly.​
 

tan kuku

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this loctor really woo ji dare to go against the establishment.
 
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