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

gerrychua

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I think all are trying their best. It's the decision maker that should be answerable.

An example.
A child has slight fever. Doctor A says take medications and rest one day. Dr B says just rest and drink water and rest three days. Both have their points.

Kiasu parents will tell the child to take medications and rest three days.

Some (ahem) will tell the child to rest, drink water and rest one day.

In both scenarios, parents followed the doctor's advice but both might have very different outcomes.
MOH treat COVID like the slight fever...
 

Philipkee

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MOH treat COVID like the slight fever...
Another example would be
Healthy don't wear mask but please control borders
Healthy still wear masks cos borders still open

Advice taken? Healthy don't wear mask but leave borders open....

Btw, that is why I think minister for health should be a doctor. At least at this time. People take instructions from the top.

That might be a reason why SAF has no real outbreaks so far. Cos minister for defence is a a doctor.
 

rachdanon

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Good reminder that the rules and guidelines are set by the same experts that define what is safe, what is better, what is considered evidence what is not, for this disease that the world is still learning about, and many take it as gospel truth.
 

rilo

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MOH very screwed up. It's like that time they release the maid from quarantine.
 

wwenze

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Tell the doctor to relax coz his colleague Dr Fisher said it's safe.
 

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.
So this doctor's professional advice to keep the infectious isolated from the community is totally ignored now with the home recovery scheme.

How many clusters will arise from this reckless home recovery route?
 

Wilberttt

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So this doctor's professional advice to keep the infectious isolated from the community is totally ignored now with the home recovery scheme.

How many clusters will arise from this reckless home recovery route?

Economic progress supercedes lives of vulnerable Singaporeans.
 

heughoghap

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Knn if this is the reason for the spike, then moh really ownself pwned ownself !
 

100Yen

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Already endemic. He talk about this for what? We not tracing actively anymore

We have 1000 cases now outside spreading the virus
 

swageat

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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.



No local evidence that prematurely releasing covid 19 postive patient can result in massive clusters

Just Helping task force Kenneth mak's behalf to say
 

Laneige

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They always want to use what shedding of virus fragments
Don’t know they accurate or not
 

trento

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Positive is positive. Negative is negative. What's so hard to understand?
 
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