Something shocking just happened in Singapore. There has been an outbreak of hepatitis C at a renal ward at SGH. 22 patients have been infected and 4 have died. The affected renal ward treated a total of 678 patients from January to June this year. Minister for Health Gan Kim Yong said: “I am gravely concerned and disappointed with the occurrence of the cluster of Hepatitis C cases in SGH. My thoughts are with the affected patients and families.”
I believe that like the rest of us, Mr Gan just found out about this disaster on Tuesday. Otherwise, it must have been very tiring being “gravely concerned” and “disappointed” for months. Seems like the health minister’s seat is not more comfortable than that of the transport minister.
At the moment, the prime suspect for this outbreak is the multi-dose vial. For the uninitiated, the cost-conscious hospital shared a bigger and more economical dose between patients. This is of course reasonable as long as common sense and protocols are followed. A new needle goes into the vial to draw out the dose required. The hospital changes to a fresh needle to inject the patient. Even if the same needle were used on the patient and subsequently thrown away, the original vial would not have been contaminated. Apparently, this practice is very common and no problems were encountered. The hospital has now switched to using single dose vials. Frankly, I’m not reassured as the multi-dose vial is probably not the cause. A hair-raising question comes to mind. 273 doctors and nurses have been involved in treating the renal patients. Could it be intentional sabotage, perhaps by a mentally ill healthcare worker or someone seeking revenge? We may get the answers soon; if not from lab tests, then perhaps CCTV recordings.
The response from the public is surprisingly muted. We see a few expressing their fears and concerns on social media. Only a few bloggers mentioned it. There were even some voices that played apologist, saying that the reputation of the hospital should not suffer just because of the negligence of a few. Quite strangely, I saw a lot more fury directed at Anton Casey when he complained about the stench of public transport. In fact, there was even more fury directed at malfunctioning trains and Mr Lui Tuck Yew who could have retained his seat judging from the results of GE2015. All that zest, gumption and grouchiness from netizens seem to have died down after GE2015. Have people become more understanding towards overworked healthcare workers? Or are they not concerned because unlike public transport, they think that things that happen in renal wards won’t affect them? Until investigations have concluded, we can’t really put the blame on the people directly involved. But what about the administrators? What stares us in the face is the surprising time lapse between discovery of the outbreak and the announcement. Have they withheld information from the public for a longer period of time than what is acceptable? Let’s take a look at the timeline for the hepatitis C outbreak at SGH provided by Today newsPAPer:
April 17 to May 14: Five cases of Hepatitis C infections detected
May 15: SGH conducted internal investigations on dialysis centre
May 25 to 27: 6th and 7th cases detected
May 29: Dialysis centre cleared as potential source of infection
May 30: 8th case detected
June 2: Infection control team activated; 9th case detected
June 10: Renal ward stop using multi-dose vials
June 11 to 16: 10th, 11th, 12th, 13th and 14th cases detected
My own addition from other sources: The 21st case surfaced on Aug 11, more than a month before the 22nd case on Sept 18.
This information was made known to the public on Tuesday 6th Oct 2015. The minister just found out about it and is “gravely concerned”.
At a press conference on Tuesday, SGH chief executive officer Ang Chong Lye was asked about the delay in making public the outbreak. Ang said that the hospital started investigating a possible outbreak in early June and informed the Ministry of Health (MOH) in late-August. However, the timeline says that investigations commenced in May.
Further explanation for the delay in informing the public was made on Thursday. A spokesman from SGH said that “public not told earlier as there were no signs of acute hepatitis C cases”. Yao mo gao chor ah? Let’s take a look at the timeline again. Where do we insert the cases first showing signs of acute hepatitis? Where do we insert the 4 patients who had already died? I can’t find this information anywhere. Obviously they couldn’t have died just a day before this disaster was made known to the public. They must have been falling ill and dying long before 6th October when a public statement was first made. Never mind that there were no cases of acute hepatitis after the first few infections were discovered. The unacceptable fact is that the announcement was only made after the 4th death.
Most people agree that the latest acceptable time to announce the disaster was August 2015. And conspiracy theorists on social media are quick to suggest that it may have something to do with GE2015. We can never prove anything, but suffice to say that if this matter came to light in late August or early September, the lapses in AHPETC town council accounts would not have made it to the headlines even in our local newsPAPers.