ZIKA ERUPTS IN S’PORE: HOW WE MADE IT WORSE THAN IT MIGHT HAVE BEEN

‘Cover up!’ screamed the immediate reaction I noticed on social media. The Health ministry had just announced that they have found 41 cases of Zika infection, barely 24 hours after they said that there was one confirmed case (on Saturday 27 August 2016). How can the number jump so fast without them knowing about these other cases earlier — was the implication behind the shouting headlines. They must be hiding facts from the public!

The accusation is not fair. The bits and pieces of information released thus far indicate a somewhat flat-footed ministry, but not one that is consciously withholding important information from the public. It is not at all like the Transport ministry concealing for several years the fact that about 35 train sets had dangerous defects, and that 26 of them needed to be sent back to China for overhaul. Unfortunately, this is how impressions are formed. All it takes is for a few government departments to be caught redhanded for trust in government as a whole to suffer.

In this essay, I hope to show why I think the ministry was flat-footed. But in the course of examining the details, the practices of the construction industry come into view too, and with them come larger questions as to the cost to society that flows from our being too lenient, perhaps even supportive, of this industry’s labour practices.

The cost is going to be significant. Overnight, Singapore has become the Asia hotspot for Zika, with more reported cases than any neighbouring country barring perhaps Thailand. Travel advisories have been issued against us. No doubt we all knew that sooner or later Zika would arrive, but to arrive in this big-bang way, making headlines, was something that was entirely avoidable.

The timeline

Zika is not a new disease. Wikipedia has a timeline showing how the virus was first isolated in Uganda in 1947, and over the years appeared on and off in Pacific islands. On 29 April 2015, the first confirmed case was reported in Brazil. By the middle of the year, cases of microcephaly were giving cause for great concern, having been linked to Zika. Other neurological symptoms might also be related to this infection, but it’s still too early to be sure. In other words, it is not just a threat to unborn babies in pregnant women, but there could be longer-term effects we don’t yet know on adults who have been infected.

Perhaps because microcephaly was so attention-grabbing, and so much of the reporting centred on Brazil and its neighbours, most people might not have noticed a small article dated 30 January 2016 in the Straits Times. The report (Straits Times, 30 Jan 2016, Thailand has most Zika cases in region) said that between 2012 and 2014, there were seven Zika cases in Thailand in various provinces. The Philippines, Cambodia, Indonesia and Malaysia each have had one Zika-related case since 2010. The short report added that the World Health Organisation was of the view that the confirmed reports vastly under-represented the real situation. The disease was likely to have spread far more widely in South-east Asia than the number of confirmed cases suggested.

In other words, the disease was already endemic in our region — makes sense, since we’re not that far from the Pacific islands — except that we weren’t alert to it. That said, by July 2016, people were beginning to take notice. “Thailand wary as Zika cases soar close to 100” was the headline of a Nikkei story dated 5 July 2016.

By then, Singapore already had its first case. A male permanent resident, aged 48, went to see a doctor on 12 May 2016. He mentioned to the doctor that he had been in Sao Paolo, Brazil, five days earlier. He was quickly hospitalised and tested for Zika. The tests came back positive and he was transferred to the Communicable Diseases Centre at Tan Tock Seng Hospital. The Ministry of Health announced it on 13 May 2016. The patient recovered and no follow-on cases were found.

In early and mid-August 2016, three doctors at Sims Drive Medical Clinic noticed a spike in the number of patients complaining of fever, rash and joint pain. Yet, tests for dengue, chikungunya, measles and rubella came back negative. Today newspaper reported that “The possibility of them contracting Zika was not raised, as most of these patients — a bulk of whom are foreign workers who worked at a construction sites in the vicinity — had not travelled to countries with ongoing Zika outbreaks.”

Nonetheless, the doctors decided to inform the Ministry of Health on 22 August 2016 of what they had noticed.  It is not clear what the ministry did on receipt of this information, at least not in the immediate days that followed, though there are clues that they did little, as I will share with you below. No public announcement was made.

Five days later, on Saturday 27 August, the Ministry of Health and the National Environment Agency released the news that they had

“been informed of a case of Zika virus infection. The patient is a 47-year-old female Malaysian who resides at Block 102 Aljunied Crescent and works in Singapore. As she had not travelled to Zika-affected areas recently, she was likely to have been infected in Singapore.”

The Straits Times reported (28 August 2016, Aljunied woman is first case of local Zika infection) that “She started to have a rash, fever and conjunctivitis on Thursday and saw a doctor on Friday before being sent to the Communicable Diseases Centre at Tan Tock Seng Hospital.” It is not clear which GP or clinic she went to. Upon admission to the CDC, the diagnosis was confirmed.

By around Sunday night, the ministry announced that they had identified a total of 41 cases (including the Malaysian woman). It said in its press release early on 29 August 2016 that it had “confirmed 41 cases of locally transmitted Zika virus infection in Singapore. Of these cases, 36 were identified through active testing of potentially infected persons.”

This, alas, is where the gobbledegook begins, giving people reason to accuse them of being parsimonious with the truth.

Meaning-deficient sentences and gap-ridden statements

Click on the link below to read more. 

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