Singapore, Oct 07: Questions on the efficacy of Singapore’s biomedical safety controls have come into focus as Round Two of the outbreak of Sars in Singapore came to a generally innocuous close on Tuesday with the discharge of the researcher who was diagnosed with the disease two weeks ago.
The 27-year-old post-doctoral virology student, who is believed to have been infected with the virus while working in the microbiology laboratory of the National University of Singapore, will be on home quarantine for two more weeks. Although he was only working on another virus (the mosquito-borne West Nile Virus not related to Sars), it is in this laboratory that live samples of the Sars virus are kept for research. The Sars scare was back to haunt Singapore on September 8, just three days after proud proclamations that researchers in the island nation have developed the world`s fastest Severe Acute Respiratory Syndrome test kit, the Sars scar is back to haunt Singapore again. Nonetheless, the rapid test kit and another locally developed ELISA (Enzyme-Linked Immunosorbent Assay) test were not used on the student. The kits were jointly developed by Genelabs Diagnostics and the Institute of Molecular and Cell Biology, a premier biomedical science research institute in Singapore. While the openness of Singapore in quickly alerting the world to the new Sars case came in for global praise, the Ministry of Health was not forthcoming on why the test kit was not used on the patient. Perhaps the initial silence was just an attempt to avoid yet another piece of negativity, given that Singapore had to contend with the unsavoury reputation of being the first in the world to bring Sars back in focus after a near four-month lull.
Given that the antibody-based tests are claimed to have been developed using samples from probable Sars patients and followed controls that fulfilled the criteria set by WHO, this could have been a good test-bed. As they are still not tried-and-tested products, it was probably thought fit to go with the WHO-recommended polymerase chain reaction (PCR) and serology tests than the new kits. "Not so," says Dr Guan Ming, product development manager of Genelabs, adding they were developed fully conforming to WHO standards.
"It is perhaps a question of timing. Our development and the new Sars case occurred almost simultaneously. This could have prevented the use of our kits in this case," Dr Ming told this writer. He said large-scale clinical evaluations of the two tests were being conducted in Hong Kong and China. With its clean and green pollution-free environment, Singapore was by all means an unlikely candidate for the Sars scar. While, like the economic crisis faced by the country in recent years, the first outbreak of Sars was also triggered by external factors this time it is of its own making - coming as it does from its research facility though not from the community.
Due credit nonetheless must go to the government as Singapore`s Minister of Health Dr Balaji Sadasivam was quick to admit that the laboratory may have been the source for the infection, although the National Environmental Agency (NEA) thought there was only some coincidental link.
While the second round of Sars has wound up with no damage done to the community at large as there was no human-to-human transmission, it is not curtains yet for the disease as it is feared winter is when it could strike in full force. The resurrection of Sars has also sparked such fears that China has already evolved plans to pump billions into Sars research to keep the virus at bay.
But light-hearted humour was to the fore even when Singapore was at the height of the Sars crisis in summer this year. Everything from a sari to Sarsi (a local soft drink) was then brought into linguistic play by joke mongers for some alliterative humour. Hong Kong was not spared too as it even has the ominous abbreviation of SAR (Special Administration Region) appended to its name, prompting a friend to say with a tinge of SARcasm that Sars was the result of a political curse inherited from China.
The Hong Kong aside apart, even as the Singapore establishment was busy building various lines of defence against Sars, leading to the country being declared Sars-free by the World Health Organization the first time round on May 30, Singaporeans have been laughing away the blues dabbling in shopping and circulating jokes through emails, SMS (short message service) and online forums, probably giving credence to the maxim that laughter is the best medicine!
But Sars, a new form of atypical pneumonia that affects the lungs, can in its advanced stage leave you gasping for breath. The virus has been identified (corona virus associated with the normal flu) and the World Health Organization (WHO) is spearheading efforts to develop a vaccine and combat Sars.
There are claims from some manufacturers (one such is Berna Biotech) about having developed a prototype vaccine against the Sars pneumonia virus, but it may take time before its foolproof efficacy is established.
Sars has killed more than 800 people around the world since it originated in southern China towards the end of last year and spread to more than 30 countries, including Canada.
It was first imported into Singapore by a young woman who went on a holiday to Hong Kong with some friends and returned with the highly contagious virus, only to spread it to her near and dear. Branded the "Super-Infector", she survived the ordeal but tragically lost her parents who contracted Sars from her. Even the pastor who visited them to pray for their recovery fell victim to Sars, which claimed the lives of 33 people in Singapore, including a few prominent doctors and health personnel.
Businesses were hit across the board as tourism took a sound beating. Airlines and hotels were the worst hit as corporate travel to Sars-hit countries ground to a halt and passenger traffic in general suffered a precipitous drop.
Singapore, after all, can get real tough when the situation warrants it. Even Webcams were installed at the homes of those kept in quarantine to monitor their movement. Such measures, including a S$10,000 fine for those violating home quarantine orders, were dubbed draconian by Canada, a country that saw Sars rage through the country, presumably because of its lenient measures.
Some people even ended up in court, paying fines ranging from S$300 to S$500 for spitting in public. With fines in place for many such actions, there is even this enduring joke about Singapore being a "fine" city. While the new development in Singapore is unlikely to provide the underpinning for stringent anti-Sars measures to kick in again, caution will reign given that winter is looming.