It was all over the news and on the front pages of the newspapers yesterday (7 Oct).
Four deaths at the Singapore General Hospital earlier this year were found to be linked to the Hepatitis C renal viral infection, with a total of 22 (including them) being infected with it.
Here are five observations that show the SGH-Hep C spread may be the first comms crisis for the government after General Election:
1. The Ministry of Health convened an independent Review Committee on this.
When were the last few times an independent committee was appointed by the government?
There was a Committee of Inquiry (COI) appointed by Deputy Prime Minister Teo Chee Hean on December 2013 to examine the cause(s) of the Little India Riot which occurred on the night of December 8, 2013.
There was also a COI that looked into the December 2011 twin North-South Line MRT disruptions.
While this is not a COI, the Hep C incidents must have struck the government as a matter of sufficiently huge concern to do this.
2. The CEO of the organisation involved has apologised, with the Health Minister "gravely concerned and disappointed".
This was what Prof Ang Chong Lye, Chief Executive Officer, SGH, said,
"We would like to apologise unreservedly for the grief, pain and anguish this has caused our patients and their families...
Patient safety is non-negotiable. What happens to our patients is always our responsibility. We will spare no effort in reviewing our processes and examining all possible sources of infection to prevent recurrence. We have been in touch with affected patients and their families.”
In'>
early June 2015, we noted an increased frequency of newly-diagnosed hepatitis C virus infections in a renal ward. A...
In a statement released by former NCMP Gerald Giam, WP questioned the "delay in Hep C outbreak announcement" and sought clarification from the Minister with regard to the standard protocol in releasing information on such outbreaks, whether or not they occur within a treatment facility.
These are the two main questions WP posed to MOH:
a) Is there a time frame within which healthcare institutions must report such incidents to the ministry?
b) What does the ministry believe is a permissible interval of time before the public is made aware of such incidents?
A statement shared by Singapore Democratic Party leader Chee Soon Juan echoes this, questioning the ministry over and above the hospital:
[Media'>
Release] ...This is because individuals who may have been recently infected with the virus and incubating it...
a) The fact that even if the MOH was only informed in August that the deaths of the patients were suspected to be linked to the Hep C virus, it would have been aware of the first outbreak in April — yet the public wasn't informed of this.
b) SGH's infection control reviews were conducted from as early as June this year. Because the public wasn't alerted to the outbreak, the safety of patients and the hospital's blood supply could have been compromised, especially for vulnerable patients who passed through the wards and renal treatments. Worse, people who were infected with it could have gone on to donate blood without realising they were incubating it — an extremely serious situation.
When MOH revealed the incidents on Oct 7 during the press conference, it did not provide the detailed timeline of events related to SGH cases. However, it should have anticipated the public interest on the matter, since many Singaporeans would be wondering why there was nearly two months delay in the announcement.
Late August: SGH reported to MOH it had identified a cluster of 21 hepatitis C cases and suspected that they were linked.
September 4: An MOH team led by Daphne Khoo, Group Director, Healthcare Performance Group, MOH, visited the renal ward (Ward 64A and 67) for a process walk through with SGH.
September 7: External verification of SGH’s phylogenetic analysis by an A*STAR laboratory was completed and confirmed SGH’s initial findings that the 21 cases were related.
September 9: SGH commenced Hepatitis C screening for all doctors and nurses involved in the direct care of the affected patients. 76 staff members have been screened. All were found to be negative for Hepatitis C on September 25.
September 18: Health Minister Gan Kim Yong was informed. He requested for a briefing from SGH, who asked for more time to complete their investigation and have the briefing take place on September 25.
September 21: MOH was notified of the 22nd case.
September 24: SGH’s report was submitted to MOH.
September 25: A briefing to the Minister was conducted. Minister Gan instructed that an independent review committee be set up, and for SGH to make public its preliminary findings. MOH and SGH made preparations to appoint the independent review committee and prepare for a media briefing.
September 28: The members of the Review Committee were appointed.
October 6: SGH conducted its media briefing. MOH released a press statement on the appointment of the independent MOH Review Committee.
From the timeline, it appears that MOH was informed by SGH about the Hep C cases in "late August" (When is late August?"). But Minister Gan was only informed on September 18.
5. The incident was covered by several news sites overseas, with many expressing surprise over the incident.
On Sep.16, 1955, the late Lee Kuan Yew told the Foreign Correspondents Association:
“I have no headline material to offer you tonight. In fact, I believe that the art of Government is, in part, the art of not creating headlines in the world press.”
This time, Singapore is in the news for the wrong reasons.
You can almost feel the sense of surprise from some of the news sites. They highlighted how SGH is a top and prestigious hospital, with Singapore's healthcare system rated among the best in the world.
The Associated Press — "A top public hospital in Singapore said Tuesday that four of its patients died after a new renal ward was hit by an outbreak of hepatitis C, likely from intravenous treatment. The Singapore General Hospital apologized "unreservedly" for the deaths, a startling and rare tragedy for a nation that prides itself on its efficiency and high-quality health care...The country's founding leader, Lee Kuan Yew, who died earlier this year, spent his last days on life support in its intensive care unit."
The Malay Mail — "The medical fraternity was shocked by news of the hepatitis C outbreak in Singapore General Hospital (SGH), given that hospitals here have established robust systems for handling medical equipment".
Agence France-Presse — "Singapore's largest hospital apologised Tuesday after 22 kidney patients were infected with hepatitis C, with four dying in a rare outbreak at the prestigious facility...Singapore's health care system has been rated among the best in Asia and government hospitals are well-funded."
As the article noted, "patients from around the world fly to Singapore for treatment at SGH and other hospitals".
Let's hope the findings by the independent MOH Review Committee can rebuild the confidence Singaporeans and foreigners have of Singapore's healthcare system.
October 08, 04:29 PM 
514 Chai Chee Lane 03-16, Singapore 469029 
