The Ministry of Health (MOH) reported a new development on Feb. 6, concerning two new confirmed cases of the novel coronavirus (nCoV).

Both patients had no record of recent travel history to mainland China.

How did Patient 29 contract the virus?

The authorities were able to ascertain that Patient 30, a 27-year-old male Singaporean attended a private business meeting at Grand Hyatt Singapore.

This meeting, attended by Chinese nationals, was previously linked to other cases of nCoV.

However, Patient 29, a 41-year-old male Singaporean, was not at the Grand Hyatt Singapore, according to MOH.

Nor did he appear to have any immediate links to any of the previous existing cases.

So how did he contract the virus?

Two possibilities

MOH said of Patient 29:

"Epidemiological investigations and contact tracing are ongoing to identify individuals who had close contact with the case, and to establish any link he may have had with confirmed cases in Singapore or travellers from mainland China.

We are interviewing the patient and his close contacts, and investigating the locations he had recently been to."

There exist two possibilities.

The first is that Patient 29 did have close contact with any of the previous confirmed cases in Singapore, or travellers from mainland China, but this information has yet to be discovered or confirmed.

The second, in a worst case scenario, is that it may mark the beginning of a community spread, in which the source of the infection is unknown.

Previous Lavender cluster is not widespread community transmission, as source of infection is known

Previously, with regards to the Lavender cluster of cases, MOH's Chief Health Scientist Tan Chorh Chuan said that it was not an example of widespread community transmission.

This was due to MOH's ability to identify the source of the infection and establish a clear chain of transmission among those affected, allowing the authorities to contain it.

Patient 29's movements

Patient 29 reported that he had developed a fever on Jan. 28, and visited a general practitioner (GP) clinic the next day.

He sought treatment at another GP clinic on Jan. 30, before being admitted to Mount Elizabeth Novena Hospital (MEN) on Feb. 3.

Patient 29 was admitted to MEN on Feb. 3. Test results confirmed an infection of the coronavirus on Feb. 5 at about 11:00pm.

He was transferred to the National Centre for Infectious Diseases (NCID) for further treatment and is currently warded in an isolation room.

Prepare for the possibility of new infection clusters within community

MOH stated:

"His case was confirmed late last night and contact tracing is still in progress, with focus on identifying any links it may have with past cases or travellers from China. We will provide further updates tomorrow as the investigations progress."

MOH added:

"Thus far all our previously announced confirmed cases have been either PRC travellers from Hubei, or individuals with links to PRC travellers. All such cases have been isolated and ring-fenced.

But we must be prepared for the possibility of new infection clusters involving locals within the community, not linked with recent travel to China or contact with recent PRC travellers."

MOH added that this has already happened in a number of places outside mainland China, and precautionary measures have already been stepped up to reduce the risk of community spread.

MOH is ready to further ramp up the measures once the ongoing investigations provide more information.