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A Home Recovery Programme (HRP) will be implemented for eligible monkeypox cases in Singapore from Aug. 22, 2022.

This was announced by the Ministry of Health on Aug. 19.

Currently, all confirmed cases recover at a Monkeypox Isolation Facility (MIF) with telemedicine support, if they are assessed by public hospitals to be clinically stable.

From Aug. 22, however, those who are clinically stable and have a suitable place of residence are allowed to self-isolate at home.

To do so, the following conditions by MOH have to be fulfilled:

• The case can self-isolate in a bedroom with an attached bathroom, and there is an additional bathroom for other household members’ use.
• None of the other household members are:

  • (i) pregnant;
  • (ii) children aged below 12 years;
  • (iii) seniors aged 80 years and above;
  • (iv) individuals who are undergoing dialysis, immunocompromised or on immunosuppressants; or
  • (vi) individuals at higher risk of being infected (e.g. with caregiving needs).

• There are no pets at home.

  • This is to avoid any animal-to-human transmission, which may occur when an animal contracts monkeypox from an infected person and then spreads it through bites or scratches. It can also spread through direct contact with skin, mucosa, blood, and bodily fluids, MOH said.

Cases that are not eligible for home recovery can continue to recover at the isolation facility, while cases with higher risk of complications will continue to be managed in hospitals.

In any case, all confirmed cases will be issued with an Isolation Order and are required under the Infectious Diseases Act to remain isolated until they are medically assessed to be non-infectious.

What happens during home recovery programme

Cases on HRP will receive regular telemedical consultations to assess their state of recovery.

If necessary, they will be conveyed to the National Centre for Infectious Diseases (NCID) for additional reviews.

Patients can also call a dedicated MOH hotline if they require any assistance during the period of recovery.

If they experience any shortness of breath, chest pains, severe headaches, stiff neck, changes in mental state (e.g. mood, behaviour), or unusual symptoms with their nerves (e.g. numbness, weakness, changes in speech or vision, abnormal movement of the arms or legs), they should call 995 immediately and inform the operator that they are monkeypox patients.

At the end of the isolation period, patients will be conveyed to NCID to undergo a discharge review.

Those who have fully recovered can then exit isolation.

Otherwise, they will continue to be isolated until the next appointed discharge review.

Suspect cases may also isolate at home, instead of hospitals

In line with the shift to home recovery, suspect monkeypox cases (who are clinically well) will no longer be required to isolate in the hospital while awaiting their test results.

Instead, they may do so at home, if they are able to.

Those who are unable to self-isolate in their home will be isolated at an isolation facility while awaiting their test results.

Suspect cases who require admission for clinical care will continue to be managed in hospitals.

What is monkeypox?

According to MOH, monkeypox is a viral disease caused by the monkeypox virus (MPV).

Monkeypox is typically a self-limiting illness (an illness that goes away on its own) that presents with fever and rash.

However, serious complications or death can occur in some individuals.

Local and international data continue to show that majority of patients recover within two to four weeks without requiring hospitalisation, MOH added.

As the transmission of monkeypox requires close physical or prolonged contact, including face-to-face and skin-to-skin contact such as sexual contact, the risk to the general public remains low.

As of Aug. 18, 2022, there are 15 monkeypox cases in Singapore.

Top photo via NIAID/Flickr, Aliff Haikal/Unsplash