# ent

id: cord-007026-ejv0gidp
type: TAXON
entity:
  virus parainfluenza 1 4 virus respiratory syncytial virus metapneumovirus rhinovirus enterovirus human coronavirus OC43 and 229E NL63 adenovirus


id: cord-021673-vs4famsa
type: ORG
entity:
  the National Arts Council 2 National Heritage Board 1 Singapore Tourism Board 1 Singapore Sports Council


id: cord-022234-jjaqlyo5
type: ORG
entity:
  A Comparative Assessment of Three Southeast Asian Tourism Recovery Campaigns Singapore Roars Post SARS 2003


id: cord-023140-ytal7wog
type: ORG
entity:
  The Cornell Hotel and Restaurant Administration At Risk Natural Hazards People s Vulnerability and Disasters Tourism


id: cord-178791-cywjp5jh
type: WORK_OF_ART
entity:
  A Novel Top k Strategy for Influence Maximization in Complex Networks with Community Structure Maximizing the Spread of Influence via


id: cord-027047-xlz576hm
type: ORG
entity:
  Dubai s Forgotten Urban Spaces The Anti Politics Machine Development The Bare Life Labour Productivity


id: cord-254288-duukt2wh
type: ORG
entity:
  COVID 19 control Manual for the Depression Anxiety Stress Scales Ebola and Psychological Stress of Health Care Professionals Living


id: cord-256163-62cc135r
type: ORG
entity:
  South China Morning Post Newspaper United Nation International Telecommunication Union Report Information Service Department


id: cord-320945-swr3l0ur
type: WORK_OF_ART
entity:
  Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations A Letter Report Reducing


id: cord-294628-ecg13s7a
type: PROTEIN
entity:
  20Individualist 20societies 20people 20are and 20their 20direct 20family 20only text Singapore 2C 20with 20a 20score 20of


id: cord-294628-ecg13s7a
type: ORG
entity:
  Singapore Ministry of Health COVID 19 Situation Report Reorganisation of Healthcare System Into Three Integrated Clusters


id: cord-290305-8u2zxsam
type: ORG
entity:
  the Australian National Hand Hygiene Initiative National Program for Prevention of Healthcare Associated Infections and Antimicrobial Resistance


id: cord-321754-sy3ncwgw
type: ORG
entity:
  Healthcare Branch Ministry of Defence Singapore 6 Department of Psychological Medicine National University Hospital Singapore Authors


id: cord-272526-2fgtjouu
type: FAC
entity:
  Holland Village Building a Competitive Pearl River Delta Region Cooperation Coordination and Planning


id: cord-292767-xazsbhbw
type: PROTEIN
entity:
  SIN05 22 46 79 86 150 167 218 243 250 258 263 268 275 290 325 328 371 374 427 441 and 500 with 100 sequence


id: cord-321704-jozrgcq3
type: DISEASE
entity:
  Coronavirus HKU1 CoV HKU1 Parainfluenza 1 hPIV 1 hPIV 2 hPIV 4 Influenza A H1N1 the prepandemic strain respiratory syncytial virus A RSV A RSV B CoV


id: cord-328501-mbwgi56x
type: TAXON
entity:
  Mycoplasma pneumoniae Chlamydophila pneumoniae Legionella pneumomophila Streptococcus pneumoniae Neisseria meningitides


id: cord-328501-mbwgi56x
type: ORG
entity:
  Patterns of Illness in Rhinovirus Infections of Military Personnel Relationship of Rhinovirus Infection


id: cord-328501-mbwgi56x
type: DISEASE
entity:
  influenza A H1N1 pdm09 AOR 1 50 95 CI 1 04 2 15 and coxsackie echovirus AOR 1 67 95 CI 1 19 2 36 mono infection


id: cord-328501-mbwgi56x
type: DISEASE
entity:
  influenza A H1N1 pdm09 which was found to be significantly protective was accounted for in the multivariate model Personnel in the recruit camp were


id: cord-322802-id9jg6v4
type: ORG
entity:
  the Implementation of the Framework Convention on Tobacco Control Asia the Pacific Studies World Health Organization Global Health Observatory GHO Data Overweight


id: cord-326574-ke0iktly
type: LAW
entity:
  Countries Using Operational and Technology Innovation to Overcome Funding Deficiencies Clinical Features


id: cord-326574-ke0iktly
type: WORK_OF_ART
entity:
  Google Trends in Infodemiology and Infoveillance Methodology Framework Annual Research Review Ecological


id: cord-326574-ke0iktly
type: ORG
entity:
  Cognitive Processing Therapy for Posttraumatic Stress Disorder via Telehealth Practical Considerations


id: cord-330464-j4o7m9ck
type: GGP
entity:
  Singapore 8 3 On 7 February 2020 as cases of COVID 19 continued to rise and cases of with no prior travel history or traceable link to prior cases were discovered the Disease 5 Outbreak Response System Condition DORSCON alert level was raised from yellow to 6 orange signifying more severe disease and easier community transmission 9 The DORSCON 7


id: cord-339973-kj56zi59
type: ORG
entity:
  The MetaSUB International Consortium The Metagenomics and Metadesign of the Subways and Urban Biomes MetaSUB International Consortium


id: cord-340138-u8hxyfml
type: WORK_OF_ART
entity:
  The Role of Dentists in COVID 19 Is Beyond Dentistry Voluntary Medical Engagements and Future Preparedness


id: cord-296226-ugeupo3u
type: WORK_OF_ART
entity:
  the WHO Strategic Technical Advisory Group on Neglected Tropical Diseases and Strategic Advisory Group of Experts Working Group for Dengvaxia


id: cord-296226-ugeupo3u
type: ORG
entity:
  the World Health Organization World Health Organization Global Vector Control Response World Health Organization Framework


id: cord-296226-ugeupo3u
type: ORG
entity:
  Ministry of National Development Centre for Liveable Cities Singapore Sustainable Singapore Blueprint Forging a Greener Tomorrow


id: cord-023049-fio7cjj5
type: PROTEIN
entity:
  mutant protein Boutahar N 1 Reynaud E 1 Nasser Y 1 Camdessanché JP 1 Antoine JC 1 1 University Hospital Saint Etienne France Dysimmune sensory neuronopathies


id: cord-023049-fio7cjj5
type: CELL_LINE
entity:
  NIH Rare Diseases Clinical Research Network grant 1U54NS065712 01 Feely SME 1 Saade D 1 Shy ME 1 1 Carver College of Medicine University of Iowa Iowa City IA USA


id: cord-023049-fio7cjj5
type: CELL_LINE
entity:
  NIH Rare Diseases Clinical Research Network grant 1U54NS065712 01 Fisgun A 1 Luan X 1 Hoke A 1 1 Johns Hopkins University Baltimore MD USA Molecular mechanisms that underlie slow distal axonal degeneration seen in chemotherapy induced peripheral neuropathy CIPN are unclear However several identified molecular targets


id: cord-023049-fio7cjj5
type: CELL_LINE
entity:
  MMN Krarup C 1 2 Moldovan M 1 2 Alvarez S 1 Ciano C 3 Pisciotta C 3 Pareyson D 3 1 University of Copenhagen Copenhagen Denmark 2 Rigshospitalet Copenhagen Denmark 3 Fondazione IRCCS Istituto Neurologico C Besta INCB Milan Italy Mutations


id: cord-023049-fio7cjj5
type: PROTEIN
entity:
  RDCRN INC Contact Registry Martinez C 1 Hubsch A 2 Watson DJ 3 Shebl A 4 Wallenhorst C 1 Simon TL 3 1 Institute


id: cord-023049-fio7cjj5
type: PROTEIN
entity:
  CMT Painous C 1 López Pérez MA 2 Illa I 1 3 Querol L 1 3 1 Neuromuscular Diseases Unit Neurology Department Hospital de la Santa Creu


id: cord-023049-fio7cjj5
type: DNA
entity:
  MPZ missense mutations Poitras T 1 Chandrasekhar A 1 Singh V 1 Martinez J 1 Zochodne DW 1 1 Neuroscience Mental Health Institute and Division


id: cord-023049-fio7cjj5
type: PROTEIN
entity:
  Antinuclear Antibody 1 1280 reference 1 40 SS A 148 reference 20 U SS B 79 reference 20 U and Rheumatoid Factor 24 reference 14 IU mL titers


id: cord-023049-fio7cjj5
type: CELL_LINE
entity:
  São Paulo Ribeirão Preto Brazil 2 Neurogenetics Department of Neurosciences and Behaviour Sciences University of São Paulo Ribeirão Preto Brazil


id: cord-023049-fio7cjj5
type: DNA
entity:
  Topa A 1 Spina E 1 Iodice R 1 Tozza S 1 Ruggiero L 1 Dubbioso R 1 Esposito M 1 Santoro L 1 Manganelli F 1 1 University of Naples Federico II Naples Italy


id: cord-023049-fio7cjj5
type: CELL_LINE
entity:
  Paediatric CMT Best Practice Guidelines Consortium 1 Royal Children s Hospital Melbourne Melbourne Victoria Australia 2 Murdoch Childrens Research Institute Melbourne Victoria Australia 3 University of Melbourne Melbourne Victoria Australia 4 University of Sydney New South Wales Australia 5 Sydney Children s Hospitals Network Randwick and Westmead New South Wales Australia Charcot Marie Tooth disease CMT


id: cord-023049-fio7cjj5
type: GGP
entity:
  Kagiava A 1 Karaiskos C 1 Richter J 2 Tryfonos C 2 Lapathitis G 1 Sargiannidou I 1 Christodoulou C 2


id: cord-023049-fio7cjj5
type: ORG
entity:
  Spain 3 Department of Cell Biology Physiology and Immunology Institute of Neurosciences Universitat Autònoma de Barcelona


id: cord-023049-fio7cjj5
type: ORG
entity:
  Department of Neurology Reference Center for Rare Peripheral Neuropathies University Hospital of Limoges Limoges France Prolonged


id: cord-023049-fio7cjj5
type: FAC
entity:
  1 Hilmarsen HT 1 Svendsen M 1 Høyer H 1 1 Section of Medical Genetics Department of Laboratory Medicine Telemark Hospital


id: cord-023049-fio7cjj5
type: ORG
entity:
  Department of Neurology University of Iowa Carver College of Medicine Iowa City IA USA 3 Department of Neurogenetics


id: cord-023049-fio7cjj5
type: ORG
entity:
  University of Colorado Hospital Aurora CO USA 2 University of Iowa Hospitals and Clinics Iowa City IA USA


id: cord-023049-fio7cjj5
type: ORG
entity:
  Massachusetts General Hospital Boston MA USA 2 University of Massachusetts Medical School Worcester USA 3 University Hospital


id: cord-023049-fio7cjj5
type: ORG
entity:
  Department of Rehabilitation and Medicine University of Occupational and Environmental Health Kitakyushu Japan 3 Division of Plastic


id: cord-023049-fio7cjj5
type: ORG
entity:
  Hayes JM 1 O Brien PD 1 Backus C 1 Feldman EL 1 1 Department of Neurology University of Michigan Ann Arbor


id: cord-023049-fio7cjj5
type: ORG
entity:
  National Neuroscience Institute Singapore Singapore 2 Lee Kong Chian School of Medicine Nanyang Technological University


id: cord-023049-fio7cjj5
type: ORG
entity:
  Yong Loo Lin School of Medicine National University Singapore Singapore 4 Tan Tock Seng Hospital Singapore


id: cord-023049-fio7cjj5
type: ORG
entity:
  Perelman School of Medicine University of Pennsylvania Philadelphia PA USA 2 Columbia University School of Medicine New York NY USA Heterozygous


id: cord-023049-fio7cjj5
type: ORG
entity:
  Department of Neurology National Referral Center for Rare Neuromuscular Diseases Pitié Salpêtrière Hospital


id: cord-023049-fio7cjj5
type: ORG
entity:
  The Department of Neurology Peking Union Medical College Hospital Chinese Academy of Medical Sciences


id: cord-023049-fio7cjj5
type: ORG
entity:
  Department of Neurology University of Michigan Ann Arbor USA 2 Department of Internal Medicine Division on Metabolism Endocrinology and Diabetes University of Michigan


id: cord-023049-fio7cjj5
type: ORG
entity:
  Neurology Clinics Cyprus Institute of Neurology and Genetics and Cyprus School of Molecular Medicine


id: cord-023049-fio7cjj5
type: ORG
entity:
  Hunter James Kelly Research Institute University at Buffalo Buffalo USA 5 Department of Biochemistry University at Buffalo Buffalo USA 6 Neurology Jacobs School of Medicine and Biomedical Sciences University


id: cord-023049-fio7cjj5
type: ORG
entity:
  the Netherlands 2 Academic Medical Center University of Amsterdam Department of Clinical Rheumatology and Immunology Amsterdam


id: cord-023049-fio7cjj5
type: ORG
entity:
  Neuroscience University of Padua Padua Italy 2 Hematology and Clinical Immunology Unit Department of Medicine University of Padua Padua Italy 3


id: cord-023049-fio7cjj5
type: ORG
entity:
  Mount Sinai Medical Center Beth Israel Deaconess Medical Center Northwestern University Medical Center University of Utah Medical Center


id: cord-023049-fio7cjj5
type: CHEMICAL
entity:
  Alonso Jiménez A 1 2 Belvis Nieto R 3 Diaz Manera J 1 2 Illa I 1 2 Querol L 1 2 1 Neuromuscular Diseases


id: cord-023049-fio7cjj5
type: CHEMICAL
entity:
  El Soury M 1 Muratori L 1 2 Tos P 4 Battiston B 3 Geuna S 1 2 Gambarotta G 1 1 Department of Clinical and Biological Sciences University of Turin Italy


id: cord-023049-fio7cjj5
type: CHEMICAL
entity:
  Gundapaneni B 1 Sultan MB 2 Keohane DJ 2 Schwartz J 2 1 inVentiv Health Inc Burlington MA USA 2 Pfizer Inc New York NY USA Transthyretin


id: cord-023049-fio7cjj5
type: DISEASE
entity:
  peripheral nerve sheath tumors Jacobsen B 1 Parry G 2 Allen J 2 Walk D 2 Muley S 1 Ortega E 1 1 Barrow Neurological Institute Phoenix AZ


id: cord-023049-fio7cjj5
type: CHEMICAL
entity:
  Moschella F 3 Geuna S 1 2 Raimondo S 1 2 1 Department of Clinical and Biological Sciences University of Turin Orbassano TO Italy 2 Neuroscience Institute of the Cavalieri Ottolenghi Foundation


id: cord-023049-fio7cjj5
type: CHEMICAL
entity:
  D 1 Stojkovic T 2 Leonard Louis S 2 Reilly MM 3 Laurà M 3 Parman Y 4 Battaloglu E 4 Tazir M 5 Bellatache M 5 Bonello Palot N 6 Sacconi S 7 Guimarães Costa R 2 Attarian S 6 Latour P 8 Megarbane A 2 Schenone A 9 Ursino G 9 Sabatelli M 10 Luigetti


id: cord-023049-fio7cjj5
type: CHEMICAL
entity:
  Psimaras D 3 Kuntzer T 4 Taieb G 5 Créange A 6 Delmont E 7 Camdessanché JP 1 Antoine JC 1 1 University


id: cord-023049-fio7cjj5
type: CHEMICAL
entity:
  Kovalova E 1 2 Nekvapilova E 1 2 Belobradkova J 6 Olsovsky J 7 Weber P 8 Dusek L 9 Jarkovsky J 9 Bednarik J 1 2 Despite


# bib

id: cord-003360-mkv1jc7u
author: Chen, Yirong
date: 2018-10-22
txt: ./txt/cord-003360-mkv1jc7u.txt
cache: ./cache/cord-003360-mkv1jc7u.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283473/
doi: 10.4269/ajtmh.18-0099
summary:
  title: The Effect of School Closure on Hand, Foot, and Mouth Disease Transmission in Singapore: A Modeling Approach Singapore implements a school closure policy for institutional hand, foot, and mouth disease (HFMD) outbreaks, but there is a lack of empirical evidence on the effect of closure on HFMD transmission. The effects of school closure due to 1) institutional outbreaks, 2) public holidays, and 3) school vacations were assessed using a Bayesian time series modeling approach. These policies provide data that enable us to obtain three sources of information on the effect of school closure: 1) the reduction in the numbers of cases after a public holiday, when childcare centers and schools close; 2) the reduction during school vacations; and 3) the impact within childcare centers of school closure in response to an ongoing outbreak. To measure the effect of school vacations on HFMD transmission, we built time series models, fit Bayesianly, for the weekly number of children with HFMD aged 12 years and younger.

title:
  The Effect of School Closure on Hand, Foot, and Mouth Disease Transmission in Singapore: A Modeling Approach

abstract:
  Singapore implements a school closure policy for institutional hand, foot, and mouth disease (HFMD) outbreaks, but there is a lack of empirical evidence on the effect of closure on HFMD transmission. We conducted a retrospective analysis of 197,207 cases of HFMD over the period 2003–2012 at the national level and of 57,502 cases in 10,080 institutional outbreaks over the period 2011–2016 in Singapore. The effects of school closure due to 1) institutional outbreaks, 2) public holidays, and 3) school vacations were assessed using a Bayesian time series modeling approach. School closure was associated with a reduction in HFMD transmission rate. During public holidays, average numbers of secondary cases having onset the week after dropped by 53% (95% credible interval 44–62%), and during school vacations, the number of secondary cases dropped by 7% (95% credible interval 3–10%). Schools being temporarily closed in response to an institutional outbreak reduced the average number of new cases by 1,204 (95% credible interval 1,140–1,297). Despite the positive effect in reducing transmission, the effect of school closure is relatively small and may not justify the routine use of this measure.


id: cord-007026-ejv0gidp
title: Adenoviral Infections in Singapore: Should New Antiviral Therapies and Vaccines Be Adopted?
author: Coleman, Kristen K
date: 2020-02-15
txt: ./txt/cord-007026-ejv0gidp.txt
cache: ./cache/cord-007026-ejv0gidp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7107482/
doi: 10.1093/infdis/jiz489
summary:
  METHODS: To understand the epidemiology of HAdV infections in Singapore, we studied 533 HAdV-positive clinical samples collected from 396 pediatric and 137 adult patients in Singapore from 2012 to 2018. CONCLUSIONS: Singapore would benefit from more frequent studies of clinical HAdV genotypes to identify patients at risk for severe disease and help guide the use of new antiviral therapies, such as brincidofovir, and potential administration of HAdV 4 and 7 vaccine. Clinical samples previously collected from HAdV-positive patients admitted to Singapore General Hospital (SGH) and KK Women''s and Children''s Hospital (KKH) between 2012 and 2015 were preserved at −80°C and transferred to Duke-NUS Laboratory of One Health Research for study. Human adenovirus-C datasets consisted of 4 novel genomes from Singapore and 22 representative virus isolates from different genotypes (HAdV-C1, HAdV-C2, HAdV-C5, and HAdV-C6).

abstract:
  BACKGROUND: A number of serious human adenovirus (HAdV) outbreaks have been recently reported: HAdV-B7 (Israel, Singapore, and USA), HAdV-B7d (USA and China), HAdV-D8, -D54, and -C2 (Japan), HAdV-B14p1 (USA, Europe, and China), and HAdV-B55 (China, Singapore, and France). METHODS: To understand the epidemiology of HAdV infections in Singapore, we studied 533 HAdV-positive clinical samples collected from 396 pediatric and 137 adult patients in Singapore from 2012 to 2018. Genome sequencing and phylogenetic analyses were performed to identify HAdV genotypes, clonal clusters, and recombinant or novel HAdVs. RESULTS: The most prevalent genotypes identified were HAdV-B3 (35.6%), HAdV-B7 (15.4%), and HAdV-E4 (15.2%). We detected 4 new HAdV-C strains and detected incursions with HAdV-B7 (odds ratio [OR], 14.6; 95% confidence interval [CI], 4.1–52.0) and HAdV-E4 (OR, 13.6; 95% CI, 3.9–46.7) among pediatric patients over time. In addition, immunocompromised patients (adjusted OR [aOR], 11.4; 95% CI, 3.8–34.8) and patients infected with HAdV-C2 (aOR, 8.5; 95% CI, 1.5–48.0), HAdV-B7 (aOR, 3.7; 95% CI, 1.2–10.9), or HAdV-E4 (aOR, 3.2; 95% CI, 1.1–8.9) were at increased risk for severe disease. CONCLUSIONS: Singapore would benefit from more frequent studies of clinical HAdV genotypes to identify patients at risk for severe disease and help guide the use of new antiviral therapies, such as brincidofovir, and potential administration of HAdV 4 and 7 vaccine.


id: cord-010050-utbrf4ad
title: Preventing local transmission of SARS: lessons from Singapore
author: Fisher, Dale A
date: 2003-06-02
txt: ./txt/cord-010050-utbrf4ad.txt
cache: ./cache/cord-010050-utbrf4ad.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168499/
doi: 10.5694/j.1326-5377.2003.tb05358.x
abstract: nan
summary:
  4 Instituting this Preventing local transmission of SARS: lessons from Singapore Clinical record At 11:30 on 8 April 2003, a 64-year-old man presented to the National University Hospital emergency department (ED) complaining of light headedness for 3 days, and dry cough and body aches for 2 days. Australia must ensure rapid identification of a potential index case at points of initial contact in hospitals, community clinics and general practices across the country. 1, 2 In countries with the resources to implement full and effective contact and respiratory isolation for all suspect patients, local transmission of the virus has been almost non-existent. Provided there is consistent early identification of imported suspect cases, then Australia''s healthcare system can manage these patients with appropriate isolation to prevent secondary transmission. Each health jurisdiction in Australia must have a plan for managing a local SARS outbreak, which should include prompt hospital and community responses, and an ability to meet potential needs at short notice.


id: cord-016006-7yas4yqt
author: Yoshikawa, Minako Jen
date: 2010-06-18
txt: ./txt/cord-016006-7yas4yqt.txt
cache: ./cache/cord-016006-7yas4yqt.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120152/
doi: 10.1007/978-4-431-53875-2_4
summary:
  This paper discusses countermeasures of Republic of Singapore towards mosquito-borne infectious diseases, particularly, dengue and chikungunya virus infection to identify an essential factor in controlling emergence of infectious diseases. Although a considerable number of studies on its outbreak response, surveillance, prevention, and disease management have been conducted by the medical and science community, others often attribute Singapore''s outstanding infectious disease control to the small territory and economic affluence alone. In addition, the regulatory requirement made dengue infection legally notifiable in 1977 under the Infectious Diseases Act of 1976 while DHF had been already made administratively notifiable in 1966 [11, 12, 13] .While the rest of the Southeast Asian region experienced epidemics in 1976 and 1977, the vector control system contributed to low frequency of DHF in Singapore [10] . It is necessary to keep in mind that curving mosquito-borne epidemics like dengue infection and chikungunya fever require capacities such as laboratory-based surveillance and territory-wide vector control program as well as regional collaboration.

title:
  Dengue and chikungunya virus infection in Southeast Asia: active governmental intervention in Republic of Singapore

abstract:
  This paper discusses countermeasures of Republic of Singapore towards mosquito-borne infectious diseases, particularly, dengue and chikungunya virus infection to identify an essential factor in controlling emergence of infectious diseases. In spite of expanding areas affected by and upsurge of these diseases in the region, the tropical urban country is known to have sustained an effective vector control, which often resulted in moderate prevalence and/or quick control of domestic outbreaks. This research has adopted an inter-disciplinary review of previous studies combined with field studies: interviewing at the Ministry of Health, Singapore and the National Environment Agency, Singapore; visiting a laboratory and hospitals; and observing on-site vector mosquito surveillance operations conducted by the agency. The findings have pointed out the national vector surveillance and control system implemented by 1970s, followed by improved countermeasures like vector and virus surveillance which have incorporated science and technology especially in the last two decades. The analysis produces an influential role of a government in promoting and supporting public health measures, which have been typically demonstrated through inter-ministry collaboration, public-private cooperation, and community involvement. In light of increasing transnational nature of emerging infectious diseases, Singapore’s contribution in the region like sharing its knowledge of and experiences in dengue and chikungunya virus infection is illustrated. The resilient model of Singapore’s vector control and governmental action warrants a further study to investigate transferability in other parts of the region.


id: cord-016405-86kghmzf
author: Lai, Allen Yu-Hung
date: 2014-06-13
txt: ./txt/cord-016405-86kghmzf.txt
cache: ./cache/cord-016405-86kghmzf.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120670/
doi: 10.1007/978-4-431-55022-8_15
summary:
  We use a case study to highlight the disaster impacts and insights drawn from Singapore''s risk management experience with specific references to the SARS epidemic. The implications from the SARS focus on four areas: staying vigilant at the community level, remaining flexible in a national command structure, the demand for surge capacity, and collaborative governance at regional level. To understand the principles and practices of Singapore''s approach to disaster risk management, we carry out an historical analysis of official documents obtained from the relevant Singapore government agencies as well as international organizations, literature reviews, quantitative analysis of economic impacts, qualitative interviews with key informants (e.g. public health professionals and decision-makers), and email communications with frontline managers from the public sector (e.g. the Singapore Civil Defense Force, the Communicable Disease Centre) and non-governmental organizations. Responding to the uncertainty of disease transmission, the Singapore government instituted many draconian public policies, such as social distancing, quarantine and isolation, as risk mitigating measures.

title:
  Impact of Disasters and Disaster Risk Management in Singapore: A Case Study of Singapore’s Experience in Fighting the SARS Epidemic

abstract:
  Singapore is vulnerable to both natural and man-made disasters alongside its remarkable economic growth. One of the most significant disasters in recent history was the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003. The SARS outbreak was eventually contained through a series of risk mitigating measures introduced by the Singapore government. This would not be possible without the engagement and responsiveness of the general public. This chapter begins with a description of Singapore’s historical disaster profiles, the policy and legal framework in the all-hazard management approach. We use a case study to highlight the disaster impacts and insights drawn from Singapore’s risk management experience with specific references to the SARS epidemic. The implications from the SARS focus on four areas: staying vigilant at the community level, remaining flexible in a national command structure, the demand for surge capacity, and collaborative governance at regional level. This chapter concludes with a presence of the flexible command structure on both the way and the extent it was utilized.


id: cord-021673-vs4famsa
author: Foley, M.
date: 2009-11-16
txt: ./txt/cord-021673-vs4famsa.txt
cache: ./cache/cord-021673-vs4famsa.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151847/
doi: 10.1016/b978-0-08-045100-8.00004-1
abstract: nan
summary:
  Methodologically, it draws on elite interviews with leading Singaporean cultural policy makers, observations at local, national and international events and documentary analysis of the recent strategic environment for Singapore tourism. In essence, we suggest that Singapore has used its events-led strategies to extend its internal processes of cultural planning, regeneration and development at the same time as securing a global position in the increasingly competitive events (and place) bidding wars. In urban environments across Europe, the Americas and Asia, public and private growth coalitions come together to utilise events and festivals as a means of gaining competitive advantage in increasingly aggressive place wars ( Haider, 1992 ; Short and Kim, 1999; Yeoh and Chang, 2001) with other aspiring global cities. Increasingly, sporting and other cultural festivals and events represent particularly attractive communication vehicles for cities as they interact with the globalised media complex and vie for the attention of policy makers, consumers and investors, alike.

title:
  Establishing Singapore as the Events and Entertainment Capital of Asia: Strategic Brand Diversification


id: cord-022234-jjaqlyo5
author: Beirman, David
date: 2009-11-16
txt: ./txt/cord-022234-jjaqlyo5.txt
cache: ./cache/cord-022234-jjaqlyo5.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155472/
doi: 10.1016/b978-0-7506-7898-8.50021-7
abstract: nan
summary:
  Fear of terrorism arising from the Bali bombing and the outbreak of SARS in SE Asia, much of it magnified by media coverage in the West, was exacerbated by a series of negative travel advisories issued by the governments of many economically significant tourism source markets including the United States, United Kingdom, Australia, and Japan. At the private sector level, the Bangkok-headquartered Pacific Asia Travel Association (PATA), the main travel industry body representing the Pacific Rim, placed the restoration of SE Asian tourism as its top priority project from the time of the Bali bombing and was supported by national tourist offices and peak travel industry bodies of all SE Asian nations and the International Air Transport Association (IATA). The prevailing dissonance between the private and the government sector''s approach to regional tourism marketing in SE Asia during the 1990s and the early years of the twenty-first century was radically affected by the Sari Club bombing of October 12 , 2002, and the SARS scare of March-June 2003.

title:
  A Comparative Assessment of Three Southeast Asian Tourism Recovery Campaigns: Singapore Roars: Post SARS 2003, Bali Post-the October 12, 2002 Bombing, and WOW Philippines 2003


id: cord-022473-l4jniccw
title: As Travel Medicine Practitioner during the SARS Outbreak in Singapore
author: Wilder-Smith, Annelies
date: 2009-11-16
txt: ./txt/cord-022473-l4jniccw.txt
cache: ./cache/cord-022473-l4jniccw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155737/
doi: 10.1016/b978-0-08-045359-0.50041-5
abstract: nan
summary:
  In the first week after our first cases, the WHO named the disease "SARS", and they sent out global alerts. In Singapore, the outbreak was initially only hospital based, but in April the news was out that SARS had affected a large vegetable market. The news of the death of Carlo Urbani, the Italian WHO doctor who was instrumental in the control of SARS in Vietnam, sent our hospital staff into depression. In total, we lost a total of five healthcare workers to SARS in Singapore: 2 doctors, 1 nursing officer, 1 nursing aide and 1 hospital attendant. Two to three weeks into the epidemic it became clear, that infection control measures were effective; no more new cases occurred amongst the staff of our hospital. The SARS outbreak in Singapore can be traced to the first imported case. New imported SARS cases therefore need not lead to major outbreaks if systems are in place to identify and isolate them early.


id: cord-023049-fio7cjj5
title: 2017 Peripheral Nerve Society Meeting July 8–12, 2017 Sitges, Barcelona, Spain
author: nan
date: 2017-06-22
txt: ./txt/cord-023049-fio7cjj5.txt
cache: ./cache/cord-023049-fio7cjj5.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7166380/
doi: 10.1111/jns.12225
abstract: nan
summary:
  Clinical efficacy (Medical Research Council sum score, 10-m walk, modified Inflammatory Neuropathy Cause and Treatment score, Overall Neuropathy Limitations Scale, Romberg test) and patient-reported outcomes (36-item Short Form Health Survey , Life Quality Index [LQI] ) were assessed at baseline and at regular intervals until the final visit (10-14 months after switching). To explore the issue of early biomarkers in FAP, we performed skin biopsy and compared IENF density with parameters of nerve conduction studies (NCS) and quantitative sensory testing (QST) on 36 subjects (23 men, aged 55.1 ± 11.1 years) with genetic confirmation of TTR-A97S: 17 patients and 19 carriers. Results: The Gly112Ser mutation causing CMT1C is a mild form of CMT, as patients walked on time, had less weakness than those with Charcot-Marie-Tooth Disease type 1A (CMT1A), had a Charcot Marie Tooth neuropathy score (CMTNS) indicative of mild disease, and had faster ulnar and median motor nerve conduction velocities compared to those with CMT1A.


id: cord-023140-ytal7wog
title: Responding to crisis: severe acute respiratory syndrome (SARS) and hotels in Singapore
author: Henderson, Joan C.
date: 2004-12-09
txt: ./txt/cord-023140-ytal7wog.txt
cache: ./cache/cord-023140-ytal7wog.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7167073/
doi: 10.1002/jtr.505
summary:
  title: Responding to crisis: severe acute respiratory syndrome (SARS) and hotels in Singapore The sudden outbreak of severe acute respiratory syndrome (SARS) in Singapore in 2003 was a grave crisis for the tourism industry as a whole and highlights the importance of effectively managing and planning for such occurrences. It focuses on how the epidemic impacted on Singapore''s hotel sector and management reactions to it, affording insights into the problems caused by outbreaks of infectious disease at destinations and possible responses. The epidemic of SARS in 2003 was an exceptional crisis for Singapore''s hotels and an exacting test for its managers, in which advances to near normality were dictated by outside developments and agencies as much as their own efforts. Managing a health-related crisis: severe acute respiratory syndrome (SARS) in Singapore Chaos, crises and disasters: a strategic approach to crisis management in the tourism industry

abstract:
  The sudden outbreak of severe acute respiratory syndrome (SARS) in Singapore in 2003 was a grave crisis for the tourism industry as a whole and highlights the importance of effectively managing and planning for such occurrences. This study looks at the particular consequences of the infectious virus for the hotel sector and reactions to the challenges posed. Further health‐related crises seem inevitable in the modern world and some guidelines for dealing with these are proposed, based on the Singapore experience and an existing framework for tourism crisis management. Copyright © 2004 John Wiley & Sons, Ltd.


id: cord-027047-xlz576hm
title: The Singaporean State and Community Care in the Time of Corona
author: Koh, Vanessa
date: 2020-06-04
txt: ./txt/cord-027047-xlz576hm.txt
cache: ./cache/cord-027047-xlz576hm.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300938/
doi: 10.1111/ciso.12297
abstract: nan
summary:
  Following Aulino, and contra some of the rhetoric of aid organizations, we take seriously care-as-maintenance as a valid approach to care in the time of Covid-19, and note that competence on the part of state actors and policy-makers has little to do with sentiment or "concern" per se in terms of daily problem-solving and an overall moral orientation. Rather than adding to existing critiques of the state''s lack of care-as-concern, we focus instead on the structural issue of Singapore''s policies around migrant labor in Singapore that now renders present techniques of care-as-maintenance as insufficient. Of-the-moment responses in the time of Covid-19 may, therefore, fail to highlight areas of provision most needed for migrants in Singapore, beyond perceived insufficiencies in both care-as-concern and care-as-maintenance frameworks. Care-as-maintenance can also be a serious crisis response, but its apparent insufficiencies must be read within a larger context of structural inequalities that dispossess short-term migrant laborers in Singapore, rather than simply a lack of accompanying care-as-concern.


id: cord-030529-2wkes9nk
title: COVID-19 apps in Singapore and Australia: reimagining healthy nations with digital technology
author: Goggin, Gerard
date: 2020-08-14
txt: ./txt/cord-030529-2wkes9nk.txt
cache: ./cache/cord-030529-2wkes9nk.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429912/
doi: 10.1177/1329878x20949770
summary:
  In this article, I consider the development, deployment and imagined uses of apps in two countries: Singapore, a pioneer in the field, with its TraceTogether app, and Australia, a country that adapted Singapore''s app, devising its own COVIDSafe, as key to its national public health strategy early in the crisis. The data sets generated by smartphones, computers, apps and people''s use of them, such as that data collected by Apple and Google, were used by public health officials, researchers and journalists to map population or district-level activity and movement, leading to the very interesting charts, graphs and visualisations in news and current affairs reports and features seeking to map and analyse the spread of COVID and its impact on social and economic activity. With much at stake in terms of public health concerns at a critical juncture of the COVID pandemic, the Australian government emphasised that it was keen to adopt a ''consent-based'' model, hence its interest in adapting the Singapore TraceTogether app.

abstract:
  Widely and intensively used digital technologies have been an important feature of international responses to the COVID-19 pandemic. One especially interesting class of such technologies are dedicated contact and tracing apps collecting proximity data via the Bluetooth technology. In this article, I consider the development, deployment and imagined uses of apps in two countries: Singapore, a pioneer in the field, with its TraceTogether app, and Australia, a country that adapted Singapore’s app, devising its own COVIDSafe, as key to its national public health strategy early in the crisis. What is especially interesting about these cases is the privacy concerns the apps raised, and how these are dealt with in each country, also the ways in which each nation reimagines its immediate social future and health approach via such an app.


id: cord-031942-mfz313q0
author: Kim, Hye Kyung
date: 2020-09-13
txt: ./txt/cord-031942-mfz313q0.txt
cache: ./cache/cord-031942-mfz313q0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492825/
doi: 10.1177/1075547020959670
summary:
  Guided by the RISP model (Griffin et al., 1999) , the current study examines whether and how exposure to misinformation about COVID-19 prevention motivates or deters effortful seeking and processing of relevant information. Thus, we posit the following direct and indirect effects of misinformation exposure on information seeking and avoidance, as well as systematic and heuristic processing. Because misinformation on COVID-19 prevention is characterized by scientific uncertainty, we suggest that cultural differences in uncertainty avoidance may moderate the effect of misinformation exposure on information seeking and processing. Research Question 2 (RQ2): Do the direct and indirect effects of misinformation exposure on information seeking, avoidance, and processing differ between the United States and South Korea or Singapore? In predicting information avoidance, the direct effect of misinformation was significant across all three countries (Β US = .399, Β SG = .370, Β KR = .538, all p < .001), but the effect size significantly differed only between the U.S. and South Korea samples (p = .006; United States-Singapore comparison, p = .63).

title:
  Effects of COVID-19 Misinformation on Information Seeking, Avoidance, and Processing: A Multicountry Comparative Study

abstract:
  We examined the implications of exposure to misinformation about COVID-19 in the United States, South Korea, and Singapore in the early stages of the global pandemic. The online survey results showed that misinformation exposure reduced information insufficiency, which subsequently led to greater information avoidance and heuristic processing, as well as less systematic processing of COVID-19 information. Indirect effects differ by country and were stronger in the U.S. sample than in the Singapore sample. This study highlights negative consequences of misinformation during a global pandemic and addresses possible cultural and situational differences in how people interpret and respond to misinformation.


id: cord-104426-qz8pffei
author: Tay, K
date: 2020-04-07
txt: ./txt/cord-104426-qz8pffei.txt
cache: ./cache/cord-104426-qz8pffei.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7169474/
doi: nan
summary:
  Based on the principle of complete segregation and in accordance to "Disease Outbreak Response System Condition" (DORSON) Orange 20 directive to prevent potential cross contamination between healthcare workers, the operating theatre (OT) team was segregated into two separate sub-groups; two teams to deal with acute trauma cases and one team for urgent spine surgeries. • Cutting down non-essential workload such as patients on long term follow-up or conservative management 26 • Limiting ourselves to urgent care such as trauma, infection, acute spine emergencies and tumour referrals • Allowing for off-site prescription top-ups, extension of medical leave and correspondences for whatever indications As the Outpatient services can be exposed to patients from various sources, a strict screening protocol in accordance to existing Singapore Ministry of Health guidelines covering travel histories, contact histories, and coryzal symptoms were taken before admittance to the Outpatient clinic.

title:
  COVID-19 in Singapore and Malaysia: Rising to the Challenges of Orthopaedic Practice in an Evolving Pandemic

abstract:
  With the increasing number of COVID-19 cases and related deaths worldwide, we decided to share the development of this condition in Singapore and Malaysia. First few cases were diagnosed in the two countries at the end of January 2020, and the numbers have surged to thousands by end of March 2020. We will focus on strategies adopted by the government and also the Orthopaedic community of the two countries up till the beginning of April 2020. We hope that by sharing of relevant information and knowledge on how we are managing the COVID-19 condition, we can help other communities, and health care workers to more effectively overcome this pandemic.


id: cord-178791-cywjp5jh
title: Spatial super-spreaders and super-susceptibles in human movement networks
author: Chin, Wei Chien Benny
date: 2020-05-11
txt: ./txt/cord-178791-cywjp5jh.txt
cache: ./cache/cord-178791-cywjp5jh.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2005.05063v1.pdf
doi: nan
summary:
  Here, we propose a quantitative and systematic framework to identify spatial super-spreaders and the novel concept of super-susceptibles, i.e. respectively, places most likely to contribute to disease spread or to people contracting it. Identifying these places would therefore be critical in the fight with infectious diseases such as In this article, we report a study aimed at systematically identifying the spatial super-spreaders and spatial super-susceptibles in the spatial human network of the city-state of the Republic of Singapore. We applied this analysis framework to the Singapore public transport flow network, and identified the SSP and SSS using the SUI and SPI indexes. This study uses a community detection method (MapEquation algorithm 51 ) to identify the zones from the flow network, instead of using the administrative spatial boundaries (i.e. the boundaries of planning areas and regions as defined by the Singapore Government in its Master Plan 2014 50 ) that were designed and selected for governance and political purposes.

abstract:
  As lockdowns and stay-at-home orders start to be lifted across the globe, governments are struggling to establish effective and practical guidelines to reopen their economies. In dense urban environments with people returning to work and public transportation resuming full capacity, enforcing strict social distancing measures will be extremely challenging, if not practically impossible. Governments are thus paying close attention to particular locations that may become the next cluster of disease spreading. Indeed, certain places, like some people, can be"super-spreaders."Is a bustling train station in a central business district more or less susceptible and vulnerable as compared to teeming bus interchanges in the suburbs? Here, we propose a quantitative and systematic framework to identify spatial super-spreaders and the novel concept of super-susceptibles, i.e. respectively, places most likely to contribute to disease spread or to people contracting it. Our proposed data-analytic framework is based on the daily-aggregated ridership data of public transport in Singapore. By constructing the directed and weighted human movement networks and integrating human flow intensity with two neighborhood diversity metrics, we are able to pinpoint super-spreader and super-susceptible locations. Our results reveal that most super-spreaders are also super-susceptibles and that counterintuitively, busy peripheral bus interchanges are riskier places than crowded central train stations. Our analysis is based on data from Singapore, but can be readily adapted and extended for any other major urban center. It therefore serves as a useful framework for devising targeted and cost-effective preventive measures for urban planning and epidemiological preparedness.


id: cord-252292-qz9msrl7
author: Wilder-Smith, Annelies
date: 2006-03-08
txt: ./txt/cord-252292-qz9msrl7.txt
cache: ./cache/cord-252292-qz9msrl7.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/14531977/
doi: 10.2310/7060.2003.2676
summary:
  METHODS: Information on imported cases of SARS and measures taken at entry points to Singapore was retrieved from the Ministry of Health and the Civil Aviation Authority of Singapore. The large outbreaks in Hong Kong, Toronto, Singapore and Vietnam were initiated by cases that were imported before this new disease had been identified and before appropriate measures had been put in place to prevent transmission. Information on measures taken at the national airport (Changi Airport), seaports and road entry points to reduce the importation of further cases was obtained from the Civil Aviation Authority of Singapore (CAAS) and from the websites of the Ministry of Health, Singapore (http://www.moh.gov.sq/sars/news/chronology.html; accessed 15 June). She became very unwell and breathless on her return flight from Beijing to Singapore on 26 March, but no precautions were taken on the airplane,as her diagnosis was not known.Immediately after arrival, her mother took her in a taxi to Tan Tock Seng Hospital,where she was isolated in the Intensive Care Unit.

title:
  Experience of Severe Acute Respiratory Syndrome in Singapore: Importation of Cases, and Defense Strategies at the Airport

abstract:
  BACKGROUND: The importation of SARS was responsible for the outbreaks in Singapore, Hong Kong, Vietnam and Canada at a time when this new disease had not been identified. We report the incidence and impact of cases of SARS imported to Singapore between 25 February and 31 May 2003, and describe national measures to prevent further importation. METHODS: Information on imported cases of SARS and measures taken at entry points to Singapore was retrieved from the Ministry of Health and the Civil Aviation Authority of Singapore. RESULTS: Of the 6 imported cases, which all occurred before screening measures were implemented at the airport, only the first resulted in extensive secondary transmission. Of 442,973 air passengers screened after measures were implemented, 136 were sent to a designated hospital for further SARS screening; none was diagnosed as having SARS. CONCLUSIONS: The SARS outbreak in Singapore can be traced to the first imported case. The absence of transmission from the other imported cases was probably a result of relatively prompt identification and isolation of cases, together with a low potential for transmission. New imported SARS cases therefore need not lead to major outbreaks if systems are in place to identify and isolate them early. Screening at entry points is costly, has a low yield and is not sufficient in itself, but may be justified in light of the major economic, social and international impact which even a single imported SARS case may have.


id: cord-253111-n5ywei4t
author: Keck, Frédéric
date: 2018-04-14
url: https://www.ncbi.nlm.nih.gov/pubmed/32336932/
doi: 10.1111/1467-9655.12813
title:
  Avian preparedness: simulations of bird diseases and reverse scenarios of extinction in Hong Kong, Taiwan, and Singapore

abstract:
  This article describes relations between humans, animals, artefacts, and pathogens in simulations of disasters, taking bird diseases in three Chinese sentinel posts as ethnographic cases. Drawing on distinctions between simulation, ritual, and play, it shows that the engagement of actors in the imaginary of simulations, which they describe as ‘realism’, reflectively reverses the oppositions between humans and nonhumans, active and passive, fiction and reality that shape ordinary life. Borrowing from the anthropology of hunting societies, it argues that simulations of bird diseases, considered as signs of future species extinction, rely on cynegetic techniques of power, in which humans and animals symmetrically shift perspectives, and not only on pastoralist techniques, in which humans are above the population they monitor and sometimes sacrifice.


id: cord-254288-duukt2wh
author: Chew, Nicholas W.S.
date: 2020-04-21
txt: ./txt/cord-254288-duukt2wh.txt
cache: ./cache/cord-254288-duukt2wh.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32330593/
doi: 10.1016/j.bbi.2020.04.049
summary:
  title: A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak METHODS: Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. CONCLUSIONS: Our study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We investigate the association between various physical symptoms and psychological distress amongst healthcare workers in Singapore and India during the current COVID-19 outbreak. The study questionnaire, written in English, comprised five main components-demographic characteristics, medical history, symptom prevalence in the previous month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instruments. This multinational, multicenter study found significant association between adverse psychological outcomes and physical symptoms displayed by healthcare workers during the current COVID-19 pandemic.

title:
  A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak

abstract:
  OBJECTIVE: Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, there are reports on the increased prevalence of physical symptoms observed in the general population. We investigated the association between psychological outcomes and physical symptoms among healthcare workers. METHODS: Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. Healthcare workers included doctors, nurses, allied healthcare workers, administrators, clerical staff and maintenance workers. This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. The prevalence of physical symptoms displayed by healthcare workers and the associations between physical symptoms and psychological outcomes of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were evaluated. RESULTS: Out of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety, 20 (2.2%) for moderate to extremely-severe stress, and 34 (3.8%) for moderate to severe levels of psychological distress. The commonest reported symptom was headache (32.3%), with a large number of participants (33.4%) reporting more than four symptoms. Participants who had experienced symptoms in the preceding month were more likely to be older, have pre-existing comorbidities and a positive screen for depression, anxiety, stress, and PTSD. After adjusting for age, gender and comorbidities, it was found that depression (OR 2.79, 95% CI 1.54–5.07, p = 0.001), anxiety (OR 2.18, 95% CI 1.36–3.48, p = 0.001), stress (OR 3.06, 95% CI 1.27–7.41, p = 0.13), and PTSD (OR 2.20, 95% CI 1.12–4.35, p = 0.023) remained significantly associated with the presence of physical symptoms experienced in the preceding month. Linear regression revealed that the presence of physical symptoms was associated with higher mean scores in the IES-R, DASS Anxiety, Stress and Depression subscales. CONCLUSIONS: Our study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We postulate that this association may be bi-directional, and that timely psychological interventions for healthcare workers with physical symptoms should be considered once an infection has been excluded.


id: cord-255511-nk3iyg07
title: Spatial super-spreaders and super-susceptibles in human movement networks
author: Chin, Wei Chien Benny
date: 2020-10-29
txt: ./txt/cord-255511-nk3iyg07.txt
cache: ./cache/cord-255511-nk3iyg07.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1038/s41598-020-75697-z
doi: 10.1038/s41598-020-75697-z
summary:
  Here, we propose a quantitative and systematic framework to identify spatial super-spreaders and the novel concept of super-susceptibles, i.e. respectively, places most likely to contribute to disease spread or to people contracting it. We applied this analysis framework to the Singapore public transport flow network, and identified the SSP and SSS using the SUI and SPI indexes. This study uses a community detection method (MapEquation algorithm 60 ) to identify the zones from the flow network, instead of using the administrative spatial boundaries (i.e. the boundaries of planning areas and regions as defined by the Singapore Government in its Master Plan 2014 59 ) that were designed and selected for governance and political purposes. Figure 7 shows the local out-and in-degree (left column), the outgoing and incoming neighborhood zone-entropy (central column) and coreness-entropy (right column) of the weekday (first two rows) and weekend (bottom two rows) flow networks.

abstract:
  As lockdowns and stay-at-home orders start to be lifted across the globe, governments are struggling to establish effective and practical guidelines to reopen their economies. In dense urban environments with people returning to work and public transportation resuming full capacity, enforcing strict social distancing measures will be extremely challenging, if not practically impossible. Governments are thus paying close attention to particular locations that may become the next cluster of disease spreading. Indeed, certain places, like some people, can be “super-spreaders”. Is a bustling train station in a central business district more or less susceptible and vulnerable as compared to teeming bus interchanges in the suburbs? Here, we propose a quantitative and systematic framework to identify spatial super-spreaders and the novel concept of super-susceptibles, i.e. respectively, places most likely to contribute to disease spread or to people contracting it. Our proposed data-analytic framework is based on the daily-aggregated ridership data of public transport in Singapore. By constructing the directed and weighted human movement networks and integrating human flow intensity with two neighborhood diversity metrics, we are able to pinpoint super-spreader and super-susceptible locations. Our results reveal that most super-spreaders are also super-susceptibles and that counterintuitively, busy peripheral bus interchanges are riskier places than crowded central train stations. Our analysis is based on data from Singapore, but can be readily adapted and extended for any other major urban center. It therefore serves as a useful framework for devising targeted and cost-effective preventive measures for urban planning and epidemiological preparedness.


id: cord-256163-62cc135r
title: Cybercrime in cloud: Risks and responses in Hong Kong, Singapore
author: Laurie Lau, Yiu Chung
date: 2015-06-05
txt: ./txt/cord-256163-62cc135r.txt
cache: ./cache/cord-256163-62cc135r.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/B9780128015957000021
doi: 10.1016/b978-0-12-801595-7.00002-1
summary:
  Then, I review how the authorities in Hong Kong and Singapore respond to cybercrime risks and explore the current government policies on cloud computing, particularly in fighting cybercrime. For instance, in accordance with the United Nation International Telecommunication Union (UNITU) report on the digital divide in 2012, 1 IT disparities in terms of access to information and communication technology are pronounced between the developed Western economies such as those of America, Canada, and Western European countries (this group includes a few advanced economies in Asia such as those of Japan, South Korea, Singapore, and Hong Kong), and the lessdeveloped economies such as those of Northern Africa, Latin America, Pacific Ocean Islands, and some parts of South Eastern Asia. At the domestic level, both governments in Hong Kong and in Singapore must provide sufficient financial support to the policing agencies to enable them to fight the emerging crime such as cloud and smart mobile phone crimes.

abstract:
  The popularity and commercialization of the “Internetwork” began in the late 1990s through the interconnection of computer networks using special gateways or routers to transfer packets of electronic data. As with many things in life, Internetwork technology has had both positive and negative effects on society, and Asia has been no exception. One of the negative effects has been a surge in Internet crime. According to a report released by the Gartner Consulting Group, in 2013 smart phone sales exceeded regular phone sales for the first time, with 968 million smart phones sold, representing 54% of the global mobile phone total and an increase of 54% from 2012. The popularity and technology of the mobile Internetwork, especially the smart mobile phone web, has changed the Internetwork landscape through the concept of cloud computing. Cloud computing is distributed computing over a network, using a program or application that can run on many connected computers and in different locations around the globe simultaneously at a reduced cost. This distributed cloud computing presents law enforcement authorities with the unique challenge of policing Internet crime. Cloud computing relies on sharing resources to achieve coherence, and in doing so creates economies of scale for converged infrastructures and shared services. Accordingly, one problem facing the authorities is the presence of trans- and multijurisdictional crimes. In this chapter, I explore this topic in the contexts of Hong Kong and Singapore, as both are key players on the international stage, especially in relation to international finance and information technology. In both locations, infrastructure works to maintain global financial center status. The remainder of this chapter is organized as follows. A brief overview of the development of cloud computing is followed by an examination of cybercrime risks in the cloud. Then, I review how the authorities in Hong Kong and Singapore respond to cybercrime risks and explore the current government policies on cloud computing, particularly in fighting cybercrime.


id: cord-257719-5s6acr7m
title: The Virus That Changed My World
author: Poh Ng, Lisa Fong
date: 2003-12-22
txt: ./txt/cord-257719-5s6acr7m.txt
cache: ./cache/cord-257719-5s6acr7m.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/14691538/
doi: 10.1371/journal.pbio.0000066
abstract: Personal account of a young virologist working in Singapore at the height of the 2003 SARS pandemic
summary:
  In the three months that Singapore was labelled as a "SARS country" by the World Health Organization (WHO), over 200 cases of SARS were reported, and 33 people died. Referring to the high standards of medical care and the societal measures put in place, Dr David Mansoor of WHO said that if not even Singapore could contain the outbreak, it was going to be very hard for other countries to prevent SARS from spreading (Chua 2003 I was to be part of the diagnostic team, and work began almost immediately. Data obtained from this work were significant for further understanding of coronavirus replication and pathogenesis, but never had I imagined that I would be able to use this knowledge in designing the SARS-CoV diagnostic kit with Roche. The months working on SARS opened my mind, as it did my heart, about the importance of research and of keeping our faith and motivation even in the toughest times.


id: cord-260179-g9umdcn2
author: He, Zonglin
date: 2020-04-18
txt: ./txt/cord-260179-g9umdcn2.txt
cache: ./cache/cord-260179-g9umdcn2.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.04.15.20066613
doi: 10.1101/2020.04.15.20066613
summary:
  METHOD Pearson correlation and generalized additive modeling were performed to assess the relationships between daily new COVID-19 cases and meteorological factors (daily average temperature and relative humidity) with the most updated data currently available. In most of the cities (Shanghai, Guangzhou, Hong Kong, Seoul, Tokyo, and Kuala Lumpur), generalized additive modeling analysis showed the number of daily new confirmed cases was positively associated with both average temperature and relative humidity, especially in lagged 3d model, where a positive influence of temperature on the daily new confirmed cases was discerned in 5 cities except in Beijing, Wuhan, Korea, and Malaysia. Generalized additive models (GAMs) with a Poisson family and logarithm link function were used to estimate the associations of daily COVID-19 new cases with average temperature and relative humidity. The correlation between average temperature and relative humidity was found positive in Shanghai, Guangzhou, Hong Kong, Korea, and Japan, and negative in Beijing, Wuhan, Singapore, and Malaysia according to the pairwise Pearson correlation test ( Table 2) .

title:
  Meteorological factors and domestic new cases of coronavirus disease (COVID-19) in nine Asian cities: A time-series analysis

abstract:
  AIM To investigate the associations of meteorological factors and the daily new cases of coronavirus disease (COVID-19) in nine Asian cities. METHOD Pearson correlation and generalized additive modeling were performed to assess the relationships between daily new COVID-19 cases and meteorological factors (daily average temperature and relative humidity) with the most updated data currently available. RESULTS The Pearson correlation showed that daily new confirmed cases of COVID-19 were more correlated with the average temperature than with relative humidity. Daily new confirmed cases were negatively correlated with the average temperature in Beijing (r=-0.565, P<0.01), Shanghai (r=-0.471, P<0.01), and Guangzhou (r=-0.530, P<0.01) , yet in contrast, positively correlated with that in Japan (r=0.441, P<0.01). In most of the cities (Shanghai, Guangzhou, Hong Kong, Seoul, Tokyo, and Kuala Lumpur), generalized additive modeling analysis showed the number of daily new confirmed cases was positively associated with both average temperature and relative humidity, especially in lagged 3d model, where a positive influence of temperature on the daily new confirmed cases was discerned in 5 cities except in Beijing, Wuhan, Korea, and Malaysia. Nevertheless, the results were inconsistent across cities and lagged time, suggesting meteorological factors were unlikely to greatly influence the COVID-19 epidemic. CONCLUSION The associations between meteorological factors and the number of COVID-19 daily cases are inconsistent across cities and lagged time. Large-scale public health measures and expanded regional research are still required until a vaccine becomes available and herd immunity is established.


id: cord-264924-ds6jv5ek
title: Severe acute respiratory syndrome from the trenches, at a Singapore university hospital
author: Tambyah, Paul A
date: 2004-11-30
url: https://www.ncbi.nlm.nih.gov/pubmed/15522681/
doi: 10.1016/s1473-3099(04)01175-2
abstract:
  Summary The epidemiology and virology of severe acute respiratory syndrome (SARS) have been written about many times and several guidelines on the infection control and public health measures believed necessary to control the spread of the virus have been published. However, there have been few reports of the problems that infectious disease clinicians encounter when dealing with the protean manifestations of this pathogen. This is a qualitative account of some of the issues faced by an infectious disease physician when identifying and treating patients with SARS as well as protecting other healthcare workers and patients, including: identification of the chain of contagion, early recognition of the disease in the absence of a reliable and rapid diagnostic test, appropriate use of personal protective equipment, and the use of isolation to prevent super-spreading events. Many issues need to be addressed if clinicians are to be able to manage the virus should it reappear.


id: cord-267326-355q6k6k
title: Geospatial distribution of viromes in tropical freshwater ecosystems
author: Gu, Xiaoqiong
date: 2018-06-15
txt: ./txt/cord-267326-355q6k6k.txt
cache: ./cache/cord-267326-355q6k6k.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/29550725/
doi: 10.1016/j.watres.2018.03.017
summary:
  This study shows that spatial factors (e.g., reservoirs/tributaries, land use) are the main drivers of the viral community structure in tropical freshwater ecosystems. However, up till now, studies of land use impacts on the virome community in freshwater ecosystems are still limited as they mainly rely on traditional methodology (culture-based method or qPCR/RT-qPCR), which focuses on limited human virus targets without considering the whole picture of the viral community in the water environment (Corsi et al., 2014; Lenaker et al., 2017) . Thus, the objectives of this study were to: 1) investigate the overall virome distribution and diversity in diverse freshwater ecosystems (reservoirs/tributaries) in a tropical environment, 2) compare the virome community based on the different land use patterns, 3) assess the extent of human-related pathogenic viruses in surface waters, especially emerging zoonotic and human-related viruses, which may have been undetected before.

abstract:
  This study seeks to understand the general distribution of virome abundance and diversity in tropical freshwater ecosystems in Singapore and the geospatial distribution of the virome under different landuse patterns. Correlations between diversity, environmental parameters and land use patterns were analyzed and significant correlations were highlighted. Overall, the majority (65.5%) of the annotated virome belonged to bacteriophages. The percentage of Caudovirales was higher in reservoirs whereas the percentages of Dicistroviridae, Microviridae and Circoviridae were higher in tributaries. Reservoirs showed a higher Shannon-index virome diversity compared to upstream tributaries. Land use (urbanized, agriculture and parkland areas) influenced the characteristics of the virome distribution pattern. Dicistroviridae and Microviridae were enriched in urbanized tributaries while Mimiviridae, Phycodnaviridae, Siphoviridae and Podoviridae were enriched in parkland reservoirs. Several sequences closely related to the emerging zoonotic virus, cyclovirus, and the human-related virus (human picobirnavirus), were also detected. In addition, the relative abundance of PMMoV (pepper mild mottle virus) sequences was significantly correlated with RT-qPCR measurements (0.588 < r < 0.879, p < 0.05). This study shows that spatial factors (e.g., reservoirs/tributaries, land use) are the main drivers of the viral community structure in tropical freshwater ecosystems.


id: cord-269939-8nvrt5y7
title: Personal View: Managing The Covid-19 Pandemic As A National Radiation Oncology Centre In Singapore
author: Tan, Boon Fei
date: 2020-04-23
txt: ./txt/cord-269939-8nvrt5y7.txt
cache: ./cache/cord-269939-8nvrt5y7.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S093665552030162X
doi: 10.1016/j.clon.2020.04.006
summary:
  title: Personal View: Managing The Covid-19 Pandemic As A National Radiation Oncology Centre In Singapore Abstract COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020. On 23 January 2020, Singapore reported its first imported case of the novel coronavirus infection, officially named COVID-19, [AQ1]which was later declared a global pandemic by the World Health Organization (WHO) [1] . The division serves about 61% of the country''s population who require radiotherapy, treating about 280-300 patients per day, including inpatients from SGH and other hospitals within the healthcare cluster. Should any patient who is quarantined for 14 days due to close contact with confirmed COVID-19 cases or those with a Stay Home Notice (SHN) due to recent entry from abroad as of 20 March 2020 require radiotherapy, it will be conducted in a highly controlled manner with close collaboration with the Ministry of Health.

abstract:
  Abstract COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020. It has impacted the world medically, financially, politically and socially, with countries such as China and Italy adopting a full lockdown of their cities to mitigate the transmission. The current mortality rate is 5.4%, with 1 056 159 people infected worldwide. The disease is reminiscent of SARS in 2002, from which the healthcare system of Singapore has garnered many lessons and applied them in the current climate. As a result of the high transmissibility of the virus, hospitals in Singapore have reduced clinic loads and elective treatments to halt propagation of the virus and also to allow redistribution of healthcare workforce to the frontline. Cancer patients, who are often immunocompromised, are at risk of contracting the disease and becoming seriously ill. At the same time, delaying treatment such as radiotherapy in cancer patients can be detrimental. Here, we describe our experience as a large radiation oncology department in Singapore, including the challenges we encountered and how we managed our patient flow.


id: cord-270969-zb6ih5dl
title: Health and health-care systems in southeast Asia: diversity and transitions
author: Chongsuvivatwong, Virasakdi
date: 2011-01-25
url: https://doi.org/10.1016/s0140-6736(10)61507-3
doi: 10.1016/s0140-6736(10)61507-3
abstract:
  Southeast Asia is a region of enormous social, economic, and political diversity, both across and within countries, shaped by its history, geography, and position as a major crossroad of trade and the movement of goods and services. These factors have not only contributed to the disparate health status of the region's diverse populations, but also to the diverse nature of its health systems, which are at varying stages of evolution. Rapid but inequitable socioeconomic development, coupled with differing rates of demographic and epidemiological transitions, have accentuated health disparities and posed great public health challenges for national health systems, particularly the control of emerging infectious diseases and the rise of non-communicable diseases within ageing populations. While novel forms of health care are evolving in the region, such as corporatised public health-care systems (government owned, but operating according to corporate principles and with private-sector participation) and financing mechanisms to achieve universal coverage, there are key lessons for health reforms and decentralisation. New challenges have emerged with rising trade in health services, migration of the health workforce, and medical tourism. Juxtaposed between the emerging giant economies of China and India, countries of the region are attempting to forge a common regional identity, despite their diversity, to seek mutually acceptable and effective solutions to key regional health challenges. In this first paper in the Lancet Series on health in southeast Asia, we present an overview of key demographic and epidemiological changes in the region, explore challenges facing health systems, and draw attention to the potential for regional collaboration in health.


id: cord-272526-2fgtjouu
author: Hutton, Thomas A
date: 2003-05-30
txt: ./txt/cord-272526-2fgtjouu.txt
cache: ./cache/cord-272526-2fgtjouu.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0305900603000138
doi: 10.1016/s0305-9006(03)00013-8
summary:
  5 5 In general scholarly attention to the growth and development of service activities has evolved as follows: (a) an early interest in the growth of high-rise offices in the CBDs of the largest metropolitan cities, including important theoretical and conceptual contributions (Gottmann, 1961) , (b) a stream of empirical studies of office location, emphasizing regional policy implications and urban planning problems (Daniels, 1975; Goddard, 1975) , (c) growing interest in the social ramifications of services growth (Bell, 1973) , (d) a sharper analytical focus on business, ''producer'' and other intermediate services, and their role in urban and regional development (Noyelle and Stanback, 1984) , and in the operation of ''flexible'' industrial regimes, (e) assessments of the global dimensions of services development, especially in banking and finance, as well as in producer services and communications (Daniels, 1993 ), (f) acknowledgement of the importance of specialized services in the emergence of the ''informational city'' and urban society (Castells, 1989) , and (g) explorations of the intersections between tertiarization, occupational shifts, urban class (re)formation, and community-level impacts, especially in the metropolitan core (Ley, 1996) .

title:
  Service industries, globalization, and urban restructuring within the Asia-Pacific: new development trajectories and planning responses

abstract:
  While industralization programmes have been central to the development of Asia-Pacific states and city-regions over the past half-century, service industries are increasingly important as instruments of urban growth and change. The purpose of this paper is to establish service industries as increasingly significant aspects of urban development within the Asia-Pacific, and to propose a conceptual and analytical framework for scholarly investigation within this important research domain. To this end the paper explores a sequence of related themes and issues, concerning the larger developmental implications of urban services growth (or tertiarization), the facets of urban transformation associated with tertiarization, and a preliminary typology of urban service functions which acknowledges the rich diversity of service vocations and stages of development within the Asia-Pacific. The paper concludes that “advanced services”—specialized, intermediate service industries, advanced-technology services, and creative service industries—will be quite crucial to the development of city-regions within the Asia-Pacific, with respect to employment growth and human capital formation, to the urban economic (or export) base, to the operation of flexible production systems, and to competitive advantage. The development of these urban service poles will require innovative policy commitments and regulatory adjustments, as will the multi-centred specialized urban service corridors which function as engines of regional economic growth, and which provide platforms for national modernization and responses to the pressures (and opportunities) of globalization. To date, urban and regional development strategies for service industries within the Asia-Pacific have privileged globalization, industrial restructuring, and modernization aims, but there is also an encouraging record of more progressive planning experimentation in some jurisdictions, incorporating principles of sustainability and co-operative development. There is also increasing interest in policies to support cultural and creative industries among Asia-Pacific city-regions, informed by some recent urban policy experimentation in this domain. These experiences can offer models for further policy and programmatic innovation in the 21st century, as service industries continue to play larger roles in urban and regional development within the Asia-Pacific.


id: cord-279861-gk8cow8k
title: Modeling and public health emergency responses: Lessons from SARS
author: Glasser, John W.
date: 2011-01-28
txt: ./txt/cord-279861-gk8cow8k.txt
cache: ./cache/cord-279861-gk8cow8k.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1755436511000028
doi: 10.1016/j.epidem.2011.01.001
summary:
  By overestimating the potential of managing contacts versus cases, moreover, we may even have inadvertently contributed to a lingering misunderstanding of means by which this epidemic was controlled that will affect their future responses to newly-emerging infectious diseases. Given the assumptions outlined above, together with a gamma distribution, these results suggest that for a disease with ℜ 0 = 3, isolation that was 100% effective in blocking transmission could prevent ℜ 0 − 1 infections (and thus lead to epidemic control) if implemented up to 5.2 days after symptom onset, on average (Fig. 1) . Knowledgeable public health practitioners might have cautioned against overestimating the potential impact of managing contacts of SARS patients, and interpreted observations suggesting that infected people were not particularly infectious until acutely ill as an indication for managing cases instead.

abstract:
  Modelers published thoughtful articles after the 2003 SARS crisis, but had limited if any real-time impact on the global response and may even have inadvertently contributed to a lingering misunderstanding of the means by which the epidemic was controlled. The impact of any intervention depends on its efficiency as well as efficacy, and efficient isolation of infected individuals before they become symptomatic is difficult to imagine. Nonetheless, in exploring the possible impact of quarantine, the product of efficiency and efficacy was varied over the entire unit interval. Another mistake was repeatedly fitting otherwise appropriate gamma distributions to times to event regardless of whether they were stationary or not, particularly onset-isolation intervals whose progressive reduction evidently contributed to SARS control. By virtue of their unknown biology, newly-emerging diseases are more challenging than familiar human scourges. Influenza, for example, recurs annually and has been modeled more thoroughly than any other infectious disease. Moreover, models were integrated into preparedness exercises, during which working relationships were established that bore fruit during the 2009 A/H1N1 pandemic. To provide the most accurate and timely advice possible, especially about the possible impact of measures designed to control diseases caused by novel human pathogens, we must appreciate the value and difficulty of policy-oriented modeling. Effective communication of insights gleaned from modeling SARS will help to ensure that policymakers involve modelers in future outbreaks of newly-emerging infectious diseases. Accordingly, we illustrate the increasingly timely care-seeking by which, together with increasingly accurate diagnoses and effective isolation, SARS was controlled via heuristic arguments and descriptive analyses of familiar observations.


id: cord-289006-7dv1zsp9
author: Tan, Kimberly-Anne
date: 2020-05-14
txt: ./txt/cord-289006-7dv1zsp9.txt
cache: ./cache/cord-289006-7dv1zsp9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32403894/
doi: 10.31616/asj.2020.0224
summary:
  The following topics were discussed: repurposing of surgeons, continuity of spine services, introduction of telemedicine, triaging of spinal surgeries, preoperative testing, new challenges in performing spine surgery, and preparing for the post-pandemic era. The aforementioned challenges in clinical practice brought about by the COVID-19 pandemic raise the question of whether we can use present-day technology to improve patient care. The orthopedic spine service of the National University Hospital has had a long-standing tradition of auditing all upcoming spine surgery cases every week and has reported this to be especially beneficial during the COVID-19 pandemic where resource availability is constantly changing. While the following set of guidelines provide a framework to help spine services triage their patients, the need to continually evaluate the operating lists on a case-by-case and resource-dependent basis remains crucial during this pandemic.

title:
  Addressing Coronavirus Disease 2019 in Spine Surgery: A Rapid National Consensus Using the Delphi Method via Teleconference

abstract:
  The magnitude and potential duration of the current coronavirus disease 2019 (COVID-19) pandemic is something that most doctors currently in practice have yet to experience. While considerable information regarding COVID-19 is being published every day, it is challenging to filter out the most relevant or appropriate information for our individual practice. The Spine Society of Singapore convened via a teleconference on April 24, 2020 to collaborate on a national level and share collective wisdom in order to tackle the ongoing crisis. In the teleconference, 13 spine surgeons from across various hospitals in Singapore constituted the panel of experts. The following topics were discussed: repurposing of surgeons, continuity of spine services, introduction of telemedicine, triaging of spinal surgeries, preoperative testing, new challenges in performing spine surgery, and preparing for the post-pandemic era. While some issues required only the sharing of best practices, the Delphi panel method was adopted to form a consensus on others. Existing spine specific triage guidelines were debated and a locally accepted set of guidelines was established. Although preoperative testing is currently not performed routinely, the panel voted in favor of its implementation because they concluded that it is vital to protect themselves, their colleagues, and their patients. Solutions to operating room specific concerns were also discussed. This article reflects the opinions and insights shared during this meeting and reviews the evidence relevant to the issues that were raised. The rapid consensus reached during the teleconference has enabled us to be concerted, and thus stronger, in our national efforts to provide the best standard of care via our spine services in these challenging times. We believe that this article will provide some guidance for addressing COVID-19 in spine surgery and encourage other national/regional societies to conduct similar discussions that would help their navigation of this pandemic.


id: cord-289054-fh95b5n4
title: Reducing droplet spread during airway manipulation: lessons from the COVID-19 pandemic in Singapore
author: Au Yong, Phui S.
date: 2020-04-15
txt: ./txt/cord-289054-fh95b5n4.txt
cache: ./cache/cord-289054-fh95b5n4.txt
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mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0007091220302191
doi: 10.1016/j.bja.2020.04.007
abstract: nan
summary:
  E-mail: angie.au.yong.p.s@singhealth.com.sg Keywords: airway management; COVID-19; extubation; infection control; intubation; operating room; prevention EditordCoronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization 1 on March 11, 2020 because of its rapid worldwide spread. 2 Airway manipulation poses a high risk of viral transmission to humans within close contact because of the proximity of the respiratory secretions that can aerosolise from coughing and gagging. The Singapore General Hospital instituted guidelines for airborne and contact precautions, including (i) environmental, reducing staff during airway manipulation, regular disinfection and sterilisation, sufficient air exchange time; and (ii) personal protective equipment (PPE). The main aim of constructing a tent or screen is that, if the patient coughs/gags during intubation, secretions will land under the sheet. A videolaryngoscope and tracheal tube can be passed under the plastic tent for intubation. Alternatively, Supplementary Fig 4 shows the use of a large plastic screen for intubation.


id: cord-290305-8u2zxsam
author: Fisher, D.
date: 2013-09-05
txt: ./txt/cord-290305-8u2zxsam.txt
cache: ./cache/cord-290305-8u2zxsam.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2013.07.005
doi: 10.1016/j.jhin.2013.07.005
summary:
  METHODS: The bundle included active surveillance on admission and transfer/discharge to identify ward-based acquisition of MRSA, isolation and cohorting of MRSA-infected patients, enhanced hand hygiene initiatives, and publicly displayed feedback of MRSA acquisition and hand hygiene compliance rates. 6e9 Effective interventions for controlling MRSA transmission in a hospital setting are well known and include active surveillance, improving hand hygiene compliance, and isolating all MRSA cases, whereas general strategies such as obtaining focused and committed hospital leadership are critical towards lowering implementation barriers and improving sustainability. À Other measures included a bare-below-the-elbows policy for all clinical staff, coloured bracelets to identify all colonized and infected patients, and cash rewards (of around US$250) for exemplary performances by wards or departments with regards to hand hygiene compliance and MRSA transmission rates to enjoy a celebratory lunch or similar.

title:
  Sustained meticillin-resistant Staphylococcus aureus control in a hyper-endemic tertiary acute care hospital with infrastructure challenges in Singapore

abstract:
  BACKGROUND: Meticillin-resistant Staphylococcus aureus (MRSA) has been entrenched in Singapore hospitals since the 1980s, with an excess of 600 non-duplicate cases of infections (120 bacteraemia episodes) each year in our 995-bed university hospital. Approximately 5% of our hospital beds are used as isolation facilities. AIM: To study the impact of an MRSA control bundle that was implemented via gradual geographic extension across hospital wards. METHODS: The bundle included active surveillance on admission and transfer/discharge to identify ward-based acquisition of MRSA, isolation and cohorting of MRSA-infected patients, enhanced hand hygiene initiatives, and publicly displayed feedback of MRSA acquisition and hand hygiene compliance rates. Implementation was between October 2006 and June 2010 in order to provide lead-time for the incremental development of infrastructural capacity, and to develop an ethic of infection prevention among staff. Results were analysed via interrupted time-series analysis. FINDINGS: MRSA infections fell midway through the implementation, with MRSA bacteraemia declining from 0.26 [95% confidence interval (CI): 0.18–0.34] cases per 1000 inpatient-days in the first quarter of 2004 to 0.11 (95% CI: 0.07–0.19) cases per 1000 inpatient-days in the first quarter of 2012. MRSA acquisition rates fell a year after the programme had been fully implemented, whereas hand hygiene compliance rose significantly from 47% (95% CI: 44–49) in the first quarter of 2009 to 69% (95% CI: 68–71) in the first quarter of 2012. CONCLUSION: Successful staged implementation of an MRSA bundle in a hyper-endemic setting is sustainable and represents a model that may be adapted for similar settings.


id: cord-292767-xazsbhbw
title: The incidence of human bocavirus infection among children admitted to hospital in Singapore
author: Tan, Boon‐Huan
date: 2008-11-21
txt: ./txt/cord-292767-xazsbhbw.txt
cache: ./cache/cord-292767-xazsbhbw.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/jmv.21361
doi: 10.1002/jmv.21361
summary:
  The data suggest that HBoV is an important cause of lower respiratory tract infections among children admitted to hospital in Singapore, and is the first study examining the incidence of HBoV infection in a developed country in South East Asia. In the current study, 50% of the patients in which HBoV was detected presented symptoms that were consistent with lower respiratory tract infections, which compared with 57.6% and 48.3% for RSV and HMPV, respectively. Although HBoV can be the single cause of lower respiratory tract infection in children, several studies have reported that HBoV coinfections with other respiratory viruses resulted in an increased severity of infection [Allander et al., 2005; Choi et al., 2006; Chung et al., 2006; Foulongne et al., 2006; Manning et al., 2006; Sloots et al., 2006; Fry et al., 2007] .

abstract:
  Human bocavirus (HBoV) is a parvovirus, belonging to the genus Bocavirus. The virus was identified recently in Sweden, and has now been detected in several different countries. Although it is associated with lower respiratory tract infections in pediatric patients, the incidence of HBoV infection in a developed country in South East Asia, has not been examined. The objective of this study was to determine the importance of HBoV as a cause of lower respiratory tract infections among children admitted to hospital in Singapore. Five hundred nasopharyngeal swabs were collected from anonymized pediatric patients admitted to the Kandang Kerbau Women's and Children's Hospital for acute respiratory infections. The specimens were tested for the presence of HBoV using polymerase chain reactions. HBoV was detected in 8.0% of the patients tested, and a majority of these HBoV patients exhibited lower respiratory tract infections. A significant level of coinfection with respiratory syncytial viruses and rhinoviruses was also observed in these HBoV patients. The data suggest that HBoV is an important cause of lower respiratory tract infections among children admitted to hospital in Singapore, and is the first study examining the incidence of HBoV infection in a developed country in South East Asia. J. Med. Virol. 81:82–89, 2009. © 2008 Wiley‐Liss, Inc.


id: cord-293704-tnik6sd3
author: Tey, Jeremy
date: 2020-03-31
txt: ./txt/cord-293704-tnik6sd3.txt
cache: ./cache/cord-293704-tnik6sd3.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S016781402030164X?v=s5
doi: 10.1016/j.radonc.2020.03.030
summary:
  There is a higher risk of mortality of COVID-19 in cancer patients and hence unique considerations for a radiation oncology department operating in an infectious disease outbreak. There is a higher risk of mortality of COVID-19 in cancer patients and hence unique considerations for a radiation oncology department operating in an infectious disease outbreak. This includes interventions, business continuity plans and workflow in managing a COVID-19 positive patient on radiotherapy. With the evolving COVID-19 outbreak, there needs to be provisions and policies to ensure continuity of radiation oncology services. There should be provisions within the department such that continuity of radiation oncology services will not be impacted as there is possibility of staff managing confirmed cases and therefore needs to be self-quarantined at home. Nonetheless, radiation oncology departments can act to better position themselves to continue radiotherapy services in the face of resource limitations brought on by the outbreak, as well as to protect staff and patients.

title:
  Navigating the challenges of the COVID-19 outbreak: perspectives from the radiation oncology service in singapore

abstract:
  In December 2019, pneumonia of unknown cause was reported by China to WHO. The outbreak was found to be caused by a coronavirus which was officially named “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), and the disease caused by it was named ‘COVID-19’. The first case in Singapore was confirmed on 23(rd) January 2020. With lessons learnt from the SARS epidemic in 2003 and the H1N1 flu pandemic in 2009, Singapore was much better prepared to deal with the virus outbreak. The government has taken swift measures to contain and break the chain of transmission. Healthcare workers face the challenge of keeping patients and staff safe from the disease. There is a higher risk of mortality of COVID-19 in cancer patients and hence unique considerations for a radiation oncology department operating in an infectious disease outbreak. This article is the recommendations and adapted workflow from the two National Cancer Centres in Singapore with the endorsement by the working committee of the Chapter of Radiation Oncology, Academy of Medicine, Singapore. It highlights the challenges that radiation oncology departments in Singapore face and the appropriate recommended responses. This includes interventions, business continuity plans and workflow in managing a COVID-19 positive patient on radiotherapy.


id: cord-294628-ecg13s7a
title: Managing COVID-19 in a Novel, Rapidly Deployable Community Isolation Quarantine Facility
author: Chia, Ming Li
date: 2020-09-17
txt: ./txt/cord-294628-ecg13s7a.txt
cache: ./cache/cord-294628-ecg13s7a.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.7326/m20-4746
doi: 10.7326/m20-4746
summary:
  During the coronavirus disease 2019 (COVID-19) pandemic, Singapore implemented large-scale institutional isolation units called Community Care Facilities (CCFs) to combat the outbreak in the community by housing low-risk COVID-19 patients from April to August 2020. During the coronavirus disease 2019 (COVID-19) pandemic, Singapore implemented large-scale institutional isolation units called Community Care Facilities (CCFs) to combat the outbreak in the community by housing low-risk COVID-19 patients from April to August 2020. In the first month, a total of 3758 patients were admitted to 4 halls, 4929 in-house medical consults occurred, 136 patients were transferred to a hospital, 1 patient died 2 weeks after discharge, and no health care workers became infected. As such, isolation centers called Community Care Facilities (CCFs) were set up throughout the country to house patients with COVID-19 who were at low risk for dying of the disease.

abstract:
  Singapore is one of the most densely populated small island–states in the world. During the coronavirus disease 2019 (COVID-19) pandemic, Singapore implemented large-scale institutional isolation units called Community Care Facilities (CCFs) to combat the outbreak in the community by housing low-risk COVID-19 patients from April to August 2020. The CCFs were created rapidly by converting existing public spaces and used a protocolized system, augmented by telemedicine to enable a low health care worker–patient ratio (98 health care workers for 3200 beds), to operate these unique facilities. In the first month, a total of 3758 patients were admitted to 4 halls, 4929 in-house medical consults occurred, 136 patients were transferred to a hospital, 1 patient died 2 weeks after discharge, and no health care workers became infected. This article shares the authors' experience in operating these massive-scale isolation facilities while prioritizing safety for all and ensuring holistic patient care in the face of a public health crisis and lean health care resources.


id: cord-294704-prizmksg
author: Lateef, Fatimah
date: 2004-06-16
txt: ./txt/cord-294704-prizmksg.txt
cache: ./cache/cord-294704-prizmksg.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1090312703004350
doi: 10.1016/j.prehos.2003.12.016
summary:
  Severe acute respiratory syndrome (SARS) is a newly emerging and highly infectious form of atypical pneumonia with a high rate of transmission, especially among health care workers. With SARS, certain policies had to be implemented rapidly by the emergency ambulance services and the Ministry of Health to support and protect all personnel adequately. The authors hope to share their experience in the implementation of these strategies by the Singapore Civil Defence Force and stress the importance of the psychological preparedness of the paramedics and prehospital care providers worldwide in this era of SARS. To date, a total of seven probable and five suspected cases were conveyed by the EAS out of a total of 204 patients with SARS-like signs and symptoms. With the declaration of the SARS outbreak in Singapore, the Ministry of Health designated Tan Tock Seng Hospital (TTSH), one of the public hospitals, as the ''''SARS hospital.'''' All suspected and probable cases were sent and managed there.

title:
  New paradigm for protection:: The emergency ambulance services in the time of severe acute respiratory syndrome

abstract:
  Severe acute respiratory syndrome (SARS) is a newly emerging and highly infectious form of atypical pneumonia with a high rate of transmission, especially among health care workers. With SARS, certain policies had to be implemented rapidly by the emergency ambulance services and the Ministry of Health to support and protect all personnel adequately. The authors discuss the changes in policies and personnel behavior, the training and education that had to be disseminated widely, and certain alternatives in policies such as transportation. The authors hope to share their experience in the implementation of these strategies by the Singapore Civil Defence Force and stress the importance of the psychological preparedness of the paramedics and prehospital care providers worldwide in this era of SARS.


id: cord-295514-vhymj0rw
author: Lim, Peter A
date: 2004-08-01
txt: ./txt/cord-295514-vhymj0rw.txt
cache: ./cache/cord-295514-vhymj0rw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/15295768/
doi: 10.1016/j.apmr.2004.01.022
summary:
  Severe acute respiratory syndrome (SARS) is a new respiratory viral epidemic that originated in China but has affected many parts of the world, with devastating impact on economies and the practice of medicine and rehabilitation. Rehabilitation was significantly affected by SARS, because strict infection control measures run counter to principles such as multidisciplinary interactions, patients encouraging and learning from each other, and close physical contact during therapy. Rehabilitation medicine was increasingly affected by everstricter infection control measures regarding close contacts and interactions between health care workers. Rehabilitation medicine was directly affected when the entire neurology ward, including patients and health care staff, were transferred out to TTSH for isolation and observation because of suspicious clusters of fevers that involved both patients and staff. Severe acute respiratory syndrome (SARS) in Singapore: clinical features of index patient and initial contacts

title:
  Impact of a viral respiratory epidemic on the practice of medicine and rehabilitation: Severe acute respiratory syndrome

abstract:
  Lim PA, Ng YS, Tay BK. Impact of a viral respiratory epidemic on the practice of medicine and rehabilitation: severe acute respiratory syndrome. Arch Phys Med Rehabil 2004;85:1365–70. Severe acute respiratory syndrome (SARS) is a new respiratory viral epidemic that originated in China but has affected many parts of the world, with devastating impact on economies and the practice of medicine and rehabilitation. A novel coronavirus has been implicated, with transmission through respiratory droplets. Rehabilitation was significantly affected by SARS, because strict infection control measures run counter to principles such as multidisciplinary interactions, patients encouraging and learning from each other, and close physical contact during therapy. Immunocompromised patients who may silently carry SARS are common in rehabilitation and include those with renal failure, diabetes, and cancer. Routine procedures such as management of feces and respiratory secretions (eg, airway suctioning, tracheotomy care) have been classified as high risk. Personal protection equipment presented not only a physical but also a psychologic barrier to therapeutic human contact. Visitor restriction to decrease chances of disease transmission are particularly difficult for long-staying rehabilitation patients. At the height of the epidemic, curtailment of patient movement stopped all transfers for rehabilitation, and physiatrists had to function as general internists. Our experiences strongly suggest that rehabilitation institutions should have emergency preparedness plans because such epidemics may recur, whether as a result of nature or of bioterrorism.


id: cord-296226-ugeupo3u
title: A greener vision for vector control: The example of the Singapore dengue control programme
author: Sim, Shuzhen
date: 2020-08-27
txt: ./txt/cord-296226-ugeupo3u.txt
cache: ./cache/cord-296226-ugeupo3u.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32853197/
doi: 10.1371/journal.pntd.0008428
summary:
  Aedes-borne diseases, in particular, including dengue, chikungunya, yellow fever, and Zika, are increasing at an alarming rate due to urbanisation, population movement, weak vector control programmes, and climate change. The environmental management put in place to implement this high standard of public cleanliness has greatly benefited Singapore''s efforts to tackle VBDs. Underscoring the view that Aedes-borne diseases are environmental diseases, dengue control in Singapore is led by the National Environment Agency (NEA), a statutory board of the Ministry of the Environment and Water Resources (MEWR). In view of the importance of infrastructure maintenance and design, environmental sanitation, people''s behaviours, and use of technologies on dengue prevention, the NEA collaborates closely with other government ministries (e.g., Health, National Development, Education, Finance), town councils (responsible for management and maintenance of the common property of public housing estates, including vector control), community associations, research and academic institutions, and the private sector (Fig 2) .

abstract:
  Vector-borne diseases are a major cause of morbidity and mortality worldwide. Aedes-borne diseases, in particular, including dengue, chikungunya, yellow fever, and Zika, are increasing at an alarming rate due to urbanisation, population movement, weak vector control programmes, and climate change. The World Health Organization calls for strengthening of vector control programmes in line with the Global Vector Control Response (GVCR) strategy, and many vector control programmes are transitioning to this new approach. The Singapore dengue control programme, situated within the country’s larger vision of a clean, green, and sustainable environment for the health and well-being of its citizens, provides an excellent example of the GVCR approach in action. Since establishing vector control operations in the 1960s, the Singapore dengue control programme succeeded in reducing the dengue force of infection 10-fold by the 1990s and has maintained it at low levels ever since. Key to this success is consideration of dengue as an environmental disease, with a strong focus on source reduction and other environmental management methods as the dominant vector control strategy. The programme collaborates closely with other government ministries, as well as town councils, communities, the private sector, and academic and research institutions. Community engagement programmes encourage source reduction, and house-to-house inspections accompanied by a strong legislative framework with monetary penalties help to support compliance. Strong vector and epidemiological surveillance means that routine control activities can be heightened to specifically target dengue clusters. Despite its success, the programme continues to innovate to tackle challenges such as climate change, low herd immunity, and manpower constraints. Initiatives include development of novel vector controls such as Wolbachia-infected males and spatiotemporal models for dengue risk assessment. Lessons learnt from the Singapore programme can be applied to other settings, even those less well-resourced than Singapore, for more effective vector control.


id: cord-300300-jqi4ylrx
title: From SARS to COVID‐19: the Singapore journey
author: Lin, Ray Junhao
date: 2020-05-31
txt: ./txt/cord-300300-jqi4ylrx.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32474940/
doi: 10.5694/mja2.50623
abstract: nan
summary:
  The 2003 severe acute respiratory syndrome (SARS) outbreak challenged the nation''s public health system and now the coronavirus disease 2019 (COVID-19) pandemic is presenting a greater challenge. This framework serves as the foundation for the national responses to any outbreak and is divided into four levels of incremental severity (green, yellow, orange and red), based on risk assessment of the public health impact of the disease and the current disease situation in Singapore (Box 1). Workers who tested positive were transferred to community isolation facilities if they had mild symptoms, or to the NCID and public hospitals for further treatment and isolation. Health care workers in direct contact with COVID-19 patients who developed fever or symptoms of acute respiratory infection were encouraged to declare their symptoms to their superiors and present themselves to the screening centre, to be managed based on their exposure risk (Box 4).


id: cord-309080-1r8t8yxv
author: Tay, Yi Xiang
date: 2020-10-19
txt: ./txt/cord-309080-1r8t8yxv.txt
cache: ./cache/cord-309080-1r8t8yxv.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jmir.2020.10.004
doi: 10.1016/j.jmir.2020.10.004
abstract: nan
summary:
  Like nursing, midwifery and many allied health education programmes, clinical training is an important cornerstone of radiographer education -equipping students to safely and competently transit into complex healthcare environments 6, 7 . However, as all the overseas students were selffinanced, the potential of additional emotional and psychological challenges had to be considered 12 One of the ways of support for the clinical educators came in the form of encouragement from notes of appreciation and gifts from the public, and the hospital senior managements to all frontline heroes -showing how much their efforts were valued through these gestures of care and appreciation. Indeed, these characteristics of Generation Z students will certainly affect how clinical educators provide education in the COVID-19 pandemic. With the new ratio, clinical educators were able to provide the students with more guidance, frequent immediate feedback and encouragement to learn from their mistakes -meeting the Generation Z students'' learner perspectives [36] [37] .

title:
  The needs and concerns of clinical educators in radiography education in the face of COVID-19 pandemic


id: cord-312045-orko04fi
author: Sreevalsan-Nair, Jaya
date: 2020-04-22
txt: ./txt/cord-312045-orko04fi.txt
cache: ./cache/cord-312045-orko04fi.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.04.17.20069724
doi: 10.1101/2020.04.17.20069724
summary:
  The first part of the paper studies the descriptive statistics and the influence of demographic parameters, namely age and gender, in the clinical recovery-period of COVID-19 patients. Firstly, we study the age-gender distribution of the patients who have been confirmed positive of COVID-19 and those who have clinically recovered. The novel contribution of our work is an in-depth analysis of the clinical recovery of COVID-19 patients to estimate the recovery rate γ, which is a key parameter in the SIR (susceptible-infected-recovered) model for the disease [9] . Secondly, we use the number of patients recovering for a specific ∆t r as a count variable and fit multivariate linear regression models considering age and gender as independent variables, and ∆t r as the dependent variable. Table 1 : Percentage values of the age-gender structure of population confirmed positive with COVID-19 during January 23-April 01, 2020 in Singapore ( §Figures 1(i), and 2(i)).

title:
  ANALYSIS OF CLINICAL RECOVERY-PERIOD AND RECOVERY RATE ESTIMATION OF THE FIRST 1000 COVID-19 PATIENTS IN SINGAPORE

abstract:
  COVID-19 has been declared as a global pandemic by the World Health Organization (WHO) on March 11, 2020. In this paper, we investigate various aspects of the clinical recovery of the first 1000 COVID-19 patients in Singapore, spanning from January 23 to April 01, 2020. This data consists of 245 clinically recovered patients. The first part of the paper studies the descriptive statistics and the influence of demographic parameters, namely age and gender, in the clinical recovery-period of COVID-19 patients. The second part of the paper is on identifying the distribution of the length of the recovery-period for the patients. We identify a piecewise analysis of three different periods, identified based on trends of both positive confirmation and clinical recovery of COVID-19. As expected, the overall recovery rate has reduced drastically during the exponential increase of incidences. However, our in-depth analysis shows that there is a shift in the age-group of incidences to the younger population, and the recovery-period of the younger population is considerably lower. Here, we have estimated the recovery rate to be 0.125. Overall, the prognosis of COVID-19 indicates an improvement in recovery rate owing to the government-mandated practices of restricted mobility of the older population and aggressive contact tracing.


id: cord-318115-xo4xop3k
title: COVID-19 Outbreak in Nursing Homes in Singapore
author: Tan, Li Feng
date: 2020-05-13
txt: ./txt/cord-318115-xo4xop3k.txt
cache: ./cache/cord-318115-xo4xop3k.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1684118220301122
doi: 10.1016/j.jmii.2020.04.018
abstract: nan
summary:
  Despite initial success in containing COVID-19 transmission, Singapore''s rate of community transmission increased exponentially in mid-March 2020 as the pandemic spread across the world and overseas travellers returned to Singapore (Figure 1 ). As of 27 th April 2020, 6 LTCFs in Singapore have detected COVID-19 cases. Despite accounting for <0.001% of total cases in Singapore, deaths of LTCF residents due to COVID-19 account for 14% of the total fatalities. Despite these tough measures, COVID-19 still found its way into 6 nursing homes in Singapore (Figure 1 ). However, preventing COVID-19 transmission to LTCFs remains a challenge if community transmission is not well-controlled. This is because staff remain vulnerable to catching the virus and inadvertently spreading it to LTCF residents especially as the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is highly contagious even while asymptomatic 2 . Preventing the Spread of COVID-19 to Nursing Homes: Experience from a Singapore Geriatric Centre


id: cord-319483-be8v9kuu
title: Epidemiology of Travel-associated Pandemic (H1N1) 2009 Infection in 116 Patients, Singapore
author: Mukherjee, Pratik
date: 2010-01-17
txt: ./txt/cord-319483-be8v9kuu.txt
cache: ./cache/cord-319483-be8v9kuu.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3201/eid1601.091376
doi: 10.3201/eid1601.091376
summary:
  To understand how travel patterns affected the initial outbreak, we examined epidemiologic and travel data for the first 116 case-patients admitted to Tan Tock Seng Hospital, Singapore, with travel-associated infection. To understand how travel patterns affected the initial outbreak, we examined epidemiologic and travel data for the fi rst 116 case-patients admitted to Tan Tock Seng Hospital, Singapore, with travel-associated infection. Human-to-human transmission of infl uenza during air travel has been reported to occur on fl ights of at least 8 hours and to affect passengers seated within 2 rows of the index case-patient (6) . During this initial period, travel from a pandemic (H1N1) 2009-affected During the containment phase, airport thermal scanners were used to detect fevers in arriving passengers at Singapore''s Changi International Airport, and health advisories were used to encourage travelers in whom infl uenza-like symptoms developed after disembarkation to seek medical care.

abstract:
  In June 2009, during Singapore’s pandemic influenza plan containment phase, pandemic (H1N1) 2009 was introduced into the country through imported cases. To understand how travel patterns affected the initial outbreak, we examined epidemiologic and travel data for the first 116 case-patients admitted to Tan Tock Seng Hospital, Singapore, with travel-associated infection. Sixty-one percent and 54% of patients, respectively, met US Centers for Disease Control and Prevention and World Health Organization temperature criteria for influenza-like illness. One fourth of the case-patients traveled after illness onset, and 15% became ill while traveling. Regions of exposure for imported infections changed rapidly; case-patients initially arrived from North America, followed by Australasia and Southeast Asia. Case-patients on longer flights were more likely to become ill before arrival; those with shorter flights tended to become ill after arrival. Thermal scanners detected fevers in 12% of the arriving case-patients, resulting in a shorter time to isolation.


id: cord-320945-swr3l0ur
author: Liu, Zhenghong
date: 2020-09-25
txt: ./txt/cord-320945-swr3l0ur.txt
cache: ./cache/cord-320945-swr3l0ur.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33043319/
doi: 10.1002/emp2.12264
summary:
  Given that even a single patient in a crowded ED can potentially ignite a nosocomial outbreak of a novel respiratory pathogen, 3 with devastating consequences and the prospect of ED closure, 3, 4 it is crucial to ensure that hospital EDs can continue to operate safely throughout the COVID-19 pandemic, without becoming hotbeds for disease transmission. 6 Over the next few months, our ED rapidly developed and implemented a response plan that maximized the limited physical space and allowed our ED to appropriately manage patients with different risk profiles for COVID-19,while simultaneously maintaining adequate protection for other patients and staff. In general, patients requiring non-ambulatory care in the first phase of our response were at low risk of COVID-19, given that imported cases At the same time, our ED was also experiencing an increase in non-ambulatory suspect COVID-19 cases, given the older age profile of patients presenting during this phase.

title:
  Dynamic emergency department response to the evolving COVID‐19 pandemic: the experience of a tertiary hospital in Singapore

abstract:
  The coronavirus disease 2019 (COVID‐19) pandemic has placed large stressors on emergency departments (EDs) worldwide. As the pandemic progressed, EDs faced changing patient epidemiology and numbers. Our ED needed to rapidly transform to deal with the risk of COVID‐19. Having limited floor space, we opted for a phased, dynamic response that allowed us to adapt the ED multiple times as the epidemiology of the pandemic evolved. The principles behind our response include guiding ED operations with data, enhancing infection control practices, and being prepared to transform areas of the ED to care for different groups of patients. Our experience can serve to guide other EDs in planning their response to surge capacity and ED operations during such pandemics.


id: cord-321704-jozrgcq3
author: Tan, Xin Quan
date: 2014-04-15
txt: ./txt/cord-321704-jozrgcq3.txt
cache: ./cache/cord-321704-jozrgcq3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/24735158/
doi: 10.1186/1471-2334-14-204
summary:
  METHODS: From May 2009 through October 2012, 7733 consenting cases of febrile respiratory illness (FRI) (temperature [greater than or equal to]37.5degreesC with cough or sorethroat) and controls in the Singapore military had clinical data and nasal washes collected prospectively. As influenza viruses have accounted for only between 10.1% to 53.0% of all ILI cases [15] [16] [17] , it is important to understand the contribution of other respiratory pathogens to overall morbidity and to determine their epidemiological distribution and clinical presentation. To address these issues, this study explores data obtained from a respiratory disease sentinel surveillance system in the Singapore military to examine the etiologic viral agents of respiratory illnesses in a tropical environment, to determine the viruses that circulate post-influenza vaccination, and to compare the differences in clinical presentation.

title:
  Respiratory viral pathogens among Singapore military servicemen 2009 – 2012: epidemiology and clinical characteristics

abstract:
  BACKGROUND: Few studies have comprehensively described tropical respiratory disease surveillance in military populations. There is also a lack of studies comparing clinical characteristics of the non-influenza pathogens with influenza and amongst themselves. METHODS: From May 2009 through October 2012, 7733 consenting cases of febrile respiratory illness (FRI) (temperature [greater than or equal to]37.5degreesC with cough or sorethroat) and controls in the Singapore military had clinical data and nasal washes collected prospectively. Nasal washes underwent multiplex PCR, and the analysis was limited to viral mono-infections. RESULTS: 49% of cases tested positive for at least one virus, of whom 10% had multiple infections. 53% of the FRI cases fulfilled the definition of influenza-like illness (ILI), of whom 52% were positive for at least one virus. The most frequent etiologies for mono-infections among FRI cases were Influenza A(H1N1)pdm09 (13%), Influenza B (13%) and coxsackevirus (9%). The sensitivity, specificity, positive predictive value and negative predictive value of ILI for influenza among FRI cases were 72%, 48%, 40% and 69% respectively. On logistic regression, there were marked differences in the prevalence of different symptoms and signs between viruses with fever more prevalent amongst influenza and adenovirus infections than other viruses. CONCLUSION: There are multiple viral etiologies for FRI and ILI with differing clinical symptoms in the Singapore military. Influenza and coxsackevirus were the most common etiology for FRI, while influenza and adenoviruses displayed the most febrile symptoms. Further studies should explore these differences and possible interventions.


id: cord-321754-sy3ncwgw
author: Yap, Jonathan
date: 2010-07-28
txt: ./txt/cord-321754-sy3ncwgw.txt
cache: ./cache/cord-321754-sy3ncwgw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/20667076/
doi: 10.1186/1471-2458-10-442
summary:
  title: Knowledge, attitudes and practices towards pandemic influenza among cases, close contacts, and healthcare workers in tropical Singapore: a cross-sectional survey METHODS: We performed a cross-sectional knowledge, attitudes and practices survey in the Singapore military from mid-August to early-October 2009, among 3054 personnel in four exposure groups laboratory-confirmed H1N1-2009 cases, close contacts of cases, healthcare workers, and general personnel. The questionnaire collected basic demographic data on age, sex, ethnicity, education level and housing type while is a commonly-used national proxy for socio-economic status [19] ; and included questions on knowledge, attitudes, and practices on pandemic influenza. From the univariate analyses, significant predictors for higher practice scores included female sex, exposure group (patients, contacts and healthcare workers compared to general individuals), ethnicity (Malay and Indian compared to Chinese), older age group, private housing compared to 3 room flats, and higher knowledge and attitude scores.

title:
  Knowledge, attitudes and practices towards pandemic influenza among cases, close contacts, and healthcare workers in tropical Singapore: a cross-sectional survey

abstract:
  BACKGROUND: Effective influenza pandemic management requires understanding of the factors influencing behavioral changes. We aim to determine the differences in knowledge, attitudes and practices in various different cohorts and explore the pertinent factors that influenced behavior in tropical Singapore. METHODS: We performed a cross-sectional knowledge, attitudes and practices survey in the Singapore military from mid-August to early-October 2009, among 3054 personnel in four exposure groups - laboratory-confirmed H1N1-2009 cases, close contacts of cases, healthcare workers, and general personnel. RESULTS: 1063 (34.8%) participants responded. The mean age was 21.4 (SE 0.2) years old. Close contacts had the highest knowledge score (71.7%, p = 0.004) while cases had the highest practice scores (58.8%, p < 0.001). There was a strong correlation between knowledge and practice scores (r = 0.27, p < 0.01) and knowledge and attitudes scores (r = 0.21, p < 0.01). The significant predictors of higher practice scores were higher knowledge scores (p < 0.001), Malay ethnicity (p < 0.001), exposure group (p < 0.05) and lower education level (p < 0.05). The significant predictors for higher attitudes scores were Malay ethnicity (p = 0.014) and higher knowledge scores (p < 0.001). The significant predictor for higher knowledge score was being a contact (p = 0.007). CONCLUSION: Knowledge is a significant influence on attitudes and practices in a pandemic, and personal experience influences practice behaviors. Efforts should be targeted at educating the general population to improve practices in the current pandemic, as well as for future epidemics.


id: cord-322802-id9jg6v4
author: Fouda, Ayman
date: 2020-08-28
txt: ./txt/cord-322802-id9jg6v4.txt
cache: ./cache/cord-322802-id9jg6v4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32874858/
doi: 10.1016/j.hlpt.2020.08.015
summary:
  title: The COVID-19 pandemic in Greece, Iceland, New Zealand, and Singapore: Health Policies and Lessons Learned OBJECTIVE(S): This paper aims at providing an overview of the COVID-19 situation, health policies, and economic impact in Greece, Iceland, New Zealand, and Singapore. The countries Greece, Iceland, New Zealand and Singapore have been chosen due to their ability to mitigate the effects of COVID-19 at an early stage and, in the case of one, eliminate community transmission of SARS-CoV-2; their similar geographic nature as islands and peninsulas; and their economies which mainly rely on service producing industries. Daily data COVID-19 cases, deaths, recoveries As of the 9 th of August 2020, Greece, Iceland, New Zealand and Singapore had reported 20,440 laboratory confirmed cases of SARS-CoV-2 between them, accounting for 0.6% of the world''s confirmed cases [34] .

title:
  The COVID-19 pandemic in Greece, Iceland, New Zealand, and Singapore: Health Policies and Lessons Learned

abstract:
  OBJECTIVE(S): This paper aims at providing an overview of the COVID-19 situation, health policies, and economic impact in Greece, Iceland, New Zealand, and Singapore. The four countries were chosen due to their ability to contain the spread and mitigate the effects of COVID-19 on their societies. METHOD(S): We use document analysis based on the available national reports, media announcements, official coronavirus websites and governmental decrees in each of the four countries starting from the 1(st) of January o the 9th of August announcements. We apply a policy gradient to compare and examine the policies implemented in the four countries. FINDING(S): The four countries have different demographic, epidemiological, socioeconomic profiles but managed to control the pandemic at an early stage in terms of total number of positive cases. The four countries managed to absorb the health system shock and decrease the case fatality ratio of COVID-19. Early interventions were crucial to avoid expected life lost in case of no early lockdown. The pandemic triggered several economic stimulus and relief measures in the four countries; the impact or the economic rebound is yet to be fully observed. CONCLUSION(S): We conclude that early, proactive and strict interventions along with leveraging previous experience on communicable diseases and the evolution of testing strategies are key lessons that can be synthesized from the interventions of the four countries and that could be useful for a potential second wave or similar pandemics.


id: cord-324345-j43rpvwk
title: SARS – My personal battle
author: Leong, Hoe Nam
date: 2010-11-19
txt: ./txt/cord-324345-j43rpvwk.txt
cache: ./cache/cord-324345-j43rpvwk.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.tmaid.2010.10.007
doi: 10.1016/j.tmaid.2010.10.007
summary:
  I vividly remember the time when I first saw the index patient with Severe Acute Respiratory Syndrome (SARS) in Singapore. The index patient was admitted to Tan Tock Seng Hospital (TTSH) on Saturday, (1st March 2003), and an infectious disease consult was sought on the following Monday. It was an exceedingly busy day for me as I had to attend to new referrals, run an outpatient clinic, and subsequently draft a clinical summary of these two patients by the early evening. Eventually, the patient''s fever defervesced on day 14 of illness. I wasn''t scheduled to perform the ward round that day, but I returned to visit the patient that Sunday morning. My wife and I telephoned a colleague in Singapore and we concurred to have a full blood count test done at the clinic the next day. My wife eventually joined me when she developed fever at the end of the second day of arrival. With that news, my days as a patient in isolation continued.

abstract:
  It isn’t every day that a doctor becomes a patient. It is more peculiar when it occurs with an unknown mysterious epidemic respiratory illness that kills. Severe acute respiratory syndrome (SARS) gripped the world in 2003, spreading via air-links and throwing the global economy into disarray. As a practicing physician in Singapore, one of the first countries affected, I describe my first-hand account of my battle with this illness, how I acquired this illness in Singapore, and eventually quarantine in Frankfurt am Main, Germany.


id: cord-326185-gjte739i
author: Mukherjee, Pratik
date: 2020-06-19
txt: ./txt/cord-326185-gjte739i.txt
cache: ./cache/cord-326185-gjte739i.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1259/bjro.20200017
doi: 10.1259/bjro.20200017
summary:
  Since confirmation of the first COVID-19 imported case in Singapore on 23 January 2020, there has been a gradual increase in numbers of infected patients, mostly from imports and within small local clusters, in the first 2 months or so, that is February and March 2020. From the outbreak onset, measures were taken to keep all potential COVID-19 cases presenting to the emergency department (ED) separate from the "cold" patients and HCWs, in order to prevent cross-infection. Multiple factors contributed to the situation: (a) additional workload of screening chest radiographs in the ED (ESW and ARW), as well as the isolation wards; (b) increased time required to perform cross-sectional imaging on COVID-19 positive or suspected cases due to additional infection control measures; (c) less available workforce due to segregation strategies to protect staff providing essential services and redeployment of staff to other areas of need; both within our hospital and at other institutions, for example, NCID and (d) limited hospital beds.

title:
  Adaptability and responsiveness: keys to operational measures in a regional hospital radiology department during the current COVID-19 pandemic

abstract:
  The rapid and mostly uncontrolled spread of the coronavirus disease 2019 pandemic over the past 4 months has overwhelmed many healthcare systems worldwide. In Singapore, while our public healthcare institutions were considered well prepared due to our prior experience with the SARS outbreak, there was an unexpected surge of infected patients over the recent 2 months to deal with. We describe our radiology department’s experience in modifying operational practices and implementing strict infection control measures aimed at minimizing disease transmission and mitigating the potential impact of possible staff infection. From the perspective of serving a medium-sized regional hospital and limited by physical and manpower constraints, our radiology department had to adapt quickly and modify our initial responses and practices as the disease scenario changed. We have also enumerated some guidelines for planning future radiology departments.


id: cord-326574-ke0iktly
title: Digital Health Solutions for Mental Health Disorders During COVID-19
author: Chew, Alton Ming Kai
date: 2020-09-09
txt: ./txt/cord-326574-ke0iktly.txt
cache: ./cache/cord-326574-ke0iktly.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3389/fpsyt.2020.582007
doi: 10.3389/fpsyt.2020.582007
abstract: nan
summary:
  In the context of the ongoing pandemic, several potential applications of these tools have emerged, such as predicting outbreaks of COVID-19 based on historic travel data and public health capacity (22) . Direct potential applications of OHCs for patients at-risk of mental health disorders include lowering the barrier to access care and support for stigmatized illnesses such as anxiety and depression, by allowing patients to seek initial medical advice anonymously (43) . The pyramid base catering to the needs of the general population could include screening tools such as big data systems and/or OHCs to actively identify and/or engage at-risk individuals without pre-existing mental health disorders, as well as provide tele-support services to reduce risk of progression in patients with mental health disorders (49) .


id: cord-326852-gm98s8a3
title: Implications for Border Containment Strategies when COVID-19 Presents Atypically
author: Teo, Wan-Yee
date: 2020-07-24
txt: ./txt/cord-326852-gm98s8a3.txt
cache: ./cache/cord-326852-gm98s8a3.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0033350620303140
doi: 10.1016/j.puhe.2020.07.019
summary:
  Conclusions An important global border control measure to implement quickly, will be to expand the symptom list to isolated sore throat, and/or a prior history of recent symptoms (resolved). Following the instructions on the information sheet from Singapore Global Network (a division in the Singapore Economic Development Board which broadens and deepens the overseas network of Singapore citizens) available online, 2 the patient and his family contacted the People''s Association (a government-supported statutory board to promote racial harmony and social cohesion in Singapore) to clarify the symptom of a resolved sore throat, and highlighted patient''s contact history with an Italy-returning medical student during a fencing sparring. Staff at People''s Association rapidly facilitated the patient to be picked up in a dedicated ambulance to National Center of Infection Disease, Singapore, where a chest x-ray done was normal, and the swab test was positive for COVID-19 (Day 8 of initial symptoms).

abstract:
  Abstract Objectives For a large part of COVID-19 pandemic, Singapore had managed to keep local cases in the single digits daily, with decisive measures. Yet we saw this critical time point when the imported cases surged through our borders. The gaps which we can and have efficiently closed, using a public health approach and global border containment strategies, are aptly illustrated through this case. This critical point of imported case surge, has resulted in large spike of daily local cases sustained through community transmission, up to 120/day within a very short time frame. We were able to rapidly bring this under control. Study Design This is a case study of a patient who passed through our borders, with COVID-19 masquerading as a resolved sore throat. Methods The events were prospectively documented. Results We present a case of a 21 year-old student returning from Nottingham. He presented with sore throat as the only symptom the few days prior his return, and on arrival at our border (Day 7 from initial symptoms), his sore throat had already resolved. The events leading up to his COVID-19 diagnosis highlight the gaps of the international screening processes at the global border entry, and the potential consequences of community chain transmission through imported COVID-19 cases. Conclusions An important global border control measure to implement quickly, will be to expand the symptom list to isolated sore throat, and/or a prior history of recent symptoms (resolved). This may capture a larger proportion of imported cases at border entry point, for more effective containment. This piece will be equally relevant to the general physicians, emergency care physicians, otolaryngologists and anaesthetists, who are at higher risk of encountering a throat visualization during intubation and routine examination. This information can be useful to countries with low resources or insufficient COVID-19 testing kits.


id: cord-328501-mbwgi56x
author: Pang, Junxiong
date: 2015-07-25
txt: ./txt/cord-328501-mbwgi56x.txt
cache: ./cache/cord-328501-mbwgi56x.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/26208494/
doi: 10.1186/s12879-015-1024-7
summary:
  title: Risk factors for febrile respiratory illness and mono-viral infections in a semi-closed military environment: a case-control study CONCLUSION: Increasing age, smoker, recruit-camp, stay-out personnel with ill household members and stay-in personnel with ill bunkmates were independent risk factors of FRI in a semi-closed military environment. Previous documented risk factors of FRI in other countries included body mass index equal or greater than 25 kg/m 2 , previous respiratory tract infections [30] , overcrowding and closed units [29, [31] [32] [33] , presence of sand and dust storms, extreme temperature changes [34, 35] , smoking [36] , female, Navy service, poor latrine facilities, increasing age and higher rank [37] . Increasing age, smokers, recruit camp, stay-out personnel with ill household members and stay-in personnel with ill bunkmates were independent risk factors of FRI in a semi-closed military setting. Outbreak of febrile respiratory illness associated with adenovirus 11a infection in a Singapore military training cAMP

title:
  Risk factors for febrile respiratory illness and mono-viral infections in a semi-closed military environment: a case-control study

abstract:
  BACKGROUND: Febrile respiratory illness (FRI) results in substantial burden in semi-closed environments. Tackling risk factors may reduce transmission and infection. However, risk factors involved in one setting may not be generalizable in all settings due to differences in climate, residential environment, population genetic and cultural backgrounds. This study aims to identify risk factors of FRI and mono-viral infections in a tropical military environment. METHODS: From year 2009 to 2012, military personnel with temperature ≥37.5 °C, cough and/or sore throat, and personnel with no fever or no respiratory symptoms were recruited as cases and controls, respectively. Subjects provided nasal wash specimens and answered a standardized questionnaire. Resplex assays were used to determine the viral etiologies. Descriptive, univariate and multivariate analyses of the variables were performed using appropriate descriptive tests and logistic regression modelling, respectively, with R program. RESULTS: A total of 7,743 FRI cases and 1,247 non-FRI study controls were recruited. Increasing age [adjusted odds ratio (AOR) = 1.03; 95 % confidence interval (CI) = 1.01-1.05], recruit camp (AOR = 4.67; 95 % CI = 3.99-5.46) and smoker (AOR = 1.31; 95 % CI = 1.13-1.52) were independent risk factors of FRI. Malay ethnicity was positively associated with influenza A(H1N1)pdm09 (AOR = 1.50; 95 % CI = 1.04-2.15) and coxsackie/echovirus (AOR = 1.67; 95 % CI = 1.19-2.36) mono-infection. Significant contact risk factors were stay-out personnel with ill household member (AOR = 4.96; 95 % CI = 3.39-7.24), and stay-in personnel with ill bunkmate and household member (AOR = 3.55; 95 % CI = 2.57-4.91). Staying in camp with none ill in bunk and at home was a protective factor against FRI (AOR = 0.80; 95 % CI = 0.64-0.99). These contact risk factors were similarly observed for the five most common viruses detected, namely adenovirus, rhinoviruses, influenza A and B, and coxsackie/echovirus. CONCLUSION: Increasing age, smoker, recruit-camp, stay-out personnel with ill household members and stay-in personnel with ill bunkmates were independent risk factors of FRI in a semi-closed military environment. Early identification and isolation of ill personnel from their bunk may be effective to prevent and reduce transmission and disease burden.


id: cord-329737-l8u4s73w
author: Liew, Yixin
date: 2020-08-27
txt: ./txt/cord-329737-l8u4s73w.txt
cache: ./cache/cord-329737-l8u4s73w.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0924857920303435?v=s5
doi: 10.1016/j.ijantimicag.2020.106145
summary:
  Since then, the Ministry of Health, Singapore, quickly raised "Disease Outbreak Response System Condition" (DORSCON) alert to orange (the second highest level of alert) on 7th Feb 2020, and implemented various measures nationwide, including border control, quarantine of contacts of COVID-19 cases or those who have travelled to affected areas, temperature screening as well as restricting the number of visitors to the hospital. 1 In light of increasing COVID-19 cases locally and internationally, 2 our hospital faced competing manpower needs arising from health crisis management, leading to uncertainty over manpower allocation of non-direct patient care personnel e.g. antibiotic stewardship practitioners. Here, we aim to describe the impact of COVID-19 on antibiotic use and the role of Antibiotic Stewardship Program (ASP) in Singapore General Hospital (SGH), an 1800-bed, tertiary-care hospital. Discontinuation of antibiotic therapy within 24 hours of treatment initiation for patients with no clinical evidence of bacterial infection: a 5-year safety and outcome study from Singapore General Hospital Antimicrobial Stewardship Program

title:
  Antimicrobial stewardship program, a vital resource for hospitals during the global outbreak of Coronavirus Disease 2019 (COVID-19)

abstract:
  Healthcare resources are being diverted for the containment and control of COVID-19. During this outbreak, we caution that antibiotic misuse may be increased, especially for respiratory tract infections. With stewardship interventions, duration of antibiotic therapy and length of stay of hospitalized patients can be significantly reduced. Antibiotic stewardship programs should continually engage and educate prescribers to mitigate antibiotic misuse during the COVID-19 pandemic.


id: cord-329890-wg23sa1u
title: Public image and governance of epidemics: Comparing HIV/AIDS and SARS
author: Quah, Stella R.
date: 2007-02-28
txt: ./txt/cord-329890-wg23sa1u.txt
cache: ./cache/cord-329890-wg23sa1u.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/16632071/
doi: 10.1016/j.healthpol.2006.03.002
summary:
  Abstract A comparative analysis of the 2002–2003 infectious disease outbreak, severe acute respiratory syndrome (SARS), and the HIV/AIDS epidemic that has affected the world over the past two decades reveals the significant role of socio-cultural beliefs and attitudes in the shaping of people''s lifestyles and approaches to the control and prevention of epidemics. The second assumption is that in contrast to SARS, the overall negative public ''image'' of HIV/AIDS as a disease associated with particular types of individuals tends to weaken people''s perception of susceptibility and, correspondingly, tends to discourage public support for robust preventive efforts at the community level. The second assumption to be explored here is that in contrast to SARS, the overall negative social ''image'' of HIV/AIDS as a disease associated with particular types of individuals tends to weaken people''s perception of susceptibility and, correspondingly, tends to discourage public support for robust preventive efforts at the community level.

abstract:
  Abstract A comparative analysis of the 2002–2003 infectious disease outbreak, severe acute respiratory syndrome (SARS), and the HIV/AIDS epidemic that has affected the world over the past two decades reveals the significant role of socio-cultural beliefs and attitudes in the shaping of people's lifestyles and approaches to the control and prevention of epidemics. The main research question is: what can we learn from the SARS experience about effective prevention of HIV/AIDS? The sources of data include population figures on the development of these epidemics and findings from two sociological studies of representative samples of Singapore's multi-ethnic population. The comparative study illustrates the impact of cultural beliefs and attitudes in shaping the public image of these two different infectious diseases; the relevance of public image of the disease for effective prevention and control of epidemics.


id: cord-330464-j4o7m9ck
author: Ng, Jun Jie
date: 2020-05-23
txt: ./txt/cord-330464-j4o7m9ck.txt
cache: ./cache/cord-330464-j4o7m9ck.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32454232/
doi: 10.1016/j.jvs.2020.05.026
summary:
  authors: Ng, Jun Jie; Gan, Tiffany R.X.; Niam, Jen Yong; Menon, Raj K.; Ho, Pei; Dharmaraj, Rajesh B.; Wong, Julian C.L.; Choong, Andrew M.T.L. title: Experience from a Singapore tertiary hospital with restructuring a vascular surgery practice in response to national and institutional policies during the COVID-19 pandemic The initial surge in COVID-19 cases in late January 6 and February can be attributed to travellers from China visiting Singapore and causing limited 7 local transmission. Segregated team model 23 After the DORSCON alert level system was raised to orange on 7 February 2020, our 1 vascular surgery unit immediately adopted a segregated team model as part of its business 2 continuity plan. Thus far, we have not However, due to the various institutional policies implemented for COVID-19, the 21 amount of elective vascular surgery cases such as pre-emptive dialysis access creation, and 22 venous surgery have fallen.

title:
  Experience from a Singapore tertiary hospital with restructuring a vascular surgery practice in response to national and institutional policies during the COVID-19 pandemic

abstract:
  Singapore was one of the first countries to be affected by COVID-19, with the index patient diagnosed on 23 January 2020. For two weeks in February, we had the highest number of COVID-19 cases behind China. In this article, we summarize the key national and institutional policies that were implemented in response to COVID-19. We also describe in detail, with relevant data, how our vascular surgery practice has changed due to these policies and COVID-19. We show that with a segregated team model, the vascular surgery unit can still function whilst reducing risk of cross-contamination. We explain the various strategies adopted to reduce outpatient and inpatient volume. We provide a detailed breakdown of the type of vascular surgical cases that were performed during the COVID-19 pandemic and compared it to preceding months. We discuss our operating room and personal protective equipment protocols when managing a COVID-19 patient and share how we continue surgical training amidst the pandemic. We also discuss the challenges we might face in the future as COVID-19 regresses.


id: cord-337516-hrcf2udq
title: Modelling lockdown and exit strategies for COVID-19 in Singapore
author: Dickens, Borame L.
date: 2020-08-01
txt: ./txt/cord-337516-hrcf2udq.txt
cache: ./cache/cord-337516-hrcf2udq.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S2666606520300043
doi: 10.1016/j.lanwpc.2020.100004
summary:
  Although Singapore''s lockdown seemingly had no effect on several large outbreaks among foreign worker dormitories that started in early April, it appears to have arrested the epidemic growth in the general population, using school closures and workplace distancing as recognized and effective attack rate reduction measures [ 7 , 8 ] . (1) Establishing a limited control baseline with case isolation and quarantining of family members only; (2) Measuring the impact of 6-week (early cessation), 8-week (planned) and 9-week (extended) lockdown in duration, at different start dates of 5, 6, 7 and 8 weeks, on the final infection attack size, when compared to a no-exit strategy where lockdown is immediately lifted; (3) Estimating the effects of this lockdown with GRES which includes the immediate re-opening of schools post lockdown, due to their limited epidemic suppression impact [14] , with a 3-month readjustment period.

abstract:
  Abstract Background With at least 94 countries undergoing or exiting lockdowns for contact suppression to control the COVID-19 outbreak, sustainable and public health-driven exit strategies are required. Here we explore the impact of lockdown and exit strategies in Singapore for immediate planning. Methods We use an agent-based model to examine the impacts of epidemic control over 480 days. A limited control baseline of case isolation and household member quarantining is used. We measure the impact of lockdown duration and start date on final infection attack sizes. We then apply a 3-month gradual exit strategy, immediately re-opening schools and easing workplace distancing measures, and compare this to long-term social distancing measures. Findings At baseline, we estimated 815 400 total infections (21.6% of the population). Early lockdown at 5 weeks with no exit strategy averted 18 500 (2.27% of baseline averted), 21 300 (2.61%) and 22 400 (2.75%) infections for 6, 8 and 9-week lockdown durations. Using the exit strategy averted a corresponding 114 700, 121 700 and 126 000 total cases, representing 12.07–13.06% of the total epidemic size under baseline. This diminishes to 9 900–11 300 for a late 8-week start time. Long-term social distancing at 6 and 8-week durations are viable but less effective. Interpretation Gradual release exit strategies are critical to maintain epidemic suppression under a new normal. We present final infection attack sizes assuming the ongoing importation of cases, which require preparation for a potential second epidemic wave due to ongoing epidemics elsewhere. Funding Singapore Ministry of Health, Singapore Population Health Improvement Centre.


id: cord-339070-jnmogy7s
title: Influenza associated mortality in the subtropics and tropics: Results from three Asian cities
author: Yang, Lin
date: 2011-11-08
txt: ./txt/cord-339070-jnmogy7s.txt
cache: ./cache/cord-339070-jnmogy7s.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0264410X11014903
doi: 10.1016/j.vaccine.2011.09.071
summary:
  In this study, we applied a standardized modeling strategy to the mortality and virology data from three Asian cities: subtropical Guangzhou and Hong Kong, and tropical Singapore, to estimate the disease burden of influenza in these cities. Mortality data for each city were obtained from Hong Kong Census and Statistics Department (coded according to the International Classification of Diseases Tenth Revision, ICD-10), Guangzhou Department of Health (coded in ICD-10) and Singapore Registry of Births and Deaths (coded in ICD-9), respectively. The present study adopted a standardized modeling approach to show that the overall influenza burden was comparable between the two subtropical cities Guangzhou and Hong Kong, but lower in the tropical Singapore. Annual excess all-cause mortality rates associated with influenza (per 100,000 population) between Guangzhou, Hong Kong and Singapore, all-ages group.

abstract:
  Influenza has been well documented to significantly contribute to winter increase of mortality in the temperate countries, but its severity in the subtropics and tropics was not recognized until recently and geographical variations of disease burden in these regions remain poorly understood. In this study, we applied a standardized modeling strategy to the mortality and virology data from three Asian cities: subtropical Guangzhou and Hong Kong, and tropical Singapore, to estimate the disease burden of influenza in these cities. We found that influenza was associated with 10.6, 13.4 and 8.3 deaths per 100,000 population in Guangzhou, Hong Kong and Singapore, respectively. The annual rates of excess deaths in the elders were estimated highest in Guangzhou and lowest in Singapore. The excess death rate attributable to A/H1N1 subtype was found slightly higher than the rates attributable to A/H3N2 during the study period of 2004–2006 based on the data from Hong Kong and Guangzhou. Our study revealed a geographical variation in the disease burden of influenza in these subtropical and tropical cities. These results highlight a need to explore the determinants for severity of seasonal influenza.


id: cord-339973-kj56zi59
title: Bioaerosol Sampling for Respiratory Viruses in Singapore’s Mass Rapid Transit Network
author: Coleman, Kristen K.
date: 2018-11-30
txt: ./txt/cord-339973-kj56zi59.txt
cache: ./cache/cord-339973-kj56zi59.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1038/s41598-018-35896-1
doi: 10.1038/s41598-018-35896-1
summary:
  Although baseline metagenomic maps created from these studies are said to be useful for mitigating bioterrorism and infectious disease outbreaks, most of them focus largely on mapping surface-borne bacterial DNA 17 and neglect to address the threat of weaponized or global catastrophic biological risk-level (GCBR-level) agents, both of which would likely be aerosolized or respiratory-borne RNA viruses 19 . Bioaerosol sampling in the field provides a noninvasive way to monitor and characterize the community of aerosolized respiratory viruses that regularly infect the public, as well as potentially detect or discover novel pathogens with pandemic potential, such as the influenza A(H7N9) virus. Although the air pump flow rate and sample collection times used in our study have been demonstrated to efficiently capture aerosolized influenza virus and RSV RNA [33] [34] [35] , it is possible that these parameters are not optimal for capturing the other respiratory virus DNA/RNA targeted in our study.

abstract:
  As a leading global city with a high population density, Singapore is at risk for the introduction of novel biological threats. This risk has been recently reinforced by human epidemics in Singapore of SARS coronavirus, 2009 pandemic H1N1 influenza A virus, and enterovirus 71. Other major threats to Singapore include MERS-coronavirus and various avian and swine influenza viruses. The ability to quickly identify and robustly track such threats to initiate an early emergency response remains a significant challenge. In an effort to enhance respiratory virus surveillance in Singapore, our team conducted a pilot study employing a noninvasive bioaerosol sampling method to detect respiratory viruses in Singapore’s Mass Rapid Transit (MRT) network. Over a period of 52 weeks, 89 aerosol samples were collected during peak MRT ridership hours. Nine (10%) tested positive for adenovirus, four (4.5%) tested positive for respiratory syncytial virus type A, and one (1%) tested positive for influenza A virus using real-time RT-PCR/PCR. To our knowledge, this is the first time molecular evidence for any infectious respiratory agent has been collected from Singapore’s MRT. Our pilot study data support the possibility of employing bioaerosol samplers in crowded public spaces to noninvasively monitor for respiratory viruses circulating in communities.


id: cord-340138-u8hxyfml
author: Seneviratne, Chaminda Jayampath
date: 2020-10-06
txt: ./txt/cord-340138-u8hxyfml.txt
cache: ./cache/cord-340138-u8hxyfml.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33117825/
doi: 10.3389/fmed.2020.00566
summary:
  Keywords: COVID-19, dentistry, voluntary work, preparedness, infection control BACKGROUND The emergence of the highly infectious novel coronavirus has led to a global pandemic in a span of just 3 months. Thus, the robust training of clinical medicine in dentistry strengthens the candidature of dentists to volunteer services for COVID-19 control and spread. Many dentists have therefore discontinued the provision of elective dental treatment, in accordance with guidelines released by national-level government healthcare authorities such as the Centers for Disease Control and Prevention (CDC) in the US and National Health Service (NHS) in the UK. In this context, dental clinics that are well equipped with facilities to control aerosol spread of infections, such as negative pressure rooms and high-volume excavators, can offer help to augment the capacity for COVID-19 screening. Precautions when providing dental care during Coronavirus Disease 2019 (COVID-19) pandemic

title:
  The Role of Dentists in COVID-19 Is Beyond Dentistry: Voluntary Medical Engagements and Future Preparedness

abstract:
  The emergence of the highly infectious novel coronavirus SARS-CoV-2 has led to a global COVID-19 pandemic. Since the outbreak of COVID-19, worldwide healthcare systems have been severely challenged. The rapid and explosive surge of positive cases has significantly increased the demand for medical care. Herein we provide a perspective on the role dentists can play in voluntary medical assistance and future preparedness for a similar pandemic. Though dentists and physicians have different scopes of practice, their trainings share many similarities. Hence, dental professionals, with their knowledge of basic human science and sterile surgical techniques, are an invaluable resource in the COVID-19 pandemic response. Overall, it is commendable that many dentists have risen to the challenge in the fight against COVID-19. For example, in Singapore, National Dental Centre Singapore (NDCS) deployed dental clinicians as well as volunteers from research laboratories to screen for suspected cases, provide consultations as well as conduct swabbing operations. Dental practice will be considerably changed in the post-COVID-19 era. There is a greater need to have refresher courses for practicing dentists on new infection control strategies. Moreover, the curriculum in dental schools should be expanded to include competencies in pandemic and disaster relief. In addition, voluntary medical work should be made a part of the community dentistry curriculum. This volunteerism will leave a positive impact on developing the careers of young dentists. Hence, the contribution of dentists beyond dental practice in this pandemic situation will be appreciated by future generations.


id: cord-341389-1o0ey67l
author: Tay, Kiang Hiong
date: 2020-08-11
txt: ./txt/cord-341389-1o0ey67l.txt
cache: ./cache/cord-341389-1o0ey67l.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32780206/
doi: 10.1007/s00330-020-07116-w
summary:
  This paper shares how we have reconfigured our radiology leadership team into a smaller disease outbreak task force (DOTF) to respond and coordinate all related efforts during this ongoing COVID-19 pandemic. The DOTF format is modelled after the military with domain groups looking at manpower, intelligence, operations, and logistics matters on a daily basis so that timely decisions can be made and action plans executed promptly. We share how we have reconfigured our radiology leadership team into a disease outbreak task force (DOTF) to respond and coordinate all related efforts during this ongoing coronavirus disease 2019 (COVID-19) pandemic. The division management committee, responsible for the day to day operations, is made up of key appointment holders of the departments and imaging modalities (General Radiography, CT, MRI, Ultrasound, Mammography, Interventional Radiology, and Nuclear Medicine) as well as leaders for nursing, radiography, support staff, administration, logistics, quality management, imaging informatics, and service development.

title:
  Reconfiguring the radiology leadership team for crisis management during the COVID-19 pandemic in a large tertiary hospital in Singapore

abstract:
  ABSTRACT: The coronavirus 2019 (COVID-19) outbreak poses a serious public health risk. To date, the disease has affected almost all countries in the world. The enormous scale of the outbreak and the relative lack of knowledge and information regarding a new virus, as well as the unpredictability of events, make it challenging for leadership teams to respond. This paper shares how we have reconfigured our radiology leadership team into a smaller disease outbreak task force (DOTF) to respond and coordinate all related efforts during this ongoing COVID-19 pandemic. The DOTF format is modelled after the military with domain groups looking at manpower, intelligence, operations, and logistics matters on a daily basis so that timely decisions can be made and action plans executed promptly. In managing the DOTF, discipline, flexibility, and teamwork are key principles, and these are built upon a strong foundation of focus on infection prevention and control, and patient and staff safety as well as staff well-being. The DOTF has positioned us well to confront the many challenges to date. We believe it will also help us navigate the complex issues that will arise with future surges in cases and in formulating strategies to manage exit from the present and future lockdowns. KEY POINTS: • In a pandemic, regular and directed meetings by a smaller leadership core group are required, for prompt decision making and execution of action plans. • The military format, with domain groups to look at manpower, intelligence, operations, and logistics matters, is useful in managing a pandemic. • Discipline, flexibility, and teamwork with strong focus on infection prevention and control, and patient and staff safety as well as staff well-being are key principles for leadership teams managing a pandemic.


id: cord-348129-tph0d5fl
author: De Deyn, Michelle Lee Zhi Qing
date: 2020-06-25
txt: ./txt/cord-348129-tph0d5fl.txt
cache: ./cache/cord-348129-tph0d5fl.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jinf.2020.06.058
doi: 10.1016/j.jinf.2020.06.058
abstract: nan
summary:
  Based on news reports and official press releases, it is evident that many Asian countries, which have successfully contained the first wave of infections, are now experiencing a second wave of imported cases from abroad and worsening local transmission 2 . After the 2003 severe acute respiratory syndrome-related coronavirus (SARS-CoV) outbreak, Singapore authorities had put in place a multi-ministry taskforce and a Disease Outbreak Response System Condition (DORSCON) framework that enables the whole-of-government to respond immediately to any disease outbreak and guide interventions 5 . While Hong Kong saw her first imported case on 22 January 2020 and had taken similar pre-emptive measures prior to this 6 . The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2 Confirmed imported case of novel coronavirus infection in Singapore; multi-ministry taskforce ramps up precautionary measures

title:
  A tale of two cities: a comparison of Hong Kong and Singapore''s early strategies for the Coronavirus Disease 2019 (COVID-19)


id: cord-348725-vksombro
title: "Coping with COVID-19: perspectives of student radiographers"
author: Teo, Leng Woon
date: 2020-05-29
txt: ./txt/cord-348725-vksombro.txt
cache: ./cache/cord-348725-vksombro.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1939865420301351
doi: 10.1016/j.jmir.2020.05.004
abstract: nan
summary:
  Publications about the impacts of COVID-19 on the modifications and precaution measures in clinical practice (as well as the concern/challenges about online teaching methods in radiography teaching) are widely available, yet writings on the radiography students'' perspective are lacking. With the rising number of unlinked cases of COVID-19 in Singapore, the Disease Outbreak Response System Condition (DORSCON) level was raised to Orange on February 7, 2020. Later, to further reduce the spread of COVID-19 transmission, the Singapore Government introduced the Circuit Breaker on April 7. Studies have shown the efficacy of combining e-learning with lecture-based curriculums, with increases in student satisfaction and learning rates (11, 12) . With home-based learning, everyone was studying at a different pace. Therefore, the removal of practical lessons and shortening of clinical placements delivered a huge blow to our learning. Comparison of the effect of lecture and blended teaching methods on students'' learning and satisfaction


id: cord-349073-66ulqu11
title: Transmission interval estimates suggest pre-symptomatic spread of COVID-19
author: Tindale, Lauren
date: 2020-03-06
txt: ./txt/cord-349073-66ulqu11.txt
cache: ./cache/cord-349073-66ulqu11.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.03.03.20029983
doi: 10.1101/2020.03.03.20029983
summary:
  Conclusions: Estimated serial intervals are shorter than incubation periods in both Singapore and Tianjin, suggesting that pre-symptomatic transmission is occurring. https://doi.org/10.1101/2020.03.03.20029983 doi: medRxiv preprint Our serial intervals are notably shorter than our incubation period estimates, suggesting that there is pre-symptomatic transmission, with infection occurring on average 2.89 and 2.55 days before symptom onset of the infector (Tianjin, Singapore). In both sets of estimates, samples of the incubation period minus serial interval are negative with probability 0.8 or higher (Tianjin) and 0.7 or higher (Singapore), suggesting that a substantial portion of transmission may occur before symptom onset (see Supplementary Information and Figure S2 ), consistent with the clinical observations reported by Rothe et al. Here we use transmission clusters in two locations where cases have reported links, exposure and symptom onset times to estimate both the incubation period and serial interval of COVID-19.

abstract:
  Background: As the COVID-19 epidemic is spreading, incoming data allows us to quantify values of key variables that determine the transmission and the effort required to control the epidemic. We determine the incubation period and serial interval distribution for transmission clusters in Singapore and in Tianjin. We infer the basic reproduction number and identify the extent of pre-symptomatic transmission. Methods: We collected outbreak information from Singapore and Tianjin, China, reported from Jan.19-Feb.26 and Jan.21-Feb.27, respectively. We estimated incubation periods and serial intervals in both populations. Results: The mean incubation period was 7.1 (6.13, 8.25) days for Singapore and 9 (7.92, 10.2)days for Tianjin. Both datasets had shorter incubation periods for earlier-occurring cases. The mean serial interval was 4.56 (2.69, 6.42) days for Singapore and 4.22 (3.43, 5.01) for Tianjin. We inferred that early in the outbreaks, infection was transmitted on average 2.55 and 2.89days before symptom onset (Singapore, Tianjin). The estimated basic reproduction number for Singapore was 1.97 (1.45, 2.48) secondary cases per infective; for Tianjin it was 1.87 (1.65,2.09) secondary cases per infective. Conclusions: Estimated serial intervals are shorter than incubation periods in both Singapore and Tianjin, suggesting that pre-symptomatic transmission is occurring. Shorter serial intervals lead to lower estimates of R0, which suggest that half of all secondary infections should be prevented to control spread.


id: cord-350328-wu1ygt6w
title: SARS: responding to an unknown virus
author: Tambyah, P. A.
date: 2004-07-14
txt: ./txt/cord-350328-wu1ygt6w.txt
cache: ./cache/cord-350328-wu1ygt6w.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/15252720/
doi: 10.1007/s10096-004-1175-8
summary:
  The severe acute respiratory syndrome (SARS) is an emerging infection caused by a novel coronavirus which first appeared in southern China at the end of 2002. The severe acute respiratory syndrome (SARS) is a newly recognized coronavirus infection that emerged in southern China [1] with subsequent global spread to 29 countries [2] [3] [4] [5] . The newly infected individuals traveled onward to their homes or next destinations in the USA, Canada, Singapore, Hong Kong and Ireland sparking off epidemics of varying degrees of severity in each of those countries, mainly in hospitals but also in their respective communities. A directive had gone out from the Hong Kong Department of Health on 21 February 2003 to maintain strict infection control with droplet precautions for all cases of "atypical" community-acquired pneumonia because of concerns that highly pathogenic avian influenza might be easily transmissible from person to person. Severe acute respiratory syndrome (SARS) in Singapore: clinical features of index patient and initial contacts

abstract:
  The severe acute respiratory syndrome (SARS) is an emerging infection caused by a novel coronavirus which first appeared in southern China at the end of 2002. In early 2003, through a single incident, it spread to Hong Kong, Singapore, Canada and Vietnam. For busy clinicians in large public hospitals, the response to the virus was initially based on ensuring a high level of protection for staff. However, as the epidemic progressed and more information became available about the virus, procedures were rationalized and the virus is currently under control worldwide. There are, however, numerous unanswered questions concerning super-spreading events, the modes of transmission of the virus and, perhaps most importantly, the rapid detection of the virus early in the course of disease. These issues need to be addressed in case the virus becomes more widespread in the near future.


