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YESTERDAY IN PARLIAMENT

S'pore imposes visa requirements on citizens from 3 Ebola-affected countries (Amended)

Move, from Wednesday, will allow for better oversight, control of entry and facilitate possible contact tracing of Guinea, Liberia, Sierra Leone visitors

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Dr Lam says that MOH has put in place screening measures against the Ebola virus at various checkpoints

Singapore

SINGAPORE will impose temporary visa requirements for citizens of three Ebola-affected African nations - Guinea, Liberia, Sierra Leone - when they enter the Republic from Wednesday, as part of a move to tighten border control.

Lam Pin Min, Minister of State for Health, on Monday said in Parliament that the Health Ministry (MOH) will implement this together with the Foreign Affairs Ministry, Home Affairs Ministry, Immigration and Checkpoints Authority and the Civil Avaition Authority of Singapore.

"This move will allow for better oversight, and control of entry of nationals from these countries, and facilitate possible contact tracing."

Responding to queries from MPs Lily Neo and Chia Shi-Lu on the ministry's plans to step up efforts to counter and contain the spread of the Ebola virus, Dr Lam said that MOH has put in place screening measures against the Ebola virus at various checkpoints.

Nationals and travellers from countries with significant or potentially significant Ebola transmission, such as Guinea, Liberia, Sierra Leone, Democratic Republic of the Congo (DRC) and Mali, will be screened for fever when they arrive at Singapore checkpoints.

They will also have to complete a health declaration card and be assessed for the risk of exposure to Ebola through a questionnaire, said Dr Lam.

Those found to have a fever will be sent to Tan Tock Seng Hospital (TTSH) for further testing, while those deemed to have been exposed to Ebola will be kept under phone surveillance or quarantined up to 21 days.

Dr Lam said that health advisories on the Ebola virus will be provided at all air, land and sea checkpoints to nationals from affected African countries, as well as those who self-declare their history of travel to these countries.

Responding to non-constituency MP Gerald Giam's queries on the effectiveness of the current measures, Dr Lam said that while they are part of a multi-layer defence against Ebola, the measures will not be able to identify persons who are still in the incubation period and are not symptomatic.

And while the measures, put in place since Aug 7 this year, are not able to detect passengers who are not truthful in answering the screening questionnaire, they will complement overall efforts in detecting travellers who may have been infected, said Dr Lam.

On the part of Singapore's healthcare institutions, MOH has given regular updates to all hospitals, polyclinics and primary care doctors on the Ebola situation and provided them with guidance and protocols on the criteria for identifying suspect Ebola cases, among others.

Dr Lam said that suspect and confirmed cases of Ebola will be centrally managed in TTSH, which has been designated as the national disease outbreak centre.

Ebola virus testing will be centrally conducted by the National Public Health Laboratory's designated testing facilities at DSO National Laboratories.

Currently, testing for the Ebola virus is done using the polymerase chain reaction (PCR) method, which is the mainstay of diagnosis in all reference laboratories.

Dr Lam said that while experimental treatments and vaccines are being developed and tested, none has been proven clinically safe or effective.

Rapid diagnostic test kits to diagnose Ebola are being developed and tested but none has been approved for use.

"MOH will evaluate the performance of such rapid kits to determine their suitability for use in our environment when they become available," said Dr Lam, who added that the standard treatment for Ebola is supportive therapy.

Of the five Ebola cases that were diagnosed in Spain and the United States, three involved healthcare workers who had provided care to patients who were infected with Ebola in West Africa.

Investigations of these cases suggested possible breaches in infection control measures such as improper removal of personal protective equipment.

Dr Lam said that even with proper equipment, protocols and training, human error can occur, as in the cases of secondary transmission in Spain and the US.

He said that MOH will continue to work with the National Infection Prevention and Control Committee and other experts to review Singapore's protocols to ensure "a high degree of competency and preparedness" in hospitals here.

As for the quantum and nature of Singapore's assistance, Dr Lam said it has contributed an aid package comprising medicines, medical supplies and personal protective equipment to the World Health Organization (WHO). The Republic also contributed US$150,000 in cash to support the WHO's Ebola Response Roadmap.

Dr Lam added that there is a possibility of seconding a health expert to assist WHO Headquarters in Geneva in its relief efforts.

As at end October, WHO reported a total of 13,567 cases of Ebola, including 4,951 deaths. There continues to be widespread and intense transmission of Ebola in Guinea, Liberia and Sierra Leone. Imported cases were reported in Nigeria, Senegal, Spain, the US and Mali.

WHO has since declared Nigeria and Senegal to be free of Ebola.

A separate Ebola outbreak is ongoing in the remote areas of DRC but no new case has been reported there since Oct 4. The WHO said that DRC will be declared Ebola-free on Nov 21 if no further cases are reported.

Clarification:
The earlier version of this article stated that theEbola virus testing will be centrally conducted by the National Public Health Laboratory’s designated testing facilities at Defence Science Organisation (DSO) National Laboratories, based on a speech made in parliament. It should be the DSO National Laboratories. The article above has been revised to reflect this.