Apr 16, 2008

Contagious Diseases On A Crowded Little Island

ST April 16, 2008
HFMD epidemic may be the worst since 2000
Over 1,000 kids fell ill last week, 13 warded; virulent EV71 virus behind 16% of cases By Salma Khalik & Sujin Thomas

SINGAPORE may be facing its most serious hand, foot and mouth disease (HFMD) outbreak since an epidemic killed seven children eight years ago.

More than 1,000 children fell ill last week - the highest number of weekly infections since the 2000-2001 period.

Of the 13 who needed hospitalisation, one girl was seriously ill, with inflammation of the brain.

..... HFMD is endemic in Singapore, with children catching the virus almost daily.

Symptoms include fever, headache, sore throat and a red rash, usually on the limbs and in the mouth, which gives the illness its name.

I just read the latest parents' newsletter from my kids' school (yes, the same one which teaches sex education to little kids). The newsletter reported that one student has just come down with HFMD.

Since HFMD is highly contagious, this means, unfortunately, that more students at the school may possibly be coming down with the illness in the next week or so. The usual incubation period is between 3 to 7 days.

I've just discussed with Mrs Wang and we decided that our little kids will get to skip school for the next few days.

Incidentally, I've often wondered whether the government has really considered the potential health implications of its ambitious population plan. I'm referring to the government's plan to increase Singapore's resident population to 6.5 million people (mainly by importing more foreigners).

There are plenty of reasons why we should be cautious about such a plan. One reason is that we live in a time where mankind seems to be constantly threatened by the likes of SARS and bird flu.

Squeeze 6.5 million people together on a little red dot. Make it the world's most densely populated country. Every day, pack a great number of citizens like sardines into the public transport system. What do you get?

Potentially, a great recipe for a massive epidemic .....


Miao 妙 said...

I don't understand why the government is so determined to increase the population when it is already having trouble catering to people's basic needs. There are more Singaporeans suffering in semi-poverty than they think, and it is imperative to ensure your own citizens' happiness before even thinking about attracting foreigners into the country. It is important to get the priorities correct. As you said, over-population will lead to certain undesirable effects. Eventually we must ask if the ends justify the costs.

Anonymous said...

You are very correct in highlighting the danger of living in an over crowded city like Singapore. The next flu pandemic is overdue. Looking at the sars experience, Singapore is highly vulnerable. The smart will make provisions for a holiday home in a secluded and isolated place to hide out when the next pandemic strikes.

Anonymous said...

hi mr wang

i share your concern, together with the fact that this island, being near the equator & has a hot & humid weather, easily enhances the life-cycle of diseases carriers like dengue mosquitoes, etc.

be mentally prepared that the actual population target may be higher than 6.5m that you mentioned.

Anonymous said...

Gimme that zombie epidemic NOW!!!


Unknown said...

DH (Dear Husband) and I have been talking about this a lot recently. We notice that we are catching colds a lot more often, and all we can think is that it's because of the tight squeeze here and the higher potential for person-to-person infection. I visited Singapore on a month-long business trip in 2004, before we moved here last year, and I noticed the changes in density and crush in resulting services (from recreation to shopping to transport), even during that relatively short absence.

While the government is determined to keep its economic figures high (they've obviously never heard of cycles), we've really been wondering if they've thought through the implications of a higher population.

Of course your posters will probably blame foreigners. We originally came to SG in order to settle here (we deliberately live away from the expat areas, I am Asian, and our children go to a local school), but the attitude to foreigners is much too negative. It would be hypocritical, under such circumstances, to apply for PR, so we won't, but it doesn't matter. All foreigners tend to get tarred with the same brush. As I tell the taxi drivers, we'll be doing our bit for Singapore ... by leaving at the end of the school year.

Anonymous said...

Together with 17 millions tourists.

Anonymous said...

Dear Mr Wang,

I also share your concern regarding over-crowding. It should not happen but it is happening. What to do? It is all due to Singaporeans' complacency.

Like Joe, we are also quitting this place before we die of an epidemic like SARS.


Anonymous said...

Only 2 things are very important.
1. Economic growth (through bigger numbers, not productivity) at all costs. But don't know how long this can be sustainable.
2. Weak or no opposition.
Have this 2 things, all other things no issue.
The elites (powerful and rich) are not affected by overcrowding or inflation.

Anonymous said...

PAP needs the larger influx of new immigrants. They need them to neutralize the growing trend of actual S'poreans(those who are born here) who are getting more disenchanted and frustrated by their policies and double talk over the years.
The PAP knows new immigrants - whom many are professionals and entrepreneurs - are more likely to vote for them.

As a added "incentive", after 40 years and numerous elections, there are still doubts whether our votes are truely secret. ST will always play its part by carry such commentaries and stories in the midst of every election, to instill such fear and doubt.
Naturally, these fears will obviously be impressed upon these new immigrants - (by ST and PAP spooks) - turned citizen "urging" them to vote "wisely".

Since the GRC was implemented, the top priority for LKY was for his party to maintain its grip and power over S'pore. Over the decades, they have transform their style, ideology and strategy from running a country to running a family business.

Why do you think the term Singapore Inc. came up years ago?

Anonymous said...

Hi Mr Wang,

The reason why the government wants to "Squeeze 6.5 million people together on a little red dot" is probably the same as why chicken farmers squeeze as many chickens as they can per square metre of their chicken farms.

Anonymous said...

Mr Wang, I think Steve Chia did ask a question in Parliament similiar to yours. Please check, I may be wrong.

The question were on both health and transport for a larger population.

He asked if the health services were prepared for a denser population which translates to a faster spread of diseases. Even the common flu will spread faster because of reduced space.

And whether the nation is ready to transport so many people to and from work daily and comfortably without affecting productivity.

I think these are very fundamental question which need answering when we go on a population plan. I thought the PAP will be sane enough to even stop and consider about them.

But it seems, these foundation blocks have fallen through scholarly debates and intelligent discussions of higher intent.

Anonymous said...

Question of whether Singapore is ready for such a huge influx of foreigners ?
Answer is that Singapore is not ready, but let's do it anyway.

Anonymous said...

The Experts' views in the concluding part of the Docmentary 'Planet Earth' had a common opinions. That is, ideally the Earth should have only half of it present human population.

The Natural Resources available have by and large being depleted by mankind. In the fights and struggles for these resources, much social, political problems have added tremendous difficulties to the livings of people.

The Wisdoms of the Experts should have been commonsense, as the other commonsense is congested environment results in friction, conflict and animosity. Combine the two and it is obvious that they do not lead to good, healthy livings. Not to mention the side effects of diseases, overcrowding, lack of amenities etc.

Btw, I do not believe the population of Singapore would exceed 6 millions. Personally, I think social and political problems will be a put off to local and foreigners alike right from now. As the population gradually increases and problems keep mounting, Singapore will be a place most would like to avoid.

Dare I say even the wealthy and successful will soon flock to better places of which there are plenty, just outside Singapore.

Above is a personal view.


Anonymous said...

Well the Old man did say that the best population density is 5-5.5million versus the 6.5million.
Firstly noticed that a lot of our imported Labour have a lower standard of hygiene? Spitting, urinating and being drunk in public(Eg Taman Jurong worker housing ).
This is okay in their case but given the HFMD outbreak and that the symptom only persist in adult for around 3 days as adults have better immune system.
But when Children <4 were infected a different story surface with the most serious that result in 5 child death with autopsies showing encephalitis, interstitial pneumonitis and myocarditis.
And my point is they like to hang out near the kindergaten common open area too. That post a possible cause/route for the transmission of the virus. Or it could have spread from a laboratory somewhere.
Read this research link Done by Dr. Chan ,a consultant virologist at the Department of Pathology, Singapore General Hospital.
By the way search that site for researchs on SARS too.Quite informative.

angry doc said...

I think you have done the responsible thing by keeping your children away from school, Mr Wang, but unfortunately the effectiveness of your move will depend on the actions of the other parents too - as long as the chain of transmission is not completely broken, a source of infection may still be there when your children return.

If more/all parents think and do like you did, instead of worrying about how missing two weeks of school will condemn their children to a lifetime of mediocrity in our system, we can potentially lick the epidemic in two to three weeks. Unfortunately, it is more likely we will need the government to intervene again by closing down all schools like they did in 2000.

Anonymous said...

Chicken battery farm anyone?

This is what happens when a farm is run like a business, answerable primarily to the bottom line and quarterly reports.

Birds exploited for their eggs, called "laying hens" by the industry, are crammed together in wire cages where they don't even have enough room to spread a single wing. The cages are stacked on top of each other, and the excrement from chickens in the higher cages constantly falls on those below. The birds have part of their sensitive beaks cut off so that they won't peck each other as a result of the frustration created by the unnatural confinement. After their bodies are exhausted and their production drops, they are shipped to slaughter, generally to be turned into chicken soup or cat or dog food because their flesh is too bruised and battered to be used for much else.


Chicken farm conditions "shocking"
Jan 13, 2007 6:26 PM

Rochelle Rees of Auckland Animal Action says it also shows "more horrendous" conditions, in particular, cages that had six or seven birds in them.


Anonymous said...

Mr Wang, it may sound a little far off. I believe the work culture is related to this.

In high work stress Singapore, both parents must work to upkeep a family. And you are ever challanged to multi-task for the employers' cost savings which goes into director's bonuses.

What happens is, then the kids are mostly sent to child care centers. Creating a crowding effect. I believe there are still some (many?) unlicensed centers operating out there under religious groups. But due to demand-resource issues, they're left alone.

So crowding effect ensures that the child care centers' teachers now must multi-task too. Each child gets just a little bit less attention. Those found to be sick are isolated and parents called up. But in the meantime, the centers continue operation to pay rental.

The isolated child may or may not have HFMD. But not taking immediate action, which costs a lot, exposes all the kids in the center to the possibilities of the HFMD because the germs are there already.

So when it finally gets to 10 kids falling ill, and the center reporting it, the germs would have spread far and wide. There is the incubation period.

What is the root cause of this? The system of reporting and child care center operations? Per square foot per child in the centers? Teachers per child?

Scientifically and logically, all the above can be qualified and tweaked to make the system better.

But the root cause of it all?

Costs of (rental and) living.

Anonymous said...

Is this what we get from million dollars ministers? No better plan to increase economic activity other than compromising on the health of our children? Or worse, is this plan the result of self-serving activities to remain in power so millions more can be earned for their retirement like what Dennis has mentioned?
When it comes to our children's welfare we cannot and should not continue to keep quiet about it. Most of us do not have the luxury of moving to greener and healthier pastures. Who is the minister who came out with this idea of increasing our population when just two decades ago the same government launched a campaign to ask us to stop at two. Why the sudden turnaround without any explanation. What about those who stopped at two and sacrifice their love for having more children?
Do not toy with our children's lives!!! Enough is Enough!

Anonymous said...

More fresh ideas needed to overcome the congestions and pollution, when Singapore population reach 6.5 millions and the arrivals of 17 millions tourists.

Image what will happen when this figure when we reach this figure.

Anonymous said...

My comment is that stop living in cities if we wish to avoid such infections.

As long as there is crowds of people, the possibility of such remains.


Anonymous said...

HFMD does't affect our million dollars paid ministers..so why they bother? Do you think their kids and grandchildren will be affected meh??

Anonymous said...

Recently there has been a rise in the crime around our neighbourhood due to contruction work (so got many foreigners lurking around).

Some of them even leer at our womenfolk openly.

Scary. And this is not a joke.