Surviving (suspected) H1N1

I became one of probably hundreds of patients who were hauled to Tan Tock Seng Hospital (TTSH) in the past week for suspected Influenza A (H1N1), also known as swine flu. It wasn’t a very pleasant experience, but I’m in a way glad I got to witness first hand the fight in the trenches against this viral illness.

The episode started with my 4-day business trip to Australia last week. When I returned on Monday evening, I had a little runny nose and sore throat so decided to head straight from the airport to my GP clinic, even though I had breezed through the thermal scanners at Changi Airport without incident.

Ordinarily for an illness as mild as this, I would self-medicate and just rest at home. But since I was coming back from Sydney (albeit not Melbourne, the city with the most infections), I decided it was best to play it safe and allay the fears of my family and colleagues by getting myself checked up.

Lo and behold, when the GP took my temperature (using the ear thermometer), I measured 37.7 degrees. Without wanting to take any risks, my GP immediately called 993 to request an ambulance to take me to TTSH. So there I was, with my baggage and tired from an 8.5 hour flight, not having had my dinner, waiting for over 2 hours in the clinic for the ambulance to arrive. The hotline operator had told my GP that it was a very busy day for the ambulances.

It was the first time I had been in an ambulance with emergency lights flashing. I was disgusted to see that many vehicles didn’t even bother making way for the ambulance, which ended up having to weave around the vehicles ahead instead. Singaporean drivers are really one kind!

I arrived about 20 minutes later at about 9.45pm at the Communicable Disease Centre (CDC), just behind another ambulance which not only had lights and sirens blaring, but a traffic police escort as well!

It was at the CDC that I realised the scale of this operation. All the patients were seated under a large canopy that extended from the main CDC building. There were about 60 chairs placed about 4 metres apart. Almost all the chairs had patients sitting on them. 40 of those chairs were the same Ikea armchair that I have in my home. It was a nice cool night and ventilation was more than sufficient, with more ceiling and floor fans than there were patients.

Communicable Disease Centre

Photo: The scene at CDC from where I was seated for over 8 hours.

After the initial registration, it was about an hour before I had my first examination. Within the next 4-5 hours, I had to undergo a series of tests, including taking of temperature, blood pressure, throat swab, nose swab (which was the most uncomfortable), a blood test and an X-ray. My temperature measured at 37.1 degrees — no fever! (I really don’t trust those ear thermometers.)

At about 2am, I was briefed by an attractive and polite, albeit very hurried doctor about my condition: X-ray looked ok, but the H1N1 test results will take up to 8 hours. She was unwilling to discharge me, unlike most of the other patients, because of my 8-month old baby at home. So I was told to wait until about 9am when the test results came back.

By about 6am, most of the other patients had been discharged. I was surprised to be woken up by the doctor and told that the test results were ready, and I was H1N1 negative. (Thank God!) I was discharged a few minutes later, after being billed $85 for outpatient treatment.

I finally headed back home, and gobbled up my “dinner” at 7am before hitting the sheets.

Observations

During the initial 1 hour of waiting for my first examination at CDC, I was getting a little on edge that I was never put on the queue, aware that the H1N1 test would take 6-12 hours and not wanting to be stuck there forever. After asking the nurses several times, I was repeatedly assured that my file was in the queue, and I would be attended to soon. Turns out they were right — they were more organised than I thought they were.

There appeared to be only one doctor attending to all the patients. Perhaps the others were in the backroom doing the tests. But this one attending doctor was literally running from point-to-point. I was amazed that she was able to keep up that pace for the full 8 hours I was there. Are we really so short on doctors, or is this a baptism of fire that all young doctors are expected to go through?

Most of the patients were under 30 years old. Many appeared to be students who had just come from a day at the beach. (I read later that many were probably from the cluster of infections at church camps.)

One of those kids interrupted the nurse just as she was about to take my blood, asking if there was any wireless broadband available. I couldn’t believe my ears! A few hours later that same guy tried to flag down the stressed doctor to ask for something. He was curtly told to call the nurse, and rightly so!

I guess this experience, although long and tiring, was good in that it allowed me to see the system in place to handle the H1N1 outbreak. I am in full respect of the work that all the health care professionals — the paramedics and ambulance drivers, nurses, hospital cleaners (who meticulously disinfected every patient chair that was vacated), and doctors — are putting in to treat so many suspected cases. I give TTSH and CDC staff two thumbs up for their excellent work!

However, on a national level, I feel that the government has worked itself up into a little too much of a frenzy in dealing with the swine flu. Perhaps it stems from the World Health Organization’s (WHO) unnecessarily dire warnings about H1N1. From what I’ve read, H1N1 is not that much more virulent or dangerous than the common flu.

It leads me to suspect that the government’s response is more for economic than health reasons: If infections in Singapore skyrocket like in Australia, tourists may start avoiding Singapore and our economy will take another hit. The Australian response I think is on the other end of the scale. When I was in Sydney, I didn’t see any warnings in the media about H1N1 and there didn’t seem to be any heightened state of alert there.

Frankly I think the Aussies are taking it too easy, while Singapore needs to pipe down a little because this state of alert is putting an unnecessary strain on our health care professionals.

Proposals

I would like to propose a few alternative measures to contain this virus without burdening the entire health care system:

1.  Singaporeans should make it a point to visit their GPs at the first sign of any cold or flu, particularly if they have just returned from affected areas. There should be a publicity blitz to encourage people to do this and avoid self medicating or continuing on their normal activities or going to work. I believe this is already being done.

2. GPs should be more liberal in giving out medical certificates (MC). A normal cold or flu usually needs at least 3-5 days to recover, and the MCs should cover this recovery period, so that patients don’t need to creep back to work sniffling and sneezing. In my past experience with GPs, when I saw them for mild colds, they would usually discharge me without an MC, or with 1 day MC at the most. This is one reason why I had a tendency to self-medicate because it didn’t make any difference whether I saw a doctor or not — I still had to go back to work.

3. Companies should allow more of their staff to work from home even if their staff appear well, so as to contain the spread of infections at the office and during the commute on crowded MRTs and buses. This is an excellent time for companies to put in place telecommuting policies. Companies who have such policies in place will find themselves in a better position to deal with viral outbreaks like this, which unfortunately are becoming increasingly frequent.


11 thoughts on “Surviving (suspected) H1N1”

  1. You came to Australia and didn’t call??? ;) OK no problem – I will call you when I come for Gary’s wedding.

  2. it is unfortunate a variant of the common flu got a name, H1N1.

    We all have been having nameless flu all our lives – the last one I just recovered days ago, where I have intermittent fever, cough, diarrhoea, etc and lasted almost 3 weeks – and these flu mutate all the time.

    If H1N1 have not been named, it would have just been one of those things in life.

  3. “There appeared to be only one doctor attending to all the patients. Perhaps the others were in the backroom doing the tests. But this one attending doctor was literally running from point-to-point. I was amazed that she was able to keep up that pace for the full 8 hours I was there. Are we really so short on doctors, or is this a baptism of fire that all young doctors are expected to go through?”
    —————
    As I write this (Sunday 9am) I am preparing to start my shift which will end at 1pm… TOMORROW…. yes, 28 hours. And I do this about once a week.

    And yes, all young doctors will undergo this baptism of fire, and yes, mainly because we are short of doctors.

    Why? IMHO, because of economic reasons – the powers-that-be have decided it is cheaper to overwork young doctors who are bonded to MOH(5 years post-graduation) and/or trapped in the ‘training’ system(also 5 years), than to hire more doctors.

    Why don’t they hire more doctors? Money of course. The going rate for part-time doctor is $80 an hour, whereas I get paid $330 for this ENTIRE shift – go do the math.

    But hey! I should be glad! They could pay me $0 and I would still have to do the shift, since I can’t quit anyway. Not until my bond is over at least *lol*. So I’m glad that you appreciate the underpaid, overworked doctor who attended to you (no, it’s not me ;-).

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