FAQs on Influenza A (H1N1) / Swine Flu
With the increase in the number of Influenza A (H1N1) cases, we are taking a more targeted and risk stratified approach in our management of the disease so that the hospital can focus on providing care to patients who are at high risk. Though Influenza A (H1N1) is infectious, the majority of the cases have been mild. Many patients have in fact fully recovered from the disease.
As the hospital has moved from containment phase to mitigation, we encourage those with flu like symptoms (eg: fever, cough, sore throat and runny nose) to visit their nearest Pandemic Prepardness Clinic (PPC) or polyclinic. At the PPC, the doctors will assess the patient’s condition, and based on the severity of the illness and other risk factors, PPCs may refer patients to hospitals for further management. In doing so, this will enable high risk patients – ie; those who are above 65 years, asthmatic, renal impaired, immunocompromised or are obese to receive prompt medical attention.
To date, there are more than 500 PPCs. The doctors have been trained on infection control measures and stocked with PPEs and tamiflu from the national stockpile. Doctors will exercise their clinical judgment in prescribing anti-virals on a case by case basis, taking into account the patient’s medical condition, risk of developing Influenza related complications, prevalence of Influenza A (H1N1) in the community and weighing the risks and benefits of treatment.
Patients at PPCs and polyclinics will not be required to take swabs for laboratory testing of Influenza A (H1N1) as such testing is not necessary before commencement of treatment. Laboratory testing to confirm Influenza A (H1N1) is also not available in polyclinics and PPCs. Patients with mild symptoms may also not require tamiflu.
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How am I impacted with this treatment policy?
With this policy, if you do not present any risk factors (i.e.: more than 65 years of age, asthmatic, renal impairment, immuno compromised, morbid obesity), you will be discharged from the screening centre to rest at home.
To prevent the spread of the viral illness, you are asked to isolate yourself for 7 days and keep away from young children (i.e.: those less than 5 years of age), pregnant women and the elderly (i.e.: those more that 65 years).
Why is the hospital implementing this policy?
Tan Tock Seng Hospital has moved from containment measures to mitigation measures, with the focus on patients with high risk. This is due to our experience in treating more than 300 patients, where the majority of them fall into the low risk group. During their tenure at the hospital, these patients have been well.
Do note that the patient advisory issued is not the equivalent of a Home Quarantine Order.
What is the criterion of issuing a Home Quarantine Order?
The Home Quarantine order will be issued only to those patients who are tested positive for Influenza A (H1N1).
Isn’t the concerned that you might be allowing possible cases to infect the public?
Upon their discharge from the screening centre, patients will be issued an MC for 7 days to ensure that they do not go out into the community; thereby limiting the rate of transmission. They are also given a patient advisory with instructions on the precautionary measures. We advice they practice good personal hygiene when they are at home. If in doubt, they should also wear a surgical mask.
Patients are also given the necessary treatment based on the symptoms presented, together with the appropriate medication. They are to monitor their health and look out for any flu-like symptoms.
What if my family member starts to display symptoms of Influenza A (H1N1) when they return home?
We encourage your family member(s) with flu like symptoms to see their nearest Pandemic Preparedness Clinic (PPC) or polyclinics. At the PPC, doctors will assess the patient’s condition, and based on the severity of the illness and other risk factors, PCPs may refer patients to other hospitals in Singapore for further management.
What is the hospital’s screening criterion?
Symptomatic patients with these risk factors will be screened at the hospital:-
Aged 65 years and above
Asthmatic
Renal impairment
Immunocompromised
Morbid obesity
What should I do if I have a family member who is pregnant? Can I also send her to the hospital?
Pregnant women are asked to go to KK Women and Children’s Hospital where they will be given the appropriate treatment. This also applies to children and young adults below the age of 16.
What if my domestic worker is allowed to go home. I have young children and (or) elderly adults at home and am afraid that she might infect them.
Tan Tock Seng Hospital is meant as a center for patients to come and receive treatment. As such, domestic workers are not allowed to stay at the hospital and are asked to return home.
I was diagnosed with Influenza A (H1N1) but was only given tamiflu with no testing done. Why is this the case?
Tan Tock Seng Hospital has moved into adopting mitigation measures to deal with the virus with the focus on high risk patients. With this policy, if you do not present any risk factors (i.e.: more than 65 years of age, asthmatic, renal impairment, immuno compromised, morbid obesity), you will be discharged from the screening centre to rest at home.
To prevent the spread of the viral illness, you are asked to isolate yourself for 7 days and keep away from young children (i.e.: those less than 5 years of age), pregnant women and the elderly (i.e.: those more that 65 years).
I have young children at home and would like to get myself tested as I am afraid that I would infect them. Where can I go for testing?
Currently, the cases that have been tested have been assessed to be mild and are not hospitalized but placed on home quarantine orders. Laboratory testing for the virus is not necessary before commencement of treatment.
If you feel unwell, we encourage you to visit your nearest Pandemic Preparedness Clinic (PPC) or polyclinics. At the PPC, doctors will assess your condition, and based on the severity of the illness and other risk factors, PCPs may refer you to other hospitals in Singapore for further management.
What are the costs for Influenza A (H1N1) testing and the associated charges?
To assess if a person has been infected by Influenza A (H1N1), several tests have to be done: first to detect Influenza A (H1N1), then its subtype and finally, the specific strain. Testing is by Plymerase Chain Reaction (PCR). For doubtful cases where samples have low virus concentration, more tests would need to be carried out.
It is because of this that specialized laboratories and skilled professionals take several hours to test for Influenza A (H1N1). The cost for laboratory testing amounts to about approximately $250 per patient and this cost is absorbed by the Ministry.
Patients have to pay the normal hospital attendance fee of $85 at Tan Tock Seng Hospital’s Emergency Department and the respective ward charges if they are hospitalized.
Now that the Pandemic Prepardness Clinics (PPCs) are ready, Singaporeans with mild flu like symptoms are advised to visit them. The doctors at those clinics will be able to deal with the disease clinically and give the appropriate advice.
I have just been charged for being tested for Influenza A (H1N1). What is the rationale behind the charges and who is responsible in bearing the respective costs?
Under the Ministry’s guidelines, the cost of H1N1 tests is waived for all patients. For those who are screened at the Emergency Department in the restructured hospitals, only the usual ED facility fee of $85 is charged. If you are admitted to the hospital while waiting for the test results, the daily ward charges will apply. The Ministry also subsidizes up to 80% of their medical costs.
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