New coronavirus patient initially discharged due to lack of symptoms; subsequently tested positive

Yesterday, the Ministry of Health (MOH) confirmed six new cases of the novel coronavirus (2019-nCoV) in Singapore. Four of them involved human-to-human local transmissions while two more are Singapore residents who were evacuated from Wuhan on 30 January. This brings the total number of cases in Singapore up to 24.

Of the four new cases, one is of a 28-year-old female Singapore resident who has no recent history to China. She had actually sought treatment for a sore throat at a general practitioner on 29 January. The next day, she went to Tan Tock Seng Hospital but was discharged as her chest x-ray came back negative for pneumonia.

However, a few days later (2 Feb), the patient presented with symptoms at Singapore General Hospital (SGH). There, she was diagnosed with pneumonia and was classified as a suspected case. She was immediately isolated as tests were conducted.

Results confirmed that she had been infected by the 2019-nCoV.

During a press conference, director of medical services Associate Professor Kenneth Mak said that the patient showed no signs of pneumonia during her first hospital visit, and had no travel history, which is why did not meet the case definition of a person infected with the deadly virus at the time. Hence, she was not immediately admitted.

However, Assoc Prof Mak explained that the situation had evolved by the time she presented to SGH.

Assoc Prof Mak also explained during the press conference that the MOH had extended its precautionary measures surveying patients which include testing patients with pneumonia to assess whether they show signs of this infection.

The woman had been tested in that context, which led to the positive confirmation of her infection.

Recovered patient discharged from NCID

In better news, MOH also announced that a patient who was infected with the 2019-nCoV was recovered. The 35-year-old from Wuhan has been “comprehensively tested negative” and as such was discharged from the National Centre for Infectious Diseases (NCID).

“We discharged one patient today … all his symptoms had fully resolved and he’s had consecutive tests over three days where the tests were all negative,” noted Assoc Prof Mak.

“We are quite confident that, in fact, he has no longer got any infection there.”

The man tested positive for the virus on 27 January, having arrived in Singapore four days prior. He went to Raffles Hospital after developing symptoms and was subsequently transferred to NCID.

As for the other infected patients, Assoc Prof Mak said they have being watched closes. He added that one other patient is being prepared for a possible discharge in the next few days, though he was careful to add that the decision will ultimately be made by the doctors.

Assoc Prof Mak also remarked that at least three patients were not showing symptoms while there are a number of patients who are “well”.

Five patients were given oxygen to help them breathe, though the director added that this is not surprising since they have pneumonia.

“This is basically to support them,” he said. “None of them are in the ICU (Intensive Care Unit), none of them are critically ill at this point in time,” he added.

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