Medical practitioners issue signed letter to advise everyone to wear a mask always when leaving home

Four medical practitioners in Singapore have come together to sign a letter, advising people to wear face masks when they leave home so control the spread of the Wuhan novel coronavirus which is now known as “Covid-19”.

In the letter entitled, “Health advisory from senior medical practitioners to Singaporeans”, the practitioners highlighted how “things are not so straightforward” with the Covid-19 as it was with Severe acute respiratory syndrome (SARs) coronavirus in 2003.

TOC managed to call up two of the doctors who signed the letter and confirm that the letter is authentic.

The signatories are:

  • Dr Tham Hoe Meng: Everwell Clinic & Surgery
  • Dr Colleen Thomas: Saint Jude Centre for Internal Medicine in Mount Elizabeth Hospital
  • Dr Judy Chen: Pariqua Clinic
  • Dr Lim Pin Pin: Modern Medical Glenroy (Australia)

They pointed out that “as this virus is said to be milder, infected people with no symptoms could transmit the virus to others silently. A certain percentage will developing deadly disease.” and warned that temperature screening works less well to identify those infected.

“As they mingle freely and unmasked, more and more people could be infected daily without even knowing it.”, said the practitioners.

They also warned that deaths from Covid-19 could exceed SARs as it did in 2002 because the reported death toll of the virus has already overtaken SARs.

Speaking to TOC, Dr Colleen Thomas, one of the letter signatories remarked that the ratio of seven cases that are currently in the intensive-care unit out of the 47 confirmed infected cases, is not a low figure. “So we know that the 0.2, 0.1 rate of severity is actually low for Singapore hence we have to take caution.”

The letter also mentioned how countries such as Kuwait and Qatar have issued travel advisories to their citizens concerning Singapore after Britain, Malaysia and South Korea have cases that were infected in Singapore.

Any mask is better than no mask

“We are advising everyone to wear a mask always when leaving home. If one faces a person and both parties are masked, it is considerably safer, constituting a 2 barrier protection. It may not possible for everyone to get a new surgical mask everyday. We need to find creative solutions. Some people have purchased washable cloth masks, sewed them, constructed them with suitable paper, or tied a scarf to the face. These measures are better than no mask at all.” wrote the letter.

Dr Thomas shared that cloth masks were used when she graduated from medical school so there is no reason why it could not work now.  She also pointed how the wearing of face masks would also change the behaviour of individuals such as being more cautious and staying away from crowd and also influence a certain culture such as making it normal for one to wear a face mask.

Dr Thomas said that It is understandable that one would not want to wear a face mask as it is unnatural, and hard to breathe. Also one reason that she mentioned, was the security that people have with the government’s assurance. She shared that a child of one of the signatories refuses to wear face mask because what the public are told.

From the very beginning, the multi-ministerial task force headed by Health Minister Gan Kim Yong and Lawrence Wong urged Singaporeans to refrain from hoarding masks and said that masks are needed only by those who are unwell and need to see a doctor.

This was echoed by Prime Minister Lee Hsien Loong which was widely reported in media in a Facebook post on earlier on 30 Jan, where he highlighted the MOH’s advice to only need to wear a mask if we are sick.

“There is no need to wear a mask if we are well.” wrote PM Lee. Mainstream media continued to report on PM Lee’s point in subsequent reports on the matter.

Addressing the point of wearing face masks, Professor Tambyah, an infectious Diseases Specialist and also the Chairman of Singapore Democratic Party said in an earlier interview with Straits Times, “You see, the mask actually prevents or reduces the amount of virus you’re going to shed. But ultimately, you shouldn’t be walking around town if you’re sick because when the mask gets wet, it loses its efficacy. So ideally, you should put on a mask, go see a doctor and then get treated.”

“Now, the reason why [healthy] people wear a mask is because they are not sure that people who are going to be sick are going to be staying at home. And I think that is the message that needs to get across, you see? If you are sick, you shouldn’t go to the office, you shouldn’t take the MRT, you should get yourself evaluated. You should put on a mask, go and get yourself evaluated by your doctor.”

“And if everybody does that, then there’s no need [for healthy people] to wear a mask, right? Because then everybody walking in the streets is going to be healthy. And you don’t need to worry about some guy coughing in your face and infecting you. Right now, you see, too many people are worried that there are people who are sick walking around. And that, I think, needs to be addressed.”

Avoid unnecessary mingling

The letter also covers the point of avoiding unnecessary mingling where they gave several pieces of advice.

  • In a taxi, wind-down windows.
  • Minimise dwell times in air-conditioned places, malls and food courts.
  • Use online delivery services.
  • Schools should conduct online learning.
  • Places of worship could use fans and natural ventilation, minimise the length of their services, conduct more frequent sessions so people will be in smaller groups and can stand further apart. They should not admit unmasked worshippers.

“If we all do this 2M rule ( wear Mask, stop Mingling) in 2 weeks the worst could be over.” wrote the letter.

The practitioners clarified that they are not trying to disclaim the health authorities who have a very challenging task but professionally they feel the need to disseminate this message immediately in the interest of safety and life preservation.

“We are confident that the authorities will respond accordingly in the interest of Singaporeans’ health.”

So far, there are over 45,000 cases of infection world-wide and over 1,100 deaths. Currently, Singapore has 47 cases of confirmed infection and 25 cases of local human-to-human transmissions.

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