As published in the Government Gazette on Wednesday (25 March), any patient who has been certified as having acute respiratory symptoms by a doctor and given a five-day medical certificate (MC) will have to stay home for the duration of the MC or risk being fined or sent to jail.
The update to the Infectious Diseases Act notes that any person who receives such an MC cannot leave their home or accommodation for five days, the duration of the MC. Those who violate the law could be fined up to S$10,000 or jailed for up to six months or both. The only reason these individuals would be allowed to venture out is to seek medical help.
The stiffer penalty was announced by the Ministry of Health (MOH) earlier this week to ensure that patients stick to the restrictions implemented in efforts to contain the spread of COVID-19 on the island.
Doctors were advised to grant patients with respiratory symptoms five days of medical leave to help curb the transmission of the virus which has resulted in two deaths in Singapore so far. Symptoms include fever, cough, runny nose, and sore throat.
The Act doesn’t specify what exactly it means by “acute respiratory symptoms”, which an infectious disease specialist at Mount Elizabeth Novena Hospital, Dr Leong Hoe Nam says is necessary given that symptoms for the virus could manifest differently in different people. For example, where one COVID-19 patient lost the sense of smell, another had a cough.
Speaking to TODAY, doctors noted that these measures will help to keep patients who are sick and potentially infected with COVID-19 from spreading the virus in the community.
In fact, Dr Leong said that the approach is “not draconian”, explaining that this virus can be fatal.
“And once hospitals are full, the mortality rate is going to jump by 10 per cent. If you don’t do something about it, people who could be safe will really die.”
Dr Leong further noted that people have continued to leave their homes even when asked to stay home during their sick leave, adding that if everyone had complied, “we will have a much lower transmission than today”.
On Wednesday, there were 73 new cases recorded in the country, a record one-day high to date. So far, there have been 683 cases.
Another physician, Dr Zuraimi Mohamed Dahlan at Banyan Clinic in Jurong West described the update to the act as “important”. He told TODAY that he knows of patients who have continued showing up at work even after being given MCs.
Dr Zuraimi explained that the five-day MC period is necessary to differentiate those who had the common flu from those who were infected with COVID-19 given that both share similar symptoms.
He elaborated that patients who do not show signs of recovery within the five-day period would have to be tested for COVID-19.
“(The latest measure and penalties) help to make sure that all these people are socially isolated when they are on sick leave. It will help them to prevent passing around not just COVID-19, but also the flu virus in the community,” added the physician.
Harsher penalties might deter some people from seeking medical attention for fear of losing income if forced to stay home
While doctors agreed that the strict penalty is necessary, they also acknowledged that it could be a deterrent for those who are sick to seek medical attention in the first place as they might not want to be told to stay home for five days.
Said Dr Zuraimi, “These patients must look at it as doing a greater good. We are trying to fight a war on COVID-19, not pry workers away from work,” adding that the stricter measures are meant to protect workers from employers who expect them to still work despite being on MC.
However, Dr Leong also suggested that the updated Act be used against those who refused to seek medical attention even when they are sick.
A little more optimistic, a general practitioner at YS Teo Family Clinic and Surgery in Toa Payoh, Dr Victor Teo said that given the severity of the situation, many people would likely visit the doctor if they feel unwell, only to rule out that they have COVID-19.
Though he conceded that a minority would still avoid visiting doctors over fear that they might lose their job or income if they are obliged to stay home on MC.
However, Dr Teo said that these people should be assured by the Resilience Budget announced by the government yesterday which he said is meant to provide financial support to workers.
Another physician, Dr Jason Pang from the Health Partners Medical Clinic in Singlap, added that even if a small group of people deter from visiting doctors due to the harsher measures, the majority would still likely comply, which would help better control the spread of the virus within the community as a whole.