At the National Centre for Infectious Diseases (NCID), the pressure to fight COVID-19 continued earlier this year when much of the public had grown tired of pandemic restrictions and having to watch out for an invisible enemy.

At the same time, it had to deal with the dengue outbreak. More than 25,500 cases have been recorded since the start of the year, compared with 5,258 for the whole of last year.

And by June, monkeypox had reached Singapore.

Now that COVID-19 restrictions have mostly been lifted, The Straits Times caught up with NCID executive director Leo Yee Sin recently to find out more on how it is coping with the current outbreaks and its preparations for a possible future Disease X.

Q Of the three outbreaks – COVID-19, dengue and monkeypox – which one worries you the most?
A I’m able to overcome my anxiety or fear of these conditions because we have a reasonable understanding of them. We have already put in place the ability to cope with the three conditions. What I need to worry about is what’s going to come in the future, because there is no form, no shape, nothing yet.

We want to strengthen NCID. There are a lot of things that we are doing, but it’s not so much about doing something that is extraordinary. The important thing is how you add the elements together and make NCID stronger.

This year, for our third anniversary, we decided that after two to three years of fighting COVID-19, we would have a Family Day on Sept 3. When our staff were busy fighting the war, the people who stood behind them were their families.

Q What is the COVID-19 situation at NCID like now?
A Today, there are more than 200 COVID-19 cases in hospital, with about 60 of them at NCID. We typically take in about 20 per cent of the national load of cases.

We still have to stay alert because if a new strain pops up in another part of the world, it could end up here too. So we need to have this signal from all parts of the world. So, in an outbreak, or any situation concerning the region or the world, connections are key.

I used to spend my whole night, after working here, connecting with mostly the World Health Organisation to try to bring all the different regions together.

Now, we need to look into the future. So it’s no longer fighting fire but discussing what we have learnt and the future.

Q How is NCID coping with the dengue outbreak?
A To me, without a good vaccine, without good mosquito control strategies... it’s going to be a longhaul battle with mosquitoes and the virus. So our hope is that in the future, we can have a vaccine or a very effective mosquito control technique.

(Dengvaxia is currently the only dengue vaccine approved in Singapore for individuals aged 12 to 45. However, it is not recommended for those who have had no prior infection, because of the increased risk of developing severe dengue should they get infected later in life.)

This year, or perhaps early next year, another dengue virus vaccine may become commercially available, but... you still need a lot of human effort as well as mosquito control.

What we have done through research is to understand the disease so that we bring only the cases that require hospital care into the hospital. The current admission rate of dengue is hovering somewhere around 10 per cent.

But the epidemiology is still changing, and we see more and more older people getting dengue. It’s a different challenge.

Q Singapore has reported 16 monkeypox cases. None of them is now at NCID. Is monkeypox no longer a concern for Singapore?
A We have to anticipate that monkeypox may be endemic. In Singapore, monkeypox is likely to be a sporadic disease, and intermittent small clusters can be expected. The difficulty in situations like that is that you need to have very strong clinical suspicions to pick up cases, and then get them lab-tested.

Q Are you expanding your team, as COVID-19 is here to stay and Disease X can surface at any time?
A Manpower is a constant challenge in any healthcare institution. NCID is no exception. We have been given the support to further expand manpower in clinical care, but we haven’t reached our target, so we still have vacancies.

In the interim, if something really big happens and that is beyond what the inherent manpower with NCID can cope, we will ask for help, and the closest partner will be Tan Tock Seng Hospital.

Q How would you describe life at NCID?
A This is a place where we support the nation in dealing with emerging infections… There will be a period where you know you really need to work very hard to get through the outbreak. And then you will have a down period, when you want to look at training and other things.

So perhaps, we can entice people to join, as this infectious disease speciality is actually a very interesting speciality… full of excitement and full of opportunities.

Read the full article here.
Source: The Straits Times © SPH Media Limited. Permission required for reproduction.