QUESTIONS ON THE MINISTERIAL STATEMENTS

Mr Mah Bow Tan: Mr Speaker, Sir, please allow me to respond to two of the questions that were raised just now by Members concerning the Pasir Panjang Wholesale Centre. Sir, as Members are aware, the Pasir Panjang Wholesale Centre has been closed for a period of 10 days, from 20th April, and this is due to the discovery of probable SARS infection there. This was a sudden closure and the Government recognises that because of its suddenness it has affected the business of tenants in the wholesale centre. Of course, the closure is necessary and justified to safeguard public health and also the safety of Singaporeans but, nevertheless, it has caused the tenants financial loss, not to mention inconvenience and disruption.

We have to recognise that it is not possible to adequately compensate for such loss and disruption. However, the Government will provide some financial assistance to the affected tenants and workers. First of all, HDB will waive the rentals for 10 days, in other words, for the full period of the closure. Second, the Government will provide an ex gratia payment of $1,600 to each tenant, and this is to cover part of the loss arising from the goods that were destroyed. When the Pasir Panjang Wholesale Centre was closed suddenly, tenants were not allowed to enter the premises to retrieve their goods. As a result of that, and as a result of the disinfection that was carried out, most of the vegetables stored there had to be destroyed. Finally, of course, tenants and workers whose incomes have been affected will be eligible for the HQO allowance which the Deputy Prime Minister announced earlier. This allowance provides for up to $70 per day per person.

Dr Teo Ho Pin asked for an update on the vegetable supply situation. Again, as a result of the closure of the Pasir Panjang Wholesale Centre, which accounted for something like 70% of the total vegetable supply in Singapore, from Malaysia, there was considerable disruption in the first day or so. Since then, the Agri-Food and Veterinary Authority of Singapore (AVA) has been working closely with the six major supermarkets, as well as other distributors, which import vegetables directly, without going through Pasir Panjang Wholesale Centre, to increase their imports in order to compensate for the loss. At the same time, AVA has facilitated importers, who have been placed under HQO following the closure, to make alternative arrangements for their vegetables to be brought in and to be delivered directly to their customers, without routing them through Pasir Panjang Wholesale Centre. AVA has also worked with Immigration and Customs Authority (ICA) to put in place procedures to facilitate faster clearance of consignments at the Causeway. In addition to that, AVA has approved additional suppliers from Malaysia who can export vegetables to Singapore. Now, there are over 100 such suppliers. And imports of vegetables from other countries have also been stepped up.

All these measures, the re-routing of supplies through supermarkets, opening up of secondary wholesale centres, facilitation of imports from Malaysia, additional suppliers, imports from other countries and so on, have resulted and contributed to an increase in the supply that is available in the market today. This morning, I have been told that the supplies have actually gone up above the levels seen before Pasir Panjang Wholesale Centre was closed. So, there is now ample supply of vegetables available in the market and I would like to urge members of the public not to rush or to hoard vegetables because more supply will be coming in regularly.

On the question of the safety of the workers engaged in transporting and selling vegetables, as far as the drivers and delivery workers are concerned, at the Causeway, the AVA has now instituted special measures to screen all such workers coming in from Malaysia. They will ask for a health declaration. They will ask them whether they have been to the Pasir Panjang Wholesale Centre from the 5th to 19th April. On top of that, they will take their temperatures. All these measures have been explained to the importers, and also to my Malaysian counterpart, the Minister for Agriculture. They have been accepted. We need to do this to safeguard the safety of our workers and the buyers involved in the vegetable trade and also those involved in other food centres.

We are doing similar screening in the secondary wholesale centres which have been set up - the ones in Toa Payoh, Eunos Estate and Sin Ming. All these will help to ensure that the people who are working there as well as the supplies that are coming through are safe.

Finally, as a result of the Pasir Panjang Wholesale Centre's experience, we have also started to screen the temperature of users and visitors to the Jurong and Senoko Fishing Ports and Markets, because a similar situation in the fish market prevails. In other words, most of our fish flows through these two markets. So we are also taking additional safety measures in these two areas.

The Minister for Trade and Industry (BG George Yong-Boon Yeo): Mr Speaker, Sir, let me answer some of the questions belonging to MTI. First, on the question of rice stockpile, I am glad to report to Mr Tan Soo Khoon that, in fact, we have a distributed network, and there are three stockpiles in three separate locations, precisely to ensure resilience.

On electricity, we have switched to monthly adjustment. Because oil prices have come down, and the Iraqi oilfields have not been destroyed, from next month, the electricity prices should come down by over 10%.

As for water, it can be a health hazard if the water supply is cut off. PUB's policy has been to thimble it down. But, if after six months, the household would not pay and would not agree to instalment payments, then it is cut off. This policy is being reviewed in the light of the SARS crisis. In fact, PUB moved in immediately to restore supply to 60 households to which water supply has been cut off. So we are very mindful of the importance of water to maintain hygiene at a time like this.

Mr Ahmad Khalis asked about the impact of the SARS crisis on travel and tourism, and whether we have not become overly dependent on this sector. In fact, tourism revenue in the last 10 years has been steady, which means that, as a proportion of our GDP, the importance of tourism to our economy has come down. This does not mean that we do not want it to go up. In fact, our objective is to try and jack it up under the Economic Review Committee recently.

It is too early to say what the long-term impact of the tourism industry will be. After September 11, we thought that the industry would die. It recovered soon enough. After the Bali bombing last October, tourism fell to almost zero. But within a few months, it recovered. So human beings adjust. They do their own risk assessments, precautions are taken and the flow may come back. And this is the approach we are taking with respect to our travel and tourism related industry - that we are down now, so we have got the emergency package, but keep the workforce as much as we can, retrain them, build safety hygiene into our products, so that amidst the choices that are available in the region, we represent a superior and a safer product. So, in this regard, I had a meeting with some of the top hoteliers in Singapore just last week, and we are working on many things together to see how we can gradually restore foreigner confidence in our travel and tourism industry. From the time you board SIA through Changi Airport, taxi service into our hotels and shopping centres, special precautions are taken to ensure a high level of precaution and safety. All these things we will do.

Mr Tan Soo Khoon asked whether we should, in fact, welcome Chinese tourists back into Singapore. What has happened is this. Because Malaysia quite suddenly banned Chinese tour groups, it created a lot of inconvenience for Chinese tour groups already in Singapore. In fact, we had to help make alternative arrangements for them. Since then, we have been in discussion with the Chinese National Tourism Authority to see whether we can address the specific problems. They are thinking of resuming either Singapore tours or Singapore-Thailand tours. But the Singapore-Malaysia-Thailand tours are no longer possible because of the actions the Malaysian government has taken.

They also told us that they are very mindful - and this was before the sacking of the Health Minister - of the healthcare risk that they pose to us. So it is important that throughout Asia, in the affected areas, we talk to each other and we check outbound travellers and they check outbound travellers. We check inbound travellers and they check inbound travellers. And in this way, we do not stop cross-border travel but protect ourselves, and reduce the risks which are involved.

It is very crucial at a time like this that while we should over-react on the side of caution and safety, we should not do unnecessary damage to our economy. It is to be expected that because of reporting in the newspapers and on television, because of the repetition of certain images, people who are not so familiar with Singapore get a distorted picture. So, from the beginning, MTI took the position that it is crucial for our economic agencies to put out accurate information to all our clients, and EDB and IE Singapore have been doing this on a daily basis. And this has created a certain level of trust. Not only have we been in contact with the people here, the Chairman of EDB has also been writing letters directly to the CEOs in the headquarters. As a result of this, among the important account holders, there remains a high level of trust in Singapore.

Last night, as I was going through my e-mail, I received a note from EDB saying that the American Chamber of Commerce in Singapore will soon be issuing a statement praising us for the efforts that we have made and expressing their full confidence in the precautions that we have taken to safeguard the health and safety of Americans in Singapore, and affirming their commitment to continue to do business here. In fact, tomorrow night, Stanchart will be carrying on with the celebrations of its 150th anniversary. The Chairman, Sir Patrick Gillman, and other top executives will be here, and Senior Minister will be speaking. So, these things are continuing, and that is because when we say something, they believe us.

Last night, Members would have heard that Toronto has now gone on to the same list as Hong Kong, Guangzhou and Beijing, and that is very serious. The Mayor is hopping mad. But WHO sees Singapore as a very important demonstration of what can be done and what should be done. German Chancellor Schroeder is continuing with his visit to Singapore and other countries in South East Asia next month. So, if bit by bit, we restore confidence by what we are doing, then the tourists and travellers will come here.

Just before I came here, I received a fax message from the Chairman of EDB of a letter just written to him by an American company. Because I have not cleared it with him in advance, I should not mention the name of the company, but it is an electro-chemical company based in New York. Mr Teo Ming Kian had sent him a letter updating him on the SARS situation, and he wrote back saying:

"Thank you for the update. We understand that it is extremely difficult but we are very encouraged by the response of the Singapore Government to this crisis." The last paragraph of his letter is something that we should think about. He said:

"By the way, it occurred to me that Singapore's decisive and effective handling of this serious crisis may ultimately result in significant economic opportunities for Singapore in the future." At a time like this when we are in an emergency, he tells us this. He said:

"I believe that many US companies will hesitate before investing serious money in countries which are either unwilling or unable to properly deal with a crisis of this nature, that investment may instead go to Singapore where there is a high degree of confidence in the Government and its willingness and ability to protect its citizens as well as many major foreign investments. I, for one, will think more than twice about investing millions of dollars of my shareholders' money in countries where the government is either unwilling or unable to protect the investment. I would have absolutely no hesitation in investing significant amounts of additional money in Singapore. As a matter of fact, we are in the process of doing just that right now as we speak." That cheered me up. I showed it to Mah Bow Tan and Yeo Cheow Tong who were sitting next to me just now. And since Inderjit Singh raised this issue a moment ago, I thought I should read the last paragraph to remind ourselves that we should pull out all stops to solve this crisis, and if we do not lose our nerves, if we concentrate on what we have got to do and have an eye on the medium and long term, then I think we will come out of it ahead.

RAdm Teo Chee Hean: Mr Speaker, Sir, I would like to address a point that Ms Braema raised regarding foreign students. Foreign students who come to our institutions from SARS affected countries and travelled recently are asked to take leave of absence for 10 days, after their return before they are allowed to join the institutions. This happens in our schools, universities and polytechnics.

As regards hostels, what happens is this. If a foreign student arrives from a SARS affected country, he will undergo a medical check-up and we will house him in an outside facility for 10 days and he has another medical check-up before he is allowed to join the other hostelites in the hostel. And within the hostels, there is a daily temperature taking regime, and those who are unwell are asked to see a doctor. There is a sick bay where they can rest separately from the rest of the hostelites.

If there is a need for a Home Quarantine Order for one of the hostelites, because he went to some other place and as a result of that he is subject to a Home Quarantine Order, then we have outside facilities where we can house these hostelites separately from the others in the hostel.

Mr Zainudin asked about the measures in schools and institutes of higher learning. As Members know, the schools have taken a number of measures after they have reopened over the last few weeks to try to ensure that as far as possible, only those students who are well are in school. So there is temperature screening routine. The students have to make declarations of their travel history and they should declare whether they have had any occasion to go to some of these places where they may have come into contact with SARS patients. In the event that any student does become sick outside of school, he should not come to school and therefore the chances of getting ill as a result of coming into contact with someone who is ill in school is minimal. And with the twice daily temperature taking routine with the thermometer that is issued to every student, teacher and staff member, as soon as a student has a fever, he will be picked up very quickly and he will be isolated, and the chances of any infection will be minimised.

For the institutes of higher learning, the polytechnics and universities are now in the reading period before the examinations. So there are no mass classes going on. But in any case, the universities and polytechnics will take precautions for the examinations. And as the Deputy Prime Minister has indicated just now, they have developed plans to zone the universities and polytechnics and to try and minimise cross-movement between the different zones. The universities and the polytechnics will also be looking at various procedures to see how they can do daily temperature taking when the institutions reopen.

Sir, I should stress also that social responsibility is one of the most important features as well. What we have done is that we have asked parents and students to check themselves every day before coming to the institutions, so that they will not come to the institutions if they are not feeling well. I am glad that there is high confidence among parents. Attendance rate in schools has been very high, but the attendance rate is slightly lower than normal. And I am happy about that because it shows that parents and students are taking their responsibilities seriously. Previously, when they had been slightly ill with a sniffle, slight sore throat or cough, they would go to school. Now, they are staying at home. I think that is a sensible and socially responsible thing to do. In the approach that we are taking in the schools with regard to SARS, we take it really as a public education exercise. We take the opportunity to educate the students about social responsibilities, health issues, and how to look after themselves. And we hope that these messages will also flow from the students into the homes and help to educate Singaporeans at large.

Dr Lee Boon Yang: Mr Speaker, thank you for allowing me to respond to a couple of points. There are three points here which I thought I should respond to.

First, Mrs Lim Hwee Hua traced the plight of the self-employed who, because of this outbreak of SARS, would suffer, not that they have become victims of the disease but that their income would be affected, particularly those who would need a licence to carry on with their livelihood. And if their income goes down, they would have cash flow difficulty, and cannot make their contribution to Medisave, thereby they cannot renew their licence.

Let me assure hon. Members that we would consider such cases very sympathetically. Their contribution to Medisave is actually based on their income. So if their income indeed goes down, their contribution will obviously go down. But even then, if they have special difficulty trying to meet this lower contribution rate, we would be very happy to make arrangement to ensure that their licence will be renewed and they can continue to earn a living and support their families.

Dr John Chen asked why was the foreign worker levy rebate that was announced as part of the package of measures to help businesses affected by the outbreak of SARS limited to foreign workers in the gazetted hotels, and not extended to all foreign workers. In that instance, the package was tailored, as DPM had explained when he announced the package, to the sector that was most directly hit, and this was the tourism sector, ie, hotels, travel industry, restaurants and such like. When we looked at that group, we found that the group of foreign workers who were paying higher levy, most of them were actually in the hotel sector. As hon. Members know, there are two tiers of levy for work permit holders. Those who have higher skills pay the lower levy of $30. So the levy in itself is not a major cost factor for those at the lower levy. Those who are at the higher levy of $240, most of them are actually in the hotel sector. Therefore, we decided that this is where we can make a difference. This is where by reducing the levy by half, we can make a contribution to help the employers to weather this crisis.

The other point that I want to address was made by Mdm Halimah and Mr Yeo Guat Kwang. Both of them were concerned about those people who either lost their jobs or suffered wage cuts as a result of the outbreak of SARS which affects the economy. In the case of Mr Yeo Guat Kwang, he asked what we can do to help to enhance the employability of those workers who were retrenched as a result of the business downturn. We would like to help these workers to be re-deployed wherever there are jobs. We would be prepared to retrain them for new jobs, and there are many schemes under the Ministry of Manpower's skills upgrading and retraining programme. So, I would offer this retraining programme to them. In fact, this weekend, there is a job fair organised by the North West CDC, and they have brought together many employers offering nearly 1,000 jobs, packaged together with appropriate training programme, so that anybody who is unemployed can have a chance to be retrained for the jobs that are available.

Even during this period when we have high unemployment and redundancy, my officers, when they talked to the companies which are in the process of bringing workers from the SARS affected areas, were told that, notwithstanding the present situation, they have great difficulty recruiting workers. That is why some companies still resort to bringing in new work permit holders from SARS affected areas. They know the danger. They know the risk, and they know that they have to go through this additional step of putting the workers through a 10-day quarantine which costs the company. They have to pay for the costs of the quarantine. They have to pay for the medical staff that supervise the workers under quarantine. But they are willing to do it, and they tell my officers that the reason is that, despite this present situation, Singaporeans are still not prepared to take these jobs.

So I want to take this opportunity to urge all our people - if you need a job, there are jobs available, the Ministry will be there to help you, we will find opportunity for you, but you must be prepared to make the adjustment, you must be prepared to undergo training, if necessary, so that you can take on these jobs. I think that is the most viable solution. Just giving out more financial support can only last so long. It is not a permanent solution. Yes, in the case of those who are victims of SARS, we have this special Home Quarantine Order allowance to assist them to tide over the period of home quarantine when they lose their income. But over the longer term, the only way to support yourself and your family is to get a job, and that is where we are here to help you. To retrain you for the job, if you do not have the skills. To help you to find a job, if you do not know how to go about doing so.

Mr Lim Hng Kiang: Mr Speaker, Sir, I would like to start off by responding to Dr Lily Neo's question about how the SGH outbreak started and whether it could have been averted, and also how did that lead to the outbreak in the Pasir Panjang Wholesale Centre. I hope in explaining how these got started, Members can appreciate the difficulties that we are dealing with. We do not have a reliable and quick diagnostic test system now. We have to depend on clinical symptoms and we have to depend on very rapid contact tracing in order to ringfence the contacts to prevent the spread from widening, which is also the second question which Dr Lily Neo presented.

This index case in SGH that caused this cluster was an ex-patient in Tan Tock Seng Hospital. He had a multitude of problems and he was discharged from Tan Tock Seng Hospital on 20th March. He recovered from some of his problems, and this was a regular discharge on 20th March. On 22nd March, we decided that Tan Tock Seng Hospital would be a hospital dedicated for SARS. So this was in the middle of the problems that we were having in Tan Tock Seng Hospital. He was discharged on a regular basis because he recovered.

Because of that decision to make Tan Tock Seng Hospital the dedicated hospital for SARS, when this man had gastrointestinal bleeding on 24th March, he had to go to SGH because Tan Tock Seng Hospital was only admitting patients for SARS. He went to SGH. SGH took all the necessary precautions - screened the person. He had gastrointestinal bleeding. He also had a foot ulcer and a low grade fever. SGH took a chest X-ray, which was done on the date of admission on 24th March. The chest X-ray was clear. Because of the symptoms he presented, SGH did not consider him to be a suspect SARS case, and treated him for his problems and put him in an open general ward (Ward 57). On the 5th day of admission, on 28th March, he developed high fever. So SGH took note and gave him a repeat chest X-ray. The repeat chest X-ray was normal again. He was treated with antibiotics on 29th March and the temperature came down, indicating that this could be a bacterial infection and not a viral infection. A blood culture showed that he had infection of the blood by a bacteria, E. Coli. A third chest X-ray was done on 30th March, and this was again normal. He was given a stronger antibiotic on 4th April, and he did not have fever anymore. But his chest X-ray on 4th April showed signs of pneumonia, and SGH did the right thing, which was to send him to TTSH, because with a chest manifestation, he was considered as a suspect SARS case.

At that time, SGH management also began to notice a group of their staff and healthcare workers coming down with fever, and they went into alert. A cluster of potential problems was growing. So on 5th April, they decided to transfer Wards 57 and 58 to Tan Tock Seng Hospital. The process took some time and the transfer was completed. The transfer started on 6th April, and it was completed on 7th April. In transferring two wards, we had to move all the patients, many of whom were fairly sick, and the staff together with them. We initiated contact tracing, involving 120 people - the patients and the staff - to find out whom they were in contact with. Because if they were infected, we did not know who else could be infected in the two wards. So the contact traced everybody. From the 120, we have to contact trace a few hundreds to see who they are. By the time we detected his brother who had visited him in SGH, that was already 8th April, one day later. By then, his brother who caused this cluster of problems in Pasir Panjang had onset of fever on 4th April. He still went to work at Pasir Panjang Wholesale Centre on 5th April. He was unwell on 6th April; so he did not work on 6th April. But he went back on 7th April, and again on the 8th. By the 8th of April, he was quite unwell; he was sent to NUH. So by the time we realised he was a contact of his brother in SGH, he had already been admitted to NUH on the 8th.

So this illustrates the difficulties we face. When a patient is presented with all kinds of chronic problems, it masks the typical symptoms that we associate with SARS - high fever and all the other symptoms, plus pneumonia and chest problem. In this case, they did three X-rays, they did a blood test, and this did not manifest itself till much later. We have to do contact tracing very quickly, but it still takes us 24 hours. We set a target of completing contact tracing within 48 hours. So in this case, even if we meet the limit of 48 hours, by that time the onset was on the 5th of April, he was very sick, and on the 8th he was already in NUH.

On hindsight, could we have done better? The problem is a significant one. Obviously we could have done better. I think SGH management could be on greater alert when it comes to staff coming down unwell, which is now the new standard that we impose. Any two healthcare workers having fever in the same department now sends out a red flag. But having set the standard of two healthcare workers having fever sending out a red flag, I hope Members realise now a lot of red flags are showing because it is not unusual to have fever. And we set our fever threshold now at 37.5oC, which is not a very high grade fever. So, everybody is on very high alert. And contact tracing is not 100% foolproof. We need people to be very truthful about their contact history. Otherwise, if they give us half a story, we miss out some of the contacts and we cannot ringfence these people.

So I would like to say that this SARS challenge is a tremendous challenge for us. We are flying blind. We only have two instruments which are the clinical symptoms - fever, chills, cough, muscle aches - and then only much later, ie, three days, five days, or seven days later, you get the chest manifestations. The second instrument we have is contact history so that we know that, even if you have got fever and cough, but, because of your contact history, we must suspect that you have SARS. And that is why I said in my statement that we have to depend on people taking temperature, and we have to depend on people being truthful to us in their contact history.

Dr Lily Neo asked about WHO guidelines, why we have to follow them and why do we not set our own guidelines. We have to follow a certain set of international guidelines because we have to report to WHO. This is a global problem. We cannot have a different set of guidelines. Then WHO would not have a true picture of our situation. But for the clinical guidelines set by WHO where we can be more conservative, we have done so, for example, WHO guidelines on what is deemed a recovery. When a person is deemed to have recovered from SARS, WHO says he must have no fever for 48 hours. In Singapore, we set it at 72 hours. Then they insist on a series of blood tests to see the white blood count. We do that too. They insist on X-rays. We do that. They say you need 10 days' medical leave at home. Our rule is 14 days' home quarantine, that means, not just 10 days' medical leave at home, but we insist that the person stays at home for 14 days on Home Quarantine Order, and he has to come back to TTSH regularly through the ambulance for his blood tests and chest X-ray. So we follow WHO guidelines, in terms of reporting of statistics, otherwise, there would not be sensible comparisons across the countries. When it comes to clinical guidelines, our staff here always try to be more conservative, as I have illustrated on the criteria for recovery.

Dr Lily Neo asked about epidemiological study group. We are doing this constantly, trying to piece this together and trying to get a picture of the disease pattern. We also have two WHO consultants with us and one consultant from US CDC helping us to track this pattern. They of course provide the link to their parent organisations, and whatever we do is completely transparent to them and audited by them. And so they have high confidence in their parent headquarters that whatever we report is the truth and not something which we are doctoring to give a different picture to the world.

Dr Lily Neo also asked about the healthcare workers. Are they adequately protected? We try to have as stringent a level of protection as possible. But a lot depends on correct usage of this protection. For example, if any of you have used the N95 mask, you will find that it is very, very uncomfortable. It is very hard to breathe. When I put it on, I find that I was being suffocated. And I cannot imagine how I could ever be a nurse. But the nurse has it on for eight hours, 10 hours, 12 hours. And it is very uncomfortable. In the open wards, it is very warm with the gown and the mask. These are not easy conditions. It has to be very tight-fitting, so it is hard to breathe and if it is not tight-fitting, then it does not work. So it requires a lot of vigilance and a lot of discipline. Day in and day out, keeping this protection on because you know that if you make a slip-up, it will be a very costly slip-up. So for the healthcare workers, it is a lot of stress, and they are over-stretched in the wards.

But the situation varies. When we have a big cluster like in SGH and in the Pasir Panjang Wholesale Centre, then of course the workload increases. But if you look at the situation across the public hospitals today, Tan Tock Seng Hospital is well protected. As we mentioned in our statements, we have not had any of our healthcare worker being infected for the last six weeks. So the morale is high. They know that if they are diligent and they take good care of themselves through the protection, they will continue to be protected. But once there is a slip-up, it will be a real setback.

The resources in Tan Tock Seng Hospital are bearing up. Our critical resources are the ICU and the isolation rooms. In the ICU, we are doing okay because we have nearly 40 ICU rooms and we are using about 20 each time. So we still have some capacity. Our isolation rooms are now very stretched because, with the Pasir Panjang Wholesale Centre cluster, we encourage people to come forward for screening. Because we do not have a diagnostic kit, we have to keep them in individual isolation suites to watch over them for some time. And therefore the isolation rooms are filling up very quickly.

The other hospitals are bearing up reasonably well. As I have said, KK Hospital is also clean of SARS and I think they are managing very well. Alexandra Hospital has not had an episode of SARS. As a result, the public goes there and they are now feeling the strain because Alexandra Hospital is a very small hospital and it is not used to this load. So a lot of the load that used to go to TTSH and SGH now goes to Alexandra Hospital. Changi Hospital, after their episode in end-March, has not had another episode. So they are again gearing up. So, today, I would say TTSH, KK, Changi and AH are bearing up well. We have the problems in SGH. They were doing okay until the recent episode with Dr Alex Chao. And in NUH, we still have the cluster that was started by the brother of the index case in SGH which created a cluster there. That one, we are still trying to keep it under control.

So we have the Ministerial Combat Team under SMS Khaw Boon Wan. He and his team have gone down to the hospitals to button down the protection guidelines, the execution of those protection guidelines, to raise the standards and the morale and the capabilities of the hospitals. I think they are doing a great job and we should be able to see the situation improving day by day.

Sir, our hospitals are coping fairly well with the public services. As to hospital charges, we have explained this before. Screening is free. So if you come forward for screening in Tan Tock Seng Hospital, it is free. If you are kept for observation, then you are charged C class rates. So it is heavily subsidised. And if you have financial problems, then our medical social worker would apply Medifund for you. So I do not think Singaporeans should be concerned about the medical costs of coming forward for screening or treatment.

The other group of questions which Members raised and which I thought it is worthwhile for me to go through, in some detail, is the Home Quarantine Order. When we detect a probable SARS or a high suspect SARS case, we start contact tracing and the people whom we determine to have contact with this patient, a probable SARS or a high suspect SARS, we will then issue the Home Quarantine Order. As far as this contact is concerned, he is still healthy, he is still well, but because of his contact history with a probable SARS or a suspect SARS case, he is given a Home Quarantine Order. And the reason why we do so is that we want him to stay at home, monitor his health constantly and the minute he has a high fever or other symptoms, he will call us and we will dispatch an ambulance to fetch him to Tan Tock Seng Hospital straightaway. So in that way, we minimise the likelihood of him infecting other people in his family as well as in the community. But the other family members are not contacts of a probable SARS or a suspect SARS patient. So if they are not contacts, they will not be issued a Home Quarantine Order. But if the other family members are contacts, they will also be issued a Home Quarantine Order accordingly. Then how do we treat the children? Because we felt that as schools are very sensitive institutions, we took the extra care of asking the children to also be quarantined even though the children will not be infected until the adult is infected.

Let me go through this again. If we detect a probable or a suspect SARS case, we determine the contacts. Let us say, there are 20 contacts. Then we issue a Home Quarantine Order on each of these 20 contacts. These 20 contacts will have an incubation period before they become infectious. The incubation period is between three and 10 days. But we insist that he stays at home so that, whenever he has a fever or he shows symptoms and becomes infectious, we will pull him out to TTSH. The adult family members will not get infected until the contact gets infected. Then they themselves will take another incubation period of three to 10 days before they become infectious. So the other family members can continue with their work and their life, because they are not infectious and they will not be infectious until the contact becomes infectious himself.

Why do we not do the same for children? Medically, we should do the same for children. But knowing the sensitivity of parents over the children in the schools, we decided that, for children of a contact, we will be extra kiasu and we also issue a Home Quarantine Order on them. When we started, of course, we stipulated it as a requirement in the Home Quarantine Order, as Mr Tan Soo Khoon raised. This has caused some confusion in the public's mind. Recently, we decided that we would actually issue an individual Home Quarantine Order on each of these children. There is another situation where a family member is a probable or a suspect SARS case, in which case all the family members are contacts and all the family members would be issued Home Quarantine Orders, including the children. So to minimise this confusion, nowadays, when a child is asked to stay at home, we will issue a Home Quarantine Order and there would not be any confusion among the public.

Some Members asked what about financial support for this group. If the contact is given a Home Quarantine Order and the other family members are not at risk until the contact becomes infectious, then the other family members can go about with their life as usual, go and buy grocery, etc. But we do have a situation where the entire family is served with the Home Quarantine Order. Then of course we will come in to provide support to them, in case they need grocery, etc. But if they can make their own arrangements, ie, if their relatives can bring the food to them and leave it outside their door, it is all right. This is just to be extra safe because, if they follow the rules that we set for them, they are not infectious until they exhibit the symptoms. So the workman can go to their house and do the repair as long as these people are responsible. If they do not exhibit any symptoms, they are not infectious and life goes on. But the minute they have a fever and they have symptoms, then they will call us and we will bring them to TTSH for screening.

When we serve the Home Quarantine Order on a person, the CISCO police who serves the order will set up the camera and give the instructions. I accept Mr Tan Soo Khoon's point that we should give it in four languages. We will do that. But the CISCO police will explain to the person, who is served with the Home Quarantine Order, what he has to do and how he reports through the camera whenever we call him up. At the same time, we will send a nurse to visit the person under Home Quarantine Order and the nurse will have a kit with a thermometer, a face mask and also instructions, so that he knows how to take his temperature on his own and, if he is sick, then he puts on the surgical mask and wait for the ambulance to come. So, this is the way we explain to the person what he has to do and, of course, it would help if we put it in four languages, and we will do so.

The third group of questions which I thought is important for me to elaborate on is the situation in Tan Tock Seng Hospital and why Singaporeans fear going there. We have come out several times to explain the very high level of infection control in Tan Tock Seng Hospital and that it has been screening hundreds of people since the beginning of the SARS outbreak, and people have been discharged, they go on with life as usual.

So, cross-infection in Tan Tock Seng Hospital has not taken place. If, after screening, the Tan Tock Seng clinicians feel that you should be warded for further observation, then you are kept in an isolation room. You will not infect others and others will not infect you. And the healthcare workers who come to look after you will all be fully gowned and fully protected. So, again, a very high level of infection control.

If you are down with SARS, as I explained in my statement, the main treatment is to give you medical support and allow your body's immune system to combat the virus itself. The problem is when you have other complications. Then you need the full medical support system to address these medical complications. But the actual combating of the SARS virus would really be done by the person's own immune system. Of course, if you ask yourself, logically the earlier you come forward for treatment, the better your chances of recovery, because if you do not have the full medical support, especially in the ICU, when you have congestion in your lungs and you cannot breathe, then no oxygen gets into your blood stream and your chances of survival are very low. But if you are in the ICU, then they can intubate you, they can force oxygen into your lungs and cause your body to continue to absorb the oxygen, and so you have a fighting chance. So, people can stay in the ICU, intubated, ventilated, and then the body will have a chance to fight the virus.

So, the earlier Singaporeans who are down with SARS present themselves for treatment and for this full medical support to help them fight the SARS, the higher the chances of survival. If you track the kind of cases that come to our hospitals, when they come in very, very sick and very, very late, and they have to go to ICU almost immediately, then I think the chances are all very, very slim. If you have been following stories, those who come very late and very sick and go to ICU straightaway, they have much lower chances of recovery.

Overall, our recovery rate is still very good. 85% fully recover. Those who go to ICU, more than half recover too. So, again, I urge Singaporeans to come forward if you have SARS. Seek early treatment and you will have better chances of recovery, you do not infect your family, and you do not cause infection in the community.

Dr Warren Lee asked whether we need special accommodation for the people on Home Quarantine Orders. As I explained, it is not necessary, because these people are not infectious. We just want them to be isolated in their own homes and, if they have a fever or other symptoms, then they present themselves immediately for treatment.

The next set of issues is really the level of information that we give out, ie, whether we should publicise the names of patients and people on Home Quarantine Orders. Generally, we are reluctant to do so, because I think we should try to preserve medical confidentiality as much as possible. But where there is a public health need, then we will do it. If we need an accelerated contact tracing because the way we go about it through detective work takes 24 or 48 hours and that takes too long and the risk is too high, then, of course, we will publish the names in the media.

But for recalcitrants and defaulters, I think we should publish their names and shame them because, otherwise, such Singaporeans will continue not to do what is necessary of them. So, although we try to preserve medical confidentiality, people who default and wantonly break the rules, we will definitely name them so that we can shame them.

On the supply of equipment, eg, masks, gowns, goggles, thermometers, etc, there is a shortage of masks worldwide. But we are using all our resources that we have in Singapore, eg, from MINDEF, MTI, IE Singapore, ST Logistics, to get ourselves the necessary supplies to keep our healthcare workers protected. So, our commitment to our healthcare workers is that we will leave no stones unturned to get this equipment for them. Thermometers are less of a problem. We have ordered more than a million. I think these will be available over the next few months.

Mdm Cynthia Phua asked whether there is a difference in the minimum number of days in the Home Quarantine Orders. We have used 10 days because that is the incubation period. But some employers, for example, impose a voluntary quarantine of 14 days to make it even safer. I think there is nothing to lose if you want to extend it to 14 days. But, for us, we use a minimum of 10 days because that is the incubation period.

Next is the sort of resources that we have. As you have heard from the DPM, the full resources of the Government are behind the Ministry of Health to combat this problem. We have used resources from every agency. From MINDEF, we have used the medics; we have people from the People's Association to help us in contact tracing; we have used detectives from the CID to help us in contact tracing; we have used all resources in the Government to tackle this problem. And as you would have heard from the responses of the various Ministers, all the Ministries are gearing up to tackle the different aspects of how to deal with SARS.

Some Members asked about the treatment regime. When we started off, as I said, there is no specific treatment regime. The Hong Kong experience, they tried to use Ribavirin, the anti-viral regime. But as we all know, it has toxic side effects and so we have to use it very carefully. The American clinicians are more conservative, and they prefer not to use this very aggressive approach. So, our clinicians have to make professional judgments, ie, when to use the full array of antibiotics and anti-viral regimes.

Dr Lily Neo asked about the situation in NUH Wards 55 and 68. These are the kinds of problem that we are confronted with nowadays, because our threshold of alert is now set very, very low. When you have two staff with high fever and patients with high fever, everybody gets very excited. So, in SGH, on Good Friday, we transferred Ward 74 to TTSH because of this combination of staff and patients having fever. It was a precautionary measure. We transferred lock, stock and barrel, ie, one whole ward across - a lot of resources and effort. As it turned out, it was, thankfully, a false alarm. The fever of the staff came down, and the patients in that ward, because of their other medical problems, were showing this fever. But we would rather be safe than sorry.

Similarly, for NUH Wards 55 and 68, we had been tracking the situation, and it is a combination of staff and patients having fever. Some days the fever is up, on other days the fever is down. The patients there are diabetic and kidney patients and, according to what the doctors tell me, fevers in such situations are not uncommon. But, at the same time, we are always on very high alert, and we have to make a professional decision when a combination of red flags comes up. Do we just ringfence them in NUH or do we physically move them across to Tan Tock Seng Hospital? So the Director of Medical Services and the Chairman of the Medical Board in each hospital are confronted with such professional decisions every time they are faced with situations like this.

I think I have answered most of the questions. I am sure there will be many other questions which I have not answered, in which case, I will respond later on. I do not want to hold up the others.

Mr Lee Hsien Loong: Mr Speaker, Sir, sorry to disappoint you with more answers.

May I just focus on four or five main points which the other Ministers have not yet covered before Mr Wong Kan Seng tells us what he has been doing in the Ex-Co. Most of my issues have to do with our policy measures, our response and commitment of resources and effort to this task.

Dr Lily Neo asked whether we have enough resources. We will have enough resources. Speaking as Minister for Finance, what is needed will be given. Do not waste it, but if you need it, it will be given. If you need drugs, masks, gowns, thermometers, treatment facilities, they shall be provided. We can afford it. This is the national priority. But it must be properly used and we must get the problem under control. Of course, there is never enough, and Members have asked for more. I would have been disappointed had they not asked for more.

Mr Steve Chia asked why not go all the way to the limit, ie, do it like reservists' allowance or make-up pay - whatever your salary, make up 100%. We are not quite making up 100%, but we are not doing 50%, which is what Mr Steve Chia said. I think he may have misheard me. We are doing 100%, up to a cap. The cap is $70 a day. But, below that, whatever your pay is, you get it. And if you are self-employed, we will just give you a flat rate of $70 a day. We will give you the benefit of the doubt.

What is our philosophy? I think we are in a situation where the economy is going to hurt, many Singaporeans are going to hurt, many businesses are going to hurt. The Government cannot take it upon itself to make good everybody's loss. Because from 4% growth we will go down to 1% or 0% growth. Where does the Government find $6 billion, which is equal to 4% of GDP, to make good? It is not possible. But, at the same time, where the Government's action directly impacts somebody - I shut your company, I put you out of work, I ask you to stay at home, or I close the company and, therefore, you also have to stay at home - we will provide assistance. If we do not do something to mitigate the pain, to help you out, then you are going to try your best to escape quarantine. And that is going to make our public health problem worse. So where we act and there is hurt, we will try to make good. I cannot always compensate fully, but I can extend some allowance or some gestures to address the hurt. In the case of the PPWC, we are going to waive rentals for 10 days and we are going to give them another ex-gratia payment of $1,600 per stall, more or less covering up the cost of the vegetables which became spoilt.

Is it dollar-for-dollar? I think that is not possible, because this is a situation where there would be ups and downs, but to the extent that we can help, we will. So when it comes to the HQO allowance, if you are in the lower income group, I will give you up to 100%. In fact, if you are self-employed and a hawker, you may not earn $70, but I am going to gloss that over. I do not want to have to examine your income tax returns, your employer's records, or whatever the records there are, and audit them. What I have suggested to my staff to do is that when you are served with a HQO, you will be given a form. If you are an employee, give the form to your company. Your company will deal with the CDC and make a claim. If you are self-employed, you submit the form. We will process it quickly and if we can, we might be able to give you part of the allowance early and then the other part after you have completed your HQO, just in case you do not complete your HQO. So, what we can do to alleviate the hurt we will do it, but we cannot say that we will compensate everybody 100%, because that is not realistic.

On economic assistance, this is an issue where, like Oliver Twist in the musical, he would ask, "Can I have more?" The question is: what is the solution to our problem? Will we solve our economic problem or SARS problem by having an economic stimulus package? Is it that kind of a problem? Is it because our wages are out of line, our market has disappeared, our costs are not competitive, or there is insufficient demand? So what happens if the Government spends $1-$3 billion? Well, we will all have a warm feeling - we buy each other's things, sell each other's things. But we do not solve the problem. The fundamental problem is a public health one. To get the economy going, you have got to get the medical, public health part solved. And that is not a question of money, but of the organisation, the social responsibility, the discipline and the commitment we put to it to fix the SARS problem and restore confidence. Then the economy can pick up again.

The Asian Wall Street Journal coincidentally today has an editorial on this subject. The title is "SARS Bailouts are a Bad Idea" and the editorial explains why it is a bad idea. It says that if you have an earthquake or typhoon, you compensate everybody. They rebuild their shops and stores. Then you go back to business as usual again. But this is not an earthquake or typhoon. This is a change of the landscape. Will the businesses be the same at the end of this? What kind of businesses will come back? How should you adapt and move your people and your capital and your workers, and find new jobs? You do not know yet. So, if you help people stay in the tourism industry, even though hotel occupancy is 10-20%, what if the tourists do not come back for quite a long time? You cannot afford it. Supposing we give tax rebates. Will that solve the SARS problem? Will that get people spending again? As the editorial says, they are more likely to stash their money away to get them through the difficult times ahead.

The editorial noted that various countries are looking at budget packages. Hong Kong announced a big package yesterday, which prompted this editorial. Singapore had a small package. So, at least, (according to the editorial) it could be said that Singapore has the wisdom to resist micro-managing the economy through this crisis and it is hanging back in order to allow the market mechanisms to work. In other words, we have to adjust. We do not know where, but we would have to see how the epidemic goes, what happens to the regional economy and the global economy, and then we adapt. To pour money out now does not solve the problem. It is premature.

I think their conclusion is worth reading. They say:

"Life is full of risks, and disease is one of them. ... When things go badly, especially all at once as with SARS, there is a natural temptation for government to step in. But that means that the next round of choices are distorted by the expectation that there will be a safety net. In a crisis which is ongoing like SARS, that changed perception could be particularly damaging.

The true role of government is in protecting against dangers to society as a whole which the market isn't capable of addressing. SARS is just such a danger."

To fight SARS, to get people quarantined, to change people's attitudes, to persuade them, is what the Government has to do. The economic cost will continue to grow as long as the virus is on the loose but if it is contained, recovery should soon be coming. So, the best way to solve the economic problem is to concentrate the maximum possible resources on the medical problem and that is exactly what we are doing. Of course, a request will arise. I fully expected Mr Low Thia Khiang to ask about the GST. He would be remiss if he did not do so at every opportunity. But is that our problem? The GST increase is for the end of the year, something to be dealt with then. And I hold out no promises that that will change.

Dr Wang Kai Yuen pointed out that this is a problem of human psychology. He is absolutely right. We are dealing with people. We are dealing with human beings. They are frightened. They are worried for themselves and for their children. They do not know how to react and they are looking for leadership and guidance. There is fear. There is denial. And as the Chinese and the Hongkongers point out, the fear of SARS is more damaging to the economy than SARS itself. Because when you fear, you stay at home, you do not go out, you do not spend, you do not do anything, and everything grinds to a halt.

We have to overcome this, and understand that these are human problems. We are all afraid of getting sick. Nobody welcomes illness. Your fever goes up a little bit, you say, "Something has gone wrong. Better take the temperature again." We have been taking temperatures daily in MTI and MOF. The first day, I was 37.1. My PA said, "You are the champion." I thought that was bad news but I still passed. The next day, it was 37.3, stuck in the right ear. So I said, "No, no. Let's check my left ear." The left ear was lower. It is human psychology. You wish not to believe. Today, it went back down to 36.8, so I am standing here. That is just a small example of how frightened people can be.

Do I have SARS? I wish I did not have. Maybe I am mistaken. It is not really a fever. If I see the sinseh, he may give me some banlangen or some magic potion. Or take some garlic and vinegar and then all will be well. So, you have people who go from sinseh to sinseh and GP to GP, anything but confronting the truth, the awful possibility that maybe you do have SARS and need to go to Tan Tock Seng Hospital. And that psychological hurdle to, firstly, acknowledge that you may have SARS, and, secondly, if you do have SARS, to go to Tan Tock Seng Hospital before you infect your family. Each one of those is a very big psychological hurdle for people to take. So we have got to make it easy for people to make these steps. And it means explaining, showing them Tan Tock Seng Hospital. I hear all sorts of Hokkien meanings that have been attributed to Tan Tock Seng Hospital, but it is a perfectly safe place and we have to get people to understand that. If you have SARS, going in early is your best chance of coming out.

You also have to help people to be willing to take proper measurements of their temperatures. And we have got to get people to watch out for each other - at work, in their families. So even if you are in denial, which is a natural human reaction, your spouse, your parents or your children would say, "No, I think you are sick. You better go." And they will badger you, harangue you and nag you until you go and see a doctor - not a sinseh, a doctor. Through this community support, we can hold together and overcome this problem.

There is no medical cure for SARS. We are not absolutely sure if the treatments will work except that they will help to support you through the very difficult stage of the illness. But there is a public health solution which can keep the disease down as low as possible and keep the transmission under control. We will give everybody a thermometer. I do not truly expect that 100% of Singaporeans would take their temperature every day. But if I can get 90% of Singaporeans to do that, and if a super-spreader can be detected after spreading to 2-3 people instead of 50, then we have a chance to bring the whole epidemic under control. SARS may still be in the population, but the infection level is something that we can live with.

Human beings have lived with such illnesses for generations. Until this post-war generation, when there were antibiotics, people lived with it - plague, diphtheria, polio. It is quite common that you will get ill, you will die at quite young ages, 30s or 40s - it is part of life and death.

After the Second World War, with antibiotics, suddenly people felt that they have conquered all diseases. They are eradicated, they are safe. If you are sick, you go to a doctor. The doctor gives you medicine. Take the injection, and you will be well. And it was good for about one generation. Then, you had antibiotic resistance. You had malaria which is resistant. Now, you have tuberculosis which is resistant. You have Methicillin Resistant Staphylococcus Aureus (MRSA), something which is terrible, if the hospital is not careful, you can get it. You have got AIDS, which is also a viral disease like this one. After 20 years, it is still around. There are treatments but no vaccine. It is a shock for this generation. But for the older people, life used to be like that, and so life goes on, even with these problems. And I think we have to have that attitude. After a while, the reality will sink in. We can deal with it. We can cope with it. We can fight SARS and we can have life going on normally, fully and we will be able to come out on top of it. So I think that is the approach that we have to take and I will ask Mr Wong Kan Seng to explain to you some of the specific things that he has been doing in his ExCo. 5.00 pm

The Minister for Home Affairs (Mr Wong Kan Seng): Mr Speaker, Sir, I know many Members have raised some issues which, as Chairman of the Ministerial Committee, I will try to answer them.

The SARS problem we face today is the most serious threat to our healthcare system, economy and society. As far as my experience goes, it is unprecedented. It is here to stay for some time. The Government has marshalled all its resources to deal with it and will spare no effort in containing and controlling the problem. We have to continue to function and to carry on with our lives, or we will come to a standstill.

The focus of the Ministerial Committee has thus been to put in place all the possible measures to return life in Singapore as near to normalcy as possible, with some changes to the way we do things. At the same time, we have also been thinking through and working out plans to address all the possible scenarios that could arise, to prevent them from occurring if we can, and if not, ensure that we are well prepared to deal with them if they occur.

The Minister for Health has dealt in depth on the measures that have been taken on the medical front and in our hospitals to help contain SARS. The Deputy Prime Minister himself has outlined the many precautionary measures that the Ministerial Committee has put in place at our airports and land checkpoints, workplaces, markets and hawker centres, to allay public concern and to prevent the spread of SARS. He has also outlined some of the scenarios that we have made plans for, if they should occur. I will not repeat them.

The one point that I want to emphasise is that the Government is going all out to contain the spread of SARS, to protect you and your family's health. For us to succeed in containing the SARS problem and to restore life in Singapore to an even keel, we need every Singaporean to play his part. Everyone must adopt socially responsible behaviour.

As the Deputy Prime Minister has pointed out, the entire Government machinery has been mobilised to tackle this problem. We cannot allow all these efforts to be undone by some irresponsible individuals. On a personal note, I find the behaviour of some of these Singaporeans on Home Quarantine Orders very disappointing, eg, the well-publicised case of the irresponsible and cavalier attitude of the family of eight who are related to the 70-year old SARS case in Pasir Panjang Wholesale Market. This kind of behaviour is something that should not be condoned, as people like them are putting many others at risk. These individuals either clearly do not understand the seriousness of the situation or simply do not care about the dangers that their actions could pose to others. We will come down hard on such irresponsible individuals from now on.

So, we have decided that we would no longer issue a mere warning when an individual is found to have breached his Home Quarantine Order. We would immediately electronically tag anyone who breaches the Home Quarantine Order. All individuals on Home Quarantine Orders are checked regularly via the electronic camera that is installed in their homes. The camera is on only when they are told to switch it on and, therefore, would not invade the privacy of their homes. The CISCO officers will then call these people on the telephone and ask them to turn on their camera.

Earlier on, the Deputy Prime Minister said that he received a letter from somebody who said that some smart alec may do call-forwarding on his mobile phone, so that he can be roaming around, while pretending to be on Home Quarantine Order. Let me tell them: Do not try! Anyone who is on Home Quarantine Order and uses call-forwarding will have that facility cut off. In other words, he cannot do call-forwarding. That is what we have asked SingTel to do. In any case, when a person is asked to appear before the camera, he or his other family members who are on home quarantine will also appear. At the other end, which is the CISCO office, CISCO officers will be able to match the faces and background with what they have taken at the time the electronic camera was installed. So, unless a person can put a big picture of his home background and pretend to be there, it is purely impossible. Whatever it is, he cannot try that any more because he will have no call-forwarding facility during the period of his home quarantine. So, when CISCO calls the person, he will be asked to turn on the camera and that is how he will be checked.

There are people who thought that they can pretend not to be around. So when CISCO calls, the telephone was not answered. That was one of the things that my officers have experienced. Let me tell them about this too. The moment he does not answer the telephone after three calls, and they will call three times, CISCO officers would be at his home and he will be tagged electronically. So do not try that too. Also, do not pretend not to be at home when you do not want to be bothered. There were people who were being called and said that they did not want to be bothered. Do not try that also. I do not think that all this is worth the effort, because once a person is on electronic tag, the moment he leaves the home he will be noticed at the CISCO operation centre. He "chao buay lat". So far, we have put nine such persons on electronic tag after they refused to answer after three calls.

With the amendments to the Infectious Diseases Act to allow for composition fines to be imposed, we will also not hesitate to impose fines on these individuals. If such measures still do not work, we will charge the recalcitrant type in court and have them thrown in jail. If you read the newspapers today, we have prepared one of our prisons for this purpose. I do not think it is very comfortable to stay in prison during this period of home quarantine.

Sir, it is unfortunate that we have to resort to such tough measures to ensure that Singaporeans obey their Home Quarantine Orders. But this is a serious issue. We are also making it an offence for any individual who lies to the doctor when the doctor asks him some basic questions provided by the Director of Medical Services, eg, whether he has a fever, whether he has come into contact with any suspect or any SARS patient, whether he has been to a SARS affected country - other than Singapore - of course, in the last 14 days, whether he has been doctor-hopping, and so on. If his answers are: "no", "no", "no" to these questions, but if found out later that he has done all those things, then he will be committing an offence under the Infectious Diseases Act. Sir, we do not want to implement such measures lightly, as we recognise the emotional anxiety and fear of some of these people who are on home quarantine. They face anxiety and fear because they do not know whether they will become a candidate for SARS. But to win this battle against SARS, we cannot afford any kinks in our armour, otherwise we put the whole community at risk, and the consequential impact will be very disastrous.

Sir, Singapore is an open economy. Our borders must remain open and we want to continue to welcome tourists, visitors and businessmen to our shores. However, we must also put precautionary measures in place to isolate and contain the SARS problem at our entry points. Thus, while all incoming air passengers from SARS-affected areas and all points in China are subject to temperature screening, health advisories and health declaration cards have also been implemented at the other checkpoints. Since yesterday, we have deployed three thermal imaging scanners at the land checkpoints. One each has been deployed at Woodlands Checkpoints and Tuas to check the temperatures of those coming in by bus and those walking in by the Causeway or the Second Link. Another has been deployed at Woodlands Checkpoint to check outgoing passengers. We will deploy more of these thermal imaging scanners over the next two weeks at the airport and the land checkpoints. In addition, manual temperature checks will also be implemented within the next two weeks for passengers coming in by car or motorcycles at the two land checkpoints. It is simply not practical to deploy the current thermal imaging scanners in the outdoor area because the temperature will fluctuate. These checks will be done at the secondary check area where 100% security checks are now in place.

As a responsible member of the international community, Sir, we have also taken steps to ensure that we do not inadvertently "export" SARS to the rest of the world. Temperature checks have thus been instituted for all outgoing passengers at Changi Airport and bus and foot passengers at the Woodlands Checkpoint. This will be extended to Tuas Checkpoint in the next two weeks. In addition, we will ensure that SARS patients and those on HQOs are not allowed to leave Singapore. So, do not think that they can just run away and go to another country because it will also be noted. When they are discovered checking out from our immigration checkpoints they will be picked up and the law will come down very hard on them. We have also taken similar precautionary measures at the ferry terminals, a point which one of the Members raised.

We are also working very closely with the Malaysian government to exchange information on SARS patients and minimise cross-border infection. The Joint Border Working Group, comprising health and immigration officials from both countries, has been working to establish the agreed protocols and procedures to enable SARS cases to be detected at our land checkpoints. We are also keen to share information with the Malaysians on suspected and probable SARS cases that have claimed travel history to Singapore. We read about that from time to time that they have been to Singapore. We need such information because it would tell us when that person came to Singapore, where he went to and whom he met. All this information is useful and important in doing contact tracing and containing the spread of SARS.

Since 11th April 2003, new work permit and Employment Pass holders from SARS-affected areas are placed on a 10-day quarantine upon arrival. Similarly, by next week, once all the necessary logistical arrangements are settled, we will also place all new and returning foreign students who are attending private schools, and Professional Visit Pass (PVP) holders coming in for a month or more from SARS-affected areas, on a 10-day quarantine upon their arrival. Family members accompanying the foreign students and workers will be subject to the 10-day quarantine requirement too.

The private schools and sponsors of the PVP applicants will be required to arrange suitable accommodation where the student or PVP holder can be quarantined. These foreign students, PVP applicants and family members will be subject to daily temperature checks. The private schools and sponsors of the PVPs will also be required to hire doctors to conduct pre- and post-quarantine medical check-ups for them. The student pass or Professional Visit Pass will only be issued at the end of the quarantine period, and upon presentation of a medical report to certify a clean bill of health. With these measures, we will minimise the possibility of transmission of SARS in the workplace, private schools and living quarters of foreign workers. We have to take special measures to quarantine these groups of foreigners as they are more likely to live and mix with the wider Singaporean community.

We are also beefing up all our contact tracing capability by seconding more officers from other Ministries and statutory boards to assist the Ministry of Health and the National Environment Agency colleagues. This will allow quicker and better contact tracing to be done so that cases that have come in close contact with probable SARS patients can be quickly isolated for further observation. A public communication campaign is already underway to educate people about SARS. Pamphlets have been distributed and new ones would be printed and issued. We have also put out messages through the television and radio to inform the public about SARS and what they themselves can do to prevent the spread of SARS. The radio will also be used to put across such messages in dialect to reach out to senior citizens. We are also organising dialogue sessions to be held by the Advisors for all the grassroots leaders and residents. I know some Members have already done this and many have planned to do this in the next one to two weeks. The Prime Minister himself will chair a dialogue on 2nd May to talk to community and religious leaders, shopkeepers, stallholders and so on.

To help the public to remember the hotline numbers for SARS - I know that some say that it is quite a mouthful and they cannot remember the present number - the general inquiry hotline will be changed to 1800-3339999, which is a toll free line. I think Members will like this number. And the hotline number to call for an ambulance to send somebody to Tan Tock Seng Hospital should that person need to check if he has got SARS or not will be changed to 993. This is a three digit number. It is very easy to remember. Members know 999 for Police; 995 for Civil Defence ambulance for emergency, but for suspected SARS cases going to Tan Tock Seng Hospital, please dial 993, and not 995. These two numbers will be effective from midnight this Sunday.

One Member asked how Cabinet Members ensure that the Cabinet can function. This is of greatest interest to us, as Cabinet Members. So, for a few of our colleagues like Mr Khaw Boon Wan and the three doctors, Vivian Balakrishnan, Ng Eng Hen and Balaji, we have set up video conference facilities for them - for ourselves in the Cabinet room, and for them in a separate room. Should they decide to come to attend Cabinet meetings, but not inside the Cabinet room, they can go to this room and talk to us and we can see them just as Members are looking at me on the screen now.

Even though the MOS says that they do not have a problem because they are fully garbed, gowned, masked, etc, when they walk around in hospitals, they decided to take this extraordinary step not to attend the Cabinet meetings while they are on this combat team, because if there is a minor possibility that we can get infected, the consequences will be quite bad for Singapore.

This same isolate and contain strategy must also apply at the organisational level. I just described how the Cabinet is trying to do this, and how individual Ministries are also doing it. The Ministry of Trade and Industry has been working very closely with the businesses to advise and help them on the precautionary measures that they should put in place to prevent the spread of SARS in the workplace, such as temperature taking every day to check the staff and the visitors, segregation of their staff into two teams and not allowing cross-contamination and so on. They have also been asked to develop business continuity plans should something happen.

Similarly, such precautionary measures have also been put in place for all Government agencies. For example, we take the temperature of ourselves every day. Every Government officer is now given a thermometer and he is required to take his temperature and he will be supervised by his supervisor. All Government agencies have also developed detailed operating procedures to safeguard the health of their front-line staff who may be exposed to SARS patients in the course of their work. These include the Immigration and Checkpoint Authority officers, and my Immigration officers were quite aghast when they found incoming travellers at the Airport pulling two hand trolleys and then putting their passport in between their teeth. So, we decided to take precautions so that they do not inadvertently get infected.

We are also taking precautions for our Police officers, paramedics, soldiers and so on. The consequences of a SARS infection spreading through the public service will be a serious one and we cannot afford to shut down a Government department or a Ministry. The same applies to the others, particularly those that provide essential services, because essential services such as water, electricity and public transport must continue to be provided, even during an emergency. This is a very serious problem for us and we must continue to run these services in order to have life carry on as per normal.

We have also identified a temporary office site that can be used for a Government department in the event that the whole department has to be vacated and we need to do some cleaning. Back-up information technology infrastructure has also been put in place to service this. Remote access and telecommuting work solutions are also being developed for the public service. The public are also being encouraged to make greater use of the various electronic services that Government agencies have launched over the years, so that they can minimise the level of physical interaction at the public counters.

While we take all the necessary precautions to prevent the spread of SARS, we also plan for various scenarios for which quickness of response and the ability to muster resources at extremely short notice is absolutely crucial. Even when reacting to a situation, we have to be very fast.

Let me just quote the example of the closure of the Pasir Panjang Wholesale Market. Mr Lim Hng Kiang called me on Saturday at about 8 o'clock, and we discussed what to do about the Pasir Panjang Wholesale Market in view of the number of cases there. After we assessed the situation, we thought that we should close the Wholesale Market, so that we can contain the spread of SARS, and that is the best course of action we thought we should implement immediately. So, I directed the Director of Operations, Police HQ, to marshall the Police officers to get to the ground with Environment, MOH and AVA officers to immediately quarantine the place; in other words, totally enclose the place. And then we cleared people out and registered them.

We had to find about 3,000-4,000 people who were, in one way or another, involved, connected or doing business in the Wholesale Market, and it is a very large number of people to be contacted. So, to do that, the following day we again got together a group of officers, this time from the Peoples' Association, because they have a wide network on the ground, all the 84 constituency officers plus their staff were gathered together and they were given a list of names to do the contact tracing. While people are being traced with the names and once we know where they are and are actually in, CISCO officers, together with another 100 Civil Defence officers, went to the homes to serve them with Home Quarantine Orders and to fix the electronic cameras. And we also had Civil Defence officers to volunteer to become interpreters, because the people we contact may not speak Mandarin or English. So we had to have interpreters.

This is just the immediate action that we took to trace, contact, to serve the Home Quarantine Orders and to put in the electronic cameras. But there are many regular retailers who go to the Pasir Panjang Wholesale Market and we thought it would be a useful measure if we were also to do temperature taking at all our markets, and that is how we activated the PA network again with our community leaders, merchant and hawker associations, with Town Council staff and many others, to quickly help conduct temperature taking. And the briefing was done on Monday afternoon. Monday evening, they went back to discuss with their own people together with the hawkers themselves and the following day, some were ready to roll, and by now they have covered many of the markets and hawker centres. Because this is an effort that depends on the community, and we know that community leaders are volunteers, unless they are housewives or retirees. So it is not possible to make this a sustained effort in taking body temperature of every hawker or hawker assistant. From tomorrow onwards, National Environment Agency officers - although they were also involved in the earlier task - will take over the task of temperature-taking for about 20,000 stallholders and their stall assistants. This will then make it a sustainable effort.

While the Ministry of the Environment and the Town Councils have done thorough checks and taken extra measures to ensure that the Hong Kong Amoy Gardens scenario should not occur here, we take no chances. We have identified and prepared two HDB blocks to be used as emergency housing in the event that we have to move a whole block of residents to another block should the need arise. I hope that this will not come about, but should it happen or has to happen, then at least we are prepared for this eventuality. This is to protect the residents. I know that they will be inconvenienced but that cannot be helped because investigations have to be carried out smoothly and without hindrance for us to identify whether there are other causes that could lead to, say, several cases of unconnected residents living in the same block having SARS. We hope that there would not be such a case. But should that be the situation, then we may have to activate a plan like that.

The logistics and utilities as well as the operational plan to effect such a mass evacuation have already been worked out. So, while we take all precautionary measures, we cannot afford to be complacent thinking that everything is fine with all these measures in place. We still have got to think through and review and refine as we gain experience.

However, the actions at the individual and national levels are not enough, because SARS is a global problem - in Asia, America, Europe. To fully contain SARS, international cooperation is essential. Such cooperation is already happening on the medical front where medical professions share information; they share the research that they have done and so on. The significant strides made on this within a short time in the fight against SARS shows what could be achieved if nations are prepared to work together to overcome this problem, provided we all work on it together.

Hence, the ASEAN Leaders will be meeting in Bangkok next Tuesday together with their Health Ministers and Ministers in charge of immigration matters, to discuss the measures that ASEAN member nations could take as a collective group to keep our borders open and to contain the spread of SARS. Ideally, we should also get to a position where we can assure the rest of the world that it is safe to travel in and out of ASEAN. Furthermore, it is encouraging to note that China and Hong Kong also recognise the importance of global cooperation and they may also be joining the meeting.

Mr Speaker, Sir, whether we like it or not, SARS will be with us for some time. It is important that we do not allow ourselves to be defeated and continue with our normal life with suitable adjustments. As long as the necessary precautionary measures are taken, all activities can and should continue.

I am happy to note that the majority of Singaporeans have already made the adjustments and are carrying on with their normal lives. This is evident from the many mass community events that are going on as planned as well as the crowds at hawker centres and food courts. I myself was at a restaurant last Saturday and it was full.

In summary, Sir, the Government is treating this threat very seriously. Attention is paid at the highest level, and the Government will not let up on its efforts to contain and overcome the SARS situation. If all Singaporeans cooperate and stay united, we will weather this crisis like many others before.

Mr Steve Chia Kiah Hong: Two supplementary questions, Mr Speaker, Sir. For the Minister for Health - if people are afraid of going to TTSH because of the irrational fear that TTSH is highly contagious, will the Ministry consider setting up an intermediate testing or holding centre at a different location for suspect and probable cases? This will actually alleviate the public's concern and encourage more people to be more willing to approach this intermediate medical centre for SARS testing, rather than to avoid it totally. This is human psychology at work.

Another question for the Minister for Home Affairs - how much is one thermal imaging scanner? If private corporations are interested to install one at their business premises to check for SARS, will it be possible and allowed?

Mr Wong Kan Seng: Sir, I was a bit interrupted there. But as I understand it, Mr Chia is asking how much does each thermal scanner cost. Is that his question?

Mr Steve Chia Kiah Hong: Yes, and whether it would be allowed for private companies and corporations that want to install it at their premises to test for SARS.

Mr Wong Kan Seng: Sir, this thermal imaging scanner is a scarce resource. Right now, we do not have many of them, and we have to depend on the company to produce this. But because of the urgency of this matter, we have decided to take from them first and started to deploy them at our airports and land checkpoints. How much does it cost? I was told it is more than $100,000 or thereabouts. So it shows that we are sparing no efforts, including the price of this scanner, to install as many as we can, because we have to deal with this immediately.

Mr Steve Chia Kiah Hong: When the supply is more in the future, and because SARS is going to stay with us for quite some time, if private companies request to install it at their premises, will that be allowed?

Mr Wong Kan Seng: Sir, we have to see how we want to maximise this scarce resource. Since we do not have many of these around, we have to put them in places where we can create the most effect. So the idea now is not to deploy this in the companies.

Just now I mentioned that I am encouraged that China and Hong Kong are attending the meeting. Well, that was my impression, but I do not think that has been confirmed yet. So I would withdraw that part of my statement.

Dr Warren Lee: Point of clarification, Sir. Just now I think Mr Lim Hng Kiang was under the impression that I questioned the validity of the home as a suitable place for home quarantine. I fully agree with that as a medical practitioner. I was actually trying to refer to people who were recalcitrant in trying to break quarantine, and Mr Wong Kan Seng has told us what he would be doing for that group of people. But, perhaps, he might want to address the group who is given a Home Quarantine Order because of a contact at work, and then because they are living with maybe distant relatives or actually renting a room, find that the relative or landlord saying, "Look. Please, I don't want you to be in the same household." What do they do then?

Dr Lily Neo: Could I seek clarifications, Sir? The Minister for Health earlier mentioned that we have had this epidemiological study group all this while. May I ask him what kind of study results have been obtained so far and could he share that with us? The Minister for Health also said earlier that all the medical staff in our public hospitals are protected with face masks. Could I ask him whether face masks are sufficient? Or should they don space suit outfits as well? Is the conjunctiva of the eyes not an entry route for viruses? Could I also ask him whether Tan Tock Seng Hospital could share their good practices with other hospitals?

The Minister for Health also said earlier that anti-viral drugs are being used by our doctors in our public hospitals. Can I ask him whether it is correct to say that there is no medicine that can combat SARS coronavirus? Why then are our doctors using the available anti-viral drugs now that they have many side effects? The Minister also did not answer my earlier question on public directives for better containment and contact tracing of SARS.

The Deputy Prime Minister said earlier that those under quarantine can claim $70 a day. But it has also been mentioned that they can claim $70 from the Courage Fund. Does it mean that now they can claim $140 a day?

Mr Lim Hng Kiang: Mr Steve Chia asked whether we can have a different facility as intermediate care. In fact, that is possible by going to the polyclinic. But, of course, if you know that you have contact with a SARS patient, then I think you should go directly to TTSH.

Dr Warren Lee asked whether we can have alternative home arrangements. As I have tried to explain painstakingly, the person who is on home quarantine is well and is not infectious until he has the symptoms. So he can continue renting a room or staying at home. It would be very difficult for us to make alternative arrangements for accommodation for all people serving HQOs.

Dr Lily Neo asked about the epidemiological study. I am no expert. I will get my staff to give her whatever they have found out. For the staff who are in direct contact with unknown or potential SARS patients, like people in the A&E, ICU and emergency departments where they have to deal with potential SARS patients, then they put on the full suit, together with the goggles. For those who have to do actual interventions, then they put on the hoods. That is how I have explained in my statement.

There is no cure for SARS. In the early stages, Hong Kong thought that Ribavirin would be useful. The clinicians in Singapore are not as aggressive in their approach as the Hongkongers. I think we are closer to the American clinicians and, therefore, we have used Ribavirin very, very conservatively, because we realise the toxic side effects of this anti-viral regime.

Public directives - we are building up the contact tracing setup, organisation, data collection, as Mr Wong Kan Seng explained. And when these things are more systematic, of course, we will then be able to issue these out in proper public directives.

There is some confusion on the Courage Fund. The Courage Fund offers up to $70 per day for people who come forward for screening and who are then held for observation. Because we felt that for some of these people in the Pasir Panjang Wholesale Centre, especially the casual workers, if they are served with a Home Quarantine Order, then what DPM announced today will kick in, and they will be given the financial support. But even just to come forward for screening, and you have a temperature and you are held in Tan Tock Seng Hospital for observation for a few days, there may be a loss of income for these people. So the Courage Fund has come forward to say that for screening and observation, they will also provide the financial support for up to $70 per day. So there is no double payment for the Home Quarantine Order people.

Mr Speaker: I hope Members have exhausted all questions. Introduction of Government Bills. Mr Yeo.