Volume 15, Number 12—December 2009
Research
Cost-effectiveness Analysis of Hospital Infection Control Response to an Epidemic Respiratory Virus Threat
Yock Young Dan, Paul A. Tambyah
, Joe Sim, Jeremy Lim, Li Yang Hsu, Wai Leng Chow, Dale A. Fisher, Yue Sie Wong, and Khek Yu Ho
, Joe Sim, Jeremy Lim, Li Yang Hsu, Wai Leng Chow, Dale A. Fisher, Yue Sie Wong, and Khek Yu HoTable 1
Characteristics of Singapore MOH influenza outbreak response system*
| Singapore MOH DORSCON alert level | WHO pandemic alert level | Global/local situation | Hospital measures | Community measures |
|---|---|---|---|---|
| Green 0 | 1 | No novel influenza virus circulating | Triage and isolation of febrile patients, use of PPE as appropriate | Surveillance, maintenance of antiviral drug stockpile |
| Green 1 | 2–3 | Novel virus but predominantly animal disease with limited transmission to humans | Full PPE for suspect cases, contact tracing for confirmed cases, antiviral treatment for all confirmed cases | Enhanced surveillance, communication, readiness measures |
| Yellow | 4 | Inefficient human-to-human transmission of novel virus | Full PPE for HCWs in high risk contact, visitor restriction, restrict movement of patients and HCWs | Enhanced surveillance, public health education, border body temperature screening, surveillance of returned travelers from affected areas |
| Orange | 5 | Global or local clusters but transmission still localized | PPE stepped up to cover “medium-risk” patients, no visitors, no interhospital movement of patients or HCWs, post-exposure prophylaxis for contacts | Body temperature screening at community areas, consider school closure, body temperature screening at borders, enhanced public health education |
| Red | 6 | Pandemic under way, import into Singapore is inevitable | As above with establishment of 18 influenza clinics | As above with possible use of masks in the community |
*MOH, Ministry of Health; DORSCON, Disease Outbreak Response System; WHO, World Health Organization; PPE, personal protective equipment; HCWs, healthcare workers. Adapted from (5).
