War on SARS: a Singapore experience

Abstract

On Mar. 12, 2003, the World Health Organization issued a global alert regarding cases of a severe atypical pneumonia termed "severe acute respiratory syndrome" (or SARS). In Singapore alone, there have been 238 SARS cases and 33 deaths, including 5 health care workers. With modern global inter-connectivity, SARS rapidly spread to become a worldwide phenomenon. This article describes the Singapore "war on SARS" from an emergency physician's perspective, focusing on the "prevent, detect and isolate" strategy. Notable innovations include the use of home quarantine orders, mass temperature screening using thermal imaging, modular systems of hospital staffing, "virtual" hospital visits, and innovations in emergency department design. Most emergency departments, hospitals and health care systems appear to be psychologically and logistically unprepared for a massive infectious disease outbreak. In light of recent natural and terrorism-related threats, emergency care providers around the world must adopt a new paradigm. The current SARS outbreak may be merely a taste of things to come.