Large-scale restrictions unnecessary in Singapore despite WHO declaring monkeypox global emergency, say experts
Experts here have said there is currently no need for any widespread or major health restrictions to stem the spread of monkeypox.
This comes after the World Health Organisation (WHO) declared monkeypox a global health emergency on Saturday (July 23).
Over 16,000 cases have been detected in more than 75 countries, up from about 3,000 in end-June.
Six cases have been reported in Singapore as of Sunday (July 24), all of which are men.
Following the WHO's announcement, there was speculation online about whether Singapore may see the return of large-scale restrictions seen during the Covid-19 pandemic.
On Sunday, Dr Khoo Yoong Khean, scientific officer at the Centre for Outbreak Preparedness at Duke-NUS Medical School, told The Straits Times that monkeypox is a "very different" disease from Covid-19.
He pointed out that unlike Covid-19, which could be transmitted through droplets in the air, monkeypox is primarily transmitted through close, prolonged contact with an infected person.
"Therefore, there will unlikely be lockdowns or large-scale social or movement restrictions for now," he said.
Associate Professor Hsu Li Yang, vice-dean of global health at the National University of Singapore's Saw Swee Hock School of Public Health, agreed.
"I think the reason to have restrictive measures will be to control or slow down the spread of a contagious disease. However, such measures must be effective, and must do less harm than the disease... I can think of no really good restrictive measure that will effectively block the spread of monkeypox in Singapore," he said.
Prof Hsu also highlighted that the vast majority of monkeypox cases thus far have been "among networks of gay, bisexual and other men who have sex with men" - a fact that WHO director-general Tedros Adhanom Ghebreyesus also pointed out on Saturday.
"Transmission through close skin-to-skin contact has largely been attributed to the clustering of social and sexual networks in this population.
"Contact tracing has been challenging not just in Singapore but also elsewhere partly because of the discrimination faced by this group of people - they are less likely to seek help or healthcare earlier, or to name their sexual partners even when they are known," said Prof Hsu, adding that measures such as mask-wearing and physical distancing would not help prevent the spread of the disease.
Instead, he said, there is a need for better surveillance and better education so that people can seek medical attention more quickly, take necessary precautions and refrain from high-risk activities.
Dr Khoo said that for now, targeted measures such as early testing, isolation of people when infectious, and contact tracing among high-risk populations and close contacts will be the main measures to stop the spread.
Those with a travel history from countries with high numbers of cases should also be encouraged to monitor themselves for any symptoms.
Dr Rayner Tan, visiting research fellow at the Saw Swee Hock School of Public Health, said members of the public can protect themselves by limiting close contact with those who are symptomatic, and exercising caution in settings that are conducive for skin-to-skin or close face-to-face contact, such as venues with sex on premises or large gatherings like dance parties.
He added that those experiencing symptoms of monkeypox, including fever, lesions and blisters, enlarged lymph nodes and exhaustion, should seek immediate medical help.
Dr Tan, who is also vice-president of the Society of Behavioural Health, Singapore, said: "It is important to note that anyone may be susceptible to monkeypox, and there have now been early reports of infections among children elsewhere. Stigmatising its transmission will undermine public health efforts to limit the further spread."
Dr Khoo added: "It is (important) to ensure the communication is managed accurately so as to avoid any potential stigma and create trust between authorities, the public and the affected population. This is critical to stopping the spread."