Coronavirus: Tasmanian doctor Dale Fisher leading the world in showing how the COVID-19 pandemic can be controlled

AN Aussie doctor working overseas explains why isolating positive cases is necessary with reports of infected cases in Australia who have gone missing.

AN Australian doctor who is at the forefront of containing the COVID-19 disease pandemic in Singapore has revealed that positive cases in Australia have gone missing after being sent home to self-isolate.

Dale Fisher, a Professor and senior consultant in infectious diseases at Singapore’s National University Hospital, says Australian colleagues have contacted him about patients with the virus who are not complying with home isolation instructions.

In Singapore and other Asian countries which have been managing to contain the virus, all positive cases are being isolated in dedicated facilities such as hospitals – whether they have mild or more severe symptoms.

“I have heard so many anecdotes from colleagues in Australia writing to me thanking me for pushing it [enforced isolation of positive cases] because they have been part of the auditing to see if those people [Australian positive cases] are still at home — and they weren’t at home and in some cases they weren’t even able to find the people.

“We don’t send positive cases home. In our view this needs to be airtight.”

Prof Fisher is a key player in that country’s remarkable record in controlling the virus and has rapidly become a world expert on the pandemic and part of a group advising the World Health Organisation.

HOW AND WHEN WILL THE COVID-19 CRISIS END?

At the end of January, Singapore had the most number of cases outside China but the country’s well-prepared and rapid response has meant there have been just 455 cases and just two deaths with 144 recovered. It is a remarkable achievement in a country of more than 5.6 million people in a densely populated community (more than 8300/km).

Professor Dale Fisher, Senior Consultant and Head of Division Infectious Diseases at the National University of Singapore. Picture: PAUL MILLER.

“Basically we have managed to keep the cases flat,” Prof Fisher said.

Prof Fisher is a former Hutchins student was raised in Hobart and graduated from the University of Tasmania. He completed his specialty training in Infectious Diseases at the Royal Prince Albert hospital in Sydney and worked in Darwin for 13 years before moving to Singapore in 2003 — in the middle of the SARS epidemic.

Key to Singapore’s success has been a co-ordinated approach which has involved:

ISOLATING all positive cases in hospitals, both mild and more severe cases;

TRACKING down contacts of positive cases;

TESTING widely to get a clear picture of the problem;

ENFORCING strict quarantine for anyone who has been in contact with a positive case — involving text messages several times a day and phone tracking as well as random face-to-face patrols;

ENFORCING harsh penalties for those who breach quarantine;

STRONG, regular and consistent communication on social distancing and closing venues, restaurants and bars which do not comply.

A cartoon used in Singapore to educate the public during the COVID-19 featuring Dale Fisher, Professor in Infectious Diseases at the National University of Singapore.

The measures have not only contained the spread of the virus but have allowed schools and businesses to remain open.

“Life is pretty much normal here,” Prof Fisher.

“There are things being done in Asia which are not being done in Australia. The whole approach has to be a bundle or several interventions,” he said.

“One of the components is isolation of cases.

“In Singapore, Hong Kong, Taiwan, South Korea and China we all isolate our positive cases.

“It might be in a dormitory or hotel or some sort of facility but they are not allowed to go home on an honour system.”

All of those countries have managed to slow the progress of COVID-19 case while Australia’s casual attitude to social distancing and self-isolation is proving a challenge for health officials.

Professor Dale Fisher.

Prof Fisher believes Australia’s strict lockdown measures announced by the Prime Minister Scott Morrison will work to contain the virus but it was not sustainable economically, nor in terms of long-term mental and physical health.

“Countries, states and provinces are all going to have to work out how to reopen and most importantly how do you reopen so you can put that bundle into place when you get more cases because it’s not going away and countries are just as vulnerable when they reopen,” he said.

“My words to people going through this now is just get it right the second time.”