The Ministry of Health (MOH) is inviting feedback on proposed amendments to the Infectious Diseases Act (IDA), that ensures that Singapore's ability to prevent and control infectious diseases remains relevant and up to date. The public consultation will take place for six weeks, from 27 June to 7 August 2018.

2 Infectious diseases, such as Avian Influenza, Ebola, and Middle East Respiratory Syndrome (MERS), are serious public health threats globally. As a major global trade and travel hub, it is imperative that we remain vigilant to public health threats, and safeguard the health of Singaporeans by protecting the community against new and emerging infectious diseases, both locally and overseas.

3 In view of the evolving infectious diseases landscape, MOH is proposing amendments to the IDA to:

4 Currently, the IDA allows MOH to require cases, carriers or contacts of infectious diseases to submit to surveillance1. While this may be often done in person, the IDA will be amended to allow MOH greater flexibility to carry out risk-calibrated surveillance remotely, for example, via phone calls, text messaging or video-conferencing. This means that lower risk contacts of an infectious case need not present themselves physically at a specific location for examination.

5 Under the current IDA, doctors and laboratories are required to notify MOH of infectious diseases when detected. This requirement will be amended to streamline notification requirements and reduce duplication by specifying the notification requirements for each group. For example, only laboratories will be required to report an infectious disease in situations where an infectious disease can only be properly diagnosed with a laboratory test.

6 We will introduce amendments to better manage the risk of importation of serious infectious diseases into Singapore. Currently, the IDA requires persons entering Singapore to be vaccinated against specific infectious diseases2. Unvaccinated travellers may be subjected to vaccination, isolation or surveillance in Singapore, and travellers who refuse to comply may be returned to his/her place of embarkation.

7 To safeguard Singapore against high-risk non-citizens who have not been vaccinated, the IDA will be amended to allow discretionary powers to return unvaccinated non-citizens to his/her place of embarkation without first offering vaccination, isolation or surveillance. This is in line with international practice. This discretion will be exercised judiciously, in scenarios where it is impractical to offer vaccination, isolation or surveillance. Unwell travellers arriving in Singapore will not be turned away, and will continue to receive medical attention as needed.

8 Currently, our infectious disease control measures commonly involve movement and occupational restrictions for persons identified as cases or carriers. The IDA will be amended to allow for a risk-stratified approach to manage individuals with different levels of public health risk. Contacts assessed to be of lower risk of transmission may be allowed to visit certain defined places without strict home quarantine. They may be allowed to perform certain occupational activities instead of a blanket stop-work order if certain conditions are met.

9 High-risk individuals who wilfully violate legal orders to prevent the spread of disease will be subject to tightening of movement restrictions. For example, the IDA will be amended to allow MOH to stop persons breaking isolation or movement restriction orders from leaving Singapore. For such persons, instead of arresting them, MOH will also be empowered to take necessary measures, including the use of physical means, to reinstate the isolation or movement restriction order to mitigate the risk of disease spread posed by the person.

10 Under the amended Act, MOH will be able to enlist the assistance of Singapore-based (i) mobile operators; (ii) air, sea and land transport operators; and (iii) port service and transport facility operators to disseminate health advisories to persons visiting or who have visited overseas areas affected by an infectious disease of public health concern. MOH will also be able to enlist the assistance of these operators and persons managing premises to disseminate health advisories locally. For example, operators may be asked to put up health advisories in the form of posters or distribute information leaflets to at-risk persons.

11 MOH would like to invite the public to contribute their views and feedback on the proposed amendments to the IDA.

12 All feedback should reach MOH by 7 August 2018, 6:00pm. All responses received by the closing date will be carefully considered.

[1] In the context of the IDA, surveillance is to subject a person to medical examination or observations either continuously or from time to time in order to ascertain the person's state of health.

[2] In line with the International Health Regulations (2005), Yellow Fever is currently the only infectious disease for which this requirement applies.

Source: Ministry of Health, Singapore