全国精准医学计划第二阶段工作启动 (Second phase of National Precision Medicine Programme launched)

​A Lianhe Zaobao report mentioned that in the second phase of Singapore’s National Precision Medicine (NPM) strategy, Precision Health Research, Singapore (PRECISE) will collaborate with research and clinical partners including A*STAR, Lee Kong Chian School of Medicine, NHG, NUHS, NUS and SingHealth Duke-NUS Academic Medical Centre, to study the genetic makeup of 100,000 healthy Singaporeans and up to 50,000 people with specific diseases.

Microbes on masks highlight need for frequent washing

Asst Prof John Chen, Department of Microbiology and Immunology at NUS Medicine, explained that bacteria on masks are unlikely to result in something serious in the “vast majority of cases”, but the presence of the occasional “opportunistic bacteria” may be a cause for concern. Such bacteria, which reside on healthy skin, could grow to high levels on dirty masks and cause diseases – from mild to severe allergic reactions, respiratory problems, and even nasal infections. As it is difficult to ascertain whether there may be harmful bacteria present on a mask, it is advisable for people to wash their mask frequently, or after each use where possible, he added.

Doctor discusses AstraZeneca’s Covid vaccine blood clot concerns

Prof Dale Fisher of NUS Medicine noted that while he understands that people might be reticent about the new vaccine analysis which reported a link of unusual blood clots in some individuals, the rate of occurrence is low at about four in a million, and an even lower death rate. He noted that the vaccine is a way to help us return to normal life. He opined that governments pausing the use of the AstraZeneca COVID vaccine was not an overreaction, but an honesty in sharing of information. He explained that governments are under the obligation to share the information with the community as there needs to not only be a lot of trust in the rolling of vaccines, but equally important is a need to share the information in a way that offers the public the right perspective.
 
In a South China Morning Post report, A/Prof Hsu Li Yang, Programme Leader of Infectious Diseases at NUS Saw Swee Hock School of Public Health, said that the adverse effect in question regarding the AstraZeneca vaccine is very rare – perhaps four per million vaccinated would develop this condition, which is why it was not picked up in the licensing clinical trials involving tens of thousands of subjects. It is testimony to the close monitoring of adverse effects post-COVID vaccination in the UK and EU countries that allowed such a rare side effect to be picked up so quickly. A/Prof Hsu said that it was difficult to apportion blame over the controversy given the tiny risks involved and the adherence of standard safety protocols.
 
Prof Dale Fisher said that while adverse reactions were inconvenient to the roll-out of vaccines, authorities had to be honest with the public about the risks. He opined that communicating the necessity of vaccinations despite the miniscule risk would be difficult as people tended to be much more prepared to take risk for a treatment than they are for prevention.

Singapore residents travelling during COVID-19 – the risks and payoffs of reuniting with loved ones

​CNA Online quoted Dr Thomas Soo, Head, Health and Wellness, NTFGH who advised the public against travelling abroad to places that are in the throes of a major infectious disease outbreak as they could risk being infected and bringing the disease back to Singapore. Individuals who need to travel overseas should ensure they maintain good personal hygiene practices, and be financially prepared in case their return to Singapore is delayed due to changing travel advisories or restrictions.

HPB to be model for UK public health office

​Prof Teo Yik Ying, Dean of NUS Saw Swee Hock School of Public Health, commented that Britain’s move to model their new health office after Singapore’s Health Promotion Board “clearly indicates the importance of healthy lifestyles and disease prevention, rather than simply delivering world-class medical treatments when chronic diseases happen”. Prof Teo opined that many chronic diseases can be prevented and he expects this is going to be the key mandate for the new office. 

近期输入病例多来自低接种率国家 (Recent imported cases come from countries with low vaccination rates)

Prof Teo Yik Ying, Dean of NUS Saw Swee Hock School of Public Health, who commented that the fact that most of the imported cases came from countries such as India, Bangladesh and Indonesia showed that the local epidemic control and public health measures in these countries were inadequate.
 
The article also cited A/Prof Jeremy Lim, Director, Leadership Institute for Global Health Transformation (LIGHT), SSHSPH who emphasised that Singapore cannot completely ban certain nationalities from entering the country as Singapore’s economy is largely driven by trade and open borders, and it is important to maintain local vaccination effort and rigorous border monitoring. 

Anti-cancer drug can treat Covid-19, Singapore-US study shows

A collaborative study led by Icahn School of Medicine at Mount Sinai in the US and involving researchers from National University Cancer Institute Singapore (NCIS) found that the chemotherapy drug, topotecan, can reduce the severity and death rates of infection by Sars-CoV-2 virus and may potentially be used to treat patients with moderate to severe forms of COVID-19.
 
Co-author of the study, Dr Anand Jeyasekharan, Consultant and Assistant Director of Research (Medical Oncology), Department of Haematology-Oncology, NCIS, said with the drug used in cancer treatment for over 25 years, it is globally available and inexpensive, with a well understood safety profile in humans. This research is therefore timely given the lack of universal access to vaccines.
 
The completion of the lab studies has led to a phase one clinical trial in India, given the high numbers of moderate to severe COVID-19 cases there. Dr Jeyasekharan’s team has already secured a research grant for the clinical trial to establish the lowest dose of topotecan that can safely reduce COVID-19 inflammatory markers in patients. The research is supported by MOH’s National Medical Research Council and the National Research Foundation. If the phase one clinical trial is successful, phase two will start, with a larger pool of patients recruited from different countries.
 
Ch8 News also featured an interview with Prof Lee Soo Chin, Head and Senior Consultant, Department of Haematology-Oncology, NCIS, who explained how the cancer drug could be repurposed for COVID-19 treatment.

Singapore launches next phase of National Precision Medicine Programme

​In the capacity as Chief Medical Officer at Precision Health Research, Singapore (PRECISE), Prof Tai E Shyong, Senior Consultant, Division of Endocrinology, NUH, and Professor at NUSMed, SSHSPH and Duke-NUS Medical School, commented that while the field of precision medicine has seen considerable progress in recent years, there remains an urgent need for research findings to be translated into standard clinical practice. PRECISE is an entity set up to drive Singapore’s National Precision Medicine (NPM) strategy, a 10-year plan to enhance and accelerate Singapore biomedical research, health outcomes and economic growth. In NPM Phase II, PRECISE will collaborate with research and clinical partners including NUHS, A*STAR, Lee Kong Chian School of Medicine, NHG, NUS and SingHealth Duke-NUS Academic Medical Centre, to study the genetic makeup of 100,000 healthy Singaporeans and up to 50,000 people with specific diseases.

Pandemic drags on, but people more willing to comply with curbs

The Straits Times conducted a recent poll to ask Singapore residents how the lockdown changed their lives, and they found that more people are more willing to follow safe management measures in contrast to a previous poll conducted in August 2020.
 
A/Prof Hsu Li Yang, Vice-Dean of Global Health and Programme Leader of Infectious Diseases at SSHSPH, noted that there was no obvious end in sight for safe management measures back in August 2020, and with vaccines now being rolled out, people can more clearly see that restrictions will likely be relaxed in the future. He added that since the circuit breaker, Singapore has generally not had the need to ramp up safe management measures and instead has progressively relaxed them, and this gives most people the motivation to tolerate and adapt to existing measures for a longer period.  
 
Prof Dale Fisher, Department of Medicine, NUSMed, opined that there has been very responsible messaging in Singapore, and a good relationship between the community and the leadership helps people understand the need to sustain efforts. He called for people to still get tested even if they have mild symptoms, as this is key to determining if they have COVID-19 or another viral infection.

Policyholders must come first in insurer-vs-doctor Shield debate

The article quoted A/Prof Jeremy Lim, Director, Leadership Institute for Global Health Transformation (LIGHT), SSHSPH who suggested insurers to come up with an app that provides patients with a comprehensive list of doctors, filtered by their needs and preferences, and include reviews by others. A/Prof Lim opined that this would help patients feel confident they have the right doctor.  Information on prices, costs consumers need to bear, amounts claimable and time taken for claims to be processed should also be accessible. All this would require investment into data and analytics, said A/Prof Lim.

Explainer: What is the new ‘Eek’ COVID-19 mutation, and will it stymie vaccination efforts?

​TODAY quoted A/Prof Hsu Li Yang, Vice-Dean of Global Health and Programme Leader of Infectious Diseases at SSHSPH, who commented that the E484K mutation leads to the virus having a better attachment to its target in the human cell. He explained that this means the virus can evade the antibodies produced by those who have been infected before or those who have been vaccinated, to a limited extent. A/Prof Hsu added that it is likely that prior vaccinated or infected persons will still be protected to a considerable extent against viruses with the E484K mutation, although infection and disease might not be completely prevented.

高剂量他汀或导致副作用 (High doses of statins may cause side effects)

​Commentary by Prof Tan Huay Cheem, Director and Senior Consultant, National University Heart Centre Singapore, elaborated on cholesterol-lowering medicine – statins. He commented that high doses of statins may cause serious side effects and clinical experience also suggests that the Asian population is less tolerant of high-intensity statins than the European population. He also highlighted that the use of lipid-regulating drugs should be accompanied by diet control and lifestyle improvement.

Scientists here find way to improve outcome for breast cancer patients

​Straits Times reported that researchers from National Cancer Institute Singapore, NUS' Cancer Science Institute of Singapore and A*STAR's Genome Institute of Singapore, together with their international research collaborators in Denmark, have discovered a way to use an alternative drug to counter resistance to a form of targeted therapy used to treat patients with HER2-positive breast cancer. The team, co-led by Prof Lee Soo Chin, Head & Senior Consultant, Department of Haematology-Oncology, NCIS, focused on a protein called HER2 (human epidermal growth factor receptor 2) which stimulates cancerous growth of breast cells when present in excessive amounts.

International Research Collaboration identifies a globally accessible treatment strategy for COVID-19

Heart patients with diabetes more likely to suffer complications and death: Study

Professor Tai E Shyong, Centre Director of NUHS Centre for Chronic Disease Prevention and Management added his views to an international study that tracked heart patients on a registry over five years, which found that patients who had both diabetes and chronic heart disease were almost 40% more likely to die than those without diabetes. 

Dr Tai said there is a misconception that diabetes is only about high sugar intake, whereas people should watch weight gain, the key driver of diabetes.  "There's a tendency to think that if you cut down on the amount of sugar we eat, diabetes will go away. It's not that simple. Diabetes may not relate to any single nutrient," said Dr Tai.

"Many of my patients tell me that they eat brown rice, but they still cannot lose weight. What they don't seem to realise is that brown rice is healthier than white rice, and blood sugar goes up less after it is consumed, but energy content in a bowl is about the same for both.

"So it is not surprising that simply substituting brown rice for white rice may not lead to weight loss."