DORSCON is short for Disease Outbreak Response System and it lists out the list of responses that Singapore will take
as a nation when threaten by a pandemic flu or infectious agent.
The different levels of DORSCON are green, yellow, orange, red and black.
| GREEN |
- No novel influenza virus causing severe disease in humans OR
- Occasional animal - human infections
- No Human - Human Transmission or rare cases of spread requiring very close and prolonged contact.
- Healthcare worker/ institution’s response - current triage of patients with fever in Emergency depts and
polyclinics;
- Public response - hygiene measures, mask wearing, social responsibility
|
| YELLOW |
- Inefficient human-to-human transmission. Requires sustained close contact.
- Small clusters of cases may occur.
- Isolated imported cases may occur but there is no sustained local transmission.
- Healthcare worker/ institution’s response - staff in high risk areas (Emergency Depts, ICUs, Triage stations) in PPE
- Public response - GREEN measures + contact particulars recorded when visiting hospitals & clinics.
|
| ORANGE |
- More efficient human-to-human transmission. Virus not fully transmissible. Requires close contact.
- Larger clusters of cases in Singapore.
- Healthcare worker/ institution’s response - All areas with patient contact : staff in PPE
- Public response - YELLOW measures + No visitors to hospitals
- Encourage temperature taking at schools and non healthcare establishments
- Consider closure of schools and suspension of public gatherings and events
|
| RED |
- Pandemic is underway. Virus is fully transmissible from human-to-human
- Community-level spread.
- Mild - moderate morbidity & mortality (e.g. 1957 & 1968 pandemics)
- Healthcare worker/ institution’s response - ORANGE measures + antiviral prophylaxis when local cases occur.
- Public response - ORANGE measures + social distancing when local cases occur
|
| BLACK |
- Pandemic in Singapore with high morbidity and mortality (e.g. 1918 pandemic)
- Healthcare and other social systems overwhelmed.
- Healthcare worker/ institution’s response - as in RED
- Public response - more rigorous social distancing measures
- Suspension of all schools, social gathering and institutes of higher learning
- Advise public to stay at home and even consider curfew
|
Management of cases under DORSCON
| Pre-pandemic (Green to Orange) |
- TTSH/ CDC is the designated treatment facility for any case of potentially infectious disease.
- Clinics and step down care facilities will refer suspect cases to TTSH Emergency Department for assessment and
admission, if necessary
- Hospitals will isolate all suspect cases and transfer confirmed cases to TTSH/CDC. Confirmed cases, including
children and pregnant patients will be centrally managed at TTSH/ CDC. Paediatric and obstetric services will be set up
at TTSH/ CDC by KKH when necessary. They will be activated by MOH. When TTSH/ CDC approaches full capacity, other
restructured hospitals (RHs) will also have to manage influenza cases.
|
| Pandemic (Red to Black) |
- Flu Clinics will be established at polyclinics and participating primary care clinics to provide
outpatient care.
- Patients with influenza, aged 1 year and older, will be treated with anti-virals. The severe cases will be referred
to restructured hospitals for treatment.
- Due to the expected large number of asymptomatic cases who could present other complications, both restructured
hospitals and private hospitals will need to manage flu as well as non-flu patients. Hospitals and Flu Clinics should
segregate flu and non-flu cases to minimise transmission.
- There is a dedicated ambulance service for transportation of potentially infectious cases to TTSH/ CDC.
|