Open Letter to Mr. Ong Ye Kung, Minister of Health, Singapore by Dr John Tay

28/06/2022

Date: 28 June 2022

Dear Minister,

RE: Co-infection death of a young child

Sir,

It is of great sadness that one child has died of Viral Meningitis (Brain infection).

https://www.channelnewsasia.com/singapore/toddler-dies-covid-19-singapores-first-coronavirus-death-under-12-years-old-kk-hospital-2773591

The most common cause of viral meningitis (Brain Infection) is by enterovirus according to CDC, which this child had.

https://www.cdc.gov/meningitis/viral.html

Severe illnesses and deaths from Covid-19 are usually from viral respiratory infection (Lung infection) and not from viral meningitis (Brain infection).

According to MOH, Singapore: "The symptoms of COVID-19 infection are similar to that of an acute respiratory infection or pneumonia."

https://www.moh.gov.sg/covid-19/general

I believe that:

1) It is more likely that the child died of enterovirus meningitis while having an incidental concurrent Covid-19 infection.

For Covid-19, Respiratory failure remains the leading cause of death (69.5%), followed by sepsis/MOF (28.0%), cardiac failure (14.6%), hemorrhage (6.1%), and renal failure (3.7%).

Not meningitis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347130/

2) Enterovirus infection in children is common in Singapore. Viral enterovirus meningitis is not rare locally.

"Enterovirus infections have been recognized as one of the more common childhood infections"

https://www.smj.org.sg/article/enterovirus-infections-singaporean-children-assessment-neurological-manifestations-and

3) We have not excluded the fact that the child may had enteroviral meningitis on June 22 and acquired Multiple Simultaneous Viral infections after he was hospitalized.

This is given that Multiple viral illnesses in hospitals are common.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108242/

Yours Sincerely,

Dr John Tay

Former Professor of Paediatrics, Head of Department of Paediatrics (NUS & NUH), Head of Division of Human Genetics in Dept of Paediatrics. Recipient of double doctorates in Human Genetics from NUS.