Pride Month

When COVID-19 started hitting China back in Jan 2020 and in subsequent weeks, Wuhan one of the hardest-hit city in China began a lockdown that lasted for 2 months or so, few in the rest of the world stopped to think that in the following months to come, various countries would be implementing some version of the lockdown seen in Wuhan. 

As more and more countries started to close their borders and implement movement restrictions and social distancing measures in order to control the spread of the pandemic, people around the world started to realise how much as humans we value the physical interaction we have with each other. From shaking hands of friends and co-workers to holding hands of our loved ones or visiting our elderly parents and grandparents to meeting friends for a meal, we suddenly found ourselves living in an artificial bubble where all such interactions we took for granted have all but vanished in a span of days or weeks.

Singapore is no exception. Towards the end of March 2020, the government announced that Singapore would be placed in Circuit breaker mode which initially was supposed to last for a month but has since been extended to 1st Jun 2020. In a matter of days, all forms of social interaction outside an individual’s household would come to an abrupt halt. As the circuit breaker progress through time, reports from media started highlighting vulnerable groups in society which were originally marginalized under normal circumstances and made even more vulnerable with the circuit breaker rules.

Plight of groups of the homeless, jobless, foreign workers and the elderly were talked about much in the media. This pandemic has brought to surface the many groups of vulnerable populations in any society and has raised the indignation of many. As Pride month approaches, perhaps let us think about another group of vulnerable populations in the world – the LGBT+ community. The LGBT+ community around the world still faces various forms of discrimination – legal, religious, societal and in some cases their own family.

Just as many of the heterosexual couples who under the current circumstances who are unable to meet physically with each other, the LGBT+ couples are also faced with the same scenario. While one may argue that couples both heterosexuals and LGBT+ can use technology such as Zoom/ Facebook messenger to “see” each other, it is a poor substitute for being able to hold the hands of your loved ones while walking down a street or hug each other for encouragement. How many times when we feel low have we wished for friends or family or loved ones to just hold our hands or to brush that one teardrop off our face. How many times during our moments of joy have we felt to hug our friends or family or loved ones to share in that moment of joy. The LGBT+ community is no different from any other human. They too long for those moments.

Similarly, like many heterosexual individuals who are searching for love and hope to share their lives with their loved ones, the LGBT+ community is of no exception. As humans, we hope that in our short time on this Earth, we can share our joys and tears with our loved ones. To be able to wake up in the morning and see the face of our loved ones sleeping soundly and safely, to prepare meals for our loved ones. Even with the most mundane activity like grocery shopping as long as we have our loved ones beside us, we would feel the bliss of the moment. This again is no different for the LGBT+ community.

When the time comes for heterosexual couples that they are ready to move on to the next stage of the relationship, they would propose and register to become lawfully wedded couple. Similarly, for the LGBT+ community when they found the one whom they want to share the rest of their lives together, they too hope to be able to register to become a lawfully wedded couple. It is not just a symbolic gesture but also has legal implications. For example, when medical decisions have to made because for whatever reason the other partner is unable to do so, because LGBT+ couples are not legally recognized as next of kin, many times they are not allowed to make decisions on behalf of their partner and the true wishes of the other partner is not being respected. It is a heart-wrenching experience faced by all involved.

For many of the LGBT+ community, they often are faced with the prospect of “coming out” to their family or friends. The numerous nights they toss and turn in bed trying to decide whether to “come out” to their family or friends. The umpteen times when they think they have decided to “come out” but yet at the last moment could not bring themselves to do so and then subsequently beating themselves over it later. This flip-flopping is not because they are ashamed of their gender identity but rather the fear of hurting their family or losing friendships. Let all of us as friends and family and as society in general remove that fear. No one (heterosexual or otherwise) should feel fearful when they need to tell their family or friends of some news of their lives. As family or friends, we are their safe harbour.

Some may think the fear is irrational as some family or friends may think they have not said or done anything that warrants that fear. However sometimes in our daily snippets of conversation, we have evidence and subtly expressed our discrimination or disapproval of the LGBT+ community. For example, some of us may have said in the moment of anger or jest the word fag just as we would say the F- word, it may not necessarily suggest that we are discriminating against the gay community but to the LGBT+ community is another stab in their heart.

In a YouTube video featuring a gay couple who have found love with each other but found themselves unable to be legally married because while one of the partners lives in a country that just passed a law to allow for LGBT+ marriage, it comes with a restriction that if one of the partners is not a citizen of that country and is not of a citizen of a country that legalized LGBT+ marriage then they still another not allowed to be married. One of the partners in the video asked poignantly, “All we want is to get married, is it that difficult?”

With talks of how this pandemic is going to change society even when the pandemic is over, I hope that part of that change will be a greater acceptance by society of the LGBT+ community where the LGBT+ community is finally able to be allowed to love without discrimination and be accepted as being part of society. The right to love and be loved should be unconditional.

Happy Pride Month
Dr. Julian Ng

Dr Julian Ng has 10 years of medical practice experience. He currently serves as the Chief Medical Officer of the DTAP Group of clinics in Singapore & Malaysia. He is also a member of the Singapore Men’s Health Society. His special interests are in the field Andrology, especially sexual health. He is currently practising at Dr Tan and Partners (DTAP) clinic at Novena Medical Centre.

Monkeypox – What You Need to Know

What is Monkeypox?

Monkeypox is a rare virus that is typically transmitted from animals to humans. Documented human infections occurred mostly in areas of Central and West Africa near rainforests. Human cases outside of Africa are extremely rare.
The Monkeypox virus is very similar to the human smallpox virus but causes less severe symptoms.

What are the Symptoms of Monkeypox?

The symptoms of Monkeypox usually begin 6-14 days (ranges between 5 up to 21 days) after infection by the virus.
Initial symptoms (first 5 days) include fever, headaches, muscle aches (myalgia), fatigue and swollen lymph nodes.

Within 1-3 days

Within 1-3 days of the onset of fever, a skin rash develops, usually starting from the face then spreading to the body.

Next 1.5 weeks or so

Over the course of the next 1.5 weeks or so, the rash develops from flat reddish bumps (maculopapular) to fluid filled tiny blisters (vesicles) which enlarge to become pustular, before eventually crusting and healing.
The rash can involve the palms and soles of the feet, oral mucosa and the eyes as well.
The total illness duration ranges between 2-3 weeks.

Image from CDC Public Health Image Library

Image from CDC Public Health Image Library

Is the Infection Serious?

Monkeypox is generally a self-limiting illness and symptoms fully resolve by themselves by 21 days.  Treatment for monkeypox is supportive until the illness runs its course.
However, serious complications such as pneumonia (lung infection) and encephalitis (brain inflammation) can occur.
The severity of symptoms may differ between patients and more serious illnesses have been seen in younger patients, with a mortality rate between 1-10%.

How is it spread?

Monkeypox is transmitted from animals to humans through bites, scratches, consumption of bushmeat, or through direct contact with the blood/fluid/bodies of infected animals.
Human-to-human transmission is possible through respiratory droplets or physical contact with body fluids/rash, or contaminated surfaces or materials.
The virus enters the body through the respiratory tract, mucous membranes, and broken skin.
Infected individuals are contagious from the onset of fever until their skin lesions have crusted over completely.

What is the Situation in Singapore?

On 8 May 2019, MOH confirmed the first case of imported Monkeypox infection in Singapore. The patient is a 38-year-old Nigerian male who may have contracted the virus in Nigeria through the consumption of bushmeat.
He arrived in Singapore on 28 April 2019 and subsequently developed a fever and rash on 30 April. He was hospitalised on 7 May and confirmed to have the infection and currently warded at the National Centre for Infectious Diseases (NCID). His condition is stable.
MOH is in the midst of contact tracing. Close contacts have been referred to the National Centre for Infectious Diseases (NCID) for further assessment and will be quarantined for 21 days. Low-risk contacts will be kept under surveillance to monitor their health status.

When Should I be Concerned about Monkeypox?

If you develop a fever and vesicular rash AND have travelled to West or Central Africa within the last 21 days OR have been in contact with an infected person within the last 21 days, there is a high suspicion of monkeypox and you should see a doctor immediately.
Otherwise, there is no need for unnecessary panic as all necessary steps to control the situation are already being taken.


• Maintain a high standard of personal hygiene, including frequent hand washing after going to the toilet, or when hands are soiled.
• Avoid direct contact with skin lesions of infected living or dead persons or animals, as well as objects that may have become contaminated with infectious fluids, such as soiled clothing or linens (e.g. bedding or towels) used by an infected person.
• Avoid contact with wild animals, and consumption of bushmeat.
• Returning travellers from areas affected by monkeypox should seek immediate medical attention if they develop any disease symptoms (e.g. sudden onset of high fever, swollen lymph nodes and rash) within three weeks of their return. They should inform their doctor of their recent travel history

Take Care!

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