Understanding the Seriousness of Influenza: Lessons S’poreans can learn from Barbie Hsu’s Tragic Passing
Editorial Note:
This article is an expanded and revised edition of a previously commissioned feature. It has been updated to clarify why influenza is not “just a bad cold”, how to recognise red-flag symptoms, and what “early treatment” actually means (including when to ask about antivirals, and when to seek urgent care).
Key takeaways (quick read):
- Flu can turn serious quickly, especially in higher-risk groups (older adults, young children, pregnancy, chronic illness).
- The first 48 hours matter: antivirals may help when started early (if clinically appropriate).
- Know the red flags: breathing difficulty, chest pain, confusion, dehydration, or symptoms that suddenly worsen need prompt assessment.
Quick action today: decide your “if this happens, I’ll seek care” triggers before you’re ill (for example, breathlessness, persistent high fever, or inability to keep fluids down).
The recent passing of 48-year-old Taiwanese actress Barbie Hsu (徐熙媛), also known as “Big S”, due to influenza-related pneumonia during a trip to Japan, has shocked many and brought attention to the often-overlooked dangers of influenza. Her tragic death highlights the potentially fatal consequences of the flu, a disease that is frequently dismissed as a minor seasonal illness. For Singaporeans, this serves as a critical reminder of why influenza should not be taken lightly, especially as the virus continues to spread locally.
Influenza in Singapore: A Growing Concern
Influenza is not just a problem overseas. In Singapore, the flu is a persistent public health issue, particularly during peak seasons. According to the Ministry of Health (MOH), between January 19 and January 25 this year, local clinics treated 3,045 cases of acute upper respiratory infections, a nearly 15% increase compared to the same period last year. Many of these cases were caused by viral infections such as influenza and COVID-19.
Doctors have warned that influenza is currently spreading widely in Singapore, making it difficult to avoid infection even without travelling abroad. The high population density in Singapore, combined with frequent interactions in public spaces, schools, and workplaces, creates an environment where respiratory illnesses like influenza can spread rapidly. This makes it essential for Singaporeans to take proactive measures to protect themselves and their families.
Why Influenza is More Than Just a Common Cold
Influenza, or the flu, is a highly contagious respiratory illness caused by influenza viruses, primarily types A, B, and C. It attacks the respiratory system, including the nose, throat, and lungs, leading to inflammation of the mucous membranes. Unlike the common cold, which is caused by a variety of viruses and tends to produce milder symptoms, influenza can cause severe complications, including pneumonia, bronchitis, sinus infections, and even life-threatening conditions like meningitis.
Symptoms of influenza include high fever, sore throat, persistent cough, headaches, muscle aches, and nasal congestion. Other symptoms may include fatigue, chills, loss of appetite, and general weakness. These symptoms are often more intense than those of a common cold and can leave individuals bedridden for days or even weeks.
For Singaporeans, the risk of influenza is compounded by the country’s tropical climate, where respiratory viruses can circulate year-round. This means that whilst other countries may experience flu seasons, Singaporeans face the threat of influenza throughout the year, making vigilance even more important.
High-Risk Groups in Singapore
Certain groups in Singapore are particularly vulnerable to severe complications from influenza. These include:
- Elderly individuals aged 65 and above: Singapore’s ageing population is at higher risk of developing severe outcomes from the flu.
- Young children under the age of five: Children in Singapore’s schools and childcare centres are often exposed to viruses, increasing their risk of infection.
- Individuals with chronic conditions: Those with diabetes, heart or lung diseases, or weakened immune systems are more likely to experience severe complications.
- Pregnant women: Women in their second or third trimester are at higher risk of complications and should take extra precautions.
In Singapore’s interconnected society, even healthy individuals can act as carriers of the virus, potentially infecting vulnerable family members, colleagues, or friends. This makes it a collective responsibility to prevent the spread of influenza.
The Importance of Timely Treatment
When it comes to treating influenza, early intervention is crucial. Antiviral medications can be effective in reducing the severity and duration of symptoms if taken within the first 48 hours of illness. These medications, however, are not a substitute for vaccination and are primarily used to manage active infections. Over-the-counter medications like paracetamol can help alleviate fever and pain, but they do not address the underlying viral infection.
It is important to note that antibiotics are ineffective against influenza, as it is caused by a virus, not bacteria. However, antibiotics may be prescribed if secondary bacterial infections, such as pneumonia, develop as a result of the flu. For high-risk individuals, seeking medical attention promptly can make the difference between a mild illness and a life-threatening condition.
Prevention: A Public Health Priority
Prevention is the most effective strategy against influenza, and Singaporeans should take it seriously. Vaccination is the cornerstone of influenza prevention, particularly for high-risk groups. The flu vaccine is designed to protect against the most common strains of the virus circulating in a given year. However, because influenza viruses mutate frequently, annual vaccination is necessary to maintain immunity.
In Singapore, where respiratory illnesses are common, vaccination is especially important for those who frequently interact with others in crowded settings, such as schools, offices, and public transport. The vaccine takes about two weeks to become effective, so it is recommended to get vaccinated before the flu season peaks.
In addition to vaccination, maintaining good hygiene practices can significantly reduce the risk of infection. Regular handwashing with soap and water, avoiding touching the face, and wearing a mask when feeling unwell or in crowded places are simple yet effective measures. For those who are already sick, staying home and avoiding close contact with others can help prevent the spread of the virus.
A healthy lifestyle also plays a vital role in strengthening the immune system and reducing susceptibility to infections. A balanced diet, regular exercise, adequate sleep, and avoiding smoking are all important factors in maintaining overall health and resilience against illnesses like influenza.
Why Singaporeans Should Take Influenza Seriously
Barbie Hsu’s tragic passing is a stark reminder that influenza is not a trivial illness. For Singaporeans, the risks are heightened by the country’s year-round exposure to respiratory viruses and the ease with which illnesses can spread in a densely populated environment. Influenza is not just a personal health issue; it is a public health concern that requires collective action.
By understanding the nature of influenza, recognising its symptoms, and taking steps to prevent its spread, Singaporeans can protect themselves and their loved ones. Vaccination, timely medical intervention, and healthy habits are key to reducing the impact of this disease. Barbie Hsu’s passing is a poignant reminder that influenza should never be underestimated, and it underscores the importance of vigilance in safeguarding public health.
In Singapore, where the flu is a constant threat, taking proactive measures is not just about individual protection—it is about protecting the community as a whole.
Flu: A Practical “What To Do” Guide (Red Flags, Timing, and Home Care)
Influenza is common, but it is not always benign. The safest approach is to treat it as a condition with a clear decision tree: monitor, support, and escalate early when warning signs appear.
1) Cold vs flu: a quick reality check
Colds often build gradually and stay mostly above the neck (runny nose, mild sore throat). Flu more commonly hits with abrupt fever, body aches, marked fatigue, and a cough that can become severe. Either can feel awful, but flu is more likely to cause complications in vulnerable people.
2) The “first 48 hours” question (antivirals)
Antiviral medicines may reduce severity and duration for some people when started early (often within ~48 hours of symptom onset). They are not a replacement for vaccination, and they are not needed for everyone — but they are worth asking about if you are higher risk, symptoms are severe, or you are deteriorating.
3) Red flags: seek urgent medical attention
- Difficulty breathing, shortness of breath, or breathing that feels “hard work”
- Chest pain or pressure
- Blue/grey lips or face
- Confusion, severe drowsiness, fainting, or a sudden marked decline
- Persistent vomiting or inability to keep fluids down
- Signs of dehydration (very dry mouth, dizziness on standing, very little urination)
- Fever that improves then returns with worsening cough (can signal a complication)
4) Higher-risk groups (lower threshold to seek care)
People who are pregnant, older adults, young children, and anyone with chronic heart/lung disease, diabetes, kidney disease, or a weakened immune system should generally seek advice earlier — even if symptoms seem “manageable”.
5) Home care basics (supportive care that actually helps)
- Fluids: small, frequent sips; include soups or oral rehydration if appetite is low.
- Rest: consider it part of treatment, not optional.
- Fever/pain relief: use common over-the-counter options as directed and appropriate for your health profile.
- Reduce spread: mask if you must be around others, ventilate rooms, wash hands, avoid sharing utensils.
Frequently asked questions
Do antibiotics treat flu?
No. Influenza is viral, so antibiotics do not work unless there is a secondary bacterial infection diagnosed by a clinician.
When is it safe to return to work or school?
As a general rule: when fever has resolved and you feel well enough to function, while continuing good hygiene. If symptoms are severe,
you are high-risk, or your workplace/school has specific guidance, follow that.
Medical note: This article is for general education and is not a substitute for medical advice. If you or someone you are caring for is deteriorating, has red-flag symptoms, or is in a higher-risk group, seek prompt medical assessment.
Editorial update: 22 February 2026 — expanded with red-flag guidance, antiviral timing context, and a practical home-care checklist.
Note: This piece was written as a commissioned feature and has appeared in other health and lifestyle platforms.