Immediate steps taken to mount an all-of-government response in preparation tops the list of areas that Singapore aced. - The Straits Times/ANN
SINGAPORE, Feb 19 (The Straits Times/ANN): After three long years, the Covid-19 pandemic is over for Singapore, with masks no longer required on public transport since Feb 13 and the national disease response system at a tranquil green. The pandemic hit the world hard, killing 6.84 million people globally.
The Government will soon be releasing an after-action review “to set out what we did right, what we could have done better, and how we can better prepare ourselves for the next pandemic”, said Deputy Prime Minister Lawrence Wong at the final multi-ministry task force (MTF) media conference on Feb 9.
This will be debated in Parliament “to make sure we collectively draw the right lessons and act on them”, he said. “The report is not meant to congratulate ourselves. It’s really meant to take an objective look at what has transpired over the last three years.”
Health Minister Ong Ye Kung noted that the Government also wanted to see if there were better ways of doing things, such as how to communicate with the public so as not to cause panic buying, which happened early in the pandemic.
Meanwhile, as this chapter on Covid-19 is closed, The Straits Times asked experts who were closely involved in fighting the pandemic over the last three years for their assessment of what Singapore did well, and what could have been done better.
Their verdict: Six out of 11 experts gave Singapore an A grade, three gave it A-, and two B+.
Where Singapore did well
The rapid recognition of a potential threat, and the immediate steps taken to mount an all-of-government response in preparation, tops the list of areas that Singapore aced.
The MTF was set up on Jan 22, 2020, a day before the first case of Covid-19 was diagnosed here. This was just a month after the newly emerging virus caused an outbreak in China, and well before the World Health Organisation (WHO) declared it a pandemic on March 11, 2020.
Even before the MTF, Singapore had on Jan 2, 2020, begun screening travellers from Wuhan, where the virus was first identified. Contact tracing and quarantine began with the first imported case.
Associate Professor Alex Cook, vice-dean of research at the National University of Singapore Saw Swee Hock School of Public Health, said contact tracing, isolation and quarantine were “bang on”.
These measures helped to slow the spread of the disease in the country, at a time when there was neither a vaccine nor known treatments to combat it. Without these, “we’d have lost control of the pandemic much earlier”, he said.
Delaying the spread till more was known about the disease and how to treat it, or until a vaccine became available, did much to reduce the number of those who became severely ill or died.
This prevented the healthcare system from becoming overwhelmed and kept it going, while some other countries were turning away both Covid-19 and other patients as they could not cope with the load.
Associate Professor Hsu Li Yang, vice-dean for global health at the Saw Swee Hock School of Public Health, said Singapore’s healthcare system “was stretched but not broken”.
The experts also gave Singapore top marks for having the foresight to procure vaccines early, even though this meant paying higher prices; for the speedy roll-out and high rates of vaccination in the population; and for betting correctly on the successful vaccine candidates.
This was a major factor in keeping deaths low and enabling the country to return to normalcy with confidence, knowing the majority were well protected against severe illness should they be infected.
Prof Cook said: “It really paid off to have reached deals to get enough stock in early to vaccinate as many people as possible, so we could move out of containment as early as possible, safe in the knowledge that mortality rates would be a lot lower.”
He said countries such as Thailand, which were able to contain the early spread of the disease like Singapore did but were months behind in vaccination efforts, saw more people dying.
Singapore had 1,722 Covid-19 deaths, or roughly 290 deaths per million population, against the global average of 870 deaths per million people. In this respect, it did better than 150 other countries or territories.
Professor Dale Fisher, a senior consultant in infectious diseases at the National University Hospital (NUH) who also chairs the WHO’s Global Outbreak Alert and Response Network steering committee, said Singapore’s response to the pandemic “was virtually textbook”, right from the early recognition of a potential threat to the readiness of the healthcare system.
He added: “A critical aspect of the response, in my view, was the community engagement facilitating a whole-of-community response. The authorities strategically communicated with all Singapore residents through a variety of media and spokesmen, from the prime minister to the MTF.”
Prof Hsu commended the measured response throughout the pandemic that had no “flip-flopping between lockdowns and opening up in 2020 and 2021, which would have been tremendously disruptive”.
He also praised the Government for its “proactive policies that protected the economy and households to a considerable extent during the pandemic”. He noted that there were eight Budget releases in 2020 and 2021, including a significant stimulus package in the form of the $48 billion Resilience Budget in March 2020.
Also earning kudos were ordinary people, for cooperating on policies, from mask-wearing to keeping interaction to a minimum, especially during the circuit breaker between April and June 2020.
Prof Cook said that had people here not heeded calls to stay home, mask up, reduce social interactions and be vaccinated, “without that community-mindedness, there would have been many more deaths”.
Where it could have done better
All the experts pointed to the management of the outbreaks in the foreign worker dormitories as well below par. Although concerns had been raised weeks before, no preventive measures were taken till the outbreak in the dormitories began in late March.
Prof Hsu said that once that happened, “the response was to gazette the dormitories and essentially incarcerate the workers for many months, long after the risk to them was understood to have significantly abated”.
Professor Leo Yee Sin, executive director of the National Centre for Infectious Diseases, said Singapore needs to have better risk assessments in preparation for future outbreaks, focusing on the weakest link. She said this was “areas of dense living conditions and large congregations, learning from the lessons from dense dormitories (not restricted to migrant workers) and churches, et cetera”.
Singapore was also slow in roping in the private healthcare sector to fight the pandemic, and when it did, was slow in providing it with the necessary equipment and instructions, the experts pointed out.
Singapore could have done better was in addressing the fear of the mRNA vaccine, which was being used commercially in people for the first time. It could also have addressed vaccine hesitancy in seniors earlier.
People who have been vaccinated are far less likely to become severely ill or die should they get infected. Nevertheless, even today, about 8 per cent of the population have not received a single dose of Covid-19 vaccine.
Another gripe was the complex and confusing instructions for infected individuals and close contacts that resulted in a lot of ridicule from members of the public trying to decipher what they were to do.
Prof Hsu added that it was a transient problem, since the Government remedied the situation with “Protocols 1-2-3” – people had to remember only three things to do – which simplified matters for the public considerably.
The verdict
The experts’ overall assessment: Singapore deserves a good grade for being able to keep deaths low and protect the economy, and while the healthcare system was stretched, it did not break. But there were a few black marks, such as the foreign dormitory outbreaks, that prevented an A+ rating.
As Professor Teo Yik Ying, dean of the Saw Swee Hock School of Public Health, said in summary: “On the whole, Singapore’s response was measured and guided by data and evidence.
“What stood out was also the forward planning that the whole of government exhibited, which explains why Singapore was one of the first few countries to vaccinate a considerable proportion of the population, to open our borders to resume international travel, and to have considerably fewer losses both in terms of lives and economy.” - The Straits Times/ANN
