Countries under lockdown should do what Singapore has done to blunt the spread of the coronavirus, according to an infectious disease expert working with the World Health Organization.
While the Southeast Asian nation continues to report new cases of infections daily and has seen recent spikes, it has managed to steer clear of the kind of catastrophic outbreaks that have occurred in other countries. As of March 31, Singapore recorded a total of 879 cases of COVID-19 and three deaths, its health ministry reported.
“All the things that Singapore has in place, any country under lockdown will need to do these, or implement these during lockdown, so that they can be safe afterwards,” said Dale Fisher, chair of the World Health Organization (WHO) Global Outbreak Alert and Response Network. He outlined some of these measures, including isolating and quarantining cases, contact tracing — identifying and isolating those in close contact with infected patients, and practicing social distancing.
People walk past a poster reminding people to keep a safe distance from each other at the National Gallery of Singapore on March 30, 2020 in Singapore.
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Singapore made use of the lead time when China first reported cases of COVID-19 in the city of Wuhan, and was able to rapidly identify and isolate cases, according to Fisher, who is also a senior consultant at an infectious disease division at the National University Hospital in Singapore.
“So January and February was really the time to ramp up, and that’s when Singapore was particularly active in getting itself ready … any country really had January and February to get themselves prepared,” Fisher told CNBC’s “Street Signs Asia” on Monday. “And countries that didn’t take advantage of that lead time are now the ones that have got a problem.”
While Singapore has implemented more restrictive measures in recent days, it has not gone into a total lockdown.
Schools and businesses remain open, while businesses have moved to encourage working from home, in addition to other precautionary measures like regular temperature checks at work and enacting business continuity plans.
Countries that have gone into some form of lockdown so far include India, France, Italy, Spain, some states in the U.S. and China — though the mainland is set to lift some of its lockdown measures soon.
“All the things Singapore has in place, any country under lockdown will need to do these or implement these during lockdown so that they can be safe afterwards … till a drug is found,” he said.
Social distancing markers are seen at a cafe outlet as authorities implement a social distancing measures to combat the coronavirus on March 28, 2020 in Singapore.
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“I think there is a playbook and it’s being played in Singapore, Korea, Taiwan, Hong Kong and China — China is still (coming out of a lockdown) and even China’s taking more than two months to really get ramped up again — so other countries that are locking down will need to look at several months to get the systems in place so they can then unlock slowly,” Fisher added.
However, he also emphasized that lockdowns were not the cure-all.
“So (a) lockdown is really any country’s second chance — it’s not an intervention in itself. It’s just buying time to set up all those measures of your testing and how you’re going to isolate the cases and how you’re going to enforce quarantine in close contact,” he said.
‘Long battle ahead’
Singapore has also garnered praise from the World Health Organization which said it was “very impressed” with the country’s efforts at contact tracing and its measures to limit transmission.
The tiny Southeast Asian country’s approach to case detection was also considered to be a “gold standard of near-perfect detection,” four epidemiologists at the Harvard T.H. Chan School of Public Health said in February.
However, Prime Minister Lee Hsien Loong was careful not to claim success too quickly. In an interview with cable network CNN, Lee said: “I hesitate to talk about success because we are right in the midst of a battle, which is intensifying.”
He said the country has “tried very hard” to explain to its people what needs to be done and how they can cooperate “such as keeping safe distances from one to another, such as watching their own personal hygiene, such as staying home if they are sick and not going to work, and not socializing.”
Still, he said there was more work to be done: “With great effort, I think it has helped to keep the number of cases down, but I am under no illusions that we have won. We are just going in, and there is a long battle ahead.”
Most recently, Singapore implemented more restrictions and those who fail to follow social distancing measures — such as maintaining a 1-meter distance with others in public areas — would now face fine or jail, or both. The penalties will also apply to those flouting stay-at-home notices.
Hold out for a vaccine
According to Fisher, the virus will likely remain with us for some time.
“I don’t think anything’s going to be quick — vaccine won’t be quick, the treatment won’t be quick, but they do represent the endgame because still, only a tiny percentage of the world is actually being infected if you consider … there’s over 7.5 billion people in the world,” said Fisher.
People seated in a food center in Marina Bay Sands shopping mall according to safe distancing markers on March 30, 2020 in Singapore.
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He warned that attaining herd immunity “requires far too many people to be exposed, and the devastation that (it) would cause.” Herd immunity refers to a situation where sufficient people in a population have become immune to a disease such that it effectively stops the disease from spreading.
Instead, he said he was pinning his hopes on “holding out” for a treatment or a vaccine.
“Even when there’s a vaccine or a treatment, this disease will be part of what a doctor will need to consider when someone comes in with pneumonia or upper respiratory illness. So, this is going to be with us,” he said.