Asian Insider

The many roads to a Covid-19 recovery: S’pore may not top ‘return to normalcy’ indexes, but it's doing what's necessary

Singapore tightened its outbreak control measures in May after a spike in local cases.
Singapore tightened its outbreak control measures in May after a spike in local cases.ST PHOTO: DESMOND WEE

SINGAPORE - A battle-weary global population that has had to deal with the disturbances wrought by a tiny virus for 18 months and counting is keen to know when life can go back to normal.

To answer this question, publications such as The Economist and Nikkei have rolled out indexes that track the world's progress towards "normalcy" and how countries and jurisdictions stack up against one another in this journey.

Singapore features differently on the two indexes.

The Economist's global normalcy index assigns a value of 100 to pre-pandemic levels of activities in transport, leisure and work. On this list, Singapore is ranked 43rd out of the 50 places studied, with a score of 55.5.

Hong Kong tops the list with a score of 96.3, while Malaysia is at the bottom, with a value of 27.3.

On Nikkei's Covid-19 recovery index, however, Singapore is ranked 12th out of the more than 120 countries and regions studied.

This index tracks infection management, like the number of confirmed cases per capita, vaccine roll-out, and mobility activities such as flights.

A higher ranking on Nikkei's index indicates that a country or region is closer to recovery, with low numbers of confirmed Covid-19 cases, higher vaccination rates and/or less-stringent social distancing measures.

The maximum score for Nikkei's index is 90, and Singapore was assigned a value of 65. At pole position on Nikkei's list is China with a score of 76.5, while Thailand is the lowest listed at 118, with a score of 26.

Dr Danny Soon, chief executive of the Consortium for Clinical Research and Innovation Singapore, said the indexes take different perspectives of a Covid-19 recovery and are not directly comparable.

Nikkei's index gives more weight to infection prevention measures, he said. The Economist's index, however, focuses more on the activities that individuals themselves can take part in - such as spending time outside the home, going to the movies or attending sports events.

"This reflects a combination of government mandates and the confidence amongst people to participate in such activities," said Dr Soon.

The price of normal

On Nikkei's Covid-19 recovery index, Singapore is ranked 12th out of the more than 120 countries and regions studied. ST PHOTO: JASON QUAH

But of the two, which is a better measure of Singapore's road to recovery?

Dr Soon said people might better relate to The Economist's normalcy index, since it references their ability to engage in work or recreational activities that had been curtailed as part of Covid-19 outbreak control measures.

But he added that "the caveat is that this a measure of a normalcy that can be fragile - if there is an outbreak, governments may tighten up again and a country can quickly fall down the ranks of The Economist's index".

Professor Teo Yik Ying, dean of the Saw Swee Hock School of Public Health at the National University of Singapore, said a return to normalcy based on The Economist's index will not give the full picture.

"For instance, if this normalcy is accompanied by unreasonable levels of preventable morbidity and mortality, then scoring high on that index is ultimately meaningless," he said.

He added that both indexes did not include a key parameter: hospital occupancy as a result of Covid-19 or related conditions.

"This is the problem with trying to reduce a multi-factorial situation into a single index, where the attention invariably will be on the final number and ranking, instead of which factors or components a country scored poorly in and ought to be improved," he said.

This includes, for instance, projected vaccine take-up rates.

Economist Walter Theseira, an associate professor at the Singapore University of Social Sciences, cited a concern that the vaccination roll-out in the United States may stall because many of the remaining unvaccinated people there are ideologically opposed to receiving the shots.

"Experts are warning in many of those countries that gaps in vaccine coverage, combined with the emergence of more transmissible and vaccine resistant strains, mean that the current state of normalcy is very fragile," he said.

This is even though many countries have been quick to return to normalcy in terms of transport, travel, recreation and retail, with the lifting of restrictions on public gatherings and widespread participation in public life, he said.

The European Union, for instance, is starting to welcome foreign travellers who have been inoculated with an approved coronavirus shot, while the US in May said fully vaccinated people no longer need to wear a mask or maintain a safe distance from others in most settings.

"Such countries, without significantly more work to address vaccination coverage gaps and to prepare the public for booster shots, are highly vulnerable to new waves of infection in the coming months," said Associate Professor Theseira.

Four of the experts The Straits Times spoke to said Singapore's positions on both indexes were to be expected, considering its conservative stance to reopening and its emphasis on testing, tracing and vaccinating as enablers helping it to reopen safely.

Singapore tightened its outbreak control measures in May after a spike in local cases, barring dining out and limiting group sizes to two people.

It gradually relaxed its rules as the situation improved, with the next stage of reopening to take place next Monday allowing people to dine in at food and beverage establishments in groups of up to five, and the resumption of events such as wedding receptions.

Singapore Management University law don and political observer Eugene Tan said: "I'm not too surprised by Singapore's relatively low standing in The Economist's index, given that it uses pre-pandemic normalcy as the benchmark or perhaps even the gold standard."

That raises the question: What is "normal" in a post-Covid-19 world?

Prof Theseira said that despite the talk of a "new normal" early on in the pandemic, people and businesses seem to just want to jump right back to the "old normal" - employers are recalling staff to workplaces, people are packing restaurants despite the availability of food delivery, and so on.

He noted that far more devastating past pandemics did not really result in permanent changes in behaviour.

"From the public health perspective, what makes a big difference is interventions that can improve health that are easy for people to adopt - like clean running water, sanitation, inspections for food safety. These have become permanent fixtures," he said.

"But the kinds of intervention we are deploying for Covid-19 have been resisted by many people because many of these measures don't make people's lives easier, and will likely continue to be difficult to adopt permanently."

OCBC Bank chief economist Selena Ling said vaccination is important, but will not be a panacea. Cooperation and collaboration through mechanisms such as Covax - the facility to ensure the equitable distribution of vaccines - are also important, she said.

"Even if Country A has a population that is fully vaccinated, unless it turns its back on the rest of the world for trade and human flows, it is near impossible to ensure the virus does not sneak past border controls."

Long road to recovery

Ultimately, the experts warn that both indexes merely capture the current state of affairs, when it is a long-term plan that will determine if mankind can live sustainably with the coronavirus.

Prof Teo said appraising countries based on their road maps towards achieving pre-pandemic normalcy in the near future will be more meaningful, as these set out a recovery without compromising on the health and economic well-being of the people.

He said: "From the very beginning of the pandemic, Singapore has been steadfastly focused on what is necessary for our country, irrespective of what accolades or brickbats international observers have given Singapore.

"And I expect this resolute approach will continue to feature in the way Singapore plans to return to pre-Covid-19 normalcy."