The response to the Covid-19 pandemic in Singapore is showing the extent to which we are becoming a more complex society, as people form groups to argue for or against a point of view, such as whether to get vaccinated against the virus.
While diversity in views is good, the risk is debate becoming polarised in this contested climate. There is a need for people of differing views to find common cause with one another. This can be done by building a moderate middle ground that can help forge consensus and a sense of community.
Building such a moderate middle ground, however, requires Singaporeans to reach for tools and habits most of us are not familiar with. But it is essential to build those habits and learn to use those tools, so we can listen to one another and try to find common ground in our disagreements.
Vaccine hesitancy is the latest issue in which we can see how polarisation of views leads people to stop believing authoritative sources of information and turn to ill-informed personal networks.
As at Oct 17, 84 per cent of the population in Singapore were fully vaccinated.
The unvaccinated now face more social restrictions, and are not permitted to dine at food and beverage outlets or to visit malls. This is to protect them from infection, as new Covid-19 cases now number over 3,000 daily. But the inconvenience is also meant to nudge some into taking the vaccine jabs.
Many states have imposed similar or stricter vaccine mandates, drawing protests. In Singapore, the differentiated approach drew criticism from a segment of the population that has turned down the vaccine, or is sympathetic to those who are not vaccinated. This group says the measures are discriminatory.
As reported in The Straits Times on Wednesday, vaccine hesitancy in Singapore and the region has been stoked by messages circulating on social media that share misinformation about Covid-19 and the vaccines.
But those who receive such messages do not see them as misinformation. Many come with charts, videos and convincing soundbites. As one retiree told ST, he thought the information must be true because "all these messages and information are going viral already".
The decline of officialdom
How do health authorities counter health misinformation?
Tried and tested methods are used worldwide, but may prove insufficient.
Governments and state authorities put out advisories and FAQs.
The World Health Organisation (WHO) puts out regular information that tackles myths but it is playing catch-up - its Myth Busters page has information on the use of hydroxychloroquine (fact: it is not beneficial for Covid-19 treatment) but not ivermectin (fact: it is used for parasitic infections in humans and animals and is not advised for humans against Covid-19); it advises people against using ultraviolet (UV) lamps to disinfect skin but has nothing on the common fear of mRNA vaccines possibly altering one's genetic make-up (fact: mRNA does not alter DNA).
Media companies like ST dutifully turn advisories into bite-size infographics or stories.
Such methods work with a population that trusts authority figures. The trouble starts when a segment of the population begins to be suspicious of, or distrusts, authority. This is what is happening to vaccine sceptics.
If they join Telegram groups like SG Covid La Kopi or SG Suspected Vaccine Injuries Channel, they will be exposed regularly to messages about government, media or other authority figures lying about information, hiding things from the public, or misleading them.
Psychology research shows that social influence affects how we view things: When in a group of others who believe something, people start to believe it themselves.
As scepticism stiffens into distrust, people turn to their social circle and personal networks more than to authority figures. This is fine if those networks include people who share verified, credible information, but it becomes a problem if they are conduits for poor-quality information that confuses and divides.
What can be done to try to reach out to those at risk of entering such rabbit holes of misinformation - whether it is on the merits of vaccine or on terrorism or race issues?
What can society do to counter the misinformation that threatens to turn naturally sceptical people into hardened radicals on a range of issues?
Rise of the moderate middle
This is where the moderate middle ground has to step up.
Let's take vaccine hesitancy as an example.
In Singapore, the vaccination effort is led by the Ministry of Health and the multi-ministry task force (MTF) handling Covid-19. The MTF gives regular press conferences urging people to get vaccinated. It gives daily information on Covid-19 cases and the vaccination rate. Government ministers have filmed short videos, speaking in English, Mandarin and dialects, urging the elderly to get vaccinated.
This is creditable, but it puts too many eggs in the ministerial basket. And when some Singaporeans are already irritated at the restrictions imposed by the MTF or are fatigued by the Government's messaging on Covid-19, videos starring government ministers are not going to persuade them to get vaccinated. When the majority concur with the state urging people to get jabbed, the minority who resist may end up feeling besieged and resistant to more official persuasion.
This is where I feel there is a role for civil society groups and professional organisations.
Periodically, individual posts by medical professionals on the Covid-19 situation catch attention and go viral.
In May, before the current wave of infections surged, Associate Professor David Lye, director of the National Centre for Infectious Diseases' Infectious Disease Research and Training Office, wrote on his Facebook page that he felt the nation was in a more dangerous situation than before the circuit-breaker period last year, and urged Singaporeans to "do much more beyond what government dictates".
For example, they should form their own social bubble and stick to it. He also urged people to get vaccinated, as he had noticed that the new variant of Covid-19 circulating was spreading far and wide.
The post was shared widely on social messaging apps and reported by mainstream media.
The rapid spread of such messages is an indication of the hunger for good information from credible, non-official government sources.
If individuals can sway views, imagine the impact if leaders can speak with the weight of their professional organisation behind them.
Leaders of doctors' groups like the Singapore Medical Association and the College of Family Physicians Singapore, for example, can speak up on the medical benefits of vaccination. They would be privy to current research on vaccine efficacy and can share them.
The Pharmaceutical Society of Singapore's website has a handy section on Covid-19 advice to the general public. It includes information on disinfectants and soap-free cleansers. On the use of antimalarials like chloroquine and hydroxychloroquine for Covid-19 treatment, it states clearly that it does not recommend self-medication for treatment of Covid-19 without proper medical assessment and evaluation. All this is useful.
I would have liked to see it weigh in on a key concern of vaccine sceptics, which is that vaccines themselves harm people.
Posts and tweets with the hashtag #vaccidents online are full of people sharing stories of those who fell severely ill or died after being vaccinated. These stories feature unnamed individuals, or come from unknown sources - but they are commented on and talked about as real.
Recent tweets include a reference to a Delta Air Lines vaccinated pilot who died in mid-air (the airline said no such incident occurred), and to an Austrian pro-vaccine MP who collapsed in Parliament (she fainted, recovered and was in good health the next day).
Even if some deaths did occur post-vaccination, the fact that these numbers pale beside the numbers of people who died of Covid-19 is not mentioned. Nor is it mentioned that death and severe illness are daily occurrences, and if every day in a society three people die, and on any given day 100 people are vaccinated, three of them will die anyway.
Pharmacists are specialists in the chemical properties of drugs and how they interact with one another, with the human system and how they may affect different ailments. Their word on vaccine injuries would count for something.
The Singapore Association of Pharmaceutical Industries brings together drug manufacturers, distributors and other drug-related companies in Singapore. Their input on the expedited development process that enabled Covid-19 vaccines to be rolled out in record time, and their views on the safety protocols in place amid such a global health emergency and how these compare to normal processes would be interesting, even if they come from a place of relative vested interest.
From the Singapore Nurses Association, I would have liked to hear their views on home recovery protocols, and hear advice on how to do self-testing, or how to monitor self and family members' symptoms well.
And if doctors and nurses had come together to describe what it is like to tend to very sick Covid-19 patients who are not vaccinated, and then appeal to the public to get vaccinated to ease the load at the hospitals, this would have a lot more impact than yet another official comment on this.
In New Zealand, where it is mandatory for teachers and school staff to get vaccinated, science education expert Michelle Dickinson, who goes by the name Nanogirl, has run virtual sessions with people hesitant about vaccination.
She uses a fact-based approach of breaking down information about how the vaccines were made in a way that connects with her audience.
After a few sessions, she found that many people with specific concerns were willing to be jabbed once their questions were answered. Reading her account, I wondered if there is a role for the Science Centre to overcome vaccine hesitancy. After all, the centre specialises in the art of breaking down scientific concepts into relatable, entertaining formats and activities. Can it take key messages from the WHO and other expert sources, such as the professional organisations cited above, and incorporate them into teaching kits, gallery panels, exhibits, videos, demonstrations and interactive visuals?
The above is just a quick list of professional organisations I can think of which could have played a role in galvanising public opinion on Covid-19 vaccines, if they wished to.
But why should they, if doing so exceeds their original mission, you may ask? After all, it is far easier to not get involved in public controversies. It is also difficult to develop consensus on complex issues, let alone develop a plan for advocacy and action.
Decades of being told to mind their own business and stay out of politics or the public eye have also trimmed the ambitions of any organisation's leader inclined to weigh in on thorny issues in the public interest. Unfortunately, these are the instincts of many people today.
But it is time Singaporeans and Singapore organisations developed different instincts - to speak up for what is right, and to step up to make a difference.
Singapore is becoming a more activist society, as active retirees galvanise one another on messaging groups on a range of issues, and younger citizens with a keen sense of social justice organise to change policies or make their views known. There are advocates on different issues, of all stripes and shapes these days, who do not hesitate to share information, even if it is misinformation.
Those in the moderate middle will always face the temptation to stay silent, but they must know that doing so means ceding the ground and attention span to those with more extreme views.
Voices of opposition, or voices of coercion, will then get stronger and become entrenched; and over time, the middle ground gets eroded, and people trust authority and one another less. In fact, my fear is people stop trusting anyone or anything altogether.
The so-called "post-truth" society is already unfolding in America and some developed countries in the West. I prefer the term "post-fact", as truth should continue to be upheld by sane individuals, even if we disagree on what constitutes it. But as more people quibble over facts, dispute them or refuse to accept them as true, the pressure mounts on those whose work is to uphold them to speak up and act.
Professional organisations should come out of their shell, especially during a public health emergency like the one we face today, to speak up and stand up for what is factual and reasonable from their points of view.
The Government too can send a strong signal that it welcomes their involvement, and trusts that they will be responsible in their advocacy and actions.
The point is not just to win over vaccine sceptics today, although that is the proximal motivation. The point is to get into the habit of being vigilant about what is in the public interest and develop the societal muscle to respond in an appropriate way. It is going to be a hard slog, as people need to learn to discuss contentious issues, develop a joint perspective, work out a plan, and then gather the courage to act on it.
But we have to start doing so.
The alternative is to keep silent and wake up one day to realise the forces of extremism and ignorance have become too dominant.
The article has been edited for clarity.