Singapore's coronavirus numbers in local community remain stable in past 2 weeks

Experts hopeful that situation will improve with circuit breaker steps in place, but caution that weak links remain

People wearing masks along Boon Lay Way at on April 15, 2020. ST PHOTO: DESMOND WEE

Local coronavirus cases in the community have remained stable over the past two weeks, a positive sign at a time when cases here are consistently hitting new highs with numbers soaring in worker dormitories.

While it is too early to say for sure, experts are optimistic that the situation should continue to improve, particularly with circuit breaker measures in place and most people adhering to them.

"Sufficient time has passed for the majority of household transmissions, if any, to have occurred, as a result of people staying at home," Professor Teo Yik Ying, dean of the National University of Singapore's Saw Swee Hock School of Public Health told The Straits Times.

While the number of new cases daily has hit new highs, with 728 announced yesterday, the number of new cases in the community has in fact decreased from an average of 38 cases per day in the week before to an average of 37 cases a day in the last week. There were 48 new cases in the community yesterday, the Health Ministry said.

However, just as the case numbers in dormitories have exposed a weak link that could push Singapore's Covid-19 situation into a critical state, other weak links remain, and these could seed a large cluster unless everyone is vigilant, warned Prof Teo.

Among work permit holders, the number has jumped from 48 per day two weeks ago to 260 per day in the past week, as of Wednesday.

Other weak links include old folks' homes with groups of vulnerable elderly people living together, essential workers who are still going out, and people who flout the safe distancing rules.

While there is no one-size-fits-all solution, it is vital that people keep to physical distancing and practise good hygiene, stressed Prof Teo.

Associate Professor Hsu Li Yang, infectious diseases programme leader at Saw Swee Hock School of Public Health, noted that quick intervention to create isolation zones at dorms and ring-fence these clusters could have averted disaster, an approach similar to how the authorities have successfully addressed imported cases through travel restrictions and having people serve stay-home notices in government facilities instead of their own homes.

The country has seen no new imported cases since April 9, even as the number of Covid-19 cases among dorm residents has spiked. Another nursing home was also hit by the virus, bringing the total number of old folks' homes with infected patients to three.

Foreign worker dorms and old folks' homes are clearly the weakest links now, said infectious disease expert Annelies Wilder-Smith, a visiting professor at Nanyang Technological University's Lee Kong Chian School of Medicine.

"Foreign worker dorms facilitate rapid spread but fortunately those persons do not belong to the vulnerable group. However, the old, frail and sick in old folks' homes are highly vulnerable, and even little transmission could result in many deaths," she noted.

She added that while enclosed settings such as dorms exacerbate the speed and scale of transmission, it may not spill over to the community. "All efforts now need to be taken to reduce the scale of the outbreak within such dormitories. Due to the size of the population of foreign workers, this is not going to be easy."

What Singapore has in its favour, even if clusters form, is a holistic approach to combating Covid-19, said Associate Professor Josip Car, director of the Centre for Population Health Sciences at Lee Kong Chian School of Medicine.

So even if a weak link breaks apart, it may not lead to an uncontrollable spread.

Weak links such as childcare centres, as evidenced by the PCF Sparkletots Fengshan cluster, are a reminder that children are highly social creatures who might not fully comprehend the logic behind safe distancing, Prof Car added.

But closing these centres down is not easy as many working parents, especially those in essential services, rely on them.

He suggested that parents take a proactive approach and adopt the mindset that they are "infected" at all times. This would remind them to try to take precautions, such as observing safe distancing, practising proper hygiene and wearing masks, Prof Car added.

As for those who flout rules on social distancing, it is important to understand why they do this.

Prof Teo said that people who refuse to abide by the guidelines could be experiencing loneliness or poverty, or have other reasons nothing to do with blatant defiance, and simple enforcement of the rule may not be that straightforward.

"There are some who are openly defiant and for those, we should levy the appropriate penalties. But there may be a segment of people out there, where the choice of following the measures may mean unacceptable hardship and other more existential issues," added Prof Teo.

Prof Car agreed, noting that there may also be some who do not abide by the measures because they are unconvinced that the issue is serious. This is "not necessarily a malicious intent, but rather an attitude that is more indifferent or cynical towards government, or established science", he added. A multifaceted and intentional approach using communication tools like survivors' accounts may be more effective, he noted.

With the virus is likely to stay for the long haul even after numbers have dropped, there will be no way to return to life as before, even if a vaccine is developed, Prof Car said.

"We must rethink how we start living, developing habits, new norms of behaviour consistent with measures that prevent the spread of the virus."

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A version of this article appeared in the print edition of The Straits Times on April 17, 2020, with the headline Singapore's coronavirus numbers in local community remain stable in past 2 weeks. Subscribe