Coronavirus has many tricks up its sleeve, getting back to a more normal life calls for new equilibrium: MOH chief health scientist

There is no place for complacency in the war against a very smart virus. ST PHOTO: LIM YAOHUI

SINGAPORE - The coming months will see researchers and policymakers here striving to maintain a delicate balance to keep the coronavirus outbreak in check, while allowing life to carry on more normally, the Health Ministry's chief health scientist Tan Chorh Chuan said on Thursday (April 30).

"All of us are searching for ways to reach a new equilibrium, a new balance where we can still keep viral spread under control," he told The Straits Times' executive editor Sumiko Tan on ST's daily talk show The Big Story.

"We may not be able to completely get it down to zero, but we keep it well under control (and) in exchange, we are able to function much more normally, and the economy can function more normally, but with a lot more precautions in place."

Prof Tan said he is hopeful that Singapore will be able to achieve this within the next few months.

But there is no place for complacency in the war against a very smart virus, he stressed.

"It still has many tricks up its sleeve. And therefore, we have to be really very vigilant. We have to respect our enemy, and therefore we have to continually keep our guard up," he said.

He explained that Sars-CoV-2, the virus that causes the Covid-19 disease, is highly contagious and difficult to control, and can spread before infected people show symptoms.

What is worse, the amount of virus shed by patients is highest very early on.

Prof Tan, who led the public health response to the severe acute respiratory syndrome (Sars) outbreak here in 2003, said that the current coronavirus is trickier to deal with than Sars.

This is because - contrary to the fears at the time - it turned out that Sars could not be transmitted through asymptomatic spread, which meant that the world was able to contain it quickly, he explained.

Sars also differed from the current coronavirus in that, while it was more severe, it was mainly spread within healthcare settings such as hospitals.

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"Once we were able to get infection control really stringently up in the hospitals, once we were able to curtail the movement of patients and healthcare workers, and we were able to quarantine people very quickly, the outbreak actually was quite quickly contained," said Prof Tan.

But Covid-19, a "community type of infection", is very different.

"It spreads in the community. It spreads through widespread contact between individuals who are circulating around. And therefore, unlike hospitals and healthcare facilities where you're able to bring public health measures to bear in a very concerted manner, this is a much more diffused problem," said Prof Tan.

Nonetheless, Singapore learnt many important lessons from Sars, which has armed it better in the fight against Covid-19.

Prof Tan said: "We now have in Singapore many individuals who are administrative leaders, clinicians, nurses, professionals, front-line workers, administrators who have had the experience of dealing with an epidemic, who have the confidence and the knowledge of what to do.

"And because of that, they have also less concerns about getting infected themselves, greater confidence in the protective equipment, and therefore somewhat less anxiety."

He added that this was probably the most valuable takeaway from the Sars outbreak here, as the new systems, research and contact tracing abilities that were developed since Sars serve to support "a human resource that is very experienced with dealing with epidemics".

Noting that Covid-19 is able to spread very rapidly, Prof Tan said: "What makes us all lose sleep is the constant worry that we will have big explosive clusters that become very hard to control. Because once the numbers go up very quickly, and if many of them are severely affected, then they will overburden the healthcare system. And that's where outcomes will be worsened and mortality may increase."

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As of noon on Thursday, there were 16,169 cases of Covid-19 infection in Singapore, the majority of whom were foreign workers living in dormitories.

The Republic's daily infection rate had been in the single and double digits for the early part of the outbreak, but first saw a spike in cases on April 5, with 120 infections confirmed that day.

Since then, hundreds of coronavirus infections have been reported on most days, with four in five cases linked to dormitories as the disease spread among the foreign worker population there.

The good news, however, is that there are examples from around the world that the virus can indeed be contained, Prof Tan pointed out.

"If you contain them well, the health system need not be overburdened.

"And in Singapore, we are thankful and fortunate that our health system has not been overburdened, that our mortality rates have been low so far, and that we have not had a lot of severe illness among the younger foreign worker population."

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