Enhanced CNY measures helped keep Covid-19 at bay but not yet time to ease restrictions: Experts

Community cases have remained low for the past month since the measures were introduced ahead of the CNY holidays.
Community cases have remained low for the past month since the measures were introduced ahead of the CNY holidays.ST PHOTO: LIM YAOHUI

SINGAPORE - The enhanced restrictions put in place for Chinese New Year last month may have helped control the spread of Covid-19 here during the festive period, but experts stress that people must remain vigilant.

The multi-ministry task force had reason to be concerned ahead of the festivities, noting at a Jan 22 briefing that there had been a rise in community cases with complacency creeping in.

Around that time, about half of those with symptoms did not seek medical treatment, said the task force. Some even continued to go to work and mingle in the community.

So before the Chinese New Year holidays on Feb 12 and 13, the task force imposed a cap of eight distinct visitors a day per household, down from eight visitors per household at any time.

People were also told to limit their visits to two other households a day, and to avoid shouting or cheering while tossing yusheng.

On Feb 19, co-chair of the task force - Education Minister Lawrence Wong - said while the situation had improved, the measures introduced would remain in place.

The authorities would also continue to monitor things for "a few weeks" after festivities had ended, he added.

Community cases have remained low for the past month, with around two new cases per week since March 3.

Enhanced measures effective

Professor Josip Car, director of the Centre for Population Health Sciences at the Nanyang Technological University's Lee Kong Chian School of Medicine, told The Straits Times on Wednesday (March 17) that the enhanced measures worked on two levels.

First, the overall case count was kept low. Most of the new cases seen in the past months were imported.

Second, the measures also sent a clear message that the danger of Covid-19 had not passed, but remained manageable to an extent.

Vice-dean of research at the National University of Singapore's (NUS) Saw Swee Hock School of Public Health Alex Cook pointed out that around the world, culturally important events with a lot of socialising - for instance, Christmas in Ireland and Independence Day in the United States - resulted in epidemic surges.

In contrast, there was a slight bump in cases here after Singapore moved into phase three on Dec 28, 2020.

During phase three, people were allowed to gather in groups of eight rather than five, and more people were allowed in malls and stores.

Religious services were also allowed to feature live performance elements and have 250 worshippers, up from 100 worshippers.

"While we cannot know for sure what would have happened in the absence of the tightening of measures... one imagines the tightening of measures (during Chinese New Year), and the community's forbearance of that, had a role to play in keeping transmission under control," added Associate Professor Cook, who is also domain leader for biostatistics and modelling at the school.

When asked if the low number of cases and increasing number of people getting vaccinated here means it is time to ease restrictions, Prof Car said: "We are still in no way out of the woods yet to be thinking of flipping a 'back to normal' switch."

He said that about 70 per cent to 80 per cent of the population here should be vaccinated first before Singapore rethinks its current measures, adding that this may not happen for some time.

As at Monday, more than 549,000 people in Singapore have received the first dose of the vaccine. About 243,000 of them have also received their second dose.

This means about 4 per cent of the population have completed their vaccination regimen.

Prof Car said: "Singapore is globally connected, and its restrictions also have to take into consideration the global situation.

"We need to be patient for a little longer, to give time for vaccine efficacies to be studied and improved, for results to be seen across the world, and for the world to adjust in response to those results."

He added: "The battle here isn't just on the virus front, it's also against us letting our guards down - vigilance may not make a sexy headline, but it's still the right one at this stage."

Professor of medicine at NUS' Yong Loo Lin School of Medicine Dale Fisher said that the restrictions had generally kept community cases from spreading beyond household and workplace contacts.

"Many countries around the world continue to go in and out of varying levels of lockdown. We should try to avoid that. Without the current restrictions, I believe we could see transmission take off again," added Prof Fisher.

Possible easing of smaller restrictions

However, Prof Cook has a different view. He noted that since last August, Singapore has recorded more than 2,000 imported cases but fewer than 200 in the community.

"That shows that we can more or less prevent transmission from overseas through quarantine."

He pointed out that in January this year, Singapore has been averaging slightly more than one community case a day, but this has now dropped to about half a case a day.

"These numbers show that even with non-zero number of cases, the measures we have can prevent the epidemic from growing. In my view, the number of cases we're seeing tells us we can relax some of the measures we have in place," he said.

He said there could be an easing of restrictions on religious gatherings and people in the workplace, stressing he was only speculating.

Singapore might also see slightly bigger group sizes and some resumption in the nightlife sector.

Currently, people can gather in groups of up to eight.

A pilot to reopen nightclubs and karaoke outlets, which would have seen up to 100 guests per club and five people per karaoke room, was put on hold in January in order to minimise risk of transmission.

But Prof Cook agreed that the vaccination level now is too low to justify large changes to the current safe management measures.

"Until we get to larger levels of vaccine-induced herd immunity, I don't think we should get our hopes on moving to a phase four. Instead we might see a gradual series of smaller liberalisations in control measures, checking all the time that the epidemic remains suppressed.

"I'd expect bigger changes to follow only once enough people have been immunised," he said.

He added that although Singapore managed to pass Chinese New Year safely, measures may need to remain in place to prevent transmission with Ramadan approaching in April.

Prof Fisher said: "We mustn't get over-confident. People with symptoms must have a test, so we can identify cases and stop transmission early.

"Avoiding groups, social distancing and mask wearing is as important as ever. This will still take a while. We have done well but shouldn't let things slip now."