SINGAPORE - A gradual realisation that too much confidence had been placed in the ability of vaccines to bring down infection numbers was one factor in Singapore's switch in approach from "zero-Covid" to "living with Covid-19".
At one low point last year amid this change of plans, the Government was also presented with a stark choice: Accept an uptick in infections as the country moved towards a situation in which the virus was endemic, or re-introduce restrictions to try to avoid a potential situation in which a number of elderly people would be hospitalised and dying of the virus.
The latter route was chosen - to "a collective national groan" - but Finance Minister Lawrence Wong, who co-chairs the country's multi-ministry task force on Covid-19, believes it was the right call.
His and other insights into the Government's handling of the pandemic are in a new book chronicling Singapore's experience with the pandemic. In This Together: Singapore's Covid-19 Story went on sale on Thursday (Jan 20).
Interviews with Mr Wong and Health Minister Ong Ye Kung, also a co-chair of the task force, reveal how discussions on accepting and planning for Covid-19 as endemic started as early as in 2020.
The idea was raised with the public by Mr Wong only on May 28 last year. In that same month, Mr Ong discussed the matter at a closed-door seminar with clinicians and doctors. Their positive response prompted Mr Wong, Mr Ong and the third co-chair, Trade and Industry Minister Gan Kim Yong, to jointly write an op-ed to "signal a change in strategy".
Published in The Straits Times on June 24, it outlined a "new normal" of living with Covid-19 involving self-testing, home recovery and resumption of travel.
But a raging Delta variant had other ideas. About a fortnight after the op-ed, large infection clusters saw Singapore retreat to the tighter curbs it had loosened only in June, with eating out banned again and gathering sizes capped at two.
Mr Wong acknowledges in the book that many Singaporeans were "understandably" frustrated.
But the decision was not taken lightly. A major consideration was the vaccination rate of just 50 per cent at the time, with a significant proportion of seniors - about 200,000 - not inoculated. Many of these older people frequented hawker centres and wet markets where infections had spread from a cluster at Jurong Fishery Port.
"The concern was, look, if you just ride it through, you will end up potentially with more seniors in hospital and quite a number of them succumbing to the illness," said Mr Wong.
Asked if the authorities had "jumped the gun" with their earlier messaging on living with Covid-19 and raising hopes that the worst was over, Mr Wong acknowledged that they had counted on high vaccination rates to bring case numbers down and help Singaporeans "start to live more normal lives".
But this view shifted as more evidence pointed to breakthrough infections in vaccinated people, along with documented waning vaccine immunity. The task force realised expectations of vaccines had been too high, the book's writers said, noting "the harsh reality was that even if everyone were vaccinated, case numbers would rise as long as society continued to open up".
Recognising this meant accepting periodic controls to stop large surges of cases from leading to more hospitalisations and deaths, which could overwhelm the healthcare system, said Mr Wong. "That is why we realised we have to be very controlled in our reopening. We have to continue with some sensible measures."
Over the next few months, public discontent snowballed as tens of thousands caught Covid-19 and a home recovery scheme ran into serious logistical hiccups. Much angst was levelled at the task force, with some demanding to know why the authorities seemed to be falling back on strict measures, thereby abandoning the endemic scenario they had laid out.
It was left to Prime Minister Lee Hsien Loong to step in to "steady the ship", according to the book.
In a speech in October, he reassured Singaporeans that the strategy remained to live with Covid-19, and predicted a runway of up to six months to reach a "new normal". This was a state where infection numbers would remain stable at perhaps hundreds a day, hospitals would go back to business as usual, some curbs would be eased, and people could resume activities while feeling comfortable in crowds.
Since then, headway has been made with the launch of several quarantine-free vaccinated travel lanes and relaxed social limits. But the Omicron variant now poses more uncertainty for the future - a future in which Disease X lurks, an as-yet-unknown virus that could be even deadlier.
In an interview for the book, Manpower Minister Tan See Leng, a medical doctor, noted that in the last 20 years, there have been five major epidemics or pandemics - Sars, H1N1, Ebola, Mers and now Covid-19.
The next one is a question of not if but when, he said. "This is a wake-up call for us to improve, to tighten and to constantly pivot to make sure (that) contingency plans are in place."