Coronavirus: Measures taken so far not akin to lockdown, says expert

Entertainment venues like bars and nightclubs were ordered to be closed as part of the Government's efforts to contain the spread of the coronavirus. ST PHOTO: KHALID BABA

To slow the spread of the coronavirus, Singapore has taken some drastic measures this week.

First, the doors were closed to tourists and short-term visitors.

Then pubs and entertainment outlets were ordered to be shuttered and large gatherings banned.

As the country's coronavirus infections climb, surging to new double-digit highs daily, calls for the Government to impose a lockdown have become louder.

The belief is that if daily life grinds to a near-halt, so too will the virus' spread.

This strategy had helped to defeat the Sars-CoV-2 virus, which causes Covid-19, in the Chinese city where it first emerged.

After a two-month lockdown, Wuhan, the epicentre of the outbreak where tens of thousands were infected, is now reporting close to zero domestic transmission daily. The Chinese government had closed schools and workplaces and ordered people to stay home except for grocery or medicine runs.

Some people have wondered if the recent spate of measures in Singapore is akin to a partial lockdown of the country.

But the dean of the National University of Singapore's Saw Swee Hock School of Public Health, Professor Teo Yik Ying, said: "I disagree with the use of the word lockdown in Singapore's case.

"People are free to move in many aspects; they can still go to malls, they can still go to restaurants, I can go to work, the schools are not closed and public transportation is not closed."

There is no universal definition of a lockdown, but in most countries, it is a protocol triggered by an emergency.

This means the movement of people, vehicles and goods is restricted by decree, and it is no longer a matter of personal choice whether to stay at home. It is required under the law.

In a lockdown, non-essential activities and even public transport can also be suspended.

Countries around the world have adopted varying degrees of physical distancing and restriction on movement, but the final decision hinges on the situation in the country, said Prof Teo.

For instance, in Italy, where there is widespread transmission of Covid-19, a lockdown that severely limits interaction among people is the right response and can help to dramatically curb the spread of the disease, he added.

"In Singapore right now, we are nowhere near that situation. For us to adopt such a measure will be unnecessary and not prudent.

"The measure we have adopted here is catered to the situation we have in Singapore," he said.

Around the world, governments are facing a tough choice as air travel, tourism and other industries grind to a halt.

If they keep businesses running and companies open, more people could catch the virus and pass it along, prolonging the public health and economic crises.

But if they do not, it could spark a recession, perhaps even a depression that may inflict lasting damage to their economies.

United States President Donald Trump, who saw his country's economy take a dive amid social distancing measures, had tweeted that the cure cannot be worse than the problem. He is said to be considering lifting public health measures after 15 days to kick-start the battered economy.

An employee at Koi at Nex in Serangoon places a customer's order on a designated area on the counter. PHOTO: ST FILE

The lieutenant-governor of Texas, Mr Dan Patrick, who is 69, had gone further, saying in a TV interview that he would rather die than see the measures to protect the elderly from the virus damage the US economy.

He also said he believed that "lots of grandparents" in the country would similarly be willing to make that sacrifice for their grandchildren.

In Europe, Sweden has eschewed extreme measures, with the head of its public health agency Johan Carlson saying the country "cannot take draconian measures that have a limited impact on the epidemic but knock out the functions of society", the Financial Times reported.

As economies falter, some have warned there could be massive job losses leading to more stress. Social distancing measures could also affect mental health in the long term.

Scientists at Oxford University, meanwhile, suggest that about half the population in the United Kingdom may already be infected by the coronavirus.

If so, it may have acquired enough herd immunity for the disease's spread to slow down.

This means there is a chance that restrictions in the UK can be removed sooner than expected, reported the Financial Times.

Even then, some Singaporeans have clamoured for a lockdown, saying the short-term pain it will cause could bring cases down to single digits, or even zero.

But Prof Teo said that while such a strategy might work to keep cases down internally, Singapore could still be affected by imported cases, with some 200,000 Singaporeans still overseas.

"Do we expect the situation globally to improve in the next few weeks? If so, then I say go ahead, have short-term pain economically for four weeks, and the whole world is better off," he added.

"But unfortunately, the situation looks like it will continue for another three to six months at the very least. What this means is if we lock down now, it is not likely that we will see zero cases."

In fact, Singapore's spike in infections in the past week has been caused largely by imported cases, with many of them infected in the UK and the US.

Prof Teo said this is why border controls have been tightened and more stringent requirements have been imposed on those returning from the two countries.

The Johor-Singapore Causeway on 18 March 2020. ST PHOTO: ALPHONSUS CHERN

They will be transported straight from the airport to hotels, where they must serve out their stay-home notice without mingling with others.

Prof Teo added that what will determine if Singapore needs to be locked down is not just the number of cases per se, but also whether the healthcare system can bear the load.

So far, Singapore has pursued a strategy of aggressive contact tracing and testing to slow the rate of people falling ill to preserve healthcare capacity, Health Minister Gan Kim Yong said in Parliament yesterday.

With Singapore still at the start of the curve, the country can, for now, avoid choosing between shutting down the economy and allowing the infection to progress until the population attains herd immunity, he said.

Instead, the Government will aim to detect cases early by initiating contact tracing as soon as possible. To this end, contact tracing capacity has been increased from the three teams at the start to 20 teams today that can trace up to 4,000 people daily.

Minister for National Development Lawrence Wong, who co-chairs with Mr Gan the multi-ministry task force to tackle the outbreak, said each set of measures introduced progressively has been aimed at putting the brakes on the spread of the disease.

But he stressed: "Underpinning all of these efforts is the need for all Singaporeans to take individual and social responsibility."

In fact, washing of hands, keeping a safe distance from one another, working from home and avoiding large gatherings are the least disruptive measures, yet also the most important.

This is why supporting behavioural change may be the key to fighting the disease.

Associate Professor of Health Psychology and Behavioural Medicine Konstadina Griva of Nanyang Technological University's Lee Kong Chian School of Medicine said: "Lockdown practices are essentially social distancing measures that further limit opportunity for social transmission.

"Even such practices cannot be effective unless accompanied by changes in individual behaviours and habits."

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A version of this article appeared in the print edition of The Straits Times on March 26, 2020, with the headline Coronavirus: Measures taken so far not akin to lockdown, says expert. Subscribe