As the coronavirus spread starts to gather speed in Europe, the Middle East and the United States, there is one place it is seemingly being contained: Singapore.
With no reported virus-related deaths despite 96 cases, and a slowing rate of infection that has been outpaced by recoveries, the Asian city-state is emerging as a litmus test of whether the deadly pathogen can be, if not contained, then neutralised.
The answer is maybe, and perhaps only with the unique combination of factors Singapore brings: A top-notch health system, draconian tracing and containment measures and a small population that is largely accepting of the Government's expansive orders. Few other countries battling an outbreak that has infected more than 83,000 globally and killed over 2,800 can replicate these circumstances.
Singapore's tally of cases is still inching up, but it is no longer the worst-hit nation outside of China after South Korea saw an over 30-fold increase in a week. Italy, with more than 600 confirmed cases, has now become the epicentre in Europe, while Iran has reported an alarming jump in numbers of those infected and dead.
"There seems to be more of a willingness to place the community and society needs over individual liberty, and that helps in a public health crisis," said infectious disease control specialist Kent Sepkowitz of the Memorial Sloan Kettering Cancer Centre in New York.
Singapore was aggressive out of the gate, and has continued to be. It was one of the first to impose restrictions on anyone with recent travel history to China and parts of South Korea. It has a strict hospital and home quarantine regimen for potentially infected patients, and is extensively tracing anyone they may have been in contact with.
It has charged a couple with giving false information on their movements and took away residency status from a person who breached his quarantine, among other punitive actions.
Singapore "will not hesitate to take strong action" against rule breakers, said Law Minister K. Shanmugam. The consistently forceful posture is in contrast to other Asian nations, which despite being closer geographically to China, have been slower to act. Japan and South Korea are both facing criticism for lax and delayed containment measures that have led to mounting virus cases.
As the epidemic that emerged from China threatens to become a global pandemic that could wipe off US$1 trillion (S$1.39 trillion) from the world's gross domestic product, Singapore used its early infections to establish an advanced contact tracing system.
It is now using a new serological test developed by Duke-NUS Medical School that can establish links between infected cases, which will allow the authorities to map out the chain of transmission and try to break it. Local researchers had earlier successfully cultured the virus within a week of Singapore's first confirmed case.
A historically "very strong epidemiological surveillance and contact-tracing capacity" in Singapore led to a high detection rate initially, according to a yet to be peer-reviewed study published by researchers at Harvard University.
The country's experience with the 2003 severe acute respiratory syndrome (Sars) outbreak in which 33 people died in Singapore, and the 2009 swine flu known as H1N1 in which an estimated 400,000 people were infected, meant that precautions were already in place. These included ready-made government quarantine facilities and a 330-bed, state-of-the-art national centre for managing infectious diseases that opened last year.
Fresh infections in Singapore may still occur, given the virus' long incubation period and lack of symptoms in some carriers. Singapore is also a regional business hub with a large flow of overseas visitors.
But what Singapore is showing the world is that when all the stars are aligned, the virus may not be as uncontrollable as feared. The situation "tells you a lot about Singapore's healthcare system and their confidence", said Dr Sepkowitz.
BLOOMBERG
