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What lessons can be learned from Singapore’s fight against COVID-19?

Manu Suvarna and Xiaonan Wang

In his In Depth News story “Can China's COVID-19 strategy work elsewhere?” (06 March, Vol. 367, pp. 1061), Kai Kupferschmidt and Jon Cohendiscussed the strategies adopted by China for the containment of the pandemic COVID-19 and its consequences on public life (1). While the present situation in China shows some respite, North America and Europe are experiencing its brunt (2). The densely packed city-state of Singapore, with close ties to China and a major aviation hub, had recorded the highest infections outside the China between February 6th -19th, 2020 (3) and yet managed to handle the outbreak compared to its peers.

Foremost, the government’s communication with the public has been vital to evade unnecessary panic and Singapore’s PM Lee Hsien Loong has received global accolades, in particular from the WHO, for his regular media updates and public assurance (4). This example stands out amidst a series of misapprehensions in COVID-19 messaging globally, including USA, South Korea, Japan and Italy (5). Singapore’s resilient surveillance and fastidious contact tracing system, has been the primer in detecting COVID-19 infected cases as well as every possible contact of those infected; which has been recognized as ‘gold standard’ by a study at Harvard (6, 7). Moreover, Singapore was vigilant right from the start and timely escalated the DORSCON level from yellow to orange (8). Quarantine and isolation protocols were strictly enforced and country-specific travel restrictions followed soon after (9). Citizens were encouraged to seek medical attention even in case of mild symptoms, practice social distancing and avoid religious mass gathering (9, 10).

Despite the recent spike in its COVID-19 cases, Singapore’s enclaves such as public assurance by the government, national alertness, data transparency and cluster tracing can be emulated–at least partially, by countries further out in the timeline, to inflict a lower infection and case fatality rate, as the global pandemic keeps lurking.

References

1. K. Kupferschmidt, J. Cohen, Can China’s COVID-19 strategy work elsewhere? Science. 367, 1061–1062 (2020).

2. J. Cohen, K. Kupferschmidt, Strategies shift as coronavirus pandemic looms. Science. 367, 962–963 (2020).

3. R. Pung, C. J. Chiew, B. E. Young, S. Chin, M. I.-C. Chen, H. E. Clapham, A. R. Cook, S. Maurer-Stroh, M. P. H. S. Toh, C. Poh, M. Low, J. Lum, V. T. J. Koh, T. M. Mak, L. Cui, R. V. T. P. Lin, D. Heng, Y.-S. Leo, D. C. Lye, V. J. M. Lee, K. Kam, S. Kalimuddin, S. Y. Tan, J. Loh, K. C. Thoon, S. Vasoo, W. X. Khong, N.-A. Suhaimi, S. J. Chan, E. Zhang, O. Oh, A. Ty, C. Tow, Y. X. Chua, W. L. Chaw, Y. Ng, F. Abdul-Rahman, S. Sahib, Z. Zhao, C. Tang, C. Low, E. H. Goh, G. Lim, Y. Hou, I. Roshan, J. Tan, K. Foo, K. Nandar, L. Kurupatham, P. P. Chan, P. Raj, Y. Lin, Z. Said, A. Lee, C. See, J. Markose, J. Tan, G. Chan, W. See, X. Peh, V. Cai, W. K. Chen, Z. Li, R. Soo, A. L. Chow, W. Wei, A. Farwin, L. W. Ang, Investigation of three clusters of COVID-19 in Singapore: implications for surveillance and response measures. The Lancet. 0 (2020), doi:10.1016/S0140-6736(20)30528-6.

4. J. TEO, WHO again praises S’pore, urges aggressive global action. The New Paper (2020), (available at https://www.tnp.sg/news/singapore/who-again-praises-spore-urges-aggressive-global-action).

5. Coronavirus Lessons From Singapore, Taiwan and Hong Kong. Time, (available at https://time.com/5802293/coronavirus-covid19-singapore-hong-kong-taiwan/).

6. S’pore’s ‘gold standard’ of Covid-19 detection is far more effective than rest of world: Harvard study. TODAYonline, (available at https://www.todayonline.com/singapore/spores-gold-standard-covid-19-detection-far-more-effective-picking-cases-rest-world).

7. Y. Ng, Evaluation of the Effectiveness of Surveillance and Containment Measures for the First 100 Patients with COVID-19 in Singapore — January 2–February 29, 2020. MMWR Morb Mortal Wkly Rep. 69 (2020), doi:10.15585/mmwr.mm6911e1.

8. Singapore Ministry of Health. Risk assessment raised to DORSCON orange., (available at https://www.moh.gov.sg/news-highlights/details/risk-assessment-raised-to-dorscon-orange).

9. Singapore Ministry of Health. Ministerial statement on whole-of-government response to the 2019 novel coronavirus (2019-NCoV). Singapore: Singapore Ministry of Health; 2020, (available at https://www.moh.gov.sg/news-highlights/details/ministerial-statement-on-whole-of-government-response-to-the-2019-novel-coronavirus-(2019-ncov)).

10. Singapore Ministry of Health. Additional precautionary measures in response to escalating global situation. Singapore: Singapore Ministry of Health; 2020, (available at http://moh.gov.sg/news-highlights/details/additional-precautionary-measures-in-response-to-escalating-global-situation).