30 March 2020 - As the novel coronavirus starts to gather speed in Europe, the Middle East, and the U.S., there’s one place it is seemingly being contained: Singapore.
With no reported virus-related deaths despite 96 cases, and a slowing rate of infection that’s 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 neutralized.
The answer is maybe, and perhaps only with the unique combination of factors that Singapore brings: a top-notch health system, draconian tracing and containment measures, and a small population that’s largely accepting of government’s expansive orders. Few other countries battling an outbreak that’s now 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’s no longer the worst-hit nation outside of China after South Korea saw an over 30-fold increase in a week. Italy, with at least 650 confirmed cases, has now become the epicenter 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 Kent Sepkowitz, an infectious disease control specialist at Memorial Sloan Kettering Cancer Center in New York.
Singapore was aggressive out of the gate and has continued to be. It was one of the first countries 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’s charging a couple who gave false information on their travel history and taking 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, Law Minister K. Shanmugam said in a statement Thursday. “The deliberate breaking of the rules, in the current situation, calls for swift and decisive response.”
The country started a text and mobile web-based software solution on Feb. 10 through which people placed under home quarantine could report their location to the government, according to a statement Thursday from the Prime Minister’s Office.
“This served as the first level of verification of compliance for close to 12,000 foreign employees,” the office said in statement.
The consistently forceful posture is in contrast to other Asian nations, who 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 $1 trillion from the world’s gross domestic product, Singapore used its early infections to establish an advanced contact tracing system.
It’s now using a new serological test developed by Duke-NUS Medical School that can establish links between infected cases, which will allow authorities to map out the chain of transmission and therefore try to break it. Local researchers had earlier successfully cultured the novel virus within a week of Singapore confirming its first 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 the Harvard University.
The country’s experience with the 2003 SARS outbreak in which 33 people died in Singapore, and the 2010 swine flu known as H1N1 where an estimated more than 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 center for managing infectious diseases that opened last year.
Image: REUTERS/Feline Lim