WORLD Unique COVID-19 challenges for city-state Singapore


Unique COVID-19 challenges for city-state Singapore


04:46, February 24, 2020


Singapore's Prime Minister Lee Hsien Loong remarks on the coronavirus situation. (Photo: CGTN)

"You know Singapore is hot all year round, the virus is killed by heat," Anita's grandma joked when she again found the masks were out of stock in a convenient store near her home.

Anita Du, who lives in Singapore with her family, said she has seen more people wearing masks on the street recently. She and her grandma have tried several times in local supermarkets to buy masks, but the shelves of masks and sanitation products have been empty since the coronavirus outbreak began. "I only wear a mask when I am sick, but I could feel more secure if I am prepared."

Failing to stock up on masks is just a small problem for her, however. Anita is working in the MICE (Meeting, Incentive, Convention and Exhibition) industry – a pillar sector to the country's economy that has been seriously hit by the disease.

As an international economic and transportation hub, Singapore is always a top destination for business, investment, travelers and big events. This time, ironically, its uniqueness in interconnecting global business, capital and human resources inevitably helped the spread of the novel coronavirus, not only testing its domestic health system but affecting the world. 

On February 7, Singapore's Ministry of Health (MOH) stepped up the DORSCON level to orange as well as related measures. It clearly advises that only people who have a fever, cough or runny nose and patients who are recovering from illness need to wear a mask. Obviously, the policy is totally opposite to China's: All residents are required to wear masks when in public spaces. Chinese state media and social media continue to stress the importance of wearing a mask to everyone, especially since Hubei Province was declared the epicenter of a global health emergency.

A whole-of-government response by Singapore's MOH again confirmed that "it may sound simple," but the most effective ways to prevent all kinds of infection are regularly washing your hands with soap and water, and avoiding touching your face with your hands. Its message to the public is that potential infection from asymptomatic persons is less likely to be from coughing or sneezing directly, but more likely by touching contaminated surfaces, for which masks offer no protection. "Wearing a mask when we are well often gives people a false sense of security instead, and people are more likely to touch their faces when they need to constantly adjust the masks, which is one way the disease spreads," said Associate Professor Kenneth Mak, director of medical services at the MOH.

"Personal hygiene in daily lives won't take much effort but can help a lot, as public healthcare system's advisory can be slow sometimes," said Dr. Pietro Vernazza, chief of the infectious disease division at Kantonsspital St. Gallen in Switzerland. He pointed out the coronavirus can be prevented by better hygiene measures, which push us to change our behavior to avoid risky actions during an outbreak. "A mask is not a necessarily important part, while the important part is we don't get into the risky context."

Singapore, which overcame SARS in 2003, is eager to keep economic costs to a minimum when facing COVID-19. "As globalization comes to this stage, no country can distance itself from the virus," said Singaporean senior political adviser Chua Yoke Lim. He added that it's impossible for Singapore to stand alone in this "global incident." Balancing the cost and public health interventions based on Singapore's situation is the key to tackling this issue.

Thinking like an international citizen instead of an isolated individual is "normal" for Singaporeans, according to Chua. Thus, disease outbreak is a kind normal to this city-state. Policy making usually stems from this perception, which means the country is trying to maintain normal operation throughout society, without "locking down the city or confining everybody to stay at home." Meanwhile, the government has ensured sufficient supplies, such as instant noodles, tinned food and toilet paper.

"In China and Singapore, effectiveness and efficiency of the public policies and people's social consciousness to follow regulations are different," said Chua. As Singapore has become more closely tied to China in the past 10 years, the cost of containing COVID-19 will be larger than SARS in 2002-2003.  

Panic can cause more problems. While the public health measures have been applauded by international health experts, local Singaporeans have shown doubt and not always bought the government's message. Some Singaporeans on social media say they don't believe the government's advisory to wear masks only when you're unwell, questioning if they have ample mask supplies instead. 

Health professionals have also written to the government to advise the usage of masks as they offer people a double layer of protection.

While other parts of Asia are ringing the alarm, Singapore at this stage is still focusing on eliminating public panic. Lee Hsien Loong clearly said the country "is not at that point yet." Their strategy remains to let hospitals and healthcare workers work on the most vulnerable groups and keep the public calm. The government has implemented supportive measures like waiving license fees for hotels, travel agents and tour guides, covering part of the cleaning costs for hotels and relief for taxi and private-hire drivers. 

On the other hand, the government has decided to give the current health advisory based on known information and clear risk estimations. The transparency helps transmit practical guidance to the general public, and also guarantees reasonable allocation and efficient use of public health goods.

But a more serious issue is emerging for the country – how to make more effective public health interventions before a real global outbreak. Cases of COVID-19 swelled in the past two days in South Korea, Japan's Olympic year is looming amid a rising number of cases, and globally, more than 76,000 people have been infected in around 27 countries, and more than 2,200 have died. When the tipping point is reached, Singapore as an open-border country will face more complicated challenges.

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