Our <<cat>>, Whiskey, is doing fine, but strictly a house cat
In the meant I understand and am watching Singapore which earlier bravely talked about ‘living w/ Covid’ and now seems hesitant about the stance as hospitals get crowded w/ Covid Delta. Singapore is ‘well’ ‘vaccinated’ with several flavors of multiple-jabs experimental liquid.
I am getting a sinking feeling w/r to the on-rushing flu season.
bloomberg.com
Singapore's Covid Response Overlooked a Major Factor: Fear
Mastering data is only half the battle. A major reason hospitals were getting overwhelmed is because people were scared, and the government missed an opportunity to send the right message.
Rachel RosenthalSeptember 29, 2021, 7:46 AM GMT+8
Singapore is very proud of its reputation for technocratic excellence. In recent months, government officials have tried to tackle the country’s most pressing question — how to live with Covid-19 — by scrutinizing, modeling and projecting data, as if staring hard enough at those little gray-rimmed boxes on Excel would produce the answer.
The trouble with this strategy is that living with Covid is messy, and the data will never look good. Countries that have been praised for the most meticulous of approaches to the outbreak have stumbled time and again. Ultimately, treating the coronavirus as endemic will require Singapore to do something it may find unnatural: think beyond the numbers.
In recent days, the government reintroduced a host of restrictions to curb a quickly rising case count, which has remained above 1,000 for more than a week. Low by global standards, these figures are staggering for a country that had all but eliminated the coronavirus for several months before the delta variant emerged in the spring. In an interview with Bloomberg TV on Monday, Lawrence Wong, the finance minister who co-chairs the Covid task force, said Singapore should prepare to cope with 5,000 daily cases or more.
By most measures, Singapore’s Covid situation remains under control. With 82% of the population fully vaccinated, 98% of cases have mild or no symptoms. There are 209 cases requiring oxygen supplementation and 30 people in the intensive care unit. Officials’ major concern is an exponential increase in cases that would overwhelm ICU capacity. Wong said that while just 0.2% of cases end up in the ICU, doctors need to admit 10% into hospitals to provide “timely care” — these include seniors, those with serious symptoms, and patients with comorbidities. Intensive care cases stay in the hospital for at least a week, according to Wong. At 5,000 cases a day, 10% can add up quickly, even if those cases don’t all end up in ICU beds.
Singapore’s pathway to what it has called a “whole new normal” broadly relies on a three-pronged strategy ( captured in this catchy jingle): test, trace, vaccinate. The government has delivered self-testing kits to every household throughout the month. As of Sept. 20, it had tested 19.1 million swabs in a population of 5.7 million.
The result? Lots and lots of positive mild or asymptomatic cases. Because the government made little attempt to de-stigmatize Covid — catching it is still broadly seen as some sort of moral failure or impurity — many Singaporeans justifiably got scared and flooded into emergency rooms. “A lot of people are actually very anxious,” Kenneth Mak, the director for medical services told the Straits Times last week. It’s likely that people who are well are going to the hospital because they are worried and unsure of what to do, he said.
Now the government is hustling to shore up medical staffing and facilities. The latest plans account for 1,600 Covid-19 hospital beds, up from 1,000. Singapore is opening community treatment centers for non-serious cases, providing booster shots for the vulnerable, and has introduced a number of services to get people comfortable with the idea of staying home, from telemedicine and hotlines to assigning “recovery buddies.” It’s even deploying the Singapore Armed Forces to help roll out this effort.
This military-grade exercise is Singapore at its finest, but it’s only half the battle. Anyone who looks at data for a living will tell you that numbers are a Rorschach test: You see the story you want to see. Right now, Singapore wants an aggressive Covid tracking strategy, but cannot absorb the information that it produces. That leaves two choices: 1) Stop testing asymptomatic cases because the numbers are scary and, given the high rates of vaccination, lack informative value; or 2) change the public narrative. That means, instead of playing on fear, urging people to look past the numbers. Success will come down to trusting the smart plans the country is already putting in place. As Covid becomes endemic, managing emotions will be just as critical as managing the virus.
The psychological toll of Singapore’s data-first strategy is high: 73% of respondents in a recent survey fear catching the virus, up from 37% in August 2020, before vaccinations began. More than three-quarters reported feeling sad or depressed, and many parents are again juggling working from home with home-schooling. It’s this type of pressure that pushes people to the brink over arbitrary restrictions. (A live event can have 1,000 vaccinated attendees, but toddlers “need to stay in one place with their assigned play partner,” according to the latest communication from our pre-school.)
Singapore acknowledges the frustrations of its citizens and businesses, yet far too often this is seen as a necessary sacrifice toward a larger goal. “Living with Covid,” by definition, means those priorities need to be reversed: Day-to-day life must come first.
Singaporeans are resilient. But waiting for the numbers to paint a pretty picture is a fool’s errand. Far more important is mentally preparing the population for a whole new normal. You simply cannot program your way out of Covid Zero.
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
To contact the author of this story:
Rachel Rosenthal at rrosenthal21@bloomberg.net
To contact the editor responsible for this story:
Howard Chua-Eoan at hchuaeoan@bloomberg.net
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cnbc.com
Singapore is seeing daily record Covid cases. Here’s why it may not be a bad thing
Abigail Ng
People walk at a pedestrian crossing along the Orchard Road shopping district in Singapore on September 7, 2021.
Roslan Rahman | AFP | Getty Images
SINGAPORE — Authorities in Singapore have tightened Covid measures as infections in the country rise to fresh record highs — but two health experts told CNBC they are not terribly concerned.
The country’s health-care system and workers have been strained by the increase in cases, and there is a need to slow down transmission to avoid seeing more infections in vulnerable groups such as the elderly, the health ministry said Friday when stricter measures were announced again.
For the next four weeks, group sizes for social gatherings will be reduced to two people from five people, and working from home will be the default.
Still, medical experts told CNBC that the latest virus wave may not be a bad thing since Singapore’s population is highly-vaccinated.
Many of the patients with Covid-19 have avoided severe illness and will gain further protection against future infection as antibodies fight the virus, according to Teo Yik-Ying, dean of the Saw Swee Hock School of Public Health at the National University of Singapore.
Around 82% of Singapore’s population has received two doses of a Covid vaccine. Health authorities on Sunday said 98% of infected individuals had no or mild symptoms over the last 28 days.
Case numbers may remain high for a few months, but the “vast majority” will be well protected by the vaccines and won’t fall seriously ill, Teo said.
“For these people, infection will not have any short-term or long-term consequence to their health, but may additionally trigger a natural immune response which reduces the chance of subsequent infection,” he said in an email.
Potential benefits of natural infection
Letting the virus transmit slowly through the population is “not necessarily a bad thing,” said Ooi Eng Eong, a professor in Duke-NUS Medical School’s emerging infectious diseases program.
The two main vaccines used in Singapore are developed by Pfizer- BioNTech or Moderna, and both use the messenger RNA technology
mRNA vaccines instruct the body to produce a so-called spike proteinwhich is found on the surface of the virus that causes Covid-19. It is harmless, but triggers the immune system to develop antibodies so that the body will be able to fight off infection better if exposed to the real virus.
“If we get a natural infection, our immune system will be able to recognize a larger part of the virus” as opposed to just the spike protein, Ooi said, adding that it could make a person more resilient against future variants.
Instead of infection followed by vaccination, we’re going to go vaccination followed by infection, which I think is even better because infection will mostly be mild. Ooi Eng Eong Professor at Duke-NUS Medical School
He said Singapore could reap the benefits of natural infection that some parts of Europe and North America are experiencing, but in the reverse order.
“Instead of infection followed by vaccination, we’re going to go vaccination followed by infection, which I think is even better because [infections] will mostly be mild,” he said.
“Those [countries] that had high rates of disease last year paid the price” of higher death rates, he told CNBC.
More new variants?
When asked if widespread transmission of Covid could lead to new variants emerging, Ooi acknowledged that it’s difficult to predict what will happen.
However, he pointed out that future variants will have to compete with the “very transmissible” delta variant, the dominant strain worldwide.
“It’s very hard to beat delta,” he said.
There were also concerns about mu, a new variant of interest, but it couldn’t take off because delta was too strong, he said.
“Having said that, I think the wise thing to do is still to be prepared that something fitter than delta could eventually emerge, or that the new variant could escape the immunity produced by vaccination,” Ooi said.
Local Covid situation
The number of severe Covid cases remains within expectations, according to Singapore’s health ministry.
There were 172 cases that required oxygen supplementation, and 30 in the intensive care unit (ICU) as of Sunday. ICU capacity can be ramped up to 1,600 beds if needed, the government said.
The two professors who spoke to CNBC were split on the whether there’s a need for new restrictions.
Ooi said the current virus wave is “well within the limits” of Singapore’s capacity. The new restrictions are “unnecessary” and will slow down efforts to live with the disease, he added.
While Teo agreed that the situation wasn’t worsening, he said tightening measures are needed to provide “breathing space” for Singapore to make adjustments to operational and hospitalization protocols. |
