Home Health Why the reaction to the coronavirus in Singapore worked – and what...

Why the reaction to the coronavirus in Singapore worked – and what we can all find out


Singapore’s response to the coronavirus is considered a model by many around the world. As of this week the country numbered 266 people (zero fatal), and the infection rate is much lower than in the rest of the world.

The first thing that helped with the reaction was that he was ready before the outbreak Outbreak of SARS 2002-03

It was then known that its infrastructure was not ready for an outbreak of this kind. Thus, over the years, detention centers were built, more negative pressure rooms were created and legislation was introduced.

Then, on December 31, when the world first learned about the coronavirus in China, Singapore began preparing. By that time the World Health Organization had announced Fr. health emergency in late January it was ready.

In February, Singapore again made it clear that the virus could have serious health, social and economic consequences. We knew this because we saw what happened in China. The virus has brought to its knees a country with a population of 1.4 billion people.

The rest of Asia was also clearly scared and in a hurry to prepare – Taiwan, Hong Kong, South Korea. There was no confusion in the minds of these countries as to what this virus could do.

However, other parts of the world were not prepared.

Conversation, CC BY-ND

Keeping people with a positive test in hospitals

Looking at what we are doing differently today, I think the biggest one is that Singapore has not let positive patients back into the community.

China has not done that either. Wuhan has created 50,000 hospital beds in two large temporary hospitals. These were not hospitals for the sick, these were all light cases that Australia, Europe and the US send home.

Home quarantine is not easy. You don’t have to mingle with family, you have to have your own toilet, you don’t have to have guests. If you’re going to keep people at home, you have to be really sure they’re not transmitting it.

In Singapore, we believe it is best to weed out these people and care for them elsewhere until the virus is cleared. People with mild diseases are kept in hospitals – we have enough space to unite all the positives.

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If you are going to take care of people at home, how will you know that they follow the rules of self-isolation? Do you do phone tracking? Are you doing random checks regularly enough? Are there severe enough punishments to scare people away from disobedience?

In Singapore, there are contact retrieval teams that identify all contacts of an infected person and call them. Often these people have early symptoms and we arrange for them to be picked up and examined.

Singapore is very liberal about our testing. Less than 1% of our tests are positive, so that reflects how many tests we do.

If people have no symptoms, they are placed in home quarantine. And home quarantine is very strict. A couple of times a day you will receive an SMS and you have to click on the link that will show you where your phone is.

In case you cheat and leave your phone at home with someone else, the government occasionally knocks on your door. The fines are pretty harsh.

COVID Chronicles Public Awareness Campaign. Yong Lu Lina Medical School, National University of Singapore

Consistent, regular communication

We were very strong in interacting with the public. Messages we send: if you are sick, stay home. If you are ill and have had contact with a patient on COVID-19, come for an examination. If you can’t stay home and you need to go out, put on a mask. If you cough, cough into your elbow. Avoid crowds, especially indoors.

Everyone else is talking about social distance. For restaurant and bar owners, try to reduce the number of people in your business. People know what to do, and they know that if there is a blockade, they will be shut down. A lot of business and income can be lost.

Most restaurants, malls and schools remained open in Singapore during the pandemic. AS HUI YANG / EPA

Everyone understands and adapts. You know what happens when people don’t adapt – we end up shutting things down.

Messaging was also very strategic. There is an inter-ministerial task force – we see this as a general government issue, not just a health issue. The prime minister comes on television every couple of weeks, the chairman of the task force is now a well-known person. Messaging is usually limited to a small number of reputable people

There’s a lot of transparency. There is already a lot of faith in the government, so it helps a lot.

Reports from the government are also consistent – they provide the latest figures and say what is happening in other countries and what may need to be done in Singapore.

We also set up an information campaign with cartoons. It is an alternative medium that people can contact. They are very popular, with over 1 million views online. Now the World Health Organization is translating them into other languages.

COVID Chronicles Public Awareness Campaign. Yong Lu Lina Medical School, National University of Singapore

Why Singapore is not closed

It is well known that children are asymptomatic or have a mild form of the disease, so there was no real reason to close schools. If you close schools, what could be the reason for their opening?

In Singapore, we want life to go as usual. We want businesses, churches, restaurants and schools to remain open. That’s what success looks like. Everything goes ahead with modifications as needed, and you continue to do so until there is a vaccine or treatment.

Read more: Italy’s “darkest hour”: how the coronavirus has become a very political issue

During testing, the threshold for taking the test is quite low. For the first week, we tested only people from Wuhan or Hubei Province, then we tested everyone who has been in China for the past 14 days.

Until the end of January, all our public hospitals can do tests. We then moved on to an intensified examination – we checked everyone who came to the hospital with respiratory disease, everyone who came in contact with a patient with COVID-19.

Now he has even become more liberal. If you are a hospital employee with a mild cold, we will give you a test.

But if you are a normal person who has no contact with anyone and has mild symptoms, we will just send them home. You can get a medical certificate that allows you to stay home from work for five days. If you are a casual worker, this also has financial aid.

Temperature test at the entrance to the library. AS HUI YANG / EPA

It is necessary to organize leadership

There is nothing special about it. We don’t have a magical answer, we just do it well and efficiently.

Sure, it’s harder to implement these things in big countries with different political systems, but it just means people need to know their role.

For example, communication with the nation should come from the national government, but the state level should talk about state things.

In fact, it is a matter of ensuring that the leadership is sufficiently organized to properly communicate to the team. Then people will feel more comfortable and will follow the rules much more often.


By Dale FisherDepartment of Infection Control, National University Hospital of the National University of Singapore


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