Fighting the Coronavirus Pandemic, East Asian Responses - Singapore: Anticipation, Swab Tests and Intrusive Contact Tracing

This preparedness is accompanied by measures taken on the news that a viral new pneumonia was showing signs of spreading in Wuhan and Hubei province. In Singapore, temperature screening of incoming passengers from Wuhan starts in early January, and a complete ban on inbound flights from Wuhan is imposed on January 23, 2020. From the beginning of February, Singapore has imposed increasingly strict controls on incoming travel, broadening it to the various areas affected severely by COVID-19, and extended in mid-March to all foreigners.

A feature of Singapore’s containment strategy is the swab testing of incoming passengers showing mild symptoms. Since mid-January, the government has worked to expand screening rooms at various checkpoints. The test kits with a 99% success rate used at the checkpoints are developed in February by The Home Team Science and Technology Agency (HTX), and a Singaporean company, Veredus, to facilitate in vitro diagnosis. Tests are now conducted on the basis of a tiered system of controls classifying passengers according to risk.

On February 7, the government raised its Disease Outbreak Response System Condition (DORSCON) level to "orange"- instituting multiple precautionary measures for large-scale events, the workplace, and at the individual level, such as regular checks for fever and respiratory symptoms.

The Singaporean government also puts the emphasis on sharper contact-tracing tools, the creation of more laboratories, and higher investment levels in biomedical science and clinical research.

As other East Asian countries, Singapore emphasises the production, the availability and the wearing of masks. On February 4, the government undertakes a massive operation of distributing 4 FFP2 masks per household per week from the government-run stockpile of Personal Protective Equipment (PPEs) and masks.

Another major characteristic of Singapore’s crisis management is extremely intrusive contact tracing and cluster identification. Health professionals on the ground are trained to question those who test positive in order to identify potential clusters. They can use a new serological test developed by the Duke-NUS Medical School. In addition, the Ministry of Health works in tandem with hotels and companies, going as far as to consult CCTV footage to identify and track cases. The Singaporean government has developed the app Tracetogether, which records through Bluetooth other users who have been in close proximity to a smartphone user. After that user is found to be positive, individuals at risk are contacted directly.

Proactive testing and contact tracing are accompanied by strict quarantine policies. The quarantine measures adopted by Singapore range from government-mandated leave of absences to Stay-Home Notices (SHNs), first violations of which are either fined heavily (US$6,900) or given a six-month jail sentence. The stay-at-home notices come with a requirement to share GPS location with the government, thus allowing real-time tracing. In terms of advocating social distancing, Singapore has practiced "leading by example". Many Singaporean MPs have exhibited social distancing during walkabouts.

In the second half of March, a second wave of contagion occurs in Singapore, with 80% of the confirmed cases imported. As a result, from March 22, the 14-day stay-home notice system has been expanded to all permanent residents and long-term pass holders returning from any part of the world. Short-term visitors from all over the world are barred from entry or transit. The measure is also described as allowing the conservation of resources and the direction of medical focus on Singaporeans.

As a result of quick action, strict border control with swab tests on arrival and quarantine, proactive contact tracing, Singapore was initially able to stave off a general lockdown. Following a fresh wave of cases, Singapore has instituted a one-month partial lockdown from April 3 onwards, known as a "circuit-breaker" measure. Most businesses and workplaces, except for essential services are closed, having shifted to telework, and schools shift entirely to a home-based learning system. In the first wave of contagion, a majority of cases so far were young people, indicating that the elderly have either self-isolated or are protected by their kin. However, a new upsurge in cases from April 19 onwards has found clusters concentrated in dormitories inhabited by temporary workers. So far, a total of 21 foreign worker dormitories have been declared as isolation areas by the government. Following this development, on April 21, Prime Minister Lee announces an extension in its circuit breaker measures by four weeks until June 1. By way of a plan to sustain the increasingly restrictive measures the government has introduced successive economic stimulus packages of US$ 2.6 billion on February 18 and US$ 11.8 billion on March 26. A third economic stimulus plan is announced by the government on April 6, worth US$ 3.6 billion, in response to the continuing outbreak.

Mathieu Duchâtel, François Godement, Vasudha Rajkumar and Viviana Zhu - Institut Montaigne’s Asia Program

Copyright: Catherine LAI / AFP