Singapore is a small country and an island nation to boot. But it is also a major commercial, tourism and transport hub that receives more than three times its population in visitors each year. So it is remarkable that at the time of writing it has recorded just 558 cases of Covid-19 and two deaths, with limited community transmission. The city state’s containment of the outbreak has become a global model. “The short-term costs of containment look high, but they’re much lower than the long-term costs of non-containment,” says Annelies Wilder-Smith of the London School of Hygiene and Tropical Medicine.
Vernon Lee, director of the communicable diseases division at Singapore’s health ministry, remains cautious but says the key to his country’s success so far has been early detection. Singapore did not close borders and has only restricted travel to and from high-risk areas. Travellers are routinely screened for fever upon entry to the country. But this doesn’t catch many cases, due to the virus’s incubation period, so further layers of surveillance have also been introduced. Screening is carried out at the entrances of restaurants, hotels and other public places; the contacts of every detected case are traced; healthy people are quarantined. “People asked me in the beginning, how come Singapore has so many cases?” says Lee. “It was because we were aggressively looking for them.”
The Singaporean model also involves all parts of state and society pulling as one. The government has communicated messages emphasising social responsibility. “It’s important the leadership is out there, singing the same tune,” says Lee, citing Prime Minister Lee Hsien Loong’s address to the nation at the start of February. The health ministry posts regular updates on the situation and has a dedicated web page scotching rumours – of which, a glance at the page reveals, there have been plenty. Individuals are asked to stay home if they feel ill; employers are asked to be flexible; doctors are asked to be liberal with medical leave. The police have been recruited to help trace human-to-human contacts, a process that involves monitoring CCTV footage and interviewing patients. Citizens asked to self-isolate are required to share their phone’s location regularly so that the authorities can keep track of compliance, and there are random checks. Singaporeans who don’t play their part (only a handful of cases to date) can be hit with a fine and up to six months in jail.
Thanks to these measures much of everyday life continues. Large gatherings have been cancelled, but schools, universities, shops and restaurants remain open and most public institutions are still functioning. “If everyone plays their part, the city does not come to a grinding halt,” says Lee.
Despite a package of support for wage earners, tax rebates for companies and payments to households, the damage to the economy is likely to be significant. Covid-19 could be the nail in the coffin for Singapore’s struggling oil exploration industry, for example. And the flow of visitors from overseas has inevitably dwindled as the virus has spread. On 18 March Malaysia closed its border with Singapore, cutting off the daily flow of Malaysian workers who are critical to the functioning of its economy.
With the pandemic changing daily, Singapore remains vigilant and ready to go to the next phase of containment if necessary. Since Sars in 2002-03, it has been building capacity to cope with emerging infectious diseases. Its major hospitals have separate wards for respiratory patients and negative-pressure isolation rooms for confirmed Covid-19 cases, who are cared for by staff in full protective gear. And the government continues to pursue what Lee calls “a calibrated and proportional approach”. It knows it needs to keep people onside, and to do so, potentially, for many months.
Read the rest of the “The state transformed” series here
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This article appears in the 25 Mar 2020 issue of the New Statesman, The crisis chancellor