April 25, 2020 06:57:29
Singapore has extended its partial lockdown by one month amid a surge in coronavirus cases across the country.
The city-state appeared to have the virus under control and has been held up as a model to the world in how to beat COVID-19.
But in the past few days, it has seen a rise in cases, prompting concerns it’s in the midst of a second wave.
Some groups say they had feared this would happen for some time, arguing that initial containment measures failed to address a key area that has led to a spike in cases.
The small island nation has long depended on hundreds of thousands of low-paid foreign labourers, who live in tightly packed dormitories.
And while Singapore was being praised for its meticulous coronavirus containment strategies, the disease was silently spreading in these dorms.
Singapore seemed to have the perfect plan
It wasn’t that long ago that the World Health Organisation (WHO) praised Singapore for its early response to the outbreak.
“Singapore is leaving no stone unturned, testing every case of influenza-like illness and pneumonia,” WHO chief Tedros Adhanom Ghebreyesus said in February.
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The nation had managed to initially mitigate the spread of the disease among its citizens with strict border screening, rigorous contact tracing and surveillance.
A clear communication strategy was seen as just one of the weapons in the Government’s arsenal against the new coronavirus, along with four other key steps:
1. Have a plan and use it quickly
2. Set up a network of health clinics
3. Hospitalise people infected with the virus
4. Trace contacts rigorously
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The measures allowed Singaporeans to avoid the harsh lockdowns implemented in other countries, with many schools, restaurants and businesses remaining open.
However, it had failed to address what some say was a key vulnerability: the migrant community.
Dorms become the new centre of Singapore’s outbreak
Infections within dormitories for foreign labourers are continuing to grow.
As of April 14, out of 3,252 cases recorded in Singapore, 1,625 were linked to outbreaks in migrant worker dormitories.
Singapore is quite dependent on foreign workers, with Prime Minister Lee Hsien Loong acknowledging they provide much of the manual labour.
As well as working on construction sites, they are domestic workers and take care of the sick and elderly in hospitals and aged care facilities.
Experts say the outbreak in their cramped quarters shows you can’t afford to be complacent in the fight against the virus.
The National University of Singapore’s Professor Dale Fisher said the city-state had “been caught out”.
He was in Singapore during its fight against SARS in 2003 and was this week with colleagues helping to test and treat inside the migrant dormitories.
“[You’ve got] hundreds of thousands of men in pretty overcrowded places and what this tells us is that you can have all the systems in place, you think you have got your eye on everything,” the Singapore-based Australian said.
“[But] no matter how well prepared you are, [you need to check for blind spots]. Try and find them now, try and be ready for them, try and predict them.”
Were there warning signs?
Rights groups, charities and medical experts had flagged the potential for mass infection among the more than 300,000 migrant workers living in often cramped and unsanitary conditions, according to Reuters.
They have pointed to issues with some of Singapore’s early policy responses, which they claim did not address this vulnerable community, including:
- A Singapore government order restricting doctors to single hospitals to prevent them spreading the virus, which sharply reduced volunteer health services depended upon by some workers.
- A nationwide mask distribution at the start of the outbreak, which excluded migrant workers living in dormitories
- Recent measures to confine tens of thousands of workers to packed quarters, which may have increased the risk of the infection spreading
A Singapore researcher for the rights group Amnesty International told Reuters that migrant workers living in crowded quarters, “without opportunities to self-isolate and protect themselves, are at particular risk of exposure to the virus”.
Singapore’s Health and Manpower Ministers did not respond to specific questions from Reuters about the treatment of foreign labourers.
Professor Fisher said getting the messaging right was crucial, especially in places where it is challenging to test, trace and quarantine.
“A lot of the world won’t be able to do that. That’s just a simple fact,” he said.
“In those countries, it’s going to be community engagement, which will be what is critical. You need to be able to tell people how to protect themselves.”
Professor Fisher spent the week with colleagues advising migrant workers on how to practice physical distancing and the importance of hand washing to contain the outbreak.
What’s being done now?
Singapore’s story is one of two outbreaks.
While cases in dormitories have shot up in the past few weeks, the number of new cases reported in the wider community has inched downwards.
The Government has now ordered the rest of the country to stay home and maintain at least a one-metre distance from others if going out for essential needs like food shopping.
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Singapore has also ramped up testing in dormitories and started to move some workers deemed “essential” into public housing, military camps and industrial accommodation ships, which authorities say is helping create more space.
The Government has also moved to defend its virus-prevention measures in dormitories, which include advising operators to monitor workers for fever and preventing mingling in common areas.
“It is not as if we have not done anything to try and manage the situation,” Josephine Teo, the Manpower Minister, said on April 9.
But Professor Fisher says Singapore can expect its number of infections to continue for some time.
“We have a response happening. We will make an impact on this,” he said.
“But, we need to brace ourselves for at least some weeks of high numbers.”
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April 25, 2020 04:58:06