S’pore imposes ‘stricter measures’ for safe distancing amid COVID-19 outbreak, heading closer to the Red DORSCON level measures

After several local COVID-19 cases reportedly had no links to previous cases or travel history to China, Singapore stepped up measures and raised its Disease Outbreak Response System Condition (DORSCON) to Orange on 7 February.

Ministry of Health (MOH) explained that DORSCON looks at the current situation overseas and considers how transmissible the disease is as well as how likely it is to arrive in Singapore. It also considers the impact of the disease on the population.

DORSCON is a color-coded framework that shows the current disease situation. It is used as a guideline for the Government in dealing with outbreaks. There are four codes, including Green, Yellow, Orange, and Red, depending on the severity and spread of the disease.

Following the DORSCON Orange, Health Minister Gan Kim Yong announced the additional measures being implemented to minimize the risk of more transmission via the community.

The measures include requiring employers to conduct daily health checks at the workplace such as temperature-taking and screening for respiratory symptoms; suspension of activities in schools, inter-school, and external school activities; and restrictions on visitors to pre-schools as well as eldercare and social services and facilities.

Later on, the World Health Organization (WHO), on 11 March, declared the COVID-19 virus outbreak a pandemic, and warned the global spread and severity of the disease due to “alarming levels of inaction”.

“We have never before seen a pandemic sparked by a coronavirus. This is the first pandemic caused by a coronavirus,” said WHO director-general Dr Tedros Adhanom Ghebreyesus at a media briefing, urging countries to take urgent and aggressive action.

Following WHO’s declaration, Singapore Prime Minister Lee Hsien Loong emphasized on 12 March that the COVID-19 situation in the country remains under-control, and there are no plans to raise the DORSCON level to Red.

Multi-Ministry Taskforce imposed stricter measures amid a wave of imported cases in Singapore

As the imported cases increased in the country, the Multi-Ministry Taskforce announced on Tuesday (24 March) that it will close all bars and entertainment venues that have a high risk of transmission due to sustained close contact over a period of time.

It also limits gatherings outside of work and school to 10 persons or fewer, and ensure that physical distancing of at least one metre can be achieved in settings where interactions are non-transient.

Meanwhile, other public venues such as retail malls, museums, and attractions – where contact is more transient may remain open – are to reduce their operating capacity.

Patrons of eating establishments with fixed seating – for example, hawker centres and coffee shops – must use alternate seats. Premise managers should mark out seats to facilitate these arrangements.

These measures are expected to be in place beginning from 26 March until 30 April 2020, but it may be extended if the situation does not improve.

How close are the stricter measures to DORSCON Red measures?

Based on the DORSCON Alert Levels framework by the MOH, the Orange level indicates the disease is severe and spreads easily from person to person but it has not spread widely in Singapore, and is being contained.

At this stage, moderate disruption is expected, such as quarantine, temperature screening, and visitor restrictions at the hospital. People are advised to stay at home if they are sick, maintain good personal hygiene, look out for health advisories, and comply with control measures.

Whereas at the Red level, the disease is severe and spreading widely. Major disruption will occur such as school closures and work from home orders. What’s more, this level denotes a “significant” number of deaths. It also advises people to practice social distancing and avoid crowded areas.

With the ‘stricter measures’ being imposed for safe distancing, Singapore seems to be inching towards the DORSCON Red level measures.

The country had announced for the closure of all bars and entertainment venues such as night clubs, discos, cinemas, theatres, and karaoke outlets due to the high risk of virus transmission.

All centre-based tuition, enrichment classes, religious services, and congregations were also suspended. While places of worship – temples, mosques, churches – may remain open for private worship and essential rites, but subject to group sizes of 10 persons or fewer at any one time.

Although the Ministry of Education (MOE), the Ministry of Social and Family Development (MSF), and the Early Childhood Development Agency (ECDA) have announced on 19 March that schools and kindergartens will reopen as planned, stricter measures have been imposed.

Some of the measures include the Government’s existing leave of absence (LOA) and stay-home notice policy, checks on individuals’ travel history at school gates, two-weeks suspension of students’ co-curricular activities, placing students who are feeling unwell in an isolation room or sent home, ensure all students to sit apart, and constant supervision on students.

In fact, the country also demanded for all events and mass gatherings to be deferred or canceled, regardless of size.

Nonetheless, the low fatality rate of COVID-19 is most likely the reason why the country has yet to raise its DORSCON level to the highest, as a “significant” number of deaths are part of the conditions for the escalation.

During the Severe Acute Respiratory Syndrome (SARS) period in 2003, suspension of schools was being implemented but the situation was still classified as DORSCON Orange.

“When you look at the framework today, if you were to apply that framework in the SARS situation, it would have been an Orange during SARS. For it to be Red, it would have to be worse than SARS,” said National Development Minister Lawrence Wong at a media briefing on 14 February.

In comparison, Singapore reported a higher number of COVID-19 cases with 631 total cases as of Wednesday (25 March), and only 238 cases from the SARS outbreak. In terms of death tolls, the country recorded 33 deaths from the SARS outbreak, while two deaths from the COVID-19 outbreak so far.

At a press conference on Tuesday (24 March), Mr Wong was asked whether the additional measures on safe distancing can be considered as a “lockdown”.

He responded, “Beyond the baseline, we are talking about a series of measures that can be put in place or precautionary measures that can be triggered. As we say, additional breaks, as and when the need arises.”

Mr Wong opined that the suspension of schools and workplaces is the most drastic step, which may be necessary but there is no need for the country to go to that level.

“So closure of schools, closure of workplaces, other than essential activities, that’s the most drastic step, if you will. That’s what I suppose, people call a lockdown,” Mr Wong noted. “And that set of drastic measures may well be necessary, but again, we do not have to get there in one step.”

He added that the country can take a series of breaks and proceed to take a drastic step at a later stage if the situation warrants it.

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