WHO Global Outbreak Alert and Response Network chair cites S’pore as prime model of COVID-19 management — but how objective is his assessment?

At the onset of the novel coronavirus (COVID-19) outbreak, Singapore was praised by the United Nations’ World Health Organization (WHO) for its swift response and the measures it has taken in containing the spread of the virus.
Prime Minister Lee Hsien Loong was recently invited to a virtual meeting of Health Ministers organised by WHO’s Western Pacific Regional Office to speak about the Republic’s efforts to combat the spread of COVID-19 in the country.
In a video message to the WHO Western Pacific Regional Office, posted on his Facebook page on Wed (8 Apr), Mr Lee said that Singapore has taken COVID-19 crisis management “very seriously since the start” by “doing our best to detect cases and isolate them, and to trace their contacts and quarantine them”.
“We have encouraged people to keep safe distances apart, wash their hands, and now, to wear masks when going out,” he said.

Senior Minister for Health Lam Pin Min, who represented Singapore in the meeting, said in a Facebook post today that Singapore has “learnt from our experiences during the SARS and H1N1 outbreaks, and invested resources in pandemic preparedness over the years”.
“The COVID-19 pandemic is yet another painful reminder for all Member States – that it is never too early to invest in robust pandemic preparedness and response,” said Dr Lam.
The chairman of the World Health Organization (WHO) Global Outbreak Alert and Response Network earlier said that countries currently under lockdown could have benefitted from Singapore’s approach.
In an interview with CNBC’s “Street Signs Asia” on Mon (6 Apr), Dale Fisher said that early measures taken by Singapore such as isolating and quarantining cases, contact tracing, and social distancing should be implemented by countries in lockdown “so that they can be safe afterwards”.
Professor Fisher noted that Singapore was able to utilise the lead time available after China first reported cases of COVID-19 in Wuhan, and was subsequently able to rapidly identify and isolate cases.
“So January and February was really the time to ramp up, and that’s when Singapore was particularly active in getting itself ready … any country really had January and February to get themselves prepared,” he added.
While CNBC noted that Professor Fisher is a senior consultant at an infectious disease division at the National University Hospital in Singapore, no mention of him chairing Singapore’s National Infection Prevention and Control Committee was made.
Professor Fisher’s aforementioned roles, thus, potentially brings into question his objectivity in assessing whether Singapore has demonstrated the best response in handling the deadly coronavirus outbreak among other countries.
Earlier this year, Professor Fisher told the media that wearing masks will give a false sense of security to people.
“Masks, I think by and large, offer a false sense of security in the community,” he said. “I see a lot of people that might have a mask but it might be on their forehead and it might be under their chin.”
People may not know how to wear masks properly, Professor Fisher added. They might touch the masks and then touch their eyes or other parts of their face or shake hands with others, which may cause people to spread respiratory viruses to others.
“I’d like to discourage masks in the community. I think they’re excellent in the healthcare setting where trained people look after sick people,” he said.
Professor Fisher was even featured in a cartoon series by the NUS Yong Loo Lin School of Medicine, published on a website designed to educate Singaporeans not to wear masks if one is well. Four Singaporean doctors, as well as experts from China and South Korea — and more recently, the United States’ Center for Disease Control and Prevention — however have previously spoken about the importance of wearing masks during this COVID-19 pandemic.
Last week, in an apparent “U-turn” from the Government’s previous stance on medical masks, Prime Minister Lee Hsien Loong announced that the authorities will “no longer discourage people from wearing masks”.
Mr Lee in a televised address on 3 Apr said that the Government’s reason for advising the general public to only wear such masks if they are unwell was based on “scientific advice and guidelines” from WHO.
Additionally, there were no instances of community spread of COVID-19 in Singapore initially, he noted.
“It was very unlikely for you to run into anyone with COVID-19 on the street, much less be infected by them,” said Mr Lee.
“Nevertheless, the Government gave each household four surgical masks, to use in case you got sick, and to give people peace of mind,” he added.
Presently, however, Mr Lee said that the Government is concerned about “some cases out there community going undetected” even if there are few of them.
“We also now have evidence that an infected person can show no symptoms, and yet still pass on the virus to others,” he said, adding: “This is why the WHO is reviewing the issue of face masks, and so is the US CDC.”
“Therefore we will no longer discourage people from wearing masks,” said Mr Lee.

New “circuit-breaker” measures cast light upon certain “cracks” in S’pore’s approach toward COVID-19 crisis, experts opine

Separately, Mr Lee said that containing the spread of COVID-19 in Singapore has been “a very difficult fight”.
While the early measures taken by the Government have helped “to keep the number of cases down”, Mr Lee told CNN in a recent interview that he is “under no illusions that we have won”.
“We are just going in, and there is a long battle ahead,” he told Fareed Zakaria on 29 Mar.
In explaining why Singapore has decided to implement “circuit-breaker” measures as part of the country’s “substantially tighter safe distancing measures”, Mr Lee in his Facebook post today said: “Despite all our efforts, our case numbers continue to rise.”
The temporary closure of most workplaces—except those providing essential services or are part of key economic sectors—as well as schools and other learning institutions, in addition to other heightened social distancing measures, make up part of the circuit-breaker.
Parliament has even passed a Bill this week that will grant the Health Minister and the relevant authorities powers to legally enforce the necessary measures—including subjecting errant individuals or entities to a fine or jail term.
While Singapore’s initial response garnered praises from WHO, the Government’s decision to introduce “circuit-breaker” measures on Tue (7 Apr) has cast light upon certain “cracks” in the city-state’s approach in curbing the spread of the deadly virus in the country, as observed by experts who recently spoke to Asia Times.
Phil Robertson, deputy Asia director at Human Rights Watch, told the Hong Kong-based English language news portal that the “cramped, increasingly unhygienic dormitories” in which migrant workers in Singapore are housed “is a tinderbox for COVID-19 infection”.
Concurring with critics who posit that the ramped-up measures risk exposing healthy individuals to a higher chance of infection, he stressed that the Singaporean authorities “can’t just wall it off behind a quarantine line”.
“Since medical research shows that as many as a quarter of COVID-19 cases are asymptomatic, Singapore’s Ministry of Health needs to quickly and thoroughly test workers to determine everyone who is positive, move them out of that population, and give them the health care they require,” Mr Robertson said.
Failing to do so, he warned, may lead to “a potentially deadly crisis on its hands affecting some of the most vulnerable people in the country”.
Walter Theseira, associate professor at the Singapore University of Social Sciences (SUSS), told Asia Times that Singapore’s circuit-breaker measures—part of which is the strict regulation of personal movement—could be carried out in phases.
“The most obvious next set of tightening measures would be to regulate personal movement. However, the logistics of such an exercise would be very significant and would certainly require active enforcement by the police and possibly even the military in a supporting role,” he said.
“Like other countries who have taken that step, it is an entirely plausible escalation of measures, but I do not think the government would take that step without evidence that there continues to be substantial uncontrolled, untraceable transmission,” Professor Theseira added.

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