Dr Jeremy Lim on dorms cluster: S'pore "did all the right things" with imported cases, community transmission but underestimated "velocity" of COVID-19

While Singapore had initially done “very well” in managing its imported cases and community transmission, it may have — in the words of former diplomat Bilahari Kausikan — “dropped the ball”, said Dr Jeremy Lim, medical doctor and co-founder of AMiLi, the region’s first microbiome bank and sequencing service.
Dr Lim was one of the panellists in a webinar titled “The COVID-19 Crisis: Through Medical, Economic and Legal Lenses”.
The webinar was held by the Workers’ Party’s Youth Wing last Sunday (26 April) via video conferencing app Zoom.
Classifying the Government’s approach in fighting COVID-19 in a battleground divided into three fronts — namely imported cases, community spread and the migrant worker dormitories clusters — Dr Lim said that Singapore “has been doing very well in the first two fronts”.
Singapore, he said, has done “all the right things” with curbing imported cases through “very aggressive testing, large and complex contact tracing, and marrying public health intervention with economic or financial assurance”.
The move, he said, has ensured that “Chinese tourists would be more forthcoming, knowing that their financials would be taken care of in terms of testing and treatment”.
Dr Lim, a board member of non-governmental organisation HealthServe — which provides affordable medical care and social assistance to migrant workers — said that the current situation at the migrant worker dormitories, however, may have been a “cognitive blindspot” on the Government’s part.
“I would not say that the Government overlooked vulnerabilities when it comes to the foreign worker dorms, but it underestimated the velocity and the severity of COVID-19 racing like wildfire,” said the former Ministry of Health senior consultant.
The Government, noted Dr Lim, had focused on Singaporeans, and instead “issued directives and guidance” to dorm operators and employers without setting “realistic expectations” as to how much they could do in terms of social distancing at the dorms.
Highlighting the astronomical rise of confirmed cases of COVID-19 presently from the fewer than 1,000 cases recorded on 1 April, Dr Lim cautioned that “the numbers will be[come] harder and harder to interpret”, as the definition of what a COVID-19 positive case is changing due to constraints in testing.
“There is a limit to how much complexity and how much sophistication a system can take before we are overwhelmed by this complexity … and that has been the major challenge when it comes to the dormitories,” he said. “Let us have accountability after the crisis and offer constructive feedback at this point”.

Govt’s purported vulnerability in COVID-19 crisis to date “opens up the opportunities” for increased participation from private sectors and NGOs in managing outbreak: Dr Jeremy Lim

Dr Lim, who is also the co-director of LIGHT, the global health institute for the NUS School of Public Health, said that the Government’s broad strategy has been “trying to balance keeping the economy and society functioning as normal as possible while driving public health and various preventative medicine interventions”.
Singapore, he said, has been “progressively ramping up healthcare capabilities” and “freeing up bed in public hospitals” and “developing facilities” in places such as Singapore Expo and Changi Exhibition Centre.
Touching on the situation at the migrant worker dormitories again, Dr Lim said that the Government is currently doing “everything possible” to manage what appears to be Singapore’s “largest humanitarian and public health crisis” to date.
“The Government is making up its playbook as we go along,” he said.
Dr Lim added that he has “never seen the Government looking so vulnerable”.
“But that’s actually a good thing, because it opens up the opportunities for private sectors and NGOs to be much more participating in the overall dynamic,” he said.
While Dr Lim is confident that Singapore will survive the COVID-19 crisis, subsequent waves of infection seem inevitable due to the Republic’s “porosity as a global transport hub”.
“At some point, even if we manage the community spread, even if we manage the [migrant] worker dormitories, there will be imported cases,” he warned.

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April 2020