In a Q&A session of the Workers’ Party (WP) Youth Wing’s webinar on Saturday (26 April), Dr Leong Hoe Nam – an infectious disease specialist at Mount Elizabeth Novena Hospital in Singapore – highlighted the importance of contact tracing in controlling the spread of the coronavirus, adding that social distancing was ranked more effective than wearing a mask.
On Saturday, WP Youth Wing organised a Livestream webinar on Facebook featuring panelists: public health expert Dr Jeremy Lim, Dr Leong Hoe Nam, lawyer Harpreet Singh, and economist Yeoh Lam Keong.
During the webinar’s Q&A session, one audience raised the question of whether Singapore should adopt the “herd immunity” strategy in combating the COVID-19 outbreak.
In response, Dr Leong said, “No, herd immunity doesn’t play out because in order for that to happen, 60% to 80% of the people will need to be infected with the virus. We cannot afford this to happen.”
The COVID-19 vaccine can only be ready after 12 months
When asked about Singapore’s progress in dealing with the virus, Dr Leong predicted that the country will come out of the COVID-19 crisis in late May or June. As for the vaccine of the virus, Dr Leong hinted that the earliest for the vaccine to be ready is after 12 months.
“I know the Oxford Vaccine Group is trying to pre-make one vaccine with one million doses ready in September,” he stated.
However, Dr Leong stressed that the vaccine must go through the whole process of testing before being released to the public, as it is important to ensure that the vaccine is safe to be used.
“There are many vaccines and drugs that are being tested, which works well on a petri dish but when it comes to human beings testing, it ended up with more complications and side effects. We cannot recommend a vaccine that will harm, we need to make sure that it works,” said Dr Leong.
Nevertheless, he noted that the whole medical profession is improving as many doctors are exchanging information from different countries.
Dr Leong suggests using entry PCR for Singaporeans who returned from overseas
Dr Leong said that trade links will start first when some countries have eliminated their infected cases down to zero or less than five, while the air traffic will come later.
On that note, he suggested to use the entry PCR (Polymerase Chain Reaction) for those who wish to enter Singapore prior to undergoing 14 days of self-quarantine. This is to prove that they are tested negative for the coronavirus 14 days later.
“I’d like them to have entry PCR, which means when the moment they come in Singapore, they will stay in a dedicated place at their own cost to make sure that they are negative and 14 days later they have a negative PCR to show that they are safe. That’s the only way to protect Singapore,” he remarked.
The use of digital contact tracing in controlling the spread of COVID-19
He pointed out that digital contact tracing has been widely used in Taiwan and South Korea to track their citizens via mobile phone. When there is no movement being recorded in the application, the authorities would immediately call the person for checking, said Dr Leong.
Despite the higher chances to control the virus transmission via contact tracing, Dr Leong asserted that it is important to consider the person’s rights and ensure that “one is not overpowering the other”.
“The less individual rights there are, the greater and faster you can control this epidemic. But I think we must have a balance and it wasn’t the one overpowering the other,” he noted.
Following that, the moderator of the webinar, Leon Perera, asked Dr Leong whether the use of contact tracing is critical to control the transmission of the virus.
Dr Leong answered, “Yes it is, if you want to control an epidemic you must be able to track almost 80% of the contacts before you can actually control the epidemic effectively.”
“When the returnees from overseas came back to Singapore, there were a lot of them. We trusted too much that they will stay in a house, but in fact, many of them were going out,” he added.
In order for the 14-day quarantine to work effectively, the officials should track the person’s movement and identify who the person has come in contact with before being diagnosed with the disease. Dr Leong stated that the person may not be able to remember who they have met in the last five to 10 days, adding that only with the use of technology the person will be able to keep track of that.
“The virus is mutating fast, but are we working fast enough?” he said.
Public health expert Dr Jeremy Lim also pointed out that the country could have done better in tracking the cases.
“About what we could have done better, I think we probably should have searched even faster than what we did after seeing the responses in other countries. Perhaps a lot of these expo types facilities ought to have been prepared even when we have 50 or hundred cases per day, because we were probably too confident that our contact tracing and other efforts would be sufficient to flatten the curve,” Dr Jeremy noted.
Social distancing was ranked more effective than wearing a mask, according to evidence
Meanwhile, one audience brought up about the mask issue and the lesson that the country should learn from the outbreak. In response to that, Dr Leong relayed about the Severe Acute Respiratory Syndrome (SARS) experience in 2003 which prompted the Government to start stockpiling equipment for medical staff.
“If you think about it, these equipments have been stockpiled from 2004 to 2020, that’s 16 years of stockpiling and then these things are actually decaying with expiry dates,” he said, adding that the country now realised that the COVID-19 is more transmissible than SARS.
In terms of the mask issue, Dr Leong noted that the doctors’ decision was based on the best evidence which indicated social distancing as the first level evidence that proved to be effective. The second level is washing hands regularly, and the third level – which is the lowest – is wearing a mask.
“Masks, scientifically in a large setting, actually work very well and this is why our healthcare workers are protected because we know how to use it and we use it properly,” he explained. “But if you give it to common people, a layperson who doesn’t wear it properly, you are effectively losing masks.”
Dr Jeremy Lim also agreed with Dr Leong’s remark, and indicated that social distancing is far more important than wearing a mask.