It is not practical for Singapore to stick with its circuit breaker phase for a long time to prevent the spread of COVID-19, and the country has to deal with the virus being present here for some time until a vaccine is discovered, said National Centre for Infectious Diseases (NCID) executive director Leo Yee Sin.
Till the vaccine is found, Singapore can try to reduce the impact of the virus by coming up with a solid plan, Professor Leo said on Thursday (14 May) while speaking at the sixth edition of the COVID-19: Updates from Singapore webinar series.
“We are hoping to be able to suppress the transmission (of the virus), but I do not think we can attain complete elimination,” she said.
The webinar was co-organised by the World Health Organization’s (WHO) Global Outbreak Alert and Response Network, the National University of Singapore’s Yong Loo Lin School of Medicine and the National University Health System.
Just a day before Prof Leo spoke at the webinar, WHO revealed that the coronavirus “may never go away”, implying it is here to stay in our communities.
Seeing how various countries have begun to ease the lockdown restrictions that were meant to curb the spread of the deadly virus, the WHO warned that it would not be able for the virus to be wiped out entirely.
“This virus may become just another endemic virus in our communities, and this virus may never go away. We have a new virus entering the human population for the first time and therefore it is very hard to predict when we will prevail over it,” said WHO’s emergencies director Michael Ryan at a press conference in Geneva.
On the local front, Prof Leo explained that having an expert healthcare system could help to bring the mortality and morbidity rate down.
Revealing information from WHO, she added that completely interrupting human-to-human transmissions “is not very attainable at this point”, due to the characteristics of the virus.
“It is very likely that we will have recurring epidemic waves interspersed with periods of low-level transmissions,” Prof Leo stressed.
She added, “In other words, we need to have the ability and capacity to be able to cope with intermittent surges (in infections).”
When this happens, Singapore must be equipped with sufficient healthcare facilities to take in new cases as they come. This includes having enough personal protective equipment (PPE) as well as well-trained healthcare workers all set to provide patients with optimal care, Prof Leo noted.
Apart from this, active case findings and contract tracing must also go on, and the Republic require a “rapid response team” to deal with any possible epidemic waves in the future.
“We are all waiting for more good news for effective pharmaceutical interventions… and of course, we are all waiting for that one day we have effective vaccines available,” said Prof Leo.
Infections among healthcare workers
While speaking at the webinar, Prof Leo also highlighted on concerns about frontline healthcare workers getting infected with the highly contagious COVID-19.
She explained that at the moment it is difficult to point out if the infections happened within a healthcare facility or in the community.
“If you look at the current data, a majority of them acquired the infections within the community rather than having clear-cut evidence that they acquired the disease in the hospital,” said Prof Leo.
She added that the virus is mainly transmitted during the pre-symptomatic and early phase of clinical illness.
“Clinical illness tends to be very mild at the onset, and many people do not worry. They are still moving around and going through their daily activities,” she noted.
She continued, “So the infection is actually out there in the community, rather than concentrated in the nosocomial (hospital-acquired) setting.”
This basically means that healthcare workers cannot solely rely on wearing PPE when they attend to patients in order to protect themselves, Prof Leo said.
As a matter of fact, they have to now take all the necessary precautions when interacting with co-workers, like maintaining a safe distance and wearing a mask.
“The disease not only transmits from patients to healthcare workers; it can be (a result of) just social interactions among the healthcare workers and among staff.”
COVID-19 is a hard virus to curb
Prof Leo, who also handled other epidemics like Severe Acute Respiratory Syndrome (SARS) in 2003, agreed that it was one of the “hardest viruses” she has tackled.
“I must say that no outbreaks are exactly the same they are different viruses, different characteristics,” she said.
She added, “We thought that we would not be challenged by a virus of this nature. This virus is really one of the, I would say, so far, one of the hardest virus I can see, in terms of how this virus can easily move around the human population … Just be ready that it will be with us for a long time.”
She also went on to state that this is a “very stressful period” for the healthcare sector in Singapore.
“At NCID, we were provided with a small surge team, but honestly it’s grossly inadequate. So then we have to look at our partnering institutions, Tan Tock Seng Hospital just across the road, to give us the manpower enhancement, and soon very quickly, we realised it wasn’t enough,” she expressed.
She added that the entire country is now part of the battle to fight against this deadly disease.
“This is what we call whole of Government approach, where it is no longer just restricted to the healthcare sector, it is the whole of Government being activated with almost every ministry being involved in the entire fight against COVID-19.”