Will all migrant workers be individually tested for COVID-19 before a dormitory is “cleared”?

Recently, two separate cases surfaced of migrant workers in Toh Guan Dormitory being informed that they have tested positive for COVID-19 but were not immediately placed in isolation. In fact, in both cases, the workers were told by dorm operators to stay in their rooms with their other potentially still uninfected roommates, thus exposing them to the deadly virus.

In the first case, an employer named Tsjin Dolly Chandra revealed in a Facebook post on Wednesday (15 July) that one of her migrant workers, who was recently tested positive for COVID-19, was not immediately transferred to an isolation area following the results confirmation from the Ministry of Health (MOH). Rather, the infected worker was placed in the same room as the other healthy 11 workers by the dormitory operator.

Ms Tsjin noted that the swab test was done for her worker on 22 June and she received an SMS from MOH on 13 July at 8.30 am stating that the worker has been tested positive for the coronavirus. MOH added in the SMS that the worker should “immediately” inform the dorm operator about this. However, Ms Tsjin noted that the dorm operator said that they cannot do anything about it and advised the other healthy workers in the room to put on their masks.

She also revealed that communication with the MOH was mostly unhelpful as she was shuffled around to different departments. After two days, the workers still hadn’t been isolated. This is why she eventually decided to go public with the story.

On top of that, Ms Tsjin also told TOC that security at the dormitory still required the infected worker to go “up and down to their office to see him”, revealing that the he has been moving around despite being infected with the highly contagious virus.

When asked on how the other healthy workers in the room are feeling, Ms Tsjin said to TOC that, “They are living in fear and worried. Even the infected worker (is) also worried that he might spread (the virus) to his mates”.

Just yesterday, the Ministry of Health (MOH) and Ministry of Manpower (MOM) issued a joint statement apologising for taking almost three weeks to inform the worker that he had been tested positive for COVID-19, chalking up the mistake to “administrative error”.

However, the delay in isolating him after he was informed of his condition was not specifically addressed in the statement. Instead, the ministries just said that the dormitory has been under isolation since 6 April and given the high rate of incidence in the dorms, it is likely that all 11 other roommates were also infected.

The ministries added that the worker has since recovered from the virus while seven of his roommates have also recovered from old infections. Three were transferred to a community care facility after being recently infected while one remains uninfected and is serving out a final isolation period at a government quarantine facility.

In the second case, an employer named Jianxiong James also took to Facebook to reveal an incident in which two of his workers were sent to back to their rooms in Toh Guan Dormitory—the same dorm as the previous case—after being tested positive for COVID-19, instead of being moved to an isolation facility.

In his post on Tuesday (21 July), the business owner explained that on 15 July, two of his six workers were asked to go for a swab test, and they both got a SMS from the Ministry of Health (MOH) the very next confirming that they have contracted the deadly virus.

“Both workers head down to the security to report and was asked to go back to their room,” Mr James said.

He added, “I called MOH hotline of 17/07/20 regarding this matter. They were shocked and apologise on the Ministry behalf. They asked for my worker’s name and address and where they have been.”

It was only three days later on 18 July were the workers finally transferred to an isolation facility. However, since they were still asked to stay in their rooms before that, one of their roommates started showing symptoms and will be taken to an isolation facility.

Will all workers be individually tested?

Now, the question these cases raise is on testing. Workers in both cases were randomly selected for survey testing, which is done by the authorities on a sample of workers across the dormitory to assess the extent of the spread of the virus and to develop an appropriate strategy for clearing the dorm, according to the earlier joint statement by MOH and MOM.

The thing is, in both cases the workers’ results came back positive but they were sent back to stay in their rooms with other potentially uninfected workers—in one case for nearly three weeks—because there were no more isolation rooms available within the dorms.

In the first case, based on the MOH and MOM joint statement, three of the roommates were recovering from newer infections. In fact, in that room of 12 workers, all but one eventually tested positive for the virus.

In the second case, the employer noted that one other roommate became infected after the first two were asked to stay in their dorms despite being tested positive for the virus.

Given that we know COVID-19 is highly contagious, it is safe to assume that isolated areas such as dorms are infected at this point given how the cases are are handled.

The question now is: are workers who have recovered from infections without exhibiting symptoms included in the recorded numbers of infected cases?

At the time of writing, Singapore has recorded a total of 48,434 COVID-19, where 45,647 of those are migrant workers living in dormitories.

If it weren’t for complaints made by employers on social media which prompted the MOH and MOM to release a statement, the public, employers and workers themselves would not have known that three of  the recently infected workers in the first case has recovered from the infection—something the authorities found only after testing them following the mix-up, indicating that they probably were not showing any symptoms.

This begs the questions: were these workers who recovered from the infection without exhibiting symptoms going to be individually tested before the dorm is declared ‘cleared’? Or simply put, will all the workers be tested at the end of the day before dorms are cleared?

Early in the pandemic, chair of infection control at the National University Hospital Professor Dale Fisher shared that the infection rates in certain dorms are so high that it was assumed all sick workers were infected with COVID-19. Therefore, they were being isolated immediately without testing.

“The numbers are not really coming down. It’s a function of the tests. In some of the dormitories, the infection rate or the positivity rate of the tests is so high, you get to the point where you don’t need to test anymore,” he said.

Dr Leong Hoe Nam, an infectious diseases expert from Mount Elizabeth Novena Hospital agreed with Prof Fisher’s assessment, noting that this strategy will “save lives and save resources” but would also artificially suppress numbers.

These migrant workers in dormitories have been isolated for over three months now since April. They aren’t allowed to freely move in and out of the dorms and are required to stay in their rooms at all times except to collect food and for some staggered recreation time. It’s no different from being imprisoned.

In an earlier report, TOC noted how Singapore appears to be conducted far fewer tests per confirmed COVID-19 case compared to other countries. According to data collated by statistics site Our World in Data, Singapore has conducted an average of 7.6 tests for each confirmed case since the COVID-19 outbreak started, which is below the World Health Organisation’s recommendation of between 10 to 30. This is compared to 18 test in Japan, 84.9 in South Korea, and 250.4 tests in New Zealand.

Even so, the multi-ministry task force has repeatedly said that the country’s  high number of positive cases is due to extensive testing. On 19 May, the Ministry of Health’s director of medical services Associate Professor Kenneth Mak said in a briefing that over 281,000 COVID-19 tests have been conducted to day on 191,000 unique individuals. That’s about 49,000 tests per million people being carried out in Singapore, he noted.

So since Singapore has increased its testing capacity, will all these migrant workers in dormitories be tested individually? Or is the government afraid to find out the actual number of COVID-19 cases in the country?

Some of the dorms that have been gazetted as isolation areas include the S11 Dormitory @ Punggol (13,000 men), Westlite Toh Guan (6,800 men), Toh Guan Dormitory (4,500 men) and Sungei Tengah Lodge (capacity of up to 25,000 men). And these are just a few out of the more than 20 that have been gazetted.

If we were to consider that all or most the workers in all the isolated dorms have been infected by COVID-19, how high would the total number of cases jump in Singapore?

TOC has written in to MOH and MOM on 21 July to enquire if all workers will be tested and will include their response when they reply.

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