COVID-19 outbreak will continue for a year or longer; more stringent measures may need to be put in place, says PM Lee in his second national address on the situation
Situation under control and DORSCON level not being raised to red, he says
By Linette Lai, Political Correspondent, The Straits Times, 13 Mar 2020
The COVID-19 outbreak will continue for some time - a year, and maybe longer - and more stringent measures may be needed as more imported cases are expected, said Prime Minister Lee Hsien Loong in his second national address on the situation yesterday.
But if Singaporeans keep their guard up and take practical precautions, the country will be able to keep its economy going and people will be able to carry on with their daily lives, he said.
In a video address on his social media channels, PM Lee emphasised that the situation in Singapore remains under control.
The disease outbreak response level will not be stepped up to red, the highest level, he said. It is currently at orange.
"We are not locking down our city like the Chinese, South Koreans or Italians have done," he said.
"What we are doing now is to plan ahead for some of these more stringent measures, try them out, and prepare Singaporeans for when we actually need to implement them."
His statement, which he also delivered in Mandarin and Malay, comes on the heels of the World Health Organisation declaring the outbreak a pandemic.
It follows his first address on Feb 8 where, among other things, he said Singapore may have to reconsider its strategy if the virus became widespread.
Yesterday, PM Lee said he wanted to share what the country could expect down the road in terms of the medical, economic and psychological aspects of the pandemic.
On the medical front, while Singapore has taken the outbreak with the "utmost seriousness", it expects more imported cases.
"We have already imposed some travel restrictions, for example, for China, Iran, South Korea, Italy. We will have to tighten up further temporarily, though we cannot completely shut ourselves off from the world," he said.
There are also baseline factors that all Singaporeans must get used to, such as practising good personal hygiene, adopting new social norms, discouraging large gatherings and maintaining some physical distance from one another.
More could be done in other areas like at religious gatherings, which have seen outbreaks of COVID-19.
"The issue is, of course, not religion itself, but that the virus can spread quickly to many people in crowded settings, like religious gatherings and services," he said, adding that he hopes Singaporeans understand that during this period, religious services may need to be shortened and attendance reduced.
He also said that if there are very large numbers with the coronavirus, Singapore will not be able to hospitalise and isolate every case as it currently does. Also, 80 per cent of patients get only mild symptoms.
"The sensible thing will be to hospitalise only the more serious cases, and encourage those with mild symptoms to see their family GP and rest at home - isolate themselves," he said.
This will focus resources on the seriously ill, speed up response time and hopefully minimise the number of fatalities.
In the meantime, Singapore is freeing up intensive care units and hospital beds and facilities to create additional capacity to meet any surge.
"But rest assured, any Singaporean who needs urgent medical care, whether for COVID-19 or other illnesses, will be taken care of."
A spike in cases will also mean Singapore will have to implement temporary additional social distancing measures, such as suspending school, staggering work hours or compulsory telecommuting.
On the economic front, the Government is working on a second package of measures to help companies.
PM Lee also noted that Singapore's response has received international accolades and underlying this is the people's social and psychological resilience.
"What makes Singapore different from other countries is that we have confidence in each other, we feel that we are all in this together, and we do not leave anyone behind. This is SG United, we are SG United."
Situation under control and DORSCON level not being raised to red, he says
By Linette Lai, Political Correspondent, The Straits Times, 13 Mar 2020
But if Singaporeans keep their guard up and take practical precautions, the country will be able to keep its economy going and people will be able to carry on with their daily lives, he said.
In a video address on his social media channels, PM Lee emphasised that the situation in Singapore remains under control.
The disease outbreak response level will not be stepped up to red, the highest level, he said. It is currently at orange.
"We are not locking down our city like the Chinese, South Koreans or Italians have done," he said.
"What we are doing now is to plan ahead for some of these more stringent measures, try them out, and prepare Singaporeans for when we actually need to implement them."
His statement, which he also delivered in Mandarin and Malay, comes on the heels of the World Health Organisation declaring the outbreak a pandemic.
It follows his first address on Feb 8 where, among other things, he said Singapore may have to reconsider its strategy if the virus became widespread.
Yesterday, PM Lee said he wanted to share what the country could expect down the road in terms of the medical, economic and psychological aspects of the pandemic.
On the medical front, while Singapore has taken the outbreak with the "utmost seriousness", it expects more imported cases.
"We have already imposed some travel restrictions, for example, for China, Iran, South Korea, Italy. We will have to tighten up further temporarily, though we cannot completely shut ourselves off from the world," he said.
There are also baseline factors that all Singaporeans must get used to, such as practising good personal hygiene, adopting new social norms, discouraging large gatherings and maintaining some physical distance from one another.
More could be done in other areas like at religious gatherings, which have seen outbreaks of COVID-19.
"The issue is, of course, not religion itself, but that the virus can spread quickly to many people in crowded settings, like religious gatherings and services," he said, adding that he hopes Singaporeans understand that during this period, religious services may need to be shortened and attendance reduced.
He also said that if there are very large numbers with the coronavirus, Singapore will not be able to hospitalise and isolate every case as it currently does. Also, 80 per cent of patients get only mild symptoms.
"The sensible thing will be to hospitalise only the more serious cases, and encourage those with mild symptoms to see their family GP and rest at home - isolate themselves," he said.
This will focus resources on the seriously ill, speed up response time and hopefully minimise the number of fatalities.
In the meantime, Singapore is freeing up intensive care units and hospital beds and facilities to create additional capacity to meet any surge.
"But rest assured, any Singaporean who needs urgent medical care, whether for COVID-19 or other illnesses, will be taken care of."
A spike in cases will also mean Singapore will have to implement temporary additional social distancing measures, such as suspending school, staggering work hours or compulsory telecommuting.
On the economic front, the Government is working on a second package of measures to help companies.
PM Lee also noted that Singapore's response has received international accolades and underlying this is the people's social and psychological resilience.
"What makes Singapore different from other countries is that we have confidence in each other, we feel that we are all in this together, and we do not leave anyone behind. This is SG United, we are SG United."
What PM Lee said
OUTBREAK WILL LAST FOR SOME TIME
WHO assesses that many countries will see full-blown outbreaks, with sustained community transmission, like what has happened in South Korea and Italy. And unlike Sars, this outbreak will continue for some time - a year, and maybe longer.
FOCUSING RESOURCES
With larger numbers, the sensible thing will be to hospitalise only the more serious cases, and encourage those with mild symptoms to see their family GP and rest at home - isolate themselves. This way, we focus resources on the seriously ill, speed up our response time, and hopefully minimise the number of fatalities.
SITUATION UNDER CONTROL
Let me emphasise this: The situation in Singapore remains under control. We are not going to Dorscon red. We are not locking down our city like the Chinese, South Koreans or Italians have done.
PRIME MINISTER LEE HSIEN LOONG, in remarks in English.
TEST OF JUDGMENT
The COVID-19 situation is a test of our judgment. In this age of information explosion, we have to learn to discern whether the latest news is true or not. There is a great deal of information online about COVID-19. Some can be taken seriously while others are baseless. Some events that took place elsewhere may not necessarily happen here. Even if the same situation happened in Singapore, the outcome might not necessarily be the same, as the circumstances in each country are rather different.
PM LEE, in remarks in Mandarin.
BE PREPARED PSYCHOLOGICALLY
As we continue with our existing measures which are effective, we must also be prepared psychologically if the situation should worsen drastically. To protect ourselves, we must prepare ourselves with measures for the middle and long term. Just look at Italy - with only three cases last week. But today, more than 7,000 cases.
We should be vigilant before attending any gathering, including religious ones. We already have two cases involving participants of a large 'tabligh' gathering in Kuala Lumpur recently. At this crucial time, I hope you understand and support the practical measures to reduce the number of congregants or shorten the length of sermons to protect the safety of congregants.
PM LEE, in remarks in Malay.
OUTBREAK WILL LAST FOR SOME TIME
WHO assesses that many countries will see full-blown outbreaks, with sustained community transmission, like what has happened in South Korea and Italy. And unlike Sars, this outbreak will continue for some time - a year, and maybe longer.
FOCUSING RESOURCES
With larger numbers, the sensible thing will be to hospitalise only the more serious cases, and encourage those with mild symptoms to see their family GP and rest at home - isolate themselves. This way, we focus resources on the seriously ill, speed up our response time, and hopefully minimise the number of fatalities.
SITUATION UNDER CONTROL
Let me emphasise this: The situation in Singapore remains under control. We are not going to Dorscon red. We are not locking down our city like the Chinese, South Koreans or Italians have done.
PRIME MINISTER LEE HSIEN LOONG, in remarks in English.
TEST OF JUDGMENT
The COVID-19 situation is a test of our judgment. In this age of information explosion, we have to learn to discern whether the latest news is true or not. There is a great deal of information online about COVID-19. Some can be taken seriously while others are baseless. Some events that took place elsewhere may not necessarily happen here. Even if the same situation happened in Singapore, the outcome might not necessarily be the same, as the circumstances in each country are rather different.
PM LEE, in remarks in Mandarin.
BE PREPARED PSYCHOLOGICALLY
As we continue with our existing measures which are effective, we must also be prepared psychologically if the situation should worsen drastically. To protect ourselves, we must prepare ourselves with measures for the middle and long term. Just look at Italy - with only three cases last week. But today, more than 7,000 cases.
We should be vigilant before attending any gathering, including religious ones. We already have two cases involving participants of a large 'tabligh' gathering in Kuala Lumpur recently. At this crucial time, I hope you understand and support the practical measures to reduce the number of congregants or shorten the length of sermons to protect the safety of congregants.
PM LEE, in remarks in Malay.
COVID-19 situation is serious but under control in Singapore: PM Lee
In a broadcast message yesterday, Prime Minister Lee Hsien Loong gave an update on the outbreak and what steps need to be taken to protect Singaporeans, plan for a possible spike, and address the impact on the economy and society
The Straits Times, 13 Mar 2020
Five weeks ago, I spoke to you on our COVID-19 situation. Much has happened since then. So it is timely to update you again, and share with you what we can expect down the road. I will speak about three aspects of the issue: medical, economic and psychological.
MEDICAL OUTLOOK
On the medical front, we continue to see new cases in Singapore. Most either have travelled overseas, or can be traced to imported cases. Each time, we have been able to isolate them, do contact tracing, and quarantine the close contacts. So our numbers have not blown up. But neither have we been able to eradicate the virus, despite our best efforts.
At the same time, around us, the number of cases is rising rapidly. China's situation is stabilising, but new cases are emerging all over the world - in Europe, America and the Middle East. Globally, the number of cases is doubling every five to seven days. Hence today, the World Health Organisation (WHO) declared COVID-19 to be a pandemic.
What does this mean? It means that WHO assesses that many countries will see full-blown outbreaks, with sustained community transmission, like what has happened in South Korea and Italy. And unlike Sars (severe acute respiratory syndrome), this outbreak will continue for some time - a year, and maybe longer.
The WHO named one key reason for the rapid spread: Many countries had not taken the situation seriously enough - what the WHO called "alarming levels of inaction". Here in Singapore, we have all along taken COVID-19 with the utmost seriousness. In fact, the WHO praised our efforts and held Singapore up as an example to emulate.
But we too face a serious situation. We expect more imported cases, and therefore new clusters and new waves of infection, this time coming from many countries rather than one or two. We have already imposed some travel restrictions, for example, for China, Iran, South Korea, Italy. We will have to tighten up further temporarily, though we cannot completely shut ourselves off from the world.
What else must we do? First, because COVID-19 will be with us for a long time, there are baseline things that we must get used to, like practising good personal hygiene, adopting new social norms and discouraging large gatherings, and generally, maintaining some physical distance from one another. That is why we already scaled down community activities, especially for the seniors.
And we can do more in other areas. For example, at religious gatherings. In South Korea, the cases spread through the Shincheonji church group. In Singapore, two of our big clusters happened in church groups. And several Singaporeans who attended a big international religious gathering, a "tabligh" gathering, in Kuala Lumpur recently have caught the virus. The issue is of course not religion itself, but that the virus can spread quickly to many people in crowded settings, like religious gatherings and services. That is why Saudi Arabia temporarily stopped umrah pilgrimages; and the Pope live-streamed his sermons to avoid crowds on St Peter's Square. I hope Singaporeans understand that during this period we may need to shorten religious services, or reduce our attendance at such gatherings. Please work with your religious leaders to make these practical adjustments.
Second, we need to plan for a possible spike in COVID-19 cases. With very large numbers, if it happens, we will not be able to hospitalise and isolate every case like we do now. But we now know that the majority of patients, in fact 80 per cent of them, only experience mild symptoms. The ones who are most at risk are the elderly, and those with pre-existing conditions like high blood pressure or lung problems. So with larger numbers, the sensible thing will be to hospitalise only the more serious cases, and encourage those with mild symptoms to see their family GP and rest at home - isolate themselves. This way, we focus resources on the seriously ill, speed up our response time, and hopefully minimise the number of fatalities.
In the meantime, we are freeing up ICU and hospital beds and facilities, to create additional capacity to meet any surge in COVID-19 numbers. But rest assured, any Singaporean who needs urgent medical care, whether for COVID-19 or other illnesses, will be taken care of.
Besides medical plans, if there is a spike, we will also need additional social distancing measures. These will be temporary, like suspending school, staggering work hours, or compulsory telecommuting. They will be extra "brakes", to be implemented when we see a spike in cases. The extra brakes will slow down transmission of the virus, prevent our healthcare system from being overwhelmed, and help bring the numbers back down. After the situation improves, we can ease off and go back to the baseline precautions.
But let me emphasise this: The situation in Singapore remains under control. We are not going to Dorscon red. We are not locking down our city like the Chinese, South Koreans or Italians have done. What we are doing now is to plan ahead for some of these more stringent measures, try them out, and prepare Singaporeans for when we actually need to implement them.
ECONOMIC IMPACT
As we consider these next steps, one major concern we have is the impact on our economy.
Our economy is taking a big hit. That is why we did the $4 billion Support and Stabilisation Package in the Budget last month to help businesses, workers and households tide over the immediate period. This has helped. But with things still unfolding, we knew we might have to do more. The situation is especially serious for some sectors - hotels, aviation, hospitality, and freelancers in the gig economy. But nobody has been spared. Everyone feels the impact, to different degrees.
So the Government is working on a second package of measures. We will help our companies with their costs and cash flow, to keep them afloat through the storm. We will help our workers keep their jobs, and retrain during their downtime, so that when things return to normal, our workers will be the first out of the gate, and immediately productive. And we will give those who are retrenched and unemployed, as well as their families, an extra helping hand to see through this difficult period.
SOCIAL AND PSYCHOLOGICAL RESILIENCE
I am sharing these plans with you to reassure you that we are on top of things, and thinking ahead. We anticipated the medical and economic consequences. I am confident that we can deal with them.
But what is also critical is the psychological aspect of this fight. Our front-line staff are working extremely hard to keep Singapore going - healthcare workers, immigration officers, civil servants, public transport workers, taxi drivers, cleaning staff. Singaporeans are cheering them on. The Government, for its part, has been open and transparent with our plans. When we made direct appeals to Singaporeans - for example, only wear face masks when unwell; or not to worry about our supermarkets running out of food or household items - people accepted our reassurances, and behaviour changed. I am grateful that most Singaporeans are responding calmly and responsibly. Thank you for your trust and support.
Singapore's response has received international accolades. Underlying this is the social and psychological resilience of our people. What makes Singapore different from other countries is that we have confidence in each other, we feel that we are all in this together, and we do not leave anyone behind. This is SG United, we are SG United.
We will remain in this high-risk state, nevertheless, for some time to come. But if we keep up our guard, and take practical precautions to protect ourselves and our families, we will be able to keep our economy going, and carry on with our daily lives. In such a crisis, everyone has a part to play. I hope you will work with me and colleagues to keep our families safe, keep Singapore secure, and move forward together.
Thank you.
In a broadcast message yesterday, Prime Minister Lee Hsien Loong gave an update on the outbreak and what steps need to be taken to protect Singaporeans, plan for a possible spike, and address the impact on the economy and society
The Straits Times, 13 Mar 2020
Five weeks ago, I spoke to you on our COVID-19 situation. Much has happened since then. So it is timely to update you again, and share with you what we can expect down the road. I will speak about three aspects of the issue: medical, economic and psychological.
MEDICAL OUTLOOK
On the medical front, we continue to see new cases in Singapore. Most either have travelled overseas, or can be traced to imported cases. Each time, we have been able to isolate them, do contact tracing, and quarantine the close contacts. So our numbers have not blown up. But neither have we been able to eradicate the virus, despite our best efforts.
At the same time, around us, the number of cases is rising rapidly. China's situation is stabilising, but new cases are emerging all over the world - in Europe, America and the Middle East. Globally, the number of cases is doubling every five to seven days. Hence today, the World Health Organisation (WHO) declared COVID-19 to be a pandemic.
What does this mean? It means that WHO assesses that many countries will see full-blown outbreaks, with sustained community transmission, like what has happened in South Korea and Italy. And unlike Sars (severe acute respiratory syndrome), this outbreak will continue for some time - a year, and maybe longer.
The WHO named one key reason for the rapid spread: Many countries had not taken the situation seriously enough - what the WHO called "alarming levels of inaction". Here in Singapore, we have all along taken COVID-19 with the utmost seriousness. In fact, the WHO praised our efforts and held Singapore up as an example to emulate.
But we too face a serious situation. We expect more imported cases, and therefore new clusters and new waves of infection, this time coming from many countries rather than one or two. We have already imposed some travel restrictions, for example, for China, Iran, South Korea, Italy. We will have to tighten up further temporarily, though we cannot completely shut ourselves off from the world.
What else must we do? First, because COVID-19 will be with us for a long time, there are baseline things that we must get used to, like practising good personal hygiene, adopting new social norms and discouraging large gatherings, and generally, maintaining some physical distance from one another. That is why we already scaled down community activities, especially for the seniors.
And we can do more in other areas. For example, at religious gatherings. In South Korea, the cases spread through the Shincheonji church group. In Singapore, two of our big clusters happened in church groups. And several Singaporeans who attended a big international religious gathering, a "tabligh" gathering, in Kuala Lumpur recently have caught the virus. The issue is of course not religion itself, but that the virus can spread quickly to many people in crowded settings, like religious gatherings and services. That is why Saudi Arabia temporarily stopped umrah pilgrimages; and the Pope live-streamed his sermons to avoid crowds on St Peter's Square. I hope Singaporeans understand that during this period we may need to shorten religious services, or reduce our attendance at such gatherings. Please work with your religious leaders to make these practical adjustments.
Second, we need to plan for a possible spike in COVID-19 cases. With very large numbers, if it happens, we will not be able to hospitalise and isolate every case like we do now. But we now know that the majority of patients, in fact 80 per cent of them, only experience mild symptoms. The ones who are most at risk are the elderly, and those with pre-existing conditions like high blood pressure or lung problems. So with larger numbers, the sensible thing will be to hospitalise only the more serious cases, and encourage those with mild symptoms to see their family GP and rest at home - isolate themselves. This way, we focus resources on the seriously ill, speed up our response time, and hopefully minimise the number of fatalities.
In the meantime, we are freeing up ICU and hospital beds and facilities, to create additional capacity to meet any surge in COVID-19 numbers. But rest assured, any Singaporean who needs urgent medical care, whether for COVID-19 or other illnesses, will be taken care of.
Besides medical plans, if there is a spike, we will also need additional social distancing measures. These will be temporary, like suspending school, staggering work hours, or compulsory telecommuting. They will be extra "brakes", to be implemented when we see a spike in cases. The extra brakes will slow down transmission of the virus, prevent our healthcare system from being overwhelmed, and help bring the numbers back down. After the situation improves, we can ease off and go back to the baseline precautions.
But let me emphasise this: The situation in Singapore remains under control. We are not going to Dorscon red. We are not locking down our city like the Chinese, South Koreans or Italians have done. What we are doing now is to plan ahead for some of these more stringent measures, try them out, and prepare Singaporeans for when we actually need to implement them.
ECONOMIC IMPACT
As we consider these next steps, one major concern we have is the impact on our economy.
Our economy is taking a big hit. That is why we did the $4 billion Support and Stabilisation Package in the Budget last month to help businesses, workers and households tide over the immediate period. This has helped. But with things still unfolding, we knew we might have to do more. The situation is especially serious for some sectors - hotels, aviation, hospitality, and freelancers in the gig economy. But nobody has been spared. Everyone feels the impact, to different degrees.
So the Government is working on a second package of measures. We will help our companies with their costs and cash flow, to keep them afloat through the storm. We will help our workers keep their jobs, and retrain during their downtime, so that when things return to normal, our workers will be the first out of the gate, and immediately productive. And we will give those who are retrenched and unemployed, as well as their families, an extra helping hand to see through this difficult period.
SOCIAL AND PSYCHOLOGICAL RESILIENCE
I am sharing these plans with you to reassure you that we are on top of things, and thinking ahead. We anticipated the medical and economic consequences. I am confident that we can deal with them.
But what is also critical is the psychological aspect of this fight. Our front-line staff are working extremely hard to keep Singapore going - healthcare workers, immigration officers, civil servants, public transport workers, taxi drivers, cleaning staff. Singaporeans are cheering them on. The Government, for its part, has been open and transparent with our plans. When we made direct appeals to Singaporeans - for example, only wear face masks when unwell; or not to worry about our supermarkets running out of food or household items - people accepted our reassurances, and behaviour changed. I am grateful that most Singaporeans are responding calmly and responsibly. Thank you for your trust and support.
Singapore's response has received international accolades. Underlying this is the social and psychological resilience of our people. What makes Singapore different from other countries is that we have confidence in each other, we feel that we are all in this together, and we do not leave anyone behind. This is SG United, we are SG United.
We will remain in this high-risk state, nevertheless, for some time to come. But if we keep up our guard, and take practical precautions to protect ourselves and our families, we will be able to keep our economy going, and carry on with our daily lives. In such a crisis, everyone has a part to play. I hope you will work with me and colleagues to keep our families safe, keep Singapore secure, and move forward together.
Thank you.
WHO declares COVID-19 outbreak a pandemic on 11 March 2020
The Straits Times, 12 Mar 2020
The World Health Organisation (WHO) yesterday declared the coronavirus outbreak a pandemic, citing the alarming levels of spread around the world.
"We are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction. We have, therefore, made the assessment that COVID-19 can be characterised as a pandemic," said WHO director-general Tedros Adhanom Ghebreyesus at a news conference, adding that the organisation was not using the word lightly.
There are now over 120,000 cases in 114 countries.
In Singapore yesterday, 12 new COVID-19 cases were confirmed, including eight people who are believed to have caught the disease outside the Republic.
Of the four locally transmitted cases, one is linked to the private dinner at SAFRA Jurong; another, a staff nurse at Ng Teng Fong General Hospital, is linked to an imported case from the Philippines; while contact tracing is ongoing for the other two.
The latest update brings the number of cases here to 178. Three more patients were discharged.
How flattening the epidemic curve will buy time and keep outbreak in check
Steps countries are taking to buy time to help fight the virus
By Lester Wong and Audrey Tan, Science and Environment Correspondent, The Straits Times, 13 Mar 2020
As coronavirus infections rise, many people who keep track of this say there is a curve that needs flattening.
The epidemic curve is used to visualise the extent and speed of new cases during a virus outbreak.
This n-shaped curve presents the stark reality of how quickly a virus can spread if unchecked.
As the number of patients diagnosed with Covid-19 continues to rise with the World Health Organisation declaring the outbreak a pandemic, so does the risk of healthcare systems in various countries being overwhelmed by the demands being placed on them.
But not all those diagnosed with the respiratory disease have severe symptoms.
To ensure that hospital and healthcare resources focus on the group of people who need them the most - usually the elderly and those with underlying medical conditions - experts have urged low-risk coronavirus patients to self-isolate instead of overwhelming hospitals if infected.
Currently, all Covid-19 patients in Singapore are kept in hospitals for long periods to ensure they are free of the virus before being discharged. But should there be a spike in the number of new cases reported, the Republic might have to reconsider how it treats those infected.
WHAT DOES THE EPIDEMIC CURVE SHOW?
The number of infections in a viral outbreak tends to follow a particular pattern over time, and this is the picture painted by the epidemic curve.
As The Washington Post reported, a key goal of public health officials is to avoid a huge peak in Covid-19 cases (a curve with a steep incline, spread over a shorter period of time) in favour of a slower growth that becomes a moderate plateau (a curve with a gentler incline, spread out over a longer time period).
WHAT ARE THE THREE PHASES?
Phase one: At this stage, infected patients are mostly imported, said microbiologist Siouxsie Wiles, an associate professor at the University of Auckland, in an opinion piece on New Zealand news site The Spinoff.
She wrote: "Think of Covid-19 as several fires blazing away, with embers shooting off in all directions. Our goal is to stop those embers from turning into another blazing fire."
Phase two: Community transmission begins, as infected patients continue going about their daily activities instead of staying isolated.
This is when public health officials look to flatten the curve by keeping the number of cases reported each day as low as possible.
"The quicker and higher the numbers rise, the more likely the outbreak will overwhelm us, making it harder to control," said Prof Wiles.
Phase three: The number of new cases starts to approach zero. This could be because a vaccine has been introduced or in the worst-case scenario, when everyone has been infected. A licensed Covid-19 vaccine will be ready only by the end of this year at the earliest, according to medical experts.
WHY IS IT IMPORTANT TO FLATTEN THE CURVE?
Flattening the curve will, in a way, help to buy time.
National Development Minister Lawrence Wong, who co-chairs Singapore's multi-ministerial task force set up to combat the spread of Covid-19, said last week: "Slowing down the spread and flattening the epidemic curve is very useful, because we avoid overwhelming our hospitals with a surge of cases, and we buy ourselves time - time that will be very useful because over the longer term, we may have better treatment, better anti-viral drugs and, eventually, a vaccine."
If the number of new cases goes up suddenly, there will be a greater burden on hospitals and healthcare professionals. This can increase the mortality rate.
Hospitals in the Chinese city of Wuhan, the epicentre of the outbreak, saw patients lying - and dying - on hospital floors because of a lack of beds, and health workers crumbling from exhaustion. In Lombardy, the worst-hit region in Italy, hospitals began to run out of beds in intensive care units on Monday.
WHICH PHASE IS SINGAPORE IN?
Based on Prof Wiles' classification of the phases of the outbreak, Singapore is in phase two, since community transmission has already occurred here.
However, the number of new Covid-19 cases reported here every day is much smaller compared with that in other countries.
This number has also remained very stable, with new cases in the last five days since last Saturday, for example, standing at eight, 12, nine, six and 12 respectively. This means Singapore's "curve" resembles more of a straight line at this point.
By comparison, the number of confirmed infections in Italy between last Saturday and Wednesday increased by 6,579, an exponential jump from 2,600 new cases between March 2 and 6.
Cell biologist Ong Siew Hwa said Singapore's strict containment measures have helped flatten the curve as the healthcare system here has avoided being overwhelmed by a growing number of cases.
However, she noted that it was too soon to say if Singapore has the outbreak under control.
Dr Ong, who is director and chief scientist of local company Acumen Research Laboratories, which has developed a diagnostic test kit for the virus, said epidemic curves are best plotted after an outbreak is over, since there are many factors affecting how the disease spreads.
She added: "Moreover, different countries, cities and territories all have different epidemic curves as this depends on local factors such as size of the area, population density, policies and availability of healthcare infrastructure, as well as the infected people being socially responsible."
Singapore has aggressively sought to contain the virus through testing, contact tracing and quarantines. It has put social distancing measures in place, including suspending all social activities organised by government agencies for seniors for 14 days from Wednesday.
Individuals too can play a part.
Professor Carl Bergstrom from the University of Washington tweeted that steps such as diligent hand washing, cancelling large gatherings, minimising travel and teleworking can help keep the number of people simultaneously infected at a low enough level to be manageable.
WHAT ARE OTHER COUNTRIES DOING TO FLATTEN THE CURVE?
China (the number of new cases is falling and stabilising): The country, which has seen over 80,000 cases and 3,000 deaths, has been under an extensive lockdown, with strict quarantine and travel restrictions for hundreds of millions of citizens and foreigners.
The lockdown has begun to ease slightly with the number of new cases in China falling dramatically.
Iran (number of cases could spike further): Iranian President Hassan Rouhani initially dismissed the severity of the Covid-19 outbreak, saying last month that it was no worse than other epidemics that Iran has suffered.
He also said Iran would quarantine only individuals and not cities or regions, a decision which has since been questioned by Iranian Parliament members who have called for infected areas to be quarantined and offices to be closed.
Iran reported 63 new deaths on Wednesday, its highest single-day total yet, as its number of infections reached 9,000.
Italy (number of cases approaching peak): A country-wide lockdown was imposed on Tuesday, with all non-essential travel in the country banned, and schools and universities closed.
However, it may still be some time before a decline in cases is seen, going by China's experience.
After the Wuhan and Hubei province-wide lockdowns were imposed on Jan 23 and 24 respectively, it was not until the middle of last month that the rate of new cases in Hubei began to slow down noticeably.
It is important to remember that the Covid-19 curve is still in the process of being drawn.
That means the actions of governments and the public around the world can still make a huge difference as to whether the curve ends up looking more like a mountain or a road bump.
The Straits Times, 12 Mar 2020
The World Health Organisation (WHO) yesterday declared the coronavirus outbreak a pandemic, citing the alarming levels of spread around the world.
"We are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction. We have, therefore, made the assessment that COVID-19 can be characterised as a pandemic," said WHO director-general Tedros Adhanom Ghebreyesus at a news conference, adding that the organisation was not using the word lightly.
There are now over 120,000 cases in 114 countries.
In Singapore yesterday, 12 new COVID-19 cases were confirmed, including eight people who are believed to have caught the disease outside the Republic.
Of the four locally transmitted cases, one is linked to the private dinner at SAFRA Jurong; another, a staff nurse at Ng Teng Fong General Hospital, is linked to an imported case from the Philippines; while contact tracing is ongoing for the other two.
The latest update brings the number of cases here to 178. Three more patients were discharged.
WHO's 'pandemic' label a signal to countries to act fast
Virus can still be contained and its impact reduced if governments move to deal with it
By Joyce Teo, The Straits Times, 13 Mar 2020
The World Health Organisation (WHO) has declared Covid-19 a pandemic due to "alarming levels" of its spread and severity.
As the cases continue spreading globally, more measures and more disruptions to daily lives can be expected here.
Singapore has 187 cases, of which 96 have been discharged, and has not seen any deaths yet. However, worldwide, over 4,600 people have died, with the number of cases exceeding 126,000 in 118 countries.
Declaring Covid-19 a global pandemic is a warning that the world has to take this disease very seriously and act quickly to contain and mitigate it.
"We cannot say this loudly enough, or clearly enough, or often enough. All countries can still change the course of this pandemic," WHO director-general Tedros Adhanom Ghebreyesus told a media briefing in Geneva on Wednesday.
"The challenge for many countries who are now dealing with large clusters or community transmission is not whether they can do the same - it is whether they will."
The actions of other countries have a direct bearing on Singapore, as a global aviation hub and tourist destination that is deeply integrated into the world economy.
Any visitor with the coronavirus can spread it and form new clusters here or elsewhere. But if visitors stop coming, businesses suffer.
It has been 11 years since the WHO declared the H1N1 swine flu in 2009 a pandemic, though that turned out to be milder than expected in most countries.
Previous pandemics include the Spanish flu in 1918, the deadliest in history, affecting one-third of the world's population and wiping out at least 40 million people.
Although the WHO defines a pandemic as the global spread of a new disease, the word may be associated with a large, unstoppable spread of the disease.
Covid-19 is the first pandemic fuelled by a coronavirus, though Dr Tedros also stressed that it is a controllable pandemic.
The outbreak has ballooned into a pandemic less than three months after news of the coronavirus first emerged from China.
Some experts say that the problem with calling it a pandemic is that it may steer some countries away from containment measures into pure mitigation mode.
"We shouldn't give up. Stopping containment is the risk of calling it a pandemic," warned infectious diseases expert Dale Fisher, who chairs the WHO's Global Outbreak Alert and Response Network. He said this disease can be contained.
"In fact, containing it is part of mitigation, if every case you prevent is one less you have to deal with."
At the same time, mitigation measures must be put in place.
Calling it a pandemic does not change what Singapore should do, he said.
"We have ramped up all the efforts. Every hospital knows what they are going to do, where they are going to create more beds, have more isolation beds," Professor Fisher said of Singapore's preparedness.
Yesterday, Dr Tedros said in a briefing that countries need to double down in the war on Covid-19.
"Countries that decide to give up on fundamental public health measures may end up with a larger problem and a heavier burden on the health system that requires more severe measures to control," he said.
A day earlier, he said "pandemic" is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.
"Describing the situation as a pandemic does not change WHO's assessment of the threat posed by this virus. It doesn't change what WHO is doing, and it doesn't change what countries should do."
Indeed, Associate Professor Hsu Li Yang, the infectious diseases programme leader at the National University of Singapore Saw Swee Hock School of Public Health, also said yesterday that the term "pandemic" is just to label what is happening around the world about Covid-19.
"I do not believe it should change things for Singapore just because WHO has declared this to be a pandemic," he added.
"As things stand, it is increasingly clear that the pandemic and the risk from the virus will continue for many more months, and sustainability of efforts will be a critical consideration," he said.
Yesterday, Prime Minister Lee Hsien Loong told Singaporeans in a broadcast message on Covid-19 that the situation here remains under control, and the disease outbreak response level will not be stepped up to "red".
But if there is a spike in cases, there will be a need for temporary additional social distancing measures, such as suspending school, staggering work hours or compulsory telecommuting, to slow transmission and bring numbers down.
Social responsibility is also key.
Prof Fisher said the move to suspend all social activities for seniors organised by government agencies for 14 days from Wednesday was a call for improved social responsibility.
"It is no longer acceptable to just have hundreds of people, particularly elderly people, getting together for a whole evening in one room," he said.
"If you are not responsible, then the Government has to take drastic action.
"If people keep going to crowded restaurants and getting infected, then it would be a natural step to say, 'Okay, we are closing the restaurants'. Now, who wins out of that? People can't go to restaurants and the restaurants lose money."
Now that Covid-19 is a pandemic, it is even clearer that it will change the way we live, for longer than we want.
As Dr Tedros said on Wednesday, every sector and every individual must be involved in the fight.
Virus can still be contained and its impact reduced if governments move to deal with it
By Joyce Teo, The Straits Times, 13 Mar 2020
As the cases continue spreading globally, more measures and more disruptions to daily lives can be expected here.
Singapore has 187 cases, of which 96 have been discharged, and has not seen any deaths yet. However, worldwide, over 4,600 people have died, with the number of cases exceeding 126,000 in 118 countries.
Declaring Covid-19 a global pandemic is a warning that the world has to take this disease very seriously and act quickly to contain and mitigate it.
"We cannot say this loudly enough, or clearly enough, or often enough. All countries can still change the course of this pandemic," WHO director-general Tedros Adhanom Ghebreyesus told a media briefing in Geneva on Wednesday.
"The challenge for many countries who are now dealing with large clusters or community transmission is not whether they can do the same - it is whether they will."
The actions of other countries have a direct bearing on Singapore, as a global aviation hub and tourist destination that is deeply integrated into the world economy.
Any visitor with the coronavirus can spread it and form new clusters here or elsewhere. But if visitors stop coming, businesses suffer.
It has been 11 years since the WHO declared the H1N1 swine flu in 2009 a pandemic, though that turned out to be milder than expected in most countries.
Previous pandemics include the Spanish flu in 1918, the deadliest in history, affecting one-third of the world's population and wiping out at least 40 million people.
Although the WHO defines a pandemic as the global spread of a new disease, the word may be associated with a large, unstoppable spread of the disease.
Covid-19 is the first pandemic fuelled by a coronavirus, though Dr Tedros also stressed that it is a controllable pandemic.
The outbreak has ballooned into a pandemic less than three months after news of the coronavirus first emerged from China.
Some experts say that the problem with calling it a pandemic is that it may steer some countries away from containment measures into pure mitigation mode.
"We shouldn't give up. Stopping containment is the risk of calling it a pandemic," warned infectious diseases expert Dale Fisher, who chairs the WHO's Global Outbreak Alert and Response Network. He said this disease can be contained.
"In fact, containing it is part of mitigation, if every case you prevent is one less you have to deal with."
At the same time, mitigation measures must be put in place.
Calling it a pandemic does not change what Singapore should do, he said.
"We have ramped up all the efforts. Every hospital knows what they are going to do, where they are going to create more beds, have more isolation beds," Professor Fisher said of Singapore's preparedness.
Yesterday, Dr Tedros said in a briefing that countries need to double down in the war on Covid-19.
"Countries that decide to give up on fundamental public health measures may end up with a larger problem and a heavier burden on the health system that requires more severe measures to control," he said.
A day earlier, he said "pandemic" is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.
"Describing the situation as a pandemic does not change WHO's assessment of the threat posed by this virus. It doesn't change what WHO is doing, and it doesn't change what countries should do."
Indeed, Associate Professor Hsu Li Yang, the infectious diseases programme leader at the National University of Singapore Saw Swee Hock School of Public Health, also said yesterday that the term "pandemic" is just to label what is happening around the world about Covid-19.
"I do not believe it should change things for Singapore just because WHO has declared this to be a pandemic," he added.
"As things stand, it is increasingly clear that the pandemic and the risk from the virus will continue for many more months, and sustainability of efforts will be a critical consideration," he said.
Yesterday, Prime Minister Lee Hsien Loong told Singaporeans in a broadcast message on Covid-19 that the situation here remains under control, and the disease outbreak response level will not be stepped up to "red".
But if there is a spike in cases, there will be a need for temporary additional social distancing measures, such as suspending school, staggering work hours or compulsory telecommuting, to slow transmission and bring numbers down.
Social responsibility is also key.
Prof Fisher said the move to suspend all social activities for seniors organised by government agencies for 14 days from Wednesday was a call for improved social responsibility.
"It is no longer acceptable to just have hundreds of people, particularly elderly people, getting together for a whole evening in one room," he said.
"If you are not responsible, then the Government has to take drastic action.
"If people keep going to crowded restaurants and getting infected, then it would be a natural step to say, 'Okay, we are closing the restaurants'. Now, who wins out of that? People can't go to restaurants and the restaurants lose money."
Now that Covid-19 is a pandemic, it is even clearer that it will change the way we live, for longer than we want.
As Dr Tedros said on Wednesday, every sector and every individual must be involved in the fight.
How flattening the epidemic curve will buy time and keep outbreak in check
Steps countries are taking to buy time to help fight the virus
By Lester Wong and Audrey Tan, Science and Environment Correspondent, The Straits Times, 13 Mar 2020
As coronavirus infections rise, many people who keep track of this say there is a curve that needs flattening.
The epidemic curve is used to visualise the extent and speed of new cases during a virus outbreak.
This n-shaped curve presents the stark reality of how quickly a virus can spread if unchecked.
As the number of patients diagnosed with Covid-19 continues to rise with the World Health Organisation declaring the outbreak a pandemic, so does the risk of healthcare systems in various countries being overwhelmed by the demands being placed on them.
But not all those diagnosed with the respiratory disease have severe symptoms.
To ensure that hospital and healthcare resources focus on the group of people who need them the most - usually the elderly and those with underlying medical conditions - experts have urged low-risk coronavirus patients to self-isolate instead of overwhelming hospitals if infected.
Currently, all Covid-19 patients in Singapore are kept in hospitals for long periods to ensure they are free of the virus before being discharged. But should there be a spike in the number of new cases reported, the Republic might have to reconsider how it treats those infected.
WHAT DOES THE EPIDEMIC CURVE SHOW?
The number of infections in a viral outbreak tends to follow a particular pattern over time, and this is the picture painted by the epidemic curve.
As The Washington Post reported, a key goal of public health officials is to avoid a huge peak in Covid-19 cases (a curve with a steep incline, spread over a shorter period of time) in favour of a slower growth that becomes a moderate plateau (a curve with a gentler incline, spread out over a longer time period).
WHAT ARE THE THREE PHASES?
Phase one: At this stage, infected patients are mostly imported, said microbiologist Siouxsie Wiles, an associate professor at the University of Auckland, in an opinion piece on New Zealand news site The Spinoff.
She wrote: "Think of Covid-19 as several fires blazing away, with embers shooting off in all directions. Our goal is to stop those embers from turning into another blazing fire."
Phase two: Community transmission begins, as infected patients continue going about their daily activities instead of staying isolated.
This is when public health officials look to flatten the curve by keeping the number of cases reported each day as low as possible.
"The quicker and higher the numbers rise, the more likely the outbreak will overwhelm us, making it harder to control," said Prof Wiles.
Phase three: The number of new cases starts to approach zero. This could be because a vaccine has been introduced or in the worst-case scenario, when everyone has been infected. A licensed Covid-19 vaccine will be ready only by the end of this year at the earliest, according to medical experts.
WHY IS IT IMPORTANT TO FLATTEN THE CURVE?
Flattening the curve will, in a way, help to buy time.
National Development Minister Lawrence Wong, who co-chairs Singapore's multi-ministerial task force set up to combat the spread of Covid-19, said last week: "Slowing down the spread and flattening the epidemic curve is very useful, because we avoid overwhelming our hospitals with a surge of cases, and we buy ourselves time - time that will be very useful because over the longer term, we may have better treatment, better anti-viral drugs and, eventually, a vaccine."
If the number of new cases goes up suddenly, there will be a greater burden on hospitals and healthcare professionals. This can increase the mortality rate.
Hospitals in the Chinese city of Wuhan, the epicentre of the outbreak, saw patients lying - and dying - on hospital floors because of a lack of beds, and health workers crumbling from exhaustion. In Lombardy, the worst-hit region in Italy, hospitals began to run out of beds in intensive care units on Monday.
WHICH PHASE IS SINGAPORE IN?
Based on Prof Wiles' classification of the phases of the outbreak, Singapore is in phase two, since community transmission has already occurred here.
However, the number of new Covid-19 cases reported here every day is much smaller compared with that in other countries.
This number has also remained very stable, with new cases in the last five days since last Saturday, for example, standing at eight, 12, nine, six and 12 respectively. This means Singapore's "curve" resembles more of a straight line at this point.
By comparison, the number of confirmed infections in Italy between last Saturday and Wednesday increased by 6,579, an exponential jump from 2,600 new cases between March 2 and 6.
Cell biologist Ong Siew Hwa said Singapore's strict containment measures have helped flatten the curve as the healthcare system here has avoided being overwhelmed by a growing number of cases.
However, she noted that it was too soon to say if Singapore has the outbreak under control.
Dr Ong, who is director and chief scientist of local company Acumen Research Laboratories, which has developed a diagnostic test kit for the virus, said epidemic curves are best plotted after an outbreak is over, since there are many factors affecting how the disease spreads.
She added: "Moreover, different countries, cities and territories all have different epidemic curves as this depends on local factors such as size of the area, population density, policies and availability of healthcare infrastructure, as well as the infected people being socially responsible."
Singapore has aggressively sought to contain the virus through testing, contact tracing and quarantines. It has put social distancing measures in place, including suspending all social activities organised by government agencies for seniors for 14 days from Wednesday.
Individuals too can play a part.
Professor Carl Bergstrom from the University of Washington tweeted that steps such as diligent hand washing, cancelling large gatherings, minimising travel and teleworking can help keep the number of people simultaneously infected at a low enough level to be manageable.
WHAT ARE OTHER COUNTRIES DOING TO FLATTEN THE CURVE?
China (the number of new cases is falling and stabilising): The country, which has seen over 80,000 cases and 3,000 deaths, has been under an extensive lockdown, with strict quarantine and travel restrictions for hundreds of millions of citizens and foreigners.
The lockdown has begun to ease slightly with the number of new cases in China falling dramatically.
Iran (number of cases could spike further): Iranian President Hassan Rouhani initially dismissed the severity of the Covid-19 outbreak, saying last month that it was no worse than other epidemics that Iran has suffered.
He also said Iran would quarantine only individuals and not cities or regions, a decision which has since been questioned by Iranian Parliament members who have called for infected areas to be quarantined and offices to be closed.
Iran reported 63 new deaths on Wednesday, its highest single-day total yet, as its number of infections reached 9,000.
Italy (number of cases approaching peak): A country-wide lockdown was imposed on Tuesday, with all non-essential travel in the country banned, and schools and universities closed.
However, it may still be some time before a decline in cases is seen, going by China's experience.
After the Wuhan and Hubei province-wide lockdowns were imposed on Jan 23 and 24 respectively, it was not until the middle of last month that the rate of new cases in Hubei began to slow down noticeably.
It is important to remember that the Covid-19 curve is still in the process of being drawn.
That means the actions of governments and the public around the world can still make a huge difference as to whether the curve ends up looking more like a mountain or a road bump.
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