9 out of 10 imported cases from March 18-20 are asymptomatic

The Missing Link



We had been harping on the lack of details from the imported cases. Other than age, nationality and country visited, the critical details are missing from the reports.



The missing information
1) Date of arrival
2) Date of detection
3) Are they on Stay Home Notice
4) Places they visited after arrival and before detection
Includes Workplace, attractions, places of worship,etc


As a result of the lack of information, we concluded that it might be different to track them and the possibility of community spread could arise from such cases. On numerous updates on FB, we constantly state the need to be vigilant and there are silent carriers out there.

90% of imported cases probably do not have SHN
Now there is more clarity in the situation with the latest update


For Cases between March 18 and March 20, the following points are stated
1) 9 out of 10 cases did not show symptoms
This implied that they are not detected at the airports and would be free to move if they arrive before the SHN period

2) 90% of the imported cases saw a doctor at a hospital or GP after they return home
This implies that 90% are not on Stay Home Notice as SHN cases would be directly sent to NCID for testing if symptoms appear.

With 87 imported cases within the time period, it would mean that about 80 people had been travelling around Singapore before the detection. This does not include the 99 imported cases reported over the last 3 day (from Sat) . With the increase in unlinked cases during the same time frame, there may be a correlation which implies community spread is happening.


Imported cases vs Unlink cases

Dates	Imported Cases	Unlink Cases	Official Unlink Tally
5	1	0	12
6	2	1	12
7	0	1	13
8	1	1	14
9	3	0	14
10	0	1	9
11	8	2	10
12	5	0	9
13	9	1	10
14	9	1	11
15	9	0	11
16	11	2	12
17	17	4	16
18	33	5	17
19	24	6	23
20	30	3	24
21	39	6	31
22	18	2	31
22	48	6	31

We were quite fervent on the need to be cautious and avoid crowds during the school holidays. Although unlink cases remain low, the risk of transmission was high due to the imported cases that are NOT on SHN.


Community Spread might have already started
At this stage, we have to believe that community spread had probably taken place. This is not fear-mongering but analysis based on the information disclosed. Unless the information is provided on an individual basis, we have to go for the worst cases scenario.

The slew of measures announced in recent days - Banning short term visitors, Social distancing measures, Health declaration before entry to Singapore seem to imply that that might be carriers within us. The string of unlink cases add to that justification.









Quarantine all travellers from now instead of SHN
We also think the SHN should be changed to Quarantine. For SHN, there is still a risk to family members. Given the risk of transmission is high judging by the numbers reported, we should not take any additional risks for new returning travellers . Since we are expecting students and workers to return from aboard in masses , Quarantine Orders should be given to replace SHN.


Go to a doctor regardless of travel history if you have the symptoms
If you are unwell, regardless if you have travelled, as long as you were out and had contact with others do not take it lightly. Stay at home and monitor, head straight to the PHPC clinics if symptoms appear. If you have travelled, please apply for LOA and stay in for 14 days even if you are not mandated to do so. This is no longer the time for a wait and see approach. Do what you can to stop the spread.

It might be already a step too late.