Singapore : Dark Days ahead

On Apr 3, we have 1049 cases.

That was the date when Circuit Breaker was announced. 18 days in, and we added on than 10,000 to the number of confirmed cases. Today the number stands at 12705.

How did Singapore, once branded as Gold Standard for COVID19, experience a freefall when CB was introduced?

With CB, we had high hopes that the nation will have a chance to flatten the curve. In a month prior to CB, we added a 1000 cases. That itself was worrisome. Unfortunately, it was the tip of the ice-berg as we had an outbreak at Dormitories that bought us to today. With a thousand cases fast becoming the daily norm, are we flattening to a plateau or is this a premonition to a freefall?

Darker Days to come?

  • Workers living in Dorms - 323,000
  • Work Permit Holders (ex FDW) not living in Dorms - 410,000 (Approximate)*

A recent report dated Apr 21 states that base on current infection rate, the prevalence of positive cases in the dorms was 1.9 % among 323,000 workers living in dorms and 0.05% among the 664,000 workers not living in dorms. We do feel that the numbers are incorrectly stated due to the following

1) Not all 323,000 workers had been tested. As such, we cannot conclude that it affects only 1.9%. On the contrary, base on a recent report on TNP, between 1500-2500 tests were carried out on Foreign workers in recent days. Using 1000 average cases a day in the dorms alone, that would imply an infection rate of 40-66% a day.

2) The Workers not living in dorms include FDW, we should omit this group as most of the FDW are isolated in their respective household.

If we were to extrapolate the numbers base on current tests, we may end with at least 120,000 cases from the dorms itself. This does not include those living outside of the dorms with may add a few thousand to the numbers. At that number, we will be higher than China's official figures.

However, at the rate of testing at 3000 per day, it will take 100 days if not more just to test the whole population. In addition, the authorities had been rehousing those workers on essential service out of the dorms. Unfortunately, this number is small compared to the general population at the dorms.

 We may test more per day but there is a finite limit to our resources on the ground. With cases increasing on a daily basis to add to the count, it would be almost impossible to get this covered within 6 weeks (The timeline set for CB to end). Would this result in a longer CB than anticipated?

To answer the questions, it will depend on the magnitude of the cases as we approach June. If it continues on its trajectory unabated, it might be hard to justify a return to normalcy. However, if the wider community spread reduce to single digit or zero, it would mean we are able to isolate the spread. In that case, certain measures may be lifted when CB ends.

Will this overwhelming the Health System and Support System?

We had touched on the Health System being compromised. With a capacity of only 11K, we might not be able to cope with the influx.

As of 23 Apr, it was shown that the hospitalised cases were only at 1342. Given the young and healthy demographics of the dormitories' workers, most of them are diagnosed to be either mild or asymptomatic. This would mean that the healthcare system may not take the big hit as anticipated.

While this is encouraging the number of discharge to isolation remains high at 8874. This implied that if the number of infected were to be as projected, there is a  need to increase the community isolation facility exponentially.

Currently, we have 3 isolation facilities :

D Resort NTUC in Pasir Ris: 500 pax
Singapore Exp Hall: 950 pax
Changi Exhibition hall: 2800pax

The recent numbers discharged to isolation (8874 Apr 23) had already exceeded the limit. There is a new mega facility at Tanjong Pagar to house 15,000 people. If the numbers were to increase, there might be a need to build another one in 2 weeks time.

Source: ST

These facilities will take time and resource to build. To make it dicer if the numbers were to increase tenfold, the manpower to man the facilities would be severely strained. As a nation, we probably would need to step up and take on roles these roles individually if the need arises. The question is, will we heed the call if this happens?

Potential Impact
Other than health and support system, the spike in Foreign Workers would delay other sectors of the economy. This includes construction as well as maintenance of Singapore. In addition, the economic cost of rehabilitation of the infected would be high due to the sheer numbers anticipated. These are issues we have to cope in the near future.

Lastly, there is the question of rehousing those that have recovered. We might be facing bottlenecks at community isolation facilities. Thus, those recovered cannot be afforded to house in them. The issue is that they cannot head back to the dorms since we are uncertain if reinfection can occur. That begs the question. Where are they going to go when they recover?

Silver Lining?
When this dorm episode passes us, 'the worse has yet to come' would be a foreign term. It will take more than a while before we will see the light. Nonetheless, if the battle is concerted on one front where the combatants are healthy to withstand the onslaught of the virus, there is a chance we might come out relatively unscathed.

However, in order to make sure that this is not a prequel to the worse, there is one thing the nation needs to do during CB. Everyone would need to play their part and ensure we do not contribute to the numbers.

The only way we can do this is to stay at home as much as possible. Break our self-centred habits and think of the consequences of our actions. If we place country before self, we would do well to protect Singapore from the dark days ahead.

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