The reality of Singapore's Fight against COVID19 : Vaccine, Herd Immunity or Eradication



Circuit Breaker will NOT eradicate COVID19 in Singapore.


If that is the expectation that we are holding out for on May 4, sad to say, we will be very disappointed. On Day 3, even with strict measures in place, we still see crowds at Market and Parks. While the measures reduced contact at the workplace and school, it had also opened up new venues where possible infections may take place.





Here is what we think the strategy will be like going forward

Possible Strategy

Start-Stop Measures (ST Strategy) 


The Circuit Breaker is a tool to flatten the curve, not to make the virus disappear. If it was the latter, a full lockdown with a stricter regime with Martial Law implemented. That said, if the public continues to flout the rules and the spread worsens as a result, we might see a  Full Lockdown in the works.

For a Circuit Breaker to work, the following should be fulfilled before it is lifted

Reduce cases reported for consecutive days
The number of cases must decline for a consecutive number of days. To play it safe, it has to be the length of the incubation period. The incubation period of Covid-19 is estimated to be up to 14 days by WHO.

Hospitals to be able to accommodate a reasonable number of new cases 
The backlog of current cases needs to be shifted away from hospitals before the measures are lifted. If the confirmed cases drop but not the recovered cases, it is still not sufficient to lift the measures.

Trace and Contain
Currently, the number of unlink cases are escalating. They have to be reduced for effective tracking and quarantine measures to continue. If that can be done, we can return to some form of normalcy like school reopening and heading back to work. However, do not expect a return to pre-COVID19 days where mega-events are allowed to be held.



Herd Immunity (LT Strategy)



Would herd immunity work in Singapore?

It had been touted as a cure by the British during the early days of the spread. As such, the country had at some stage given up on testing ( they are ramping up tests now as we speak). Base on medical reports for herd immunity, it has to infect 60-70% of the population. In Singapore's context, that is 3-3.5 million infections. At an optimistic 2% death rate, we have to accept 60-70K deaths.

The problem is that we cannot afford the death rates. Moreover, it will take time for that to happen. If this happens too fast, the hospital system will be overwhelmed. If that situation materialises, it will lead to possible unrelated deaths. Thus, herd immunity is not a short term strategy.

Maybe over a 5 year period, it will be the norm (Like H1N1). For the short term, that phase is as dangerous as getting infected itself.


Unlikely Strategy
The Greater Evil - Ridding the Virus before the Cure


It is almost impossible to eradicate the virus on a global scale given the extend of transmission in US and EUROPE. Unless we close our doors completely, such a strategy will be a big waste of resources.  Given that Singapore's economy is linked to the world, it is one solution we might not be able to sustain. Unlike countries that are self-sufficient in demand and supply of essential products and services, we are very much reliant on the world to survive.

While morally ideal, it is one that will cost the Nation more in the longer term should we opt to close shop and be a hermit state ala North Korea. Reopening channels to work may even take a longer time than finding the vaccine to end this.



Waiting Game - The Search for a Vaccine


For these coming months, our lives will change. It is naive to think all will be back to normal once the circuit breaker is lifted. We have to be on our toes and expect another Circuit Breaker to be in the works should the situation worsen after the measures are lifted. For those anticipating National Day Parade and even the New Year Eve Countdown Fireworks, it will not happen without a cure.

We need a vaccine to stop the virus on the track. As long as it is out there, it is impossible to rid it even in a small country like us. Unless we do a full lockdown for a whole 2 -3 months, it will be difficult to contain.

The repercussion of a long term lockdown would be devasting to employment. Small business will collapse and many other businesses will struggle to stay afloat. That would lead to greater unemployment.

Moreover, such a status would lead to Singapore being ostracised on a global scale. Given our reliance on external partners, it will lead to cascading scenarios where global operations would just relocate their headquarters away from Singapore. This would exacerbate the problem and pull us into a deeper hole. The cure is worse than the disease.

This is a vicious cycle we cannot afford.

We would have to play hide and seek with Covid19 for now. Restarting when we can to keep operations and business going when numbers are down,  but be prepared for short term closure if spikes occur. That way, we could keep businesses afloat until the vaccine is in place. For the record, even if the vaccine is developed, it will still need time to be tested, manufactured in masses and distributed. It would take at least a year if we are lucky, more if complications such as mutation of the virus occur.

Reality Bites


In truth, the government would probably consider all aspects of the virus and have a multi-prong strategy to combat it. Given, the fluidity of the situation, it could change over time.

As for the rest of us, realistically we could almost write off 2020. The vaccine would most likely not be ready for this year. If we can survive this year, it will probably be 2021 (if we are lucky) where we can dust off this virus and get back our normalcy with the vaccine.

Until then, it WILL be a  long and painful ride. One that we must do as a nation. The success will be dependant on the individual and not just the government's policy. Regardless of strategy, if we choose to continue to live in oblivion, utopia will always be a dream.


Disclaimer
We do not profess to be crisis experts. Theses deductions are base mostly off commonsense as well as research on what is done elsewhere in the world. Should it be implemented, it is purely coincident  







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