The Path Out Of COVID

Three Singapore Ministers wrote an Op-Ed on June 24th in the Singapore Straits Times on how the influential city state plans on living normally with COVID. Their roadmap is a smart pathway to reopening and will undoubtedly influence other countries in Southeast Asia and beyond.

Trade and Industry Minister Gan Kim Yong, Finance Minister Lawrence Wong and Health Minister Ong Ye Kung are co-chairs of the Covid-19 multi-ministry task force.

The Ministers begin their article with a realistic assessment of COVID-19, “The bad news is that Covid-19 may never go away. The good news is that it is possible to live normally with it in our midst. This means Covid-19 will very likely become endemic. But what does that mean?

Having laid out that COVID-19 will be with us all they pivot to the good news, “The evidence is clear: Vaccines are highly effective in reducing the risk of infection as well as transmission. Even if you are infected, vaccines will help prevent severe Covid-19 symptoms.

 It means that the virus will continue to mutate, and thereby survive in our community. One example of such an endemic disease is influenza. Every year, many people catch the flu. The overwhelming majority recover without needing to be hospitalised, and with little or no medication. But a minority, especially the elderly and those with co-morbidities, can get very ill, and some succumb.

Israel’s experience shows that the infection rate among vaccinated persons is 30 times less than that of the unvaccinated. The hospitalisation rate for the vaccinated is also lower – by 10 times.”

With this new reality they then lay out a plan for returning Singapore to a “new normal”. This new normal includes allowing international travel and opening workplaces. In other words, it foresees a future without the need for continued lockdowns.

The Singapore plan calls for a combination of vaccinations, testing and social responsibility to move past COVID-19 lockdowns.

As the authors note, “Essentially with a high rate of vaccination, Israel has brought the clinical outcomes of Covid-19 close to that of seasonal influenza in the US. These are very promising outcomes.” With this data, they propose a plan which includes easy, readily available testing, improved treatments for those who do become ill, and continued social responsibility where personal hygiene play a major role in allowing Singapore to open up.

In their minds the path is clear, “The new norm can perhaps look like this:

First, an infected person can recover at home, because with vaccination the symptoms will be mostly mild. With others around the infected person also vaccinated, the risk of transmission will be low. We will worry less about the healthcare system being overwhelmed.

Second, there may not be a need to conduct massive contact tracing and quarantining of people each time we discover an infection. People can get themselves tested regularly using a variety of fast and easy tests. If positive, they can confirm with a PCR test and then isolate themselves.

Third, instead of monitoring Covid-19 infection numbers every day, we will focus on the outcomes: how many fall very sick, how many in the intensive care unit, how many need to be intubated for oxygen, and so on. This is like how we now monitor influenza.

Fourth, we can progressively ease our safe management rules and resume large gatherings as well at major events, like the National Day Parade or New Year Countdown. Businesses will have certainty that their operations will not be disrupted.

Fifth, we will be able to travel again, at least to countries that have also controlled the virus and turned it into an endemic norm. We will recognise each other’s vaccination certificates. Travellers, especially those vaccinated, can get themselves tested before departure and be exempted from quarantine with a negative test upon arrival.”

Singapore plans to move past the pandemic as quickly as possible and their strategy can serve as a roadmap for other countries. We find this to be a smart, well reasoned plan which deftly balances public health with economic realities, along with the very real human need to connect and interact with others.

Recognizing that Singapore has an easier job vaccinating its 5.7 million residents than many countries is important. But this roadmap is still applicable. Singapore hopes to have delivered at least one shot to two-thirds of its residents within weeks and expects to have two thirds fully vaccinated by early August.

And while this plan makes sense, COVID has proven itself to be a very worthy adversary. As the authors conclude, “We are drawing up a road map to transit to this new normal, in tandem with the achievement of our vaccination milestones, though we know the battle against Covid-19 will continue to be fraught with uncertainty.”

Here’s to there being an end in sight.