After receiving global praise for its handling of the coronavirus, Singapore is now showing signs that it's struggling to flatten the COVID-19 curve.
As the world scrambles to contain the coronavirus, Singapore has been held up as a role model for its early and decisive response to the threat. The city-state drew international praise for its ability to blunt the spread of COVID-19 while avoiding some of the drastic containment measures seen in countries like China, Italy and Spain. But Singapore's lauded response has come into question. Last week, it enforced a partial lockdown as it struggles to contain a sharp rise in coronavirus cases.
As part of Singapore's stricter "circuit breaker" measures, it shuttered most workplaces last Tuesday. The following day, school closures went into effect for at least a month, shifting students to "full home-based learning." The government has also banned public and private social gatherings of any size, meaning residents who entertain guests face six months of jail time or a fine of up to $7,000.
"We have decided that instead of tightening incrementally over the next few weeks, we should make a decisive move now, to preempt escalating infections," Singapore's prime minister, Lee Hsien Loong, said in an address to the nation on April 3.
The move underscores the risks that the coronavirus poses -- even after a country has seemingly taken the necessary steps to protect itself. The semi-lockdown came after Singapore witnessed an explosion of confirmed coronavirus cases, from 106 infections on March 1 to 1,000 on April 1. Those figures indicate most infections were transmitted locally and that a growing number of cases have no known links to confirmed patients.
Until early April, Singapore was one of a few countries that refrained from closing schools, pointing to early research that suggested children aren't as vulnerable to the COVID-19 disease as adults, even as more than 150 countries had shut down their educational institutions.
Lee said the situation is under control, but the prime minister also noted that daily reported cases have "routinely" increased.
"Looking at the trend, I am worried that unless we take further steps, things will gradually get worse or another big cluster may push things over the edge," Lee said.
The island nation's spike in cases comes at a time when the world is scrambling to flatten the curve. The number of coronavirus cases is more than 2 million globally, and the virus has caused more than 138,000 deaths, according to a Thursday tally by Johns Hopkins University. Across the world, cities remain in lockdown, hospitals are inundated with patients, and the global economy is reeling. Germany and France have each warned of their worst economic downturn since World War II, while nearly 22 million people in the US have filed for unemployment benefits over the last month.
Singapore's circuit breaker strategy "should help to reset the epidemic to a lower level to mitigate the effect of recent rises," said Alex R. Cook, vice dean (research) of the Saw Swee Hock School of Public Health at the National University of Singapore. "It has been calibrated to be long but not too long."
On Wednesday, Singapore's Ministry of Health announced that coronavirus cases had climbed to a fresh record daily high of 447, with a majority of cases coming from the migrant worker dormitories. Like Hong Kong, Singapore is in the grip of what experts call a second wave of infections. Initially, many of the new cases originated from returning Singaporeans who'd contracted the coronavirus while traveling overseas, mostly in Europe. Then in the last few weeks, the island nation began to witness a worrying spike in locally transmitted cases.
"Even if the social distancing is perfect going forward, unlinked cases will go up for some days" as transmissions that happen in recent days are detected, Jon Huang, an epidemiologist at Singapore's Institute for Clinical Sciences, said in a thread on Twitter on Thursday.
Singapore has at least 20 local clusters, including a bridal studio and a nursing home, but a significant number of local cases have been traced back to at least three foreign workers' dormitories.
Authorities promptly quarantined the migrant workers -- tens of thousands of laborers mostly from India and Bangladesh -- to their rooms in those dorms, saying it was necessary to curb local transmission.
But the move has drawn criticism from human rights groups and Singaporean citizens alike as media reports surfaced about the crowded and unsanitary living conditions at the dorms, which among other things reportedly make it next to impossible to stay at least a meter apart.
"They stay in overcrowded dormitories and are packed likes sardines, said Rector Professor Tommy Koh, Tembusu College, National University of Singapore, in a widely shared Facebook post. "The dormitories were like a time bomb waiting to explode."
Human Rights Watch said the quarantine at the dorms created a "tinderbox" for infection and urged the government to test all workers and move those that were sick to health care facilities.
Since then, more than 5,000 workers have been moved out to safer locations, and more will be relocated in the coming days, Lawrence Wong, a cabinet minister and co-head of the government's virus-fighting task force, said at a press conference last Thursday. Lee also said a task force made up of government, military and police personnel has been established to aid the dorm operators and the housed workers.
"We are sparing no effort to contain the spread of the virus in the foreign worker dormitories," said Wong.
Last month, it appeared that Singapore had managed to keep a lid on coronavirus infections through a system that included exhaustive contact tracing, early travel restrictions and strict social distancing measures. Though it was one of the worst-hit places in the early stages of the pandemic, the country managed to keep cases to fewer than 390 and had zero deaths until March 21, nearly two months after it reported its first coronavirus infection.
Since then, Singapore's confirmed cases have risen dramatically, to 3,699 as of Wednesday, according to a Johns Hopkins University tracking tool, but the island nation still appears to be handling the coronavirus better than many other developed countries and cities. US cities and counties that have roughly double Singapore's population size of 5.6 million have a disproportionately higher number of cases. Los Angeles County, for instance, has 10,047 confirmed cases and 360 deaths as of Wednesday, while the state of Georgia has 14,223 confirmed cases and 501 deaths. Singapore has ten deaths. Meanwhile, New York City, which has a similar population size and density to Singapore, has 10,899 deaths as of Wednesday, after confirming its first cases more than a month after Singapore. Hong Kong and Taiwan are some of the few if not only places that have an edge over Singapore in their containment of the coronavirus.
"What they [Singapore] are really showing the rest of the world is that this is just a difficult virus to beat back and keep down," Michael Osterholm, an infectious disease expert at the University of Minnesota told Reuters.
First published on April. 11, 2020 at 5:00 a.m. PT.