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One of the reasons for this change may be related to the six days of February, when what later turned into an explosion of infection among migrant workers became apparent for the first time. It will be a story that even those countries that do not have priority in dealing with epidemics can make fundamental mistakes in tackling this rare disease, especially when it spreads to disadvantaged communities.
In early February, a small-scale outbreak was reported in Singapore, which was effectively halted without austerity measures, such as school closings. Singapore has been praised worldwide for its calm and thoughtful approach to the virus. Around the same time, a 39-year-old Bangladeshi citizen, one of the Singapore army of nearly a million foreign workers, began developing symptoms of coronavirus.
A few days after getting sick, the worker visited the clinic and hospital for help, but was sent home both times. The Worker’s House is a dormitory where men sleep about ten in one room, sharing a shared bathroom and kitchen. He also visited the 24-hour Mustafa shopping center, which is popular with migrant workers and locals. February 7 the man was finally hospitalized and a day later his virus test result was positive.
Said Bangladeshi citizen became a Singapore patient no. 42 – and in the first case, among low-income foreign workers living in narrow dormitories of the city-state. The illnesses of migrant workers today represent more than 70 percent. out of a total of 9,125 cases in the country, the number of which is growing at a record rate of nearly a thousand each day.
The country did not register the first deaths until the end of March, but the number is now 11, and the milder social isolation strategy has been replaced by a partial quarantine, which has been intensified and extended until June 1.
Missed opportunities
The unexpectedly contagious pathogen hit many governments, and opportunities to control the virus early were lost when patients were sent home rather than immediately examined and quarantined.
However, unlike other Asian countries, such as South Korea, Singapore, according to some health experts, has been too slow to adjust the response plan developed in 2003. against SARS. Under the old strategy, the country focused on identifying people who had contact with an infected person, a classic public health model called contact tracing.
Highly contagious and in some cases mild or symptom-free, COVID-19 has been shown to be “completely different from SARS,” said Jeremy Limas, associate professor at the Saw Swee Hock School of Public Health, National University of Singapore. .
“The old guidelines must be dropped and new ones created,” he says. – The most difficult thing for all countries, with the exception of Singapore, is that the rules must be written at the same time as the measures are introduced. It is reminiscent of in-flight repairs of an airplane engine. “
Singapore Patient No. The 42 cases are similar to a patient in South Korea, leading to a breakthrough in the country’s epidemic, which now exceeds 10,000 cases.
South Korea’s turn
Not from the South Korean patient. 31 with symptoms applied to the hospital, it had been ten days before she was finally quarantined. During those ten days, a woman, a member of a religious sect, attended services where people prayed for two hours straight sitting on the ground and touching their elbows.
Until then, South Korea, like Singapore, had evaluated the people found through searching for contacts. However, in the face of an outbreak of more than 200,000 members in the sect, Korean officials quickly switched to a strategy called community testing: they forced the leaders of the sects to compile a list of members and began to verify them all, regardless of if they had symptoms and had contact with them. an infected person
As a result of such a rapid shift to community testing, the number of the South Korean epidemic increased rapidly, but decreased rapidly. In early March, the country had successfully slowed the growth of the infection and dispensed with the introduction of quarantine. Hong Kong has also expanded its antivirus spectrum, looking not only for individual contacts but also to test entire communities, as it has become clear that the coronavirus is different from SARS when infected people are seriously ill, and it is obvious.
When the patient does not. 42, Singapore has not been quick to conduct large-scale investigations in the foreign worker community, despite its living conditions leading to the spread of infectious diseases, and calls by worker protection groups. The country inspected and quarantined 19 people who had contact with the patient, and asked companies that maintain crowded dormitories, as a rule, to clean and monitor the population’s temperature more frequently.
The Singapore Ministry of Health did not answer questions about how many foreign workers were examined in the weeks following the patient failed. 42 identification, but officials’ comments suggest that large-scale community testing began much later.
During April 14. Kenneth Mak, director of medical services at the Ministry of Health, said about 1,500 foreign workers had been evaluated and another 5,000 scheduled to be examined. More than 200,000 workers, many of whom work on construction sites in Singapore, live in dormitories. .
Singapore’s public rhetoric initially showed a reluctance to conduct more extensive testing: the focus was on those who had symptoms so that the tests were not wasted in vain. March 10 Mac said that “testing in the community, testing everyone, whether or not they have symptoms, would work too much” but would yield little result.
A group that is often overlooked
Low-wage foreign workers make up a fifth of Singapore’s total population, but live mainly in isolation from the local community. The bedrooms, reportedly clogged with overflowing toilets and drains, are far from reminiscent of the elegant panoramas of cities and states featured in Hollywood movies like Crazy Rich Asians.
This is not the first time that an infectious disease has hit Singapore’s foreign workers, earning just $ 18 a day.
2008 some of them became infected during an outbreak of chikungunya (chikungunya), a mosquito-borne disease that causes joint pain. There were no ventilation systems or mosquito nets in the workers’ bedrooms. That same year, a worker, who later died of chickenpox, infected them with a dozen more, and the bedroom manager was eventually planted behind bars. There are dozens of worker dormitories in Singapore, run by private companies like Keppel Corp. and Centurion Corp.
“It is difficult to explain why the government has not taken action in the past when it comes to controlling infection in the dormitories, perhaps it was a blind spot in Singaporean-centered politics,” said Eugene Tan, political commentator and Professor of Law at the Singapore Administration University. However, “from a public health perspective, migrant workers are an integral part of society, but for some reason, early actions to stop the spread of the virus in communities did not involve foreign workers.”
Last week, Prime Minister Lee Hsien Loong reported that infections among the majority of foreign workers were mild and promised that the government would take care of their health, well-being and livelihoods.
The quarantine challenge
Singapore is currently entering its fourth week of partial quarantine. Social gatherings are prohibited, only essential companies can operate. Schools are finally closed. The introduction of quarantine has been unusually easy for a country that is generally praised for effective governance and whose citizens are known to discipline the law. Sanctions have also been introduced for violating the new rules of social isolation. The first offense was initially punished with a warning, but within a few days the fine increased to $ 300. Just before quarantine began, the government banned any gatherings, though previously only 10 or more people were banned.
“The power to change instructions, sometimes they change several times a day, does not inspire confidence that we are the gold standard,” said Inderjit Singh, a former member of parliament for the ruling Popular Action Party.
Minister of National Development Lawrence Wong on April 14. He told reporters that Singapore is adjusting its measures according to the circumstances: “Our position has not changed, our strategies and attitudes have not changed either,” said Wong, who chairs the antivirus task force.
Singapore reports that it is currently aggressively testing the foreign worker community. It is also accelerating the construction of dormitories and relocating thousands of healthy workers working in key industries to temporary housing with more space. These include military camps, social housing, and marine housing commonly used in the maritime industry.
The Labor Minister, Josephine Teo, assured that living conditions in the bedrooms should improve. This will be done despite opposition from employers, who will have to bear the higher costs: “This is not only correct, but also for our own good,” he said. she emphasized in a Facebook post.
Patient no. 42 The condition is now stable: After two months of intensive care hooked up to a ventilator, but while in the hospital, she lost the birth of her first child on April 16. Facebook reported the Migrant Workers Center. “You can breathe on your own now, but you will need to receive speech therapy as soon as you start to recover.”
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