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SINGAPORE: In the seven months since the pandemic was declared, there has been a radical shift in goalposts to control it.
Initial optimism that COVID-19 would be neutralized by the summer temperatures turned into global lockdowns and now a new normal for wearing masks, social distancing and telecommuting for the foreseeable future.
With its hot climate, fast-paced urbanization, and lush biodiversity, Southeast Asia is particularly susceptible to future outbreaks of infectious diseases.
The US Centers for Disease Control and Prevention (CDC) estimated that approximately 75 percent of emerging infectious diseases (EIDs) found in humans are zoonoses, which originated in animals.
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According to the Food and Agriculture Organization of the United Nations (FAO), 60 percent of the world’s pigs and 43 percent of its poultry were produced and raised in East and Southeast Asia in 2012.
These numbers would have grown exponentially since then, causing rapid deforestation and a boom in unregulated wet markets, wildlife trafficking, and factory farms, all of which have increased the number of human-animal interactions leading to transfer. of diseases and mutations between species.
Despite these risks, the borders of the trade-dependent nations in this region cannot remain closed as the global recession deepens.
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As a key regional hub for business, aviation and shipping, home to Asia’s premier foreign exchange hub and the world’s second-largest container port, Singapore is strategically positioned to lead cargo by demonstrating how to prevent a second wave and set a benchmark. global. how to build a sustainable pandemic preparedness program.
This is especially true as Singapore is easing some of its travel restrictions. On Monday (October 26), Singapore and Indonesia opened a reciprocal green lane for essential commercial and official travel between the two countries.
Singapore will allow travelers from Brunei and New Zealand with just a virus test, while the quarantine period will be shortened to seven days for arrivals from low-risk regions, including most of Australia, China, Taiwan, Vietnam and Malaysia AFP / Roslan RAHMAN
Singapore is also exploring similar deals with other countries like Australia and Germany, while establishing a travel bubble with Hong Kong.
PREVENT A SECOND WAVE
In the early days of the outbreak, European governments, in particular, warned of an eventual desensitization to containment measures should they be implemented too soon.
There is concern that “pandemic fatigue,” as some psychologists call it, has also crept into Singapore as people become less wary of social distancing.
When Phase 2 began in mid-June, then-Minister of the Environment and Water Resources, Masagos Zulkifli, warned of the large crowds and mixing of groups seen on the beaches. More recently, Sentosa implemented capacity limits and pre-booking on its beaches to control crowds.
We still see the occasional reports of people being fined or charged for disobeying restrictions, although it must be said that these involve a small segment of the population.
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However, pandemic fatigue can be a real problem, so in order to continue to manage epidemics effectively in the future, more behavioral studies are needed to examine what will motivate people to change their daily actions on short notice and keep them long term.
When it comes to mask use, research from the US National Academy of Sciences (NAS) shows that individual mask use is often driven by a desire to be perceived as socially responsible by other mask wearers. .
In short, all citizens must understand that their individual adherence to health guidelines is crucial to maintaining the majority required to turn an action, such as constant use of contact tracing applications, into a norm.
Tourists with face masks sitting on the swings at Raffles Place in Singapore. (Photo: Jeremy Long)
One advantage the government has is that COVID-19 has given it the opportunity to advance its strategic pivot towards self-sufficiency in technology, tools and services related to the protection, detection and decontamination of infectious diseases in line with its broader vision. of Singapore as a smart nation.
A nation of digital natives is also better equipped to understand these measures, allowing for their rapid implementation – the widespread adoption of the TraceTogether app is just one example of how Singapore is setting a global standard in contact tracing.
REDEFINING PANDEMIC PREPAREDNESS
Hopefully all future virus outbreaks will not turn into a pandemic. However, the government must get ahead of this by strengthening Singapore’s pandemic preparedness efforts, especially as the COVID-19 threat is far from over.
Like emergency response training, public education is essential for epidemic preparedness.
Only when all citizens understand the next steps of a crisis will they be able to participate in its solution. One way is to foster a better understanding of viral outbreaks through school curricula.
While the evolutionary nature of infectious diseases means that it is difficult to predict the next outbreak or the nature of it, schools have yet to delve into the important role that national health systems play in society, as well as instill in young minds the importance of personal hygiene. develop psychological resilience and emphasize the responsibility that people have in the fight against a pandemic.
These are useful tools to help the nation prepare for the next outbreak, COVID-19 or otherwise.
Singapore’s initial success in controlling COVID-19 can be attributed to its rigor in early detection.
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The outbreaks detected in the dormitories of foreign workers were mitigated by massive testing and authorities should seek to increase our bio-surveillance capacity in Phase Three so that Singapore can lead the way in mapping the build-up of immunity.
The joint tests have been tested to address the shortage of test kits when the outbreak was first detected in the dormitories of migrant workers. In the future, this could be a viable solution to delineate infected groups across the island.
FILE PHOTO: A migrant worker undergoes a nasal swab test as medical workers look at a bedroom amid the coronavirus disease (COVID-19) outbreak in Singapore, April 28, 2020. REUTERS / Edgar Su
Monitoring should also be extended to recovered patients with recent data on antibody durability that vary significantly from initial results.
While previous studies indicated a sharp drop in antibodies a few months after infection, in September deCode Genetics found that antibody levels increased and then remained stable for up to four months in more than 90 percent of patients recovered in Iceland.
The lack of clarity, coupled with evidence of reinfections caused by slightly different strains of the virus, raises concerns about the duration of immunity and the risk of reinfection.
A COORDINATED REGIONAL RESPONSE
The complexity of viruses and the need to keep borders open in the long term means that Singapore must also be aware of the risks of outbreaks in the region.
Asia, as a region, lacks a harmonized regulatory approach to medical testing and development, hindering scientific collaboration, pandemic response capacity, and the accessibility of innovative treatments.
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As a biomedical and R&D center, Singapore can lead the way in establishing a robust and responsive framework that accelerates the development and commercialization of domestically developed therapies, diagnostics and vaccines.
While most nations have indicated their willingness to do so, the main challenge is staying motivated once the pandemic recedes.
To begin with, the government can turn to the International Council for the Harmonization of Technical Requirements for Pharmaceutical Products for Human Use (ICH) for guidance on how to build a coordinated regulatory framework for Asia.
Around the world, governments are racing to secure their country’s vaccine supply even as candidates are being developed. Storage, without hoarding, will bolster Singapore’s defenses against the possibilities of a future outbreak.
A community COVID-19 screening center in Ang Mo Kio on October 16, 2020 (Photo: Facebook / Lee Hsien Loong)
A more preventive approach can also be taken by ensuring a constant supply of personal protective equipment, such as face masks and medical equipment, such as ventilators, before a disease outbreak, so that front-line medical workers have the supplies they need. for Save lives.
PRACTICAL AND PSYCHOLOGICAL PANDEMIC PREPARATION
The bottom line is that preparing for a pandemic has two components: the practical and then the psychological. The latter refers to the importance of developing psychological resilience in the face of a calamity, maintaining it even when no discernible end is in sight.
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COVID-19 has highlighted our need for a longer-term, unified approach not only to pandemic response capacity, but also to preparedness.
Therein lies Singapore’s opportunity to lead by example not only by flattening the curve, but also preparing to face the next wave in better shape.
Dr. Priyabrata Pattnaik is currently Director for Asia Pacific in Merck’s Life Sciences business, a member of the Board of the Parenteral Drug Association (Singapore Chapter), specializing in infectious diseases and vaccine development. He was previously a research scientist at the United Nations International Center for Genetic Engineering and Biotechnology (ICGEB).
