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Singapore is at a crossroads.
Community cases here are extremely low now, with only six in the last fortnight.
This means that measures to contain the virus here are working and Singapore should be able to alleviate them significantly with little risk, experts told The Straits Times.
Singapore may also open its borders to visitors from countries with an equally low spread of the virus.
But it shouldn’t do both, experts cautioned.
Each relaxation of the measures, whether internally or in terms of border control, increases the risks. Doing too much too soon could result in a big second wave outbreak, they explained.
Singapore has decided to open its borders, with the promise of a slight relaxation of internal measures, as long as infection figures remain low.
People in general have welcomed the move that makes travel easier without the need for a 14-day quarantine.
But allowing travel to resume, even in a controlled manner, exposes the country to the risk of imported infections that could spread to the community, experts said.
Globally, there are more than 400,000 new Covid-19 infections and around 5,000 deaths per day.
With winter approaching in the northern hemisphere, there are fears that the numbers will rise.
While this is not the best time to allow freer travel with the countries of that country, delaying it would mean a delay of several months.
Professor Teo Yik Ying, dean of the Saw Swee Hock School of Public Health at the National University of Singapore, said Singapore should be careful about which countries it opens its borders to.
“There are certainly low-risk countries and territories, including New Zealand, Hong Kong, Taiwan, Thailand, Vietnam, Australia and China, where public health and border control measures are sensible, effective, and are properly implemented and enforced,” he said. .
“At the other end of the spectrum, there are high-risk countries where there is rampant broadcasting in the community, in part due to inadequate or poorly applied measures.”
Associate Professor Alex Cook, the school’s vice dean for research, noted that if the prevalence of Covid-19 in the other country is the same as in Singapore, “there is no additional risk of people traveling from one to another, and even less risk if there are tests before departure and on arrival “.
Dr. Asok Kurup, who chairs the Infectious Disease Physicians Chapter of the Academy of Medicine, questioned why Singapore opens its doors to Indonesia, which faces thousands of new infections daily.
Singapore has also announced green lane travel with Germany, which is experiencing thousands of new Covid-19 infections daily and has been blocked.
“Countries that have not had sustainable case mitigation should not be considered for reciprocal trips down the green lane,” Dr. Kurup said.
Travel arrangements vary with each country. Some involve the need to adhere to strict itineraries, while for others, visitors are free to roam at will.
Although travelers must be tested prior to their trip and / or upon arrival, the risk of allowing the trip to resume lies in foreigners bringing the virus here, as well as Singaporeans becoming infected abroad and returning without being detected.
The tests detect only people who are infected, and not those who have the virus during the incubation period.
Professor Cook said: “Replacing the quarantine with pre-departure and post-departure testing could filter 80 to 90 percent of cases, depending on the tests you are doing.”
While opening the borders will increase the risk of bringing the virus and reintroducing Covid-19 into the community, not opening the borders will have a significant negative impact on the economy and employment.
Singapore has always looked at the world as inside. Business travel and tourism are one of the main contributors to the economy, not only bringing in money, but also providing tens of thousands of jobs in related sectors.
Tourism accounted for 4 percent of gross domestic product last year, or about $ 20 billion in direct contribution.
Other than that, ease of travel is one of Singapore’s selling points for attracting investment.
As Transport Minister Ong Ye Kung told Parliament earlier this month: “When a company makes a significant investment in Singapore, a key reason for it to do so is our superior air connectivity because that means its customers, suppliers , partners and key executives can travel in and out of Singapore easily. “
He added: “The longer our borders are closed, the greater the risk of losing our air hub status and our attractiveness as a place to invest and create jobs because of those investments.”
Experts interviewed are confident that Singapore will be able to handle any importation of the virus, with the cooperation of the public.
People here should continue to sanitize their hands, wear masks, and make sure they are within one meter of the next person. Restrictions on large gatherings must be maintained. This will limit the spread of the virus if travelers bring it.
Professor Cook said: “I am sure that we will see clusters caused by importation, but it is worth noting that the measures we have in place have been able to contain community transmission since June.”
Dr Kurup added: “I don’t think we will go back to the gloomy days before, as long as we maintain the current public health measures that need to be maintained.”
Professor Teo said that if measures here are significantly eased and large gatherings are allowed, then any community spread could occur “at an accelerated rate.”
But if the measures are properly adhered to and meetings are limited and controlled, the spread can be contained to manageable levels, even if there are traveler leaks, he said.
Furthermore, Singapore is much more prepared today than it was at the beginning of the year, when infected visitors brought the outbreak here. About 58,000 people have been infected and 28 have died.
Said Professor Cook: “Back then, we didn’t have the testability that we have now, we didn’t have all the plugins for our contact tracing (TraceTogether and SafeEntry) that we have now, and the use of masks was not required.”
Professor Dale Fisher, an infectious disease expert at National University Hospital, agreed. “Measures such as masking, safe distancing and limiting the size of meetings are key to opening our borders.”
He said that while opening to visitors is not without risk, “it is not risk without benefit.” “In fact, it is a small risk with a large benefit. I am confident that Singapore can handle additional cases if they occur.”
Professor Leo Yee Sin, executive director of the National Center for Infectious Diseases, said Singapore has been able to keep community cases low thanks to “the effort and cooperation of everyone in the community.”
Countries with less stringent measures and that are open to travel continue to suffer large numbers of infections and deaths every day.
Professor Leo said that the relaxation of border controls and other measures “must be calibrated with the ability to cushion the disadvantages.”
Countermeasures must also be in place and implemented quickly if necessary. These include adjusting border controls in case the numbers increase.
Professor Cook said that the impact of allowing freer travel with partner countries depends on three factors: how many people arrive in a day, what is the incidence in the country of origin, and what fraction of infected travelers are filtered through border measures. .
“If we only admit a handful of business men or women, or visiting dignitaries, then we can accept a more porous network. If we expect mass tourism with tens or hundreds of thousands of travelers a day, then we need a net that will capture the cases more comprehensively, “he said.
However, even without the quarantine required, Singapore is unlikely to see a flood of tourists, given the cost of the test, which is about $ 200 here.
Since September 1, visitors from Brunei and New Zealand can enter without quarantine requirements, but so far there has not been a large influx. They have not reciprocated the arrangement for Singaporeans who wish to go there.
Singapore is also creating a travel bubble with Hong Kong. This is a two-way agreement and, unlike green lane agreements with some countries, it allows for unstructured leisure travel.
The government is also indirectly encouraging people to travel by providing free Covid-19 testing upon return and subsidized treatment, as well as insurance coverage in case they become infected.
Previously, when travel was discouraged, those leaving Singapore after March 26 had to pay the full cost of any Covid-19 infection diagnosed within 14 days of their return. His treatment was also not covered by his health insurance.
As some of the experts pointed out, the success of loosening travel restrictions to safely boost the economy will depend on people’s willingness to travel while the pandemic is on the rise and people here strictly adhering to it. to protective measures to prevent a massive outbreak.
But one thing is clear: it won’t be exactly like the old days.
As Professor Leo said: “It is important to prepare mentally so that life is not the same as before the Covid-19”.
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