Explainer: Why is Singapore’s Covid-19 death rate the lowest in the world?



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Singapore has the lowest coronavirus case fatality count globally, with just 27 deaths among the more than 57,000 people who have been infected with Covid-19 on the Southeast Asian island.

At 0.05 percent, Singapore’s death rate is well below the world average of about 3 percent, according to data compiled by Reuters from countries that have recorded more than 1,000 cases.

A comparison with countries with a similarly sized population shows a big difference: Denmark’s death rate is around 3 percent, while Finland’s is around 4 percent.

In addition, no one has died from the disease in Singapore for more than two months, according to its health ministry. The country’s leading disease experts said the following are the main factors behind the phenomenon:

Demographics of infection

About 95 percent of Singapore’s Covid-19 infections occur among migrant workers, mostly in their 20s and 30s, who live in crowded dormitories and are employed in labor-intensive sectors such as construction and construction. naval building.

While disease parameters continue to be studied as the pandemic progresses, current global trends suggest that its impact has been less severe for younger people, many of whom show few or no symptoms.

Detection

Singapore has managed to mitigate the spread of the virus through early detection through aggressive contact testing and monitoring that earned praise from the World Health Organization (WHO).

It has sampled nearly 900,000 people, more than 15 percent of its 5.7 million inhabitants, according to official data, one of the highest per capita rates in the world.

Dorm residents have been subjected to a testing regimen on a list, authorities have conducted massive testing in vulnerable communities such as nursing homes, and anyone over the age of 13 with signs of acute respiratory infection is offered a free test.

“The more we diagnose, the lower the death rate,” said Hsu Li Yang of the Saw Swee Hock School of Public Health at the National University of Singapore.

Hospitalization

The preventive approach has also been applied to treatment. Covid-19 patients older than 45 or with underlying conditions that make them vulnerable are cared for in the hospital even if they are well, the doctors said.

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“Our care is conventional but performed well – fluid management, anticoagulation, and both proven drugs and participation in drug trials,” said Dale Fisher, senior consultant at the National University Hospital of Singapore.

Singapore was already a center for medical tourism for Southeast Asia, with numerous private hospitals and high-quality public healthcare facilities. It also built bed space for coronavirus patients in cavernous exhibition rooms and other temporary facilities to house those with mild or no symptoms.

This kept the health system from being overwhelmed so that attention and resources could be focused on the most serious cases, the doctors said. Singapore currently has no Covid-19 patients in intensive care, while 42 are in hospitals and 490 more in temporary facilities.

Mandatory masks

The city-state made the masks mandatory in public in April. While experts have said more studies are needed, there is growing evidence that wearing masks helps reduce the prevalence and severity of the virus. The WHO has recommended the use of masks in combination with other social distancing measures.

“We have adopted a good mask culture in Singapore. This makes the disease milder,” said Leong Hoe Nam, an infectious disease expert at the city’s Mount Elizabeth Hospital.

Classification

Singapore rigidly adheres to the WHO case definition for classifying deaths from Covid-19. It does not include deaths not related to pneumonia such as those caused by blood or heart problems among Covid-19 patients in its official tally.

“I have no doubt that if the WHO revises its case definitions, some of the non-pneumonia-related deaths will be reclassified and the death rate will change,” said Paul Tambyah, president of the Asian Society for Clinical Microbiology and Infection. Pacific, without specifying how much it would likely change.

The Health Ministry has said its approach is consistent with international practice, although some countries like Britain have taken broader counts. NUH’s Fisher said any change to the reclassifications in Singapore would be marginal.

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