By Faris Mokhtar and Philip J. Heijmans
(Bloomberg) — Singapore, traditionally a global beacon of openness and connectedness, is grappling with how to chart a path through the lingering Covid-19 pandemic as officials worry that any significant relaxation will compromise their hard-won success against the virus.
The city-state has largely managed to stamp out infection and 36 people have died in the entire pandemic, compared to thousands elsewhere. With access to the highly effective messenger RNA vaccines and a largely compliant population, its immunisation rate leads the region. Singapore plans to give a first Covid-19 vaccine shot to most of its population by the end of July after securing more supplies.
Government officials have flagged reopening prospects, saying they’re drawing up a roadmap that will shift focus from daily infection counts to hospitalisations, and treat Covid-19 as endemic. Yet even as rival financial centre Hong Kong presses forward with easing travel and other restrictions for vaccinated residents — despite its overall lower rate of coverage — Singapore hasn’t made clear its path to the post-pandemic era with a timeline or details, for reasons likely ranging from the city’s low infection rate to its uncertain political transition.
The stalemate is causing tension. On the ground, businesses, residents and even doctors are pushing for bolder action, with some physicians saying the medical system can cope if any moves lead to a rise in cases. In the latest flareup, infections were less likely to lead to severe illnesses than in the past thanks to protection offered by the vaccines.
“Singapore cannot and will not remain closed. Open borders and trade are our lifeblood,” said Jeremy Lim, associate professor at the Saw Swee Hock School of Public Health under the National University of Singapore. “It all boils down to the risk appetite on the part of the decision makers, and clarity. And you do get a sense from the ground that people are getting fatigued and frustrated.”
The city’s exit path is being closely watched, a potential template for other areas that have contained the virus, vaccinated their populations and now want to rejoin the world. While Singapore is not alone in this dilemma, other isolationist Covid havens like mainland China and Australia have more domestic-focused economies, allowing them to remain cut-off for longer.
Billions at Risk
Singapore is facing a tourism gap that brought in US$20 billion in 2019 and risking its reputation as a top international business hub, with the expatriate community growing restless with the tight restrictions. High-profile global events like the World Economic Forum and Formula One night race that were supposed to take place later this year have been scrapped, while others like Gastech are moving to more open host locations like Dubai.
The city’s hurdles encapsulate the difficult transition that governments must navigate to exit the Covid era. It’s not clear how long the process will take, with even highly-vaccinated countries like Israel occasionally re-instating some restrictions or delaying further reopening as the fearsome delta strain spreads.
Singapore is starting with a change in how officials talk about the virus, pivoting from a perception of it as a crisis-level threat to something that is endemic and even mundane.
A single case no longer carries as much weight as it did before widespread inoculation, said Dale Fisher, an infectious diseases physician at Singapore’s National University Hospital.
If a person is infected with Covid-19, but all his co-workers and most of his family were vaccinated, only a handful of his contacts might actually get the disease, Fisher said, adding that “probably none of them will be severe anyway.”
Healthcare workers check the identity of residents at a mandatory Covid-19 test site.
In order to embrace the endemic narrative, it will be critical to trust vaccines, said Donald Low, professor at the Institute of Public Policy of the Hong Kong University of Science and Technology. Cutting quarantine time for vaccinated travelers, perhaps a bigger reduction than Hong Kong’s move to slash isolation periods by half to seven days, would send a strong message that even if people contract the virus, most will have mild or no symptoms, and very few will require hospitalisation.
“This, in turn, helps people to accept that even though vaccination does not eliminate the virus, it allows society to return to normality sooner,” Low said.
Officials have been seeding the idea that the nation has to live with the virus. Three ministers wrote in a column in a local newspaper last week that they want to turn the pandemic into “something much less threatening,” citing examples like influenza and chickenpox.
At a recent briefing, they also spoke about having large social gatherings and replacing quarantines with more testing when traveling for vaccinated people, without providing details. In a Facebook post, Health Minister Ong Ye Kung said that snap lockdown measures are likely not to be imposed again, given the city’s capacity in testing, contact-tracing and vaccination.
Yet the government itself appears to be fearful of treading into uncharted territory. Officials last week said that not even fully vaccinating two-thirds of the population — a rate that even Israel hasn’t reached — is enough to fully reopen with confidence, raising the question of what is.
The city-state aims to fully vaccinate two-thirds of the population by National Day, or Aug. 9, a day that marks its independence, at which point there will be some reopening, promised Health Minister Ong last week. Still, coverage needs “to go further than two-thirds, especially given the transmissibility of the delta variant, and for the elderly,” he said.
Part of the hesitation likely comes from the fact that unlike the U.S., European nations or Israel which faced raging outbreaks before vaccination, most Singaporeans have never been infected and lack protective antibodies.
Another major factor may be political pressure. The ruling People’s Action Party will want to prevent a repeat of the initially bungled handling of a Covid-19 outbreak among low-wage migrant workers last spring that led to tens of thousands of infections.
Months later, a rare political setback for the party occurred at the ballot box, with the opposition winning a record number of seats. Shortly after, the politician who was heir apparent to Prime Minister Lee Hsien Loong bowed out, citing his age. It sent a tremor through a nation known for political stability.
Both Finance Minister Lawrence Wong and Ong, who jointly oversee the virus taskforce, are in the running for the premiership, which currently has no clear successor. How Singapore exits Covid-19 — and whose vision brings that outcome about safely — is likely to be a deciding factor.
“Singapore has always prided itself to be exceptional, even at crisis management,” said Eugene Tan, a political commentator and an associate professor of law at the Singapore Management University. “The cautiousness is in many respects exacerbated by the fourth-generation leadership seeing the pandemic as a litmus test and the outcomes critical for its performance legitimacy.”
And the leadership transition, in some respects, is “complicating the whole-of-government messaging,” Tan said. “While there is a consensus on how to tackle the pandemic, the differences tend to cohere around the pace of re-opening the economy, the borders, and the restrictions.”
Can You Cope?
Even with the latest, delta-driven wave, Singapore has yet to see daily cases surpass 50. And the number of hospitalisations, currently at 144, are down from the staggering numbers — more than 1,800 at one point — seen during the mass outbreak among low-wage migrant workers. Only a handful of people are now in critical condition.
Singapore’s reopening decision should hinge on whether the health care system can cope, said the National University of Singapore’s Lim. “And the short answer is, at least in the Singapore setting, yes it can.”
If reopening in the U.S. and Europe continues safely, Singaporean residents will reasonably ask why the city-state can’t do the same, especially when people are dutifully queuing to be vaccinated and practicing social distancing, Lim said.
Even with government aid, businesses are hurting. Restaurants had to dip into their cash reserves during the tightened restrictions in May, which were already depleted after the lockdown a year ago, said Lim Jialiang, the owner of a beer distributor firm called Watering Hole.
“It would be better for the government to spell out what’s their plan clearly and in advance because then we can plan and forecast demand,” he said. “Otherwise, it’s all too disruptive.”
© 2021 Bloomberg L.P.