SINGAPORE – Vaccines are supposed to be a ticket off the pandemic boat. In Singapore it was not to be.
The Southeast Asian city-state is widely regarded as a success story for its early handling of the new coronavirus. It closed its borders, conducted aggressive testing and close tracking, and was one of the first countries in Asia to order the vaccine.
A senior political figure had told the public that the phased reopening was contingent on an 80 percent vaccination rate. Singapore, which has now fully vaccinated 83 percent of its population, has not opened up, but has done the opposite.
In September, with cases doubling every eight to 10 days, the government reinstated restrictions on gatherings. The U.S. advised citizens to reconsider travel to the country. Long lines began forming at the emergency departments of several hospitals. People were again being told they should work from home.
The Singapore experience has become a sobering case study for other countries that have not had a major outbreak and want to reopen. Residents of Singapore who thought the city-state would reopen once vaccination rates reached a certain level feel devastated, confused about what it would take to reopen if reaching vaccination rates didn’t make it possible.
“In a way, we are victims of our own success because we have achieved as close to zero new crown infections and very, very low mortality rates as possible,” Dr. Paul Tambyah, an infectious disease specialist at the National University Hospital (NUH) in Singapore ( Paul Tambyah) said. “So we want to stay ahead of the curve, but that’s hard to do.”
Singapore’s Finance Minister Wong Choon Choy. ore HUIYING FOR THE NEW YORK TIMES
Singapore’s cautious – and some say overly cautious – approach to reopening stands in stark contrast to the United States and Europe, where vaccinated people have run off to concerts and gathered at holiday celebrations and other big events. But unlike Singapore, both places had to deal with serious mass outbreaks in the early stages of the pandemic.
Singapore’s finance minister and head of the country’s new coronavirus working group, Huang Zhuancai, said that “lack of new coronavirus experience societies” (Covid-naive Societies) such as Singapore, New Zealand and Australia need to do their homework, “no matter how extensive the vaccine coverage “, they need to be prepared for mass infection.
“Once you reopen, more social interactions will happen,” he said. “Given the highly transmissible nature of the Delta (variant) strain itself, there will be large outbreaks of aggregation.”
The vaccine has kept most people out of the hospital, and 98.4 percent of cases are mild or asymptomatic. Deaths have occurred mainly in the elderly, usually with comorbidities, with deaths accounting for 0.2 percent of cases in the past 28 days. However, Wong Choon Choi said the vaccine does not prevent infection, especially when fighting the delta variant strain.
“In Singapore, we don’t think we can rely on the vaccine alone at this intermediate stage,” he said. “That’s why we don’t plan to reopen and declare freedom all at once.”
A sparsely patronized restaurant in Singapore in September.ORE HUIYING FOR THE NEW YORK TIMES
Two weeks after the restrictions were put in place, the country will review them on Monday and make adjustments based on community conditions. For Wong Zhuan Cai, one possible scenario for the outbreak in Singapore and elsewhere is that measures to wear masks, restrict travel and keep social distance are likely to continue until 2024.
He stressed that Singapore is still on the road to coexistence with the new coronavirus and said he recognizes that any form of tightening, no matter how small, will cause anger and frustration as people rush to return to normal life. “But we have to adjust to reality, to the situation we face,” he said.
Last month, officials rushed to build community treatment facilities equipped with oxygen tanks, requiring people with mild or no symptoms to recover at home. Many Singaporeans say they don’t know what to do, and the government seems ill-prepared.
“If the health care system is overwhelmed, and we know from experience everywhere that doctors can’t cope at times like this, the death rate will start to rise,” Wong Choon Chye said. “So we’re trying to avoid that.”
Several doctors have disputed the government’s claim that the health care system is under enormous pressure. Tambiya is also the chairman of an opposition party that recently developed an alternative strategy to deal with the outbreak. Tambiya said there is plenty of cushion in hospitals because Singapore has canceled all elective surgeries.
For many, the repeated adjustments in restrictions have had a detrimental effect.ORE HUIYING FOR THE NEW YORK TIMES
The problem for Singapore’s leaders, he said, is that they are “essentially transitioning from zero new crowns to living with the virus.
For many, the repeated adjustments to the restrictions have taken their toll. 2020 saw the highest number of suicides since 2012, a trend some mental health experts attribute to the epidemic. There are calls for the government to consider the mental health problems caused by the restrictions.
“It’s economically, socially, emotionally and spiritually unsustainable,” Devadas Krishnadas, CEO of Singapore-based consulting firm Future-Moves Group Krishnadas) said. After reaching such high vaccination rates, he said, Singapore’s decision to reintroduce restrictions made the country a global outlier.
“Importantly, it has made a 180-degree turn in Singapore, in the opposite direction of the rest of the world,” he said. “This brings us to a strategic question: where will Singapore go if we don’t get off what I call the open-and-close hamster wheel?”
Community food stall operators waiting for customers. ore HUIYING FOR THE NEW YORK TIMES
Marketing manager Angeline Ng (Angeline Ng) said the situation this year is even tougher than last year. Before her father died in May this year, she had to deal with strict hospital visitation restrictions, which were an emotional ordeal. In July, the government announced it would tighten social restrictions again, leaving her even more exhausted.
She says, “I think too often we are so focused on getting good outcomes that it narrows our perspective.”
Angelina Wu lives across the street from a testing center. Almost every day, she sees a steady stream of people going to get tested. Many public health experts say the strategy is a waste of resources in a country with a high level of vaccination.
“As our ministers have said, Freedom Day is not Singapore’s style,” said Jeremy Lim, an associate professor at the National University of Singapore and a health policy expert. He was referring to Britain’s reopening this summer. But he said it was a “bad public health” strategy to act too cautiously, regardless of the potential drawbacks of the restrictions.
In Singapore, people work and study from home. ore HUIYING FOR THE NEW YORK TIMES
“The government should not wait for the perfect conditions to emerge to reopen,” Jeremy Lim said. “Because the world is never going to be perfect. It’s almost like politicians are waiting for better conditions, and it’s so frustrating.”
Sarah Chan, who works in business development, said she had a brief taste of normalcy when she traveled to Italy last month to visit her husband’s family.
No masks were required outdoors, vaccinated people could gather, and Sarah Chan and her son could bob their heads to music in a restaurant. In Singapore, music is banned in restaurants because it could encourage the spread of the virus.
Sarah Tan said her time in Italy was so moving that she even cried.
“It was almost like a normal state. You forget what it’s like,” she said. “I really miss that feeling.”