Singapore will have to live with Covid-19 for some time, expect ‘recurring waves’: NCID executive director

SINGAPORE — It is not sustainable for Singapore to remain in its circuit breaker phase to stem the spread of Covid-19, and the nation will have to live with the coronavirus for some time until a vaccine is found, said National Centre for Infectious Diseases (NCID) executive director Leo Yee Sin.

But until then, the country will have to buy itself time to reduce the impact of the virus by having a solid plan in place, said the infectious diseases specialist.

“We are hoping to be able to suppress the transmission (of the virus), but I do not think we can attain complete elimination,” Professor Leo said on Thursday (May 14) evening during the sixth edition of the Covid-19: Updates from Singapore webinar series.

The webinar was jointly organised by the World Health Organization’s (WHO) Global Outbreak Alert and Response Network, the National University of Singapore’s Yong Loo Lin School of Medicine and the National University Health System.

Prof Leo said that an expert healthcare system would help to reduce mortality and morbidity.

Sharing information from the WHO, Prof Leo said that completely interrupting human-to-human transmission “is not very attainable at this point”, given the characteristics of the virus.

“It is very likely that we will have recurring epidemic waves interspersed with periods of low-level transmissions,” she said. “In other words, we need to have the ability and capacity to be able to cope with intermittent surges (in infections).”

This means that there must be adequate healthcare facilities to handle new cases as they come.

There must also be enough personal protective equipment (PPE) and trained healthcare workers on standby to be able to provide patients with optimal care, Prof Leo said.

Beyond these measures, she said that active case findings and contact tracing must continue, and Singapore will also need a “rapid response team” to counter any of the potential epidemic waves in the future.

“We are all waiting for more good news for effective pharmaceutical interventions… and of course, we are all waiting for that one day we have effective vaccines available,” said Prof Leo.

During her talk that lasted about 40 minutes, Prof Leo also dealt with concerns about front-line workers getting infected with Covid-19.

She said that right now, it is hard to tell whether the infections happened within a healthcare facility or in the community.

“If you look at the current data, a majority of them acquired the infections within the community rather than having clear-cut evidence that they acquired the disease in the hospital,” said Prof Leo.

She noted that the disease transmission is predominantly during the pre-symptomatic and early phase of clinical illness.

“Clinical illness tends to be very mild at the onset, and many people do not worry. They are still moving around and going through their daily activities,” she said.

“So the infection is actually out there in the community, rather than concentrated in the nosocomial (hospital-acquired) setting.”

What this means, she said, is that healthcare workers can no longer rely on just putting on their PPE when dealing with patients to protect themselves.

They will also have to observe all the necessary precautions when interacting with co-workers, such as by keeping a safe distance and wearing a mask.

“The disease not only transmits from patients to healthcare workers; it can be (a result of) just social interactions among the healthcare workers and among staff.”