The world last week: Raising the Covid-19 warning level to extremely serious

Efforts to prevent

Singapore was one of the first countries to be hit hard by the SARS-CoV-2 virus that spread from China in January. But with strict surveillance and quarantine, the small Southeast Asian nation has stemmed the tide of Covid-19 with measures that have received praise from the World Health Organization (WHO), such as efforts to trace infected people, strict isolation measures, and timely travel restrictions. Singapore's response also shows that the disease can be contained without resorting to lockdown measures. Many countries look to Singapore with admiration as a model for the world in effective epidemic control, as the country has been able to maintain a very low infection rate, while schools and shopping malls remain open and people's daily lives are not much disrupted.

A deserted view of Singapore's famous Merlion Park as the country enters phase 2 of the pandemic. Photo: Reuters

Although the island nation's approach has been assessed by WHO as "trying every possible measure to prevent the epidemic", Singapore has not been more successful in the fight against Covid-19, and is even starting to show signs of stress. On April 1 alone, Singapore recorded 74 more positive cases of the virus, and on April 2, it recorded 49 new cases. In early March, Singapore had just over 100 infections, but after 1 month, the country has reached more than 1,100 cases. More than 70% of the infections are domestic. The increase in community infections has caused authorities to have a "headache" because of cases of unknown origin, or unrelated to previous Covid-19 patients. This shows a new measure of the spread of the disease in the community, and the epidemic picture is no longer as optimistic as before. “Singapore’s approach is by far one of the best,” said Michael Osterholm, an infectious disease expert at the University of Minnesota. “The reality of the outbreak in Singapore is that this is a virus that is difficult to defeat and contain.”

Meanwhile, Singaporean health officials say that a complete lockdown is unlikely to eradicate the virus, and that any measures taken in the future need to be sustainable during an outbreak that could last for months. Tougher measures will be implemented, such as closing schools and offices. “Frankly, we are worried because we are seeing more unlinked cases. And that is a sign of sporadic community transmission that we are having trouble handling,” said Teo Yik Ying, dean of the Saw Swee Hock School of Public Health at the National University of Singapore, adding that if Singaporeans refuse to take simple measures, “no matter what the government does, the outbreak will not be controlled.”

Checking body temperature to prevent Covid-19 infection at Changi International Airport, Singapore. Photo: VNA

As new research suggests that the SARS-CoV-2 virus can be transmitted even before symptoms appear, experts are increasingly stressing the importance of social distancing. Many argue that Singapore is still lax in implementing this measure, as evidenced by the fact that only 40% of employees in companies are working from home. Infectious disease expert Leong Hoe Nam recommends that people be more aggressive in implementing social distancing, because “the current measures are not enough to defeat the epidemic. Instead, the epidemic will defeat us because of the lack of preparedness of some people.”

Next week, Singapore will close workplaces from April 7 and schools from April 8. Essential services such as markets, supermarkets, clinics, hospitals, transport services and banks will remain open. All entertainment venues such as parks, museums, casinos, gyms, swimming pools... will be closed. These are considered Singapore's latest strict measures in the context of the unpredictable epidemic.

The “surreal” calm

Unlike its neighbors Denmark, Finland and Norway, Sweden is going it alone in its fight against Covid-19, with no borders closed, schools, businesses and all activities continuing as normal. There seems to be a “surreal” calm in this European country of more than 10 million people, and in the face of warnings that half of Sweden’s population will be infected with the virus by the end of April.

People enjoy a leisurely stroll to see cherry blossoms at Kungstradgarden in Stockholm, Sweden. Photo: AFP

The global pandemic has frozen Europe’s top economies and forced millions of people across the continent to work from home. Yet Sweden has refused to take the drastic measures seen in many other European countries. Supermarkets, bars and restaurants remain open, and train stations and buses continue to ferry people across the country. No lockdown has been imposed, despite the country’s rising caseload.

To ease public concerns that the shocking images from Italian and Spanish hospitals might one day be replicated in Sweden, authorities have tightened other rules, such as limiting gatherings to 50 people instead of the previous limit of 500. The government has also issued guidelines for citizens to avoid traveling during rush hour, and for those over 70 to limit social contact and not visit relatives during Easter. Sporting events such as soccer matches have also been asked to be canceled.

Sweden’s public health agency, which has been leading the country’s response to the pandemic, has taken a different approach and ignored the warnings of its peers around the world. Swedish health officials say they do not deny the dangers of Covid-19, but believe they can manage it gently, relying on a sense of responsibility from the public, alongside regular advice. “That’s how we work,” says Anders Tegnell, Sweden’s chief epidemiologist. “All of our disease control systems are voluntary.”

Hundreds of beds are set up at a field hospital being built inside the international fairgrounds in Stockholm. Photo: AFP

This approach has drawn criticism from within Sweden itself. Panic is being felt by the Scandinavian nation’s scientific and medical community. A petition signed by more than 2,000 doctors, scientists and professors in Sweden, including Nobel Foundation President Professor Carl Henrik Heldin, has called on the government to introduce stricter containment measures. “It is the failure to test, trace and isolate enough that will lead us to disaster,” said Professor Cecilia Söderberg-Nauclér, a viral immunologist at the Karolinska Institute.

Sweden is currently ranked 19th in the list of countries affected by Covid-19 in the world, with 6,131 infections and 358 deaths (as of 1:00 p.m. on April 4). Sweden's epidemic prevention method is making neighboring countries including Denmark, Finland and Norway feel worried, even describing "what is happening in Sweden as watching a horror movie", although the total number of deaths in these 3 countries combined is still less than Sweden./.