19 March 2020

Did Singapore do everything right in the coronavirus epidemic?

Even in the developing global Covid-19 pandemic of 2020, the nation state of Singapore punches above its weight when the main action takes place in China, South Korea, Japan, then Iran and mainland Europe. Singapore—or some facsimile of it—is summoned, bound and fashioned by the intersection of medicine and politics.

Depending on the narrative, Singapore is a nigh impossible to imitate exemplar of epidemic containment, a non-dysfunctional authoritarian-technocratic polity poised to seduce the democratic West and its allies in its hour of crisis, an embarrassing failure because panic buying did break out in its otherwise well-behaved, obedient, and acquiescent population, or an embarrassing failure because it was for several weeks, the country with the highest incidents of coronavirus infections outside China. Then there is the  Global Health Security Index, whose inaugural October 2019 edition considered Singapore's pandemic preparedness far behind the developed West and even its neighbours in Southeast Asia.

Did Singapore really do everything right? How could it have done everything right if it wasn't expected to do everything right? Can Singapore's pandemic response be considered a success despite its populace succumbing to multiple bouts of panic buying?

Plague in London, 1625
Title artwork from Thomas Dekker's pamphlet "A Rod for Run-awayes"

Is panic buying as a sign of social breakdown, a national shame?
"But it was impossible to make any impression upon the middling people and the working labouring poor. Their fears were predominant over all their passions, and they threw away their money in a most distracted manner upon those whimsies."
Daniel Defoe, A Journal of a Plague Year (1722)
Ignoring Chan Chun Sing's nationalist-moralistic rant for the moment, a dispassionate analysis of the coronavirus panic buying phenomenon can and does exist. Rational people can and do panic and then panic buy in response to imminent epidemics, war, and natural disasters because these events are so far outside their ordinary experience to process psychologically and to solve individually. They panic buy and hoard up to feel they are back in control instead of feeling not in control of the situation. Others see many people panic buying and think they ought to do something too, because frantic action is preferable to passive acquiescence to an impending doom.

(This is why there was panic buying even in Taiwan, which implemented immigration checkpoint temperature testing, strict border controls, mandatory quarantines weeks earlier than the rest of the world and has held on to the world's lowest Covid-19 infection rate crown despite its proximity to China.)

With this explanation, it is possible to reduce panic buying behaviour to the 3 classic elements of mass hysterias (and also predict that bank runs, another classic mass hysteria, are likely to take place in the near future of this pandemic), fear, uncertainty, and doubt: Fear of how many people the coronavirus could infect and kill, uncertainty about the nature of the coronavirus, and doubt in the ability of the state to handle the epidemic.

The first two are in the realm of epidemic medicine and for medical experts to solve, but the third is a an issue of crisis management and communication, solely in the hands of politicians. They are the ones who make the decision that the situation is serious enough to bring in the experts and implement their plans, and also to manage the fear, uncertainly, and doubt of the populace.

Summon the epidemic experts!
Barring spectacular incompetence in a healthcare system or an incorrect epidemic response plan, the ball is the politician's to drop. European Commission president Ursula von der Leyen illustrates the point neatly with her recent admission of failure.
"I think that all of us who are not experts initially underestimated the coronavirus. We understand that measures that seemed drastic two or three weeks ago, need to be taken now"
It's not about who has the best pandemic plans. Almost everyone has some kind of foolproof plan to enact since the H1N1 and swine flu outbreaks. It's about when politicians decide they need to activate these plans, and it is their inaction during this epidemic that has created panic.

What did Singapore do wrong from the Wuhan outbreak to Dorscon Orange?

If the president of the European Commission can admit to failure to take timely action despite knowing the correct measures to take, Singapore's leaders hopefully can concede that while its choice of epidemic control strategy and implementation has been correct so far, it too suffered a similar failure of timely action.

A simultaneous reconstruction and deconstruction of the early Covid-19 timeline is sufficient to prove two worrying tendencies in the Singapore government to dither and delay what needed to be done, and put out messaging that is hardly reassuring to its populace, entirely tone deaf to the developing sense of crisis.

Nero Fiddling while Rome burns.
That's what people remember, not Nero putting out the fire the right way afterwards.

  • 31 December: China alerts the WHO about a spate of pneumonia-like cases in Wuhan
    This is a few days after whistleblowers utilise social media break the news about the outbreak. In epidemic terms, the news can no longer be quarantined by the CCP.
  • 31 December: Taiwan begins to monitor people travelling from Wuhan
  • 1 January: The seafood/animal market believed to be at the centre of the outbreak is closed
    You'll never read a news article saying the virus was positively identified in any samples taken from the market because no samples were taken for inspection during the great clean-up. If this were a murder mystery, the CCP in Wuhan just destroyed a crime scene and all evidence in it.
  • 6 January: US CDC issues travel notice for Wuhan, China
  • 9 January: WHO says the infection is caused by a new type of coronavirus
  • 11 January: First death confirmed
  • 12 January: Taiwan sends experts to China, and shortly after begins requires hospitals to test for and report cases
    Taiwan sent its experts on a fact-finding mission and they do the right thing in the face of Chinese lies a few days later.
  • 14 January: WHO repeats Chinese claim that the virus is not contagious
    Caught suppressing evidence, the CCP now lies. The pattern of self-serving obfuscation that emerges from China feeds the fear that the virus is far more lethal and contagious than admitted and that China has already failed to contain the outbreak
  • 17 January: US CDC implements health screening at US airports receiving travellers from Wuhan
  • 18 January: Experts work out that the Chinese numbers have been suppressed based on infections picked up outside China
  • 20 January: Number of cases triples to more than 200, and outbreak spreads to Beijing, Shenzhen and Shanghai; third death confirmed; Chinese officials confirm human-to-human transmission
  • 23 January: China locks down Wuhan from other Chinese provinces
    But as many as 5 million of its 11 million citizens had already left the city!
  • 23 January: First confirmed case in Singapore, Wuhan tourist arrived 20 January
  • 24 January: 2 more cases in Singapore, more Wuhan tourists arrived 21 and 23 January
  • 24 January: Singapore initiates temperature testing at land checkpoints
    Either Chinese tourists don't fly to Singapore at Changi Airport, or this is a clown show
  • 25 January: Chinese New Year
  • Nothing to do with the dithering and delay? Nothing to do with the hundreds of thousands of Chinese tourists that vacation in Singapore every Chinese New Year?
  • 25 January: Singapore denies turning away travellers from Wuhan
    Fake news circulated on social media. Instead of assuaging fears and hopes by the fearful about Wuhan tourists importing the epidemic to Singapore, a circular is released on a government website.
  • 25 January: (evening) 1 more case in Singapore, Wuhan tourist arrived 22 January
  • 26 January: Taiwan bans flights from Wuhan
  • 27 January: China suspends group gravel to foreign countries
    For 3 days after the Wuhan lockdown, China has allowed a massive exodus of Chinese holidayers out of the country despite the developing epidemic! And individual travel is not suspended either!
  • 27 January: Singapore starts screening arrivals from Hubei province
    Finally screening at the airport. Compare the dithering and delay to Taiwan. Also note this takes place after the suspension of group travel anyway by China.
  • 27 January: US CDC advises against non-essential travel to China
  • 27 January: 1 more case in Singapore, Wuhan tourist who arrived 18 January
    Are we getting the pattern here?
  • 28 January: Singapore starts quarantine measures on some visitors and PRs from Wuhan
    The measures are only for those the authorities deem "high risk", and not a blanket quarantine. This is days after Chinese researchers suggest asymptomatic spread.
  • 30 January: WHO declares novel coronavirus a public health emergency
  • 30 January: China imposes lockdown on Hubei province, travel ban on rest of nation
    By this point, it is obvious that the Chinese lockdown is pure theatre; the virus has already escaped Wuhan to other provinces in China, and quite possibly abroad. This surely adds on to the global reservoir of fear.
  • 31 January: Chingay Parade goes ahead with substantially reduced attendance.
    No, it's not a Chinese gay pride but a Singaporean Rose Parade held during the final days of the Chinese New year. And yes, sensible people were staying away from this potentially crowded event. Despite authorities insisting at first there was no cause for concern, then taking "enhanced security measures" the day before.
  • 31 January: Singapore's "Multi-Ministry Taskforce on the Wuhan Coronavirus" finally imposes a travel ban on visitors with recent history to mainland China
    Took them long enough? It's time to impose the restrictions only after the last big event that attracts the big Chinese tourist numbers and dollars? Or is it time to impose the restrictions only after China belatedly locks down Wuhan, Hubei and every province?
  • 1 February: Singapore begins distribution of masks to households
  • 3 February: Singapore advises against non-essential travel to China
  • 4 February: Redditors notice China's official coronavirus numbers follow a neat quadratic curve that's way too neat.
    This is eventually fact checked by experts and confirmed to be statistical massaging by mainstream outlets
  • 4 February: Malaysia reports its first native case; Malaysian attended international conference in Singapore 18-23 January
  • 4 February: First local cases in Singapore, picked up the virus from Chinese tourists who bought "Traditional Chinese Medicine" herbs from their shop
    Could it be some perverse form of medical tourism? Singapore is a medical tourism hub or has aspirations to be one!
  • 5 February: South Korea's CDC reports a case of a South Korean who attended the same conference 18-23 January
  • 7 February: Singapore's Ministry of Manpower allows re-entry for China workpass holders but imposes a quarantine on them
    A loophole around 31 January travel restrictions?
  • 9 February: Dorscon Orange alert in Singapore
    This is followed immediately by panic buying on toilet paper, rice, and surgical masks
  • 16 February: Singapore Airshow (aka military hardware market exhibition) not cancelled, even features People's Liberation Army pilots performing
    I know it's way after the timeline but this is mindboggling from an alleged control freak authoritarian government that takes no risks.

  • We at Illusio argue that the evident delay and dithering by the Singapore government and the contradictions between various departments working at cross-purposes are publicly visible failures of judgement exacerbated the growing fear, uncertainty, and doubt in its capabilities so that when epidemic measures were finally announced in the Dorscon Orange level alert by the Singapore government, the hysteria that had built up led to panic buying.

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