18 May 2021

Who should we blame for Singapore's second Covid lockdown?

Ship of fools, woodcut, 1494 Basel

Singapore returned to a state of lockdown on 8 May 2021. With all indoor sports, indoor dining, mandatory work from home, and social gathering severely restricted (and with all schools switching to home-based learning), this is a mere quarter-turn of the screw away from the complete lockdown ("Circuit Breaker") from April 2020.

Much has been made about the quality of decision-making of Singapore's Interministerial Covid Task Force in this matter.  Once again like the initial dithering and delays that led to travellers from Wuhan colonising Singapore with the Covid virus, our leaders dithered for a month while India reported its worst Covid spikes in a year. Just like in the Wuhan case, Singapore's leaders sat on their hands long after India announced the lockdown of its capital. Singapore's leaders allowed travellers from India into the country, in increasing numbers, even after the Indian government blamed the outbreak not on the record crowds at the Kumbh Mela river festival but on the "India variant" of the Covid virus.

It was only when the UK declared its travel restrictions on India that Singapore followed suit, on the same day. Yet why do Singapore's leaders blame Singaporeans for its own India variant Covid clusters and the subsequent lockdown?

So why shouldn't Singapore's leaders blame Singaporeans for this lockdown?

We at Illusio note that the mistakes made in 2020 by the Interministerial Task Force are the same ones that are made in 2021. While the world has moved on from the heady days of November 2019, Singapore's leaders appear stuck in a time spiral, holding their citizens hostage in a purgatory where history repeats itself.

We have already identified the delays and dithering, the failure to take decisive action, the waiting for other nations to impose travel restrictions.

In their defense, Singapore's leadership point out that the island has long been dependent on a foreign labour force. As a global city, Singapore cannot remain shut to the world for long. It is a challenge, therefore, to reconcile this enlightened globalist perspective to how the same leaders have insisted on segregating Covid cases in Singapore into "imported", "community", and "dormitory" categories—as if the virus observes such shifting, artificial and contrived categories.

Should Singaporeans blame their leaders for this lockdown?

We at Illusio warned last year that these categories were based on a foundation of sand, not science, a crude attempt at impression management, not a proper presentation of important health data. And the local Changi cluster, presumably seeded by a still-unidentified index case of a traveller who should've been an imported case, is proof that these categories do not work in the real world. The damage from playing around with Covid data and inventing ridiculous categories is real: it has induced a false sense of security, based on the mistaken notion that the "community" or "locals" can be siloed no matter how many positive Covid cases are "imported".

Post-lockdown, Singapore's leaders congratulated themselves for burning out the infection in the dormitories and failed to implement random population Covid testing and molecular variant monitoring. Choosing to believe they could manage the virus via visitor quarantines and SHNs, they decided it was unnecessary to keep an eye on developments on the ground. Yet if one truly believed that Singapore cannot but be a global city, that it must be largely porous to flows of people and goods, this would've been the exact programmes to implement straight out of the initial lockdown!

Napoleon was a military genius

Let us assume that the ministers are correct in their big picture view: Singapore is a global city and needs to stay open. Then the ministers must realise they face a simple equation with three variables: levels of controlled immigration, vaccines, and Covid cases. Immigration can only proceed insofar as the level of vaccination allows for an acceptable number of Covid cases (whose definition we will come to later). Would a reasonable, respectable, reputable leader of a global city state insist on high immigration, and plan for a slow as molasses plan to inoculate the population only by the end of 2021? Or would a reasonable, respectable, reputable leader of a global city state use his resources to amass as much vaccine doses as possible as fast as possible so the global city can function as a global city, before an outbreak gets so bad there's another forced lockdown?

Should there even be a lockdown? Did the leaders make the wrong call?

The UK, which has also experienced a recent outbreak of the Indian variant, has reacted not with more restrictions but with an increased push in its vaccination rollout. It is a calculated risk but one that is rooted in far more science than Singapore's lockdown decision. Public Health England has also provided actual data showing the effect of vaccines on the Indian strain and its double mutation. Contrary to the Singapore task force's unquantified fears about the Indian strain, PHE has actual clinical data for the so-called "highly transmissible" B.1617 strain and its mutants, debunking estimates from models that they could be up to 50% more transmissible. But don't tell that to Singapore's task force ministers!

Consider this: Singapore may be locking down in 2021 just as its case numbers approach those from April 2020. Yet time has not stood still, nor has medical science since then. We should have far more knowledge in 2021 about the novel coronavirus; the world shut down in 2020 because it didn't know anything about how dangerous this virus is, how to treat the disease it causes or mitigate its spread. Consequently, the bar for a lockdown should be far higher than it was a year ago.

We should have stocked up far more medical supplies in hospitals: PPEs, drugs, oxygen tanks.

Our hospitals should be far more resilient, more prepared, and their capacity expanded to carry out tests and treat warded and critical patients.

In 2021, we have vaccines which are proven to be highly effective against the normal coronavirus and still largely effective against the current strain of concern. On top of that, we now have a vaccination program that, per capita, is comparable to the UK's though it is half of Israel's.

The Singapore decision for a lockdown thus appears to be political rather than based on science or medical considerations. This is an unfortunate repetition of last year's Covid management, with the added malus of completely failing at health economics and cost benefit analysis.

In a world armed with improving vaccines and medication, a reasonable, respectable, and reputable authority would set the goals of Covid management as low ICU admissions, low deaths, low incidents of serious Covid-19 disease. Not low community spread, as what Singapore's Interministerial Task Force has decided on.

What can we expect from this Covid lockdown?

Lockdowns work but so does sawing off the foot to treat an ingrown toenail. Lockdowns work because they are an extreme and blunt tool at limiting social intercourse, and Singapore's leaders formed a habit of primarily resorting to blunt tools that have no nuance.

Singapore's leaders are also willing to err on the side of caution, and offloading the costs of such decisions to their citizens. Therefore, we at Illusio expect a further extension to the lockdown to last for the entire month of June at the very least, and up to mid-July if the dominant Indian variant in this outbreak proves to be more contagious than the wild type SARS-COV-2 virus. And that's an assumption that has been debunked by the NHS

Singapore's leaders in the lockdown last year imposed new and shifting adjustments to their lockdown restrictions, often without waiting for the standard 2 weeks for the impact of policy to express themselves into Covid infection and hospitalisation numbers. We at Illusio expect the same chaotic approach from the same team this year. New restrictions will be announced every other day, even before evidence of the efficacy of older regulations show up in the data.

Due to this undisciplined and unscientific rollout of measures, there is no way to prove which measures in Singapore will or will not work, which are essential, which are overkill, and which are completely unnecessary. However, if the UK approach to its Indian variant outbreak leads to better or no worse outcomes than Singapore's lockdown, it will be clear that Singapore's leaders have mishandled this outbreak.

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