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Message by A/Prof Kenneth Mak, Director Of Medical Services, Ministry Of Health, at the Yong Loo Lin School Of Medicine’s “COVID-19 Updates From Singapore” Webinar, 17 September 2020

1. Singapore first saw its first COVID case on 23 January and since then, we have had quite a number of cases that we have had to manage. The initial few cases came from imported cases from other countries but we rapidly saw the effect of imported cases coming in and the lessons we learnt if we didn’t control the spread early enough, with clusters starting to emerge in dormitories that were dedicated accommodations for migrant workers.

2. In all, we have seen 57,500 COVID-19 patients in Singapore but we have a unique situation here where only 43 patients currently remain admitted in hospitals and just over 400 patients are currently in our community care facilities or step-down facilities. The majority, in fact, have had relatively good outcomes. The fatality rate in Singapore has been just about 0.05% and it is a remarkable situation that we face. We have learned many important lessons, but above all, the important lessons that I like to comment to you for your reflection will be the importance of bringing an entire nation together.

3. We have had a Multi-Ministry Taskforce bringing various sectors of public service coming together to leverage on the resources they had and it rapidly became not just a Whole-of-Government effort but a Whole-of-Nation effort where we had many citizens and private sector organisations stepping in to contribute towards the fight against COVID-19. We found that effectively, public health’s traditional principles of management of clusters worked and that included early detection of cases, a commitment and dedication towards isolating them, disrupting chains of transmission, quarantining of close contacts, and a daring discipline to shut down, if necessary, services that contributed towards the spread of infection in the community. These were effective in helping us stem the tide and stop amplification. We added on also a recognition of patients who were vulnerable and at high risk of poor, adverse outcomes, and we were determined to take those who were at higher risk and bring them into the hospital setting for closer monitoring and treatment. By protecting those who are vulnerable, we have managed to keep the morbidity and complication rates low here in Singapore.

4. COVID-19 challenged us in many ways despite our experiences with SARS and the commitment that we had to planning of emergency services to ramp up for an infectious diseases outbreak. We had to build additional lab capacity. We had to increase the number of isolation and quarantine facilities we had. We had to build additional hospital isolation wards and ICU beds. We had to bring additional resources in and we even had to train new manpower and recruit many volunteers to contribute towards the COVID-19 fight.

5. But in all, we have learned also the importance of using new technologies to master new care models. We have learned the value of data and analysis that drives contact tracing in helping us to predict where the next cluster might erupt. We have learned about how telehealth can change and disrupt and bring new care models in, both into our hospitals and in primary care. We have learned the value of public and private collaborations and we have learned the importance – a perhaps the most important lesson of all – the importance of maintaining public trust such that we would be confident that the public, the community, and the society would be with us as we impose lockdowns, what we call locally a circuit breaker – a restriction of activities.

6. Global solidarity is important for us. We have learned the importance of working together to share information, resources, best practices and research findings. We have learned the value of collaborating on work to develop new diagnostic tests, vaccines and therapeutics, and we also appreciate the importance of collaboration across the global front to help us open our borders safely and to allow for testing to take place, to facilitate the return of economic activity.

7. I am convinced that if we can put our hearts and minds to it, we can prevail but it needs us all to acknowledge the importance of putting society before self, to maintain the discipline, to not be complacent, and to expect the next cluster to come in places where we are most vulnerable. We need to continue to work together, to continue with our close detection, be decisive in our contact tracing and isolation, while we allow our economies to safely recover, and for the social fabric to recover in our societies. Global solidarity means that we are stronger than the sum of all parts and I am convinced that the collaborations forged through the World Health Organization and other fora would stand us in good stead, preparing us for the next epidemic as well. Thank you.

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