SINGAPORE – After months of reporting nearly zero daily Covid-19 community infections, Singapore is moving swiftly to curb a resurgence of locally transmitted cases linked to India’s highly contagious B1617 variant, with lockdown-like curbs on social gatherings and public activities coming into effect from today (May 16).
The new measures are the strictest since the partial lockdown, or “circuit breaker”, that brought the city-state to a standstill last April and May. The sharp spike in community cases does, however, look set to burst a long-planned air travel bubble with Hong Kong that was set to open on May 26.
Singapore’s return to near-lockdown conditions has also raised questions as to whether high-profile events showcasing the city-state’s virus-quelling resilience will proceed as scheduled, with the Shangri-La Dialogue slated to be held in-person in early June and the Davos-based World Economic Forum (WEF) in August.
Limits on social gatherings and household visitors have been reduced from five people to two people under the new measures, which are set to last four weeks until June 13. Working from home will be the default option for office-based personnel, while dining at restaurants, hawker centers and food courts is prohibited.
“This is clearly a setback in our fight against Covid-19,” said Lawrence Wong, finance minister and co-chair of Singapore’s multi-ministry coronavirus taskforce. “If indeed the situation does not improve, we certainly will not rule out even more stringent measures thereafter,” he said at a press conference on May 14.
Singapore’s benchmark Straits Times Index closed 2.2% lower on Friday following the announcement of the lockdown-like measures, while Singapore Airlines fell 5.7% – its sharpest drop in a year – along with other aviation stocks after the government said it was “very likely” that the air travel bubble with Hong Kong would be delayed again.
The mooted quarantine-free travel corridor between the two Asian financial hubs was initially set to start last November, but was shelved due to viral flare-ups. Health Minister Ong Ye Kung said on Friday that authorities would “critically review” the plan and make an announcement early this week on whether it will proceed.
Singapore has reported 61,505 Covid-19 cases – more than 99% have recovered – with just 31 fatalities since the island republic reported its first case in late January 2020. Despite new clusters and increased community transmission, only three Covid-19 patients are currently hospitalized in critical condition.
Last year’s partial lockdown banned social gatherings of any size while all schools and non-essential workplaces were closed. The new measures will allow retail shops to remain open while schools can continue in-person classes with tightened safety measures. Authorities say the new restrictions may even be eased midstream if case numbers fall.
Health experts expect cases to at least initially rise with the mass testing of around 18,000 airport workers underway after the detection of a cluster at Changi Airport, now the country’s largest active cluster with 68 cases. Five thousand inmates at Changi Prison will also be tested in the coming days after a contract staff member tested positive.
“We’re certainly going to see more cases [as] a function of testing. A percentage of all the people currently in quarantine or on stay-home notice are going to become positive,” said Dale Fisher, a senior infectious disease consultant and professor at the NUS Yong Loo Lin School of Medicine.
“Picking up cases doesn’t worry me. Picking up unlinked cases and cases not currently in quarantine, that worries me more. We haven’t had a day with no unlinked cases for a while now,” Fisher added. “What we want to see is less unlinked cases, less cases appearing out of nowhere.”
Unlinked infections are more concerning to authorities because they signal undetected transmission in the community and potentially undiscovered clusters. Singapore detected 18 unlinked cases from May 9 to 15 out of a total 103 community cases over the same period, up from 10 unlinked cases and 43 total cases in the previous week.
While those numbers are comparably small next to the high caseloads in other parts of the world, they are significant in Singapore, where a heavy-handed approach to the virus has allowed life to function relatively normally, apart from the lack of international travel, with one of the world’s lowest Covid-19 mortality rates.
Recent outbreaks also underscore the threat posed by mutant strains from India, the United Kingdom, Brazil and South Africa flagged as “variants of concern” by the World Health Organization (WHO). All four variants, which are believed to be more contagious than earlier strains of the virus, have been detected in Singapore.
At least 18 cases linked to the Changi Airport cluster have reportedly tested positive for the B1617 variant, which Health Minister Ong said had “broke through the [airport’s] layers of defense” around an area that receives travelers from higher-risk regions including South Asia, though it isn’t clear when the pathogen was transmitted.
Singapore had already banned non-resident travelers with recent travel history to India, which is grappling with the world’s largest and deadliest Covid-19 outbreak, on April 23. The entry ban was expanded to those with a recent travel history to Bangladesh, Nepal, Pakistan and Sri Lanka on April 30, due to rising cases in the region.
B1617 variant studies aim to establish whether it is responsible for the lethal surge of cases in India, though it isn’t yet clear that the strain produces a more severe illness. “It’s my belief that there’s no specific evidence that variants of concern are more virulent, but they are probably all more transmissible,” said Fisher.
Pfizer-BioNTech and Moderna, which produce vaccines in use in Singapore, say their shots have shown effectiveness against the B1617 variant. Variants may evade immunity generated in response to a previous infection, according to a study in The Lancet medical journal, though none have been definitively shown to resist vaccine-induced immunity.
Around 90% of Singapore’s airport workers have been vaccinated to date. Of the nearly 10,000 staff tested so far, the vast majority have reportedly have been negative. While vaccination doesn’t prevent infection, experts say immunization results in Covid-19 infections that are relatively mild or asymptomatic for the majority of infected persons.
Singapore has overseen one of Asia’s fastest vaccine rollouts, with around 22% of the population now having received two doses. Fisher said there would be less of a need for restrictive “interventions” once Singapore crosses the herd immunity threshold of at least 70% of the population being vaccinated.
“We’re looking at a day in the future where the disease does transmit between vaccinated people, but it’s a mild disease,” said the disease expert. “As long as people keep getting vaccinated, then what a case means last year or now compared to what a case or a cluster will mean next year is going to be quite different.”
Given its status as a travel hub, dependence on international trade and foreign labor, and the high economic price of strict border controls, observers expect Singapore will progressively dial back restrictions as its vaccination drive progresses and it adjusts to expectations that Covid-19 will continue circulating as a milder endemic disease.
“When everyone has had the opportunity to get the vaccine, then we’re going to have to be a lot more tolerant with cases coming in because a case won’t have the same ramifications in terms of severe disease,” said Fisher, who added that Singapore’s plans to vaccinate its entire population within the year were proceeding at a “satisfactory” rate.
After Singapore announced its latest tightened virus curbs, the International Institute for Strategic Studies (IISS), which organizes the Shangri-La Dialogue, said in a statement that it would “remain committed” to holding Asia’s premier defense summit as an in-person event from June 3-4. The conference was canceled last year due to the pandemic.
US Defense Secretary Lloyd Austin has been confirmed to attend the event, which is usually attended by top-level military officials, diplomats and global arms manufacturers. Japanese Prime Minister Yoshihide Suga has been confirmed as a keynote speaker, though his decision to attend will reportedly be contingent on the Covid-19 situation in Japan.
IISS said it would review its health protocols “to ensure the highest safety levels for all our participants and the wider community in Singapore.” Disease expert Fisher believes events like Shangri-La Dialogue will go ahead as planned and noted that delegates would in any case be arriving from places with invariably higher rates of Covid-19 spread.
“There’s reputation on the line, so I think there will be a conservative approach to testing, mask-wearing and minimizing transmission risks within these events, as well as from the events to the Singapore community. I think it will be possible to do these safely, but not without a challenge, that’s for sure.”