SINGAPORE, Jan 21 — The rise in the number of Covid-19 cases in the community over the past week is a reminder that people cannot be complacent, but it is still too early to be alarmed, infectious diseases experts have said.
Over the last seven days, there have been a total of 18 infections in the community, excluding those in foreign worker dormitories.
This is a sharp increase from just four cases in the week before.
There have also been two clusters that have emerged in the past weeks.
Last Thursday (January 14), a para-veterinarian at the police K-9 dog unit was confirmed to be infected, and a cluster with a total of seven cases has since emerged, the latest being an eight-year-old boy from Chua Chu Kang Primary School on Tuesday.
On Tuesday as well, two community cases were linked to a previous confirmed case — a food processing worker — forming another cluster.
Education Minister Lawrence Wong, co-chair of the government’s Covid-19 task force, has said that the authorities are monitoring the situation carefully, and “considering if additional measures are necessary to ensure the infection remains under control”.
The increase in community cases has also prompted the authorities to defer the pilots for the reopening of nightclubs and karaoke outlets that were supposed to start this month.
Relaxed rules a factor
Dr Ling Li Min, an infectious diseases physician at Rophi Clinic, said that an increase in the number of daily cases is anticipated, due to the third phase of Singapore’s reopening after the partial lockdown last year and the increase in physical interaction.
“With our current measures in place, and the numbers as they are, we don’t need to be too alarmed yet. We need to remain cautious and vigilant,” she said.
Professor Alex Cook, vice-dean of research at the National University of Singapore's Saw Swee Hock School of Public Health, agreed.
He said that it would be of concern if the increase in community cases is sustained.
“If it stays at the current level, then that’s part and parcel of the relaxation of control measures when we moved to Phase Three,” he said.
“If the weekly average continues to grow, then it means the measures we have in place, or our compliance with them, is not quite enough to maintain epidemic equipoise (a prefectly balanced situation).”
More information needed
Dr Paul Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection, similarly said that the numbers are not as alarming as they were last April or May during the partial lockdown, and that is partly because doctors have been alert in detecting cases early.
“We need more information, including the molecular data, about the latest cases to see where they came from,” he said, when asked if more stringent measures should be considered.
This “molecular data”, Dr Tambyah explained, can come in the form of RNA fingerprinting or serological tests, to determine the source of the coronavirus, so that it can quickly be contained.
As for the concerns of new clusters being identified, Prof Cook said that linked cases pose less of a threat to the population.
“If (cases are) linked at the point of detection, that usually means they are already under quarantine for being a contact of the case they were linked to, so the impact they can have on the epidemic is less,” he said.
However, if a case with no links to confirmed ones emerges, it could be “suggestive of additional undiagnosed infections that are out there”.
The government should also wait and see before putting out tighter restrictions.
Prof Cook said that this is because it is still not clear whether the reproduction rate of the virus is above or below the level for epidemic growth.
Because data is still insufficient, the government is still needing to guess whether tighter restrictions are needed.
“Deferring the nightlife pilot for a while so we have a better sense of where the epidemic is going is a sensible approach and will allow for informed decision-making once more information is available,” Prof Cook added.
Virus still looking for weakness to spread
Commenting on the recent developments, infectious diseases expert Leong Hoe Nam sees it as the virus “adapting” to the stringent infection control measures such as physical distancing and mask-wearing.
“(The virus) has to be more successful in order to propagate further,” Dr Leong said.
“They would sacrifice their entire progeny for one successful lineage to ensure world domination.”
This means that the virus will continue to mutate until it is able to overcome measures to prevent its spread. As older or less contagious strains are controlled, new strains that are able to spread the quickest may then become dominant, Dr Leong explained.
Examples of such mutations include the new virus strains in South Africa and the United Kingdom that are said to be more contagious.
And with Chinese New Year coming next month, coupled with the recently increased group limit from five to eight, there could be more physical interactions expected in the coming weeks.
Dr Leong observed that with relaxed measures comes complacency, which may have also contributed to the rise in community cases.
“We see it in the shopping centres and restaurants... We seem to have a pent-up desire for close social gatherings… These will be the very gaps the virus will exploit.”
Dr Ling from Rophi Clinic said that other factors such as more people returning to work, regular testing at specific workplaces and “Covid fatigue” leading to a lack of compliance in safe management regulations may also account for the rise in community cases.
Don’t take things for granted
The experts said that individuals can help keep the spread of Covid-19 at bay by paying attention to their own health and not taking the relaxed rules for granted.
Whenever possible, minimise large group gatherings, stay home if feeling even slightly unwell and consider getting the Covid swab even if it is that slight sore throat or runny nose, Dr Ling said.
“Hopefully, with the coming Chinese New Year holidays, people will know where to go if they have symptoms that might be suggestive of Covid-19,” Dr Tambyah said.
“That way, they can be screened and identified if positive and promptly treated.”
Key weapon available
In the longer term, apart from exercising individual responsibility, the experts said that vaccinations will be key to “outrun” the pandemic.
Prof Cook said that the “number one intervention” will be to get a vaccination, adding that he would get himself vaccinated when it is his turn.
Agreeing, Dr Tambyah said that the big difference now compared with the previous phases of the reopening is the existence of vaccines.
“Hopefully, these will have a dramatic effect on the numbers soon, like with the polio epidemic in the 1950s,” he said. ― TODAY
