Singapore’s top-down approach of coronavirus strategy

Singapore’s health system has coped very well with the coronavirus pandemic, this is one thing you need to recognize.

It is clear that the decision makers in Singapore’s health system, such as the National Centre for Infectious Diseases clinical director Shawn Vasoo, and my previous boss executive director Professor Leo Yee Sin, are being given free rein to try to contain the virus. I respect their work.

The health system approach to advise doctors at clinics to give 5 days of medical leave to people with respiratory symptoms (at low cost for residents and citizens), otherwise which they would (likely) be sent to hospitals for coronavirus testing and inpatient treatment (free for citizens and residents) has also helped to curtail the spread of COVID-19 in Singapore. But there are loopholes – people on short-term visits aren’t covered under the low-cost/free regime for the coronavirus, which means some people might not want to be tested and fall out of the system, and also do people with other illnesses have to pay for their other illnesses even if they are hospitalized for COVID-19, and cause worry for them too? These are loopholes Singapore’s expensive health system would need to address outside of the coronavirus situation.

But it is clear Singapore’s COVID-19 strategy relies very much on the health system to contain the coronavirus (and the police to assist in contact tracing). On the one hand, this means that Singapore has built up strong systems in these areas to cope with crises such as this pandemic.

On the other, it means Singapore’s strategy does not take into account people’s involvement enough, and this creates another loophole.

From the speeches of the ministers, it is clear they have planned in advance to deal with an outbreak such as COVID-19, and the measures currently being put in place are as a result of this.

It is also clear Singapore is planning for a pandemic such as this to last for some time, after which the Singapore government hopes to emerge relatively unscathed while other countries would be seriously beaten, and then take the advantage when the time comes, to come out ahead of others. How long it is planning ahead for, I don’t know, 3 months, 6 months, maybe longer?

This is part of the reason why the Singapore ministers get angry when Singaporeans don’t go according to their plan, and of course not, Singaporeans were never informed of the grand strategy, and even if so, collective behavior cannot be planned for. This is why, when panic buying occurred, people were called stupid and idiots, and an embarrassment – because the behavior is seen as creating a smudge in the Singapore government’s aim to look all-prepared to tide through the coronavirus. And this is why some of the people who became infected were called socially-irresponsible, because if they had been more responsible, Singapore’s COVID-19 numbers would be lower, and make Singapore look better.

But herein lies the problem – a nationwide strategy cannot be implemented if it doesn’t have the involvement of people.

Singapore tied through the first wave of this coronavirus alongside countries like Taiwan and South Korea because of their strong health systems. Hong Kong and Macao was also able to successfully keep it at bay for now because of social distancing measures adopted bottom-up by the citizenry in the former and top-down in the latter.

However, the relative success in the countries in the first line lulled other countries into a false sense of security that they could cope as well. The messaging in part given by the Singapore government that COVID-19 might turn out to be just like the flu, also does not help. This has created a false sense of ease among health systems around the world, many of which cannot cope, simply because if containment measures are not put in place early on, the number of infections will rise too quickly for the health systems to cope. It means countries should have taken any new epidemic seriously, and not have allowed themselves to be lulled into complacency.

What this means for Singapore is that as the second wave of infections spread through the globe, and possibly a third wave later on that will spread through poorer countries which have tried to downplay the seriousness of the virus, the pandemic will last for many more months, and it will impact on Singapore. Infection numbers could increase further unless Singapore can close off its borders, but Singapore won’t and cannot, because Singapore relies on exports for daily necessities as well. And when fear sets in once again for whatever reason, panic buying or other such behavior could occur again.

And this is why Singapore’s coronavirus strategy cannot be just a top-down approach that does not account for the feelings of people on the ground. It cannot be a do-what-I-say-because-I-have-everything-put-in-place approach. It doesn’t work that way because in times of crisis, people do react, whether in a rich or poor country, democracy or authoritarian. People are the same no matter how much you control them or if they run free.

The Singapore government’s approach as of now seems to shame people and victim-blame to get people to conform to their strategy. This therefore presents as a massive loophole. It is 5 to 6 million of uncontrolled variables. Singapore is not North Korea, and even in North Korea, people don’t all comply.

It is therefore pertinent that on top of the highly effective health systems approach being implemented now, that the government needs to overhaul its social-psychological approach to seek to understand people’s responses and engage with them as partners to manage the coronavirus.

This means anticipating how people will respond to new measures or global occurrences and then enacting new policies and communication plans to respond to them in advance – just like how the government plans for the economy. This also means putting in place budgetary plans to compensate people who lose their jobs, for example, because people who know that they can still ensure their livelihoods can be maintained will feel more secure and calm, which will strengthen Singapore’s coronavirus response.

If the government does not have enough experts to develop the necessary understanding of people during these times, then it needs to get them onboard. Singapore’s foresight strategy has been over-reliant on planning ahead for the economy, but not enough in the aspect of the society. Thankfully, planning ahead for the economy also means putting in place a strong health systems. But it is not enough moving ahead.

What Singapore needs right now isn’t just a whole-of-government approach. What it also needs is a whole-of-society approach. Only when people can see and know that the government is also putting in place policies which takes care of them, and not just the economy, will people learn to trust the government and play their part to help secure Singapore’s defenses against COVID-19. This is what it means when we talk about psychological defense. We cannot escape the reality of it.

While Singapore’s policymakers are business people who care about maintaining their business interests, Singapore is not just a company they run. While such an approach could be feasible in times of relative calm when there are enough resources to keep people in their place, during times of crises, there are multiple variables including uncertain human reaction. This means even as Singapore’s elite business people-leaders want to continue running Singapore like a company, it requires these business-leaders to have more empathy to their employees, and support their employees, if they want their employees to support their business.

 

Roy Ngerng

 

 

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9 Responses to “Singapore’s top-down approach of coronavirus strategy”

  • patriot of TUMASIK:

    Drastic Diseases needs Drastic ACTION!!! no matter how well planned 1 day -1000 days Immediate Action must be taken for the health and safety by a Govt and not sashay through the Disease until it becomes Pandemic or WORSE…

    No matter how smart a nation or its leeders are the “we know best” does not apply in a widespread communicable disease…

    Closing schools and providing the necessities to avoid the spread is a MUST and not a choice and idiotic leeders in their well-secured lifestyle should give Fake Assurances when the majority has to face their daily routine in packed and crammed CONditions…

    The Hypocrites will return to their Saunas and what sterilize facilities that money can buy and have themselves thoroughly cleanse…

    and the Ordinary folks???…wash your hands lah!!! and take a 10-minute shower or bath…

    No sterilize and well-prepared soak in a bathtub with maids to scrub your filthy front & back

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  • patriot of TUMASIK:

    patriot of TUMASIK:
    Drastic Diseases needs Drastic ACTION!!! no matter how well planned 1 day -1000 days Immediate Action must be taken for the health and safety by a Govt and not sashay through the Disease until it becomes Pandemic or WORSE…

    No matter how smart a nation or its leeders are the “we know best” does not apply in a widespread communicable disease…

    Closing schools and providing the necessities to avoid the spread is a MUST and not a choice and idiotic leeders in their well-secured lifestyle should give Fake Assurances when the majority has to face their daily routine in packed and crammed CONditions…

    The Hypocrites will return to their Saunas and what sterilize facilities that money can buy and have themselves thoroughly cleanse…

    and the Ordinary folks???…wash your hands lah!!! and take a 10-minute shower or bath…

    No sterilize and well-prepared soak in a bathtub with maids to scrub your filthy front & back

    Correction:…should “NOT” give Fake Assuarances

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  • No chance lah:

    ” Only when people can see and know that the government is also putting in place policies which takes care of them.”

    There is better chance of seeing UFOs and aliens coming down the sky.

    Even when they pretend to take care of you, they charge superhigh fees. Look at all the 99% un-used premiums in all the take-care-of-you schemes.

    When they set aside $8 billion to take care of you, that amount is actually meant to be spent over 3 or 4 decades. In contrast, what they “robbed” from your CPF returns is way more than $8 billion EVERY year.

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  • Hu Chian:

    ” Singapore’s health system has coped very well with the coronavirus pandemic, this is one thing you need to recognize.
    ………………………………
    And this is why some of the people who became infected were called socially-irresponsible, because if they had been more responsible, Singapore’s COVID-19 numbers would be lower, and make Singapore look better.”

    Roy Ngerng, what is wrong with you?. Have you ever heard of and truly understand the meaning of Prevention is better then cure. Do really think you understand how SARS-CoV-2 works. Why are the numbers of COVID-19 cases climbing? This man, Dr. Wu Lien-teh, do you know of his story against the pneumonic plague?. Did you realise that this disease can bring a nation to its’ knee, China ,Italy ,ring a bell? You know of something Dr. Wu Lien-teh cannot comprehend?. Please!, stop this foolishness, lives are at stake.

    Site,

    The Chinese Doctor Who Beat the Plague – China Channel
    https://chinachannel.org/2018/12/20/plague/

    Covid-19 Pandemic: The Complacent Are Clueless | Zero Hedge
    https://www.zerohedge.com/health/covid-19-pandemic-complacent-are-clueless

    CHAPTER THREE: The Story of SARS – Archives of Ontario
    http://www.archives.gov.on.ca/en/e_records/sars/report/v2-pdf/Vol2Chp3.pdf

    Coronavirus ‘super-spreader’ says he’s recovered as he …
    https://www.standard.co.uk/news/uk/coronavirus-super-spreader-steve-walsh-comment-a4358916.html

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  • Harder Truths:

    The CoVID-19 attacks certain types of people especially old and those not able to get healthcare. The fatality rates mark the ease and quality of healthcare. It is not due to the clowns – but to the hardworking healthcare professionals and the common sense of locals we have yet to experience real problems in this kind of situation.

    In hindsight what you say is true – but you cannot prepare for a pandemic on prior ones or hindsight. So I can say that although $G has so far been spared – this is more to the properties of the virus itself rather than any real containment or preparedness on $G’s part.

    In future there will be other viruses and some can be very deadly. Not closing borders is based an idiotic presumption the virus and its spread can be controlled once it is discovered. In a very-high density population hub as $G, open to all and sundry, this will one day be disastrous.

    If $G people are vote for the government then they are also saying that if and when a deadly virus hits there will be no help for them and they are ok with it. Especially the older generations remember you cannot protest or vote them out if you are dead.

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  • Society need to be involved:

    Best to combine Government and Society approach to be effective .
    Singapore has done well so far.

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  • Realistically:

    I think people must distinguish between the FAILURES of the PAPie Govt and the excellent standard of medical care by our dedicated health service.

    The PAPIe govt had relied on their experience with the SARS H5N1 virus of the early 2000′s & had been rather complacent about the hadling of COVID-19 during the initial stages….which then led to community spreading as we see it now. The incompetent PAPie – u die your biz attitude; get out of the PAPies’ uncaring elite faces etc – & their stupidity about a health person need not wear mask rubbish had allowed the COVID-19 virus to take root here; after which they then introduced the current measures.

    I hv said many times, people should look at the ROOT CAUSE and not just in the out of context basis………vote OUT THE PAPIES AND THE WAYANG PARTY.

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  • Educating Singaporeans:

    Dear Roy,
    You said “it requires these business-leaders to have more empathy to their employees, and support their employees, if they want their employees to support their business.”

    My question, do you want to give empathy to :
    1. lazy, unmotivated irresponsible Singaporeans who just want free handout ?
    Just ask CARROT HEAD Gilbert Goh who had been conned BIG BIG time by these dishonest Singaporean.

    https://www.msn.com/en-sg/news/singapore/activist-files-police-report-against-woman-who-said-she-%E2%80%9Clied%E2%80%9D-about-being-evicted-by-hdb-to-seek-donations/ar-BB10HQGm?li=BBr8YXK

    My master PM Lee is right to implement mean testing to weed out the fake.
    We PAP do real ground work while opposition just oppose for the sake of opposing with no real solution. GMS is one prime example.

    2. untalented Singaporeans who need 3 years/thousand dollars to get a diploma compared to hardworking FT Ramesh who get his diploma in 3 months under $500.

    Dear Roy, worry about yourselves being make use of like CARROT HEAD Gilbert Goh.

    We PAP had mean testing in place for empathy to be given to the right group of people.

    We PAP with out of this world salaries are not corrupted like Malaysia politicians who are still negotiating among themselves for high salary and bonuses and contract before they jump ship again.

    Watch out…. ringgit is falling ringgit is falling …. hahaha

    PAP.GUARANTEED.WIN.GE2020
    PAP Millionaires huat, huat, huat arh.
    Vote PAP for 9% GST for 9% increment/bonus for PAP

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  • @ Roy:

    Contrary fact is many here did not mention or ignore on purpose thst Malaysia have overtaken ahead of Sg by several notches. Obviously all act blur here
    Now Malaysia have more cases than Sg. We kena early but fortunately the weak and feeble sick chickens have been largely flush out. There will still be cases but probably slow down or lower in numbers.

    Actually cleaners everywhere did a commendable job. They have to clean with alcohol or whatever disinfectant in the lift, toilets, tables chairs …etc.

    The fear i believe is overblown. From the first case since happen in Sg , i still go for my jogging once every week. I notice many like me also jog or continue with othrr sports activities.

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