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Singapore Seemed to Have Coronavirus Under Control, Until Cases Doubled Singapore Seemed to Have Coronavirus Under Control, Until Cases Doubled
(7 days later)
Singapore did almost everything right.Singapore did almost everything right.
After recording its first coronavirus case on Jan. 23, the prosperous city-state meticulously traced the close contacts of every infected patient, while keeping a sense of normalcy on its streets. Borders were shut to populations likely to carry the contagion, although businesses stayed open. Ample testing and treatment were free for residents.After recording its first coronavirus case on Jan. 23, the prosperous city-state meticulously traced the close contacts of every infected patient, while keeping a sense of normalcy on its streets. Borders were shut to populations likely to carry the contagion, although businesses stayed open. Ample testing and treatment were free for residents.
But over the past few days, Singapore’s coronavirus caseload has more than doubled, with more than 8,000 cases confirmed as of Monday, the highest in Southeast Asia. Most of the new infections are within crowded dormitories where migrant laborers live, unnoticed by many of the country’s richer residents and, it turns out, the government itself.But over the past few days, Singapore’s coronavirus caseload has more than doubled, with more than 8,000 cases confirmed as of Monday, the highest in Southeast Asia. Most of the new infections are within crowded dormitories where migrant laborers live, unnoticed by many of the country’s richer residents and, it turns out, the government itself.
The spread of the coronavirus in this tidy city-state suggests that it might be difficult for the United States, Europe and the rest of the world to return to the way they were anytime soon, even when viral curves appear to have flattened. Although countries can closely track contacts to try to keep an outbreak at bay as Singapore did, the coronavirus is sickening, killing and spreading with each passing day, leaving scientists and political leaders racing to catch up with its relentless pace and new dangers.The spread of the coronavirus in this tidy city-state suggests that it might be difficult for the United States, Europe and the rest of the world to return to the way they were anytime soon, even when viral curves appear to have flattened. Although countries can closely track contacts to try to keep an outbreak at bay as Singapore did, the coronavirus is sickening, killing and spreading with each passing day, leaving scientists and political leaders racing to catch up with its relentless pace and new dangers.
If anything, the trials of this intensely urban, hyper-international country hint at a global future in which travel is taboo, borders are shut, quarantines endure and industries like tourism and entertainment are battered. Weddings, funerals and graduation parties will have to wait. Vulnerable populations, such as migrants, cannot be ignored.If anything, the trials of this intensely urban, hyper-international country hint at a global future in which travel is taboo, borders are shut, quarantines endure and industries like tourism and entertainment are battered. Weddings, funerals and graduation parties will have to wait. Vulnerable populations, such as migrants, cannot be ignored.
“We will also more and more adapt to the new normal,” said Josip Car, a top expert in population health sciences at Nanyang Technological University in Singapore. “This is the likely future for the next 18 months minimum, this being the anticipated time to make a first vaccine available at scale.”“We will also more and more adapt to the new normal,” said Josip Car, a top expert in population health sciences at Nanyang Technological University in Singapore. “This is the likely future for the next 18 months minimum, this being the anticipated time to make a first vaccine available at scale.”
With cases proliferating, Singapore abandoned its strategy of maintaining a semblance of normal life. Schools were closed on April 8, and residents are now required to wear face masks in public. Hundreds of thousands of foreign workers have been quarantined in their cramped quarters, with testing among them turning up hundreds of new cases a day.With cases proliferating, Singapore abandoned its strategy of maintaining a semblance of normal life. Schools were closed on April 8, and residents are now required to wear face masks in public. Hundreds of thousands of foreign workers have been quarantined in their cramped quarters, with testing among them turning up hundreds of new cases a day.
“I am very scared, of course,” said Monir, a worker from Bangladesh who is not allowed to leave his dormitory despite his need for other medical care. He declined to give his full name because his employer had not authorized him to speak to the press. “There is the Covid, and we cannot leave.”“I am very scared, of course,” said Monir, a worker from Bangladesh who is not allowed to leave his dormitory despite his need for other medical care. He declined to give his full name because his employer had not authorized him to speak to the press. “There is the Covid, and we cannot leave.”
For all of Singapore’s reputation as a garden city-state that has banished trash and cultivated a highly educated work force, the compact island nation has long depended on more than one million low-wage workers to build its skyscrapers, mop its floors and operate its bustling port. But these foreign migrants, who have little chance of acquiring Singaporean citizenship, have been left out of the country’s social safety net, even if a raft of regulations ensures minimum workplace conditions and health care coverage.For all of Singapore’s reputation as a garden city-state that has banished trash and cultivated a highly educated work force, the compact island nation has long depended on more than one million low-wage workers to build its skyscrapers, mop its floors and operate its bustling port. But these foreign migrants, who have little chance of acquiring Singaporean citizenship, have been left out of the country’s social safety net, even if a raft of regulations ensures minimum workplace conditions and health care coverage.
The group proved a major blind spot in the coronavirus pandemic, exposing the starkly different experiences of rich expatriates and poorer ones in a city-state where 40 percent of residents are foreign born.The group proved a major blind spot in the coronavirus pandemic, exposing the starkly different experiences of rich expatriates and poorer ones in a city-state where 40 percent of residents are foreign born.
While arrivals at Singapore’s climate-controlled airport, with its butterfly gardens and orchid displays, were closely monitored for the coronavirus, the contagion was spreading in government-built dormitories crowded with 200,000 foreign laborers, mostly from South Asia and China.While arrivals at Singapore’s climate-controlled airport, with its butterfly gardens and orchid displays, were closely monitored for the coronavirus, the contagion was spreading in government-built dormitories crowded with 200,000 foreign laborers, mostly from South Asia and China.
The first low-wage foreign workers tested positive for the coronavirus in February, and their close contacts were quarantined and tested, according to the Singaporean authorities.The first low-wage foreign workers tested positive for the coronavirus in February, and their close contacts were quarantined and tested, according to the Singaporean authorities.
Now, dozens of dormitories and lodges are suffering from outbreaks. Clusters of infections have also popped up at construction sites and an industrial park. On Monday, Singapore recorded 1,426 new cases mostly tied to the testing of migrants, a record jump in a country that a month ago had about 300 total cases.Now, dozens of dormitories and lodges are suffering from outbreaks. Clusters of infections have also popped up at construction sites and an industrial park. On Monday, Singapore recorded 1,426 new cases mostly tied to the testing of migrants, a record jump in a country that a month ago had about 300 total cases.
The Singaporean authorities, it seems, failed to fully appreciate the infectiousness of the virus. Most of the cases are mild or asymptomatic and none so far have required critical care, according to the government, perhaps explaining why the spread among the foreign-worker population was not caught earlier.The Singaporean authorities, it seems, failed to fully appreciate the infectiousness of the virus. Most of the cases are mild or asymptomatic and none so far have required critical care, according to the government, perhaps explaining why the spread among the foreign-worker population was not caught earlier.
Packed with up to 20 laborers in a single stifling room, these foreign-worker dormitories have been the sites of previous outbreaks of disease, like tuberculosis. Residents complain of insect infestations and plumbing woes. Three workers said their rooms had not been disinfected in the wake of the coronavirus, despite promises that conditions would improve.Packed with up to 20 laborers in a single stifling room, these foreign-worker dormitories have been the sites of previous outbreaks of disease, like tuberculosis. Residents complain of insect infestations and plumbing woes. Three workers said their rooms had not been disinfected in the wake of the coronavirus, despite promises that conditions would improve.
Khaw Boon Wan, Singapore’s transportation minister, said in a Facebook post on Sunday that foreign construction workers were getting “top attention.”Khaw Boon Wan, Singapore’s transportation minister, said in a Facebook post on Sunday that foreign construction workers were getting “top attention.”
“I know our foreign workers are appreciative of the efforts,” he said. “They know that they are safer in Singapore now than elsewhere, even at home.”“I know our foreign workers are appreciative of the efforts,” he said. “They know that they are safer in Singapore now than elsewhere, even at home.”
Because most new patients are linked to known clusters of infection, many of them among migrants, epidemiologists are hopeful that the lockdown will help tame local transmission. So far, 11 people have died in Singapore of Covid-19, the disease caused by the coronavirus, a relatively low fatality rate. Hospitals are not overwhelmed.Because most new patients are linked to known clusters of infection, many of them among migrants, epidemiologists are hopeful that the lockdown will help tame local transmission. So far, 11 people have died in Singapore of Covid-19, the disease caused by the coronavirus, a relatively low fatality rate. Hospitals are not overwhelmed.
In a video address on April 10, delivered in three languages for the island’s multiethnic population, Prime Minister Lee Hsien Loong appealed for a sense of communal responsibility.In a video address on April 10, delivered in three languages for the island’s multiethnic population, Prime Minister Lee Hsien Loong appealed for a sense of communal responsibility.
“It only takes a few people to let down their guard and the virus will slip through,” he said. “We need everyone to play their part.”“It only takes a few people to let down their guard and the virus will slip through,” he said. “We need everyone to play their part.”
Other countries that managed to limit the pandemic within their borders are also struggling with recurrences. China has reported an uptick in imported infections, while increased testing has uncovered more cases in Japan.Other countries that managed to limit the pandemic within their borders are also struggling with recurrences. China has reported an uptick in imported infections, while increased testing has uncovered more cases in Japan.
“The reality is that Americans and Europeans will face the same issues, too,” said Teo Yik Ying, the dean of the Saw Swee Hock School of Public Health at the National University of Singapore. “My economist friends may not like this, but if trade and economic activity are resumed and people start moving without adequate measures, there will be subsequent waves of infection.”“The reality is that Americans and Europeans will face the same issues, too,” said Teo Yik Ying, the dean of the Saw Swee Hock School of Public Health at the National University of Singapore. “My economist friends may not like this, but if trade and economic activity are resumed and people start moving without adequate measures, there will be subsequent waves of infection.”
Singaporean officials stress that once local transmission is controlled — the government is able to trace up to 4,000 contacts of patients each day — some semblance of normalcy should return to the country’s manicured streets. Schools should be able to reopen with staggered schedules. Local manufacturing can recommence, and goods and services, if not people, can flow again.Singaporean officials stress that once local transmission is controlled — the government is able to trace up to 4,000 contacts of patients each day — some semblance of normalcy should return to the country’s manicured streets. Schools should be able to reopen with staggered schedules. Local manufacturing can recommence, and goods and services, if not people, can flow again.
But for a country where every flight is international, the ability of a virus to bring global travel and trade to a standstill remains a shock.But for a country where every flight is international, the ability of a virus to bring global travel and trade to a standstill remains a shock.
Daniel David, 36, normally imports baby carrots from Australia and brussels sprouts from the Netherlands to supply hotels, restaurants and catering companies. He’s now chasing clients who have closed up shop and disappeared without paying him. Life has become hyperlocal.Daniel David, 36, normally imports baby carrots from Australia and brussels sprouts from the Netherlands to supply hotels, restaurants and catering companies. He’s now chasing clients who have closed up shop and disappeared without paying him. Life has become hyperlocal.
Updated June 24, 2020 Updated June 30, 2020
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
“We’re used to getting things from all over the world and mixing it up,” Mr. David said. “We have to get used to doing our own thing.”“We’re used to getting things from all over the world and mixing it up,” Mr. David said. “We have to get used to doing our own thing.”
In the last week of March, passenger traffic from Changi Airport, from which more than 100 airlines once flew from Singapore to nearly 400 cities around the world, fell 98 percent from the year before. Ridership of public transportation has dropped more than 70 percent in the past week.In the last week of March, passenger traffic from Changi Airport, from which more than 100 airlines once flew from Singapore to nearly 400 cities around the world, fell 98 percent from the year before. Ridership of public transportation has dropped more than 70 percent in the past week.
As visitors from China brought the virus to Singapore in January, the Singaporean authorities quickly banned flights from affected areas. The police helped find close contacts of those who tested positive. People returning from ski holidays in Europe or jaunts to New York sat out their quarantines in fancy hotels.As visitors from China brought the virus to Singapore in January, the Singaporean authorities quickly banned flights from affected areas. The police helped find close contacts of those who tested positive. People returning from ski holidays in Europe or jaunts to New York sat out their quarantines in fancy hotels.
When a second wave of imported cases appeared from Europe and North America, Singapore barred all short-term foreign visitors. Everyone who returns to the island undergoes mandatory quarantine. For more than a week now, there has been only one imported case of the coronavirus.When a second wave of imported cases appeared from Europe and North America, Singapore barred all short-term foreign visitors. Everyone who returns to the island undergoes mandatory quarantine. For more than a week now, there has been only one imported case of the coronavirus.
But the rapid spread of the virus among foreign laborers was a clear lapse in the stringent epidemic planning, which was strengthened after Singapore was hit hard by the SARS virus in 2003.But the rapid spread of the virus among foreign laborers was a clear lapse in the stringent epidemic planning, which was strengthened after Singapore was hit hard by the SARS virus in 2003.
“We’ve been warning for years that these high-density dormitories are at risk, from fire or viral transmission,” said Alex Au, the vice president of Transient Workers Count Too, a migrant rights group. “We chose as a society to go ahead with living conditions that are a risky node for infection because it kept costs down.”“We’ve been warning for years that these high-density dormitories are at risk, from fire or viral transmission,” said Alex Au, the vice president of Transient Workers Count Too, a migrant rights group. “We chose as a society to go ahead with living conditions that are a risky node for infection because it kept costs down.”
Across the world, people in shared living spaces have suffered runaway spread, from nursing homes and prisons to cruise ships and aircraft carriers.Across the world, people in shared living spaces have suffered runaway spread, from nursing homes and prisons to cruise ships and aircraft carriers.
Labor experts in Singapore said that the quarantining of healthy laborers with sick ones in the past couple of weeks had probably accelerated infections. Some of those who test negative are now being separated from the sick to avoid the dormitories’ becoming viral petri dishes.Labor experts in Singapore said that the quarantining of healthy laborers with sick ones in the past couple of weeks had probably accelerated infections. Some of those who test negative are now being separated from the sick to avoid the dormitories’ becoming viral petri dishes.
“Should standards in foreign worker dormitories be raised?” wrote Josephine Teo, the minister for manpower, in a Facebook post. “There’s no question in my mind, answer is ‘yes.’”“Should standards in foreign worker dormitories be raised?” wrote Josephine Teo, the minister for manpower, in a Facebook post. “There’s no question in my mind, answer is ‘yes.’”
Tens of thousands of Singaporeans have donated funds for the well-being of migrant workers. The expectation is that the government will deliver on its vow to treat foreign workers better.Tens of thousands of Singaporeans have donated funds for the well-being of migrant workers. The expectation is that the government will deliver on its vow to treat foreign workers better.
For now, though, the country is still reeling from the pandemic’s assault on some of the most defenseless people on the island.For now, though, the country is still reeling from the pandemic’s assault on some of the most defenseless people on the island.
On Monday, Singapore imposed a 14-day stay-at-home order on about 180,000 foreign construction workers and their families. Rights groups worry about how some workers who live outside government quarters will get food.On Monday, Singapore imposed a 14-day stay-at-home order on about 180,000 foreign construction workers and their families. Rights groups worry about how some workers who live outside government quarters will get food.
Confined to his room in a government dormitory where hundreds of foreign workers have been infected with the coronavirus, Mr. Monir said he had one wish.Confined to his room in a government dormitory where hundreds of foreign workers have been infected with the coronavirus, Mr. Monir said he had one wish.
“I want to go home,” he said.“I want to go home,” he said.