Countries thought to be recovering from the COVID-19 outbreak, like China and Singapore, remain susceptible and can expect a likely surge in imported cases and new outbreaks. This is especially so given the growing numbers in Europe, North America and several countries in the Middle East, along with cases arising in African and South American countries.
How can we end, or at least manage, this pandemic? The answer lies in trying to convert a ‘tsunami’ into multiple smaller and manageable ‘waves’, wrote Associate Professor Hsu Li Yang, Programme Leader (Infectious Diseases), and Associate Professor Natasha Howard in a commentary piece.
In epidemiological terms, an outbreak is said to be on a downward trajectory if the effective reproduction number ‘R’ falls below 1 — this means that each infected person infects on average less than one other person. Transmission will end once ‘R’ reaches 0.
If ‘R’ remains just above 1, the local outbreak spreads more slowly and results in fewer infections — also termed ‘flattening the epidemic curve’ — thus not overwhelming the healthcare system.
“What we are seeing around the world in the past two weeks is a variety of different combinations of interventions aimed at ‘flattening the epidemic curve’ but time is needed for these to bear fruit,” said Assoc Prof Hsu and Assoc Prof Howard.
The effectiveness of the wide spectrum of interventions in reducing ‘R’ relative to their socioeconomic cost is dependent on each country’s situation and health system. But the more restrictive and self-isolating interventions will consequently have a grave impact on socioeconomic costs and relations between countries.
Singapore has thus far taken a relatively moderate approach with scientific evidence-based interventions to curb the spread, allowing a somewhat sustainable balance between restrictions and normalcy for now.
Nevertheless, we must be prepared to quickly implement more restrictive social distancing measures, or “extra brakes” as Prime Minister Lee Hsien Loong had termed them during his national address on 12 March.
Read Assoc Prof Hsu and Assoc Prof Howard’s full commentary here: