Covid-19 crisis Focus on symptomatic cases
I suggested that safe entry recording and contact tracing should be abandoned. They take up a lot of resources and give unreliable results.

Instead, we should focus on dealing with the symptomatic cases. 

I discussed this issue with a friend.

Friend - Mr. Tan. I read that the asymptomatic cases can also spread the virus. Are you suggesting that they be allowed to move freely in the community?

TKL - I believe that these people are already moving in the community and spreading the virus. The infections are probably mild and do not become serious. The authority did not report on the number of cases that are located through contact tracing. I believe that this number is very small.

TKL - I read a report from WHO that the spread by asymptomatic cases is low and not serious. It is the symptomatic cases that become "super spreaders". This coincides with my common sense. A small number may become serious, but we can catch them when they become symptomatic (i.e. the corona virus has reach a serious stage).

See this report from WHO;
http://www.emro.who.int/health-topics/corona-virus/transmission-of-covid-19-by-asymptomatic-cases.html

Friend - Some of these asymptomatic cases may spread the virus to the vulnerable people, i.e. those who are older and have medical conditions. It could lead to more hospital admissions and deaths.

TKL - The vulnerable people should take steps to protect themselves from exposure. They should stay at home and use masks and avoid close contacts with their family members. When they become aware of the risks, they will take the precautions. This is the reason that account for lower deaths of vulnerable people in recent months, as compared to the earlier months. People have become more aware.

Friend - There is a report of a large increase in new cases leading to a second wave and third wave of infections. Surely, with more people being infected, we should step up the contact tracing?

TKL - The large increase occurs in other countries and not in Singapore. We should not be over-reacting to the situation in other countries as their conditions are different. For example, the climate is getting colder and the virus becomes more active in cold climate. 

TKL - There is also another reason for the large increase. The authority is carrying out more testing for the virus. With more testings, more mild cases are being detected, especially with younger people (who are not vulnerable to the disease). This is why the daily deaths remain constant and do not increase with the spike in new cases.

Friend - If we stop contact tracing, we may allow the virus to spread out of control. At that time, our hospitals will be overwhelmed.

TKL - This may happen, but it may not. We should not take extreme measures to prevent a bad situation that may not arise. We can stop contact tracing and see if there is a spike in symptomatic cases. If this occurs, and I do not think that it will, we can always resume our safe entry recording and contact tracing.

Friend - I am worried about the large number of imported cases that are being reported every day.

TKL - This number is actually quite small. Most of these cases are mild and the cases are being asked to self isolate. The virus will not spread to other people. Actually, this number is not alarming. We are seeing this number because we are testing all incoming travelers. Maybe 1% of the travelers are being detected. If we test a large number of local people, we may also see a similar proportion with positive results.

Friend - Surely, we are already focusing on detecting the symptomatic cases through temperature taking - which is part of the safe entry protocol?

TKL - We can continue temperature checking but do not need to use manpower. We can set up temperature checking booths - which do not require to be manned. We can encourage every resident to have the temperature taken three times a day. More importantly, we should make it easy for for people or other symptoms (cough, shortness of breath) to visit special clinics for the covid tests. These tests should be free for people with symptoms. These special clinics should be made easily accessible to the public. These clinics can also administer the tests to people without symptoms, but they should pay a subsidized fee (say, 50% of the commercial rate). The government should also give an allowance for people who are required to stay at home after being tested as positive.

TKL - If we focus our attention to make it easy for people with symptoms to be tested, we are likely to stop the spread of the virus more effectively. It is now time for us to try a new approach, instead of continuing with the same approach that was adopted for the past nine months.

Friend - Should we stop the circuit breaker and allow people to carry out their normal activities?

TKL - Yes. It is quite safe to do so. We can still encourage them to wear a mask in crowded places and to adopt social distancing. This can be made voluntary. People already know how to take the appropriate measures relative to the real risks. We should not continue the lockdown as it is harmful to the financial and mental health of the people.

Do you agree?

Tan Kin Lian


 

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