COVID-19 Lessons from Singapore and South Korea
Even though there has been a recent surge in the number of COVID-19 cases in Singapore and South Korea, there are still practices India can adopt from these Asian countries. A HE report.
“There's no place in the world where the outbreak feels calm, but the clarity and speed of action of Singapore’s government have been impressive. SARS outbreak taught us the value of clear and effective communication: being tough on those who flout the system, constantly communicating measures around quarantine, working and schooling from home and business continuity," says Luke, a long-time Singapore resident.
It’s not just Luke’s opinion. It is the perception across the world that Singapore and South Korea picked up on information that it received rapidly and took decisive actions, particularly around testing, isolation of those infected and follow-up of contacts made by the infected.
Singapore's War on Corona
Singapore’s approach is mainly centred around using time and information flow to ensure the best possible outcome, well before the problem is too great.
What helped Singapore initially was its three-pronged approach which involved:
Lessened importation
Detecting and isolating cases early
Emphasising on social responsibility and good personal hygiene habits
Singapore Government shares updates with citizens regularly through social media channels like Twitter, Telegram and Whatsapp.
Many point out that it executed drills, created after the SARS epidemic. "Since SARS, we have deployed extensive programmes countrywide to prepare for the next pandemic. We have also invested wisely in infrastructure, like the National Centre of Infectious Diseases (NCID). Our emphasis on building up our national reserves played a huge role. It was planned to act as a rainy day fund as a way to tide us through shocks and crises such as COVID-19," says Brian Toh, who built the platform AskDr, where the public can ask questions concerning coronavirus to doctors for free.
Ravi Duggal, an Indian public health researcher, seconds his views. "Singapore was well-prepared for such a pandemic wherein it has put in place mechanisms since SARS 2003— interdepartmental task force, aggressive testing, tracing contacts and strict quarantine. And it’s done in a coordinated and integrated manner and not sequential processes. South Korea, HongKong and Taiwan also learnt from this and did a better job of containment."
Duggal adds that Singapore’s robust public health system with reliable and well-resourced primary healthcare could respond swiftly and efficiently. “Firstly, they did not have to deal with resource deficiencies. Secondly, all employees quarantined were given that period as paid medical leave, and the self-employed were paid $ SG 100 as daily allowance because of economic inactivity. And being a a police state, people are used to enforcement.”
Technology
So, what can India emulate from the island nation?
Sejal Mistry, Country Director of Access Health International, says that Singapore's digital technology solutions can be useful for India. "It introduced a mobile app called Trace Together to trace contacts faster when positive cases are confirmed. Such solutions can be beneficial for India. Smartphone penetration in India can be leveraged by using telemedicine for remote monitoring of low-risk patients, and it can also enable care of patients with health issues not related to COVID-19 to avoid visiting hospitals and risking their chances of contracting the virus.”
How South Korea fought back
So, what are the lessons that emerge out of South Korea?
South Korean strategy has often been described using the acronym: TRUST- Transparency, Robust Screening and Quarantine, Unique but Universally Applicable Testing and Strict Control and Treatment.
The most crucial weapon in the armoury of South Korea was mass testing. There were initiatives like drive-through test stations and telephone-booth testing centres. There have been slips even in S.Korean strategy—the spike in infection due to a super-spreader; however, the authorities were able to contain it, with extensive contact tracing and quarantine.
Eun A Jo, a PhD student in Department of Government at Cornell University, who has written several articles about S.Korea, says, “Among the most notable of its response is its track-and-test strategy. By tracking all confirmed and potential patients and sharing their movement histories with the public, the government was able to mobilise large-scale public participation in avoiding infection hotspots. Simultaneously, the government used tracking to deploy mass and early testing, which helped to trace and isolate the infected before they could unknowingly spread the disease."
She also notes that much of its success should be attributed to public cooperation and India must identify ways to mobilise this, but it will have to be tailored to the particular context. "It has also adopted a tiered treatment protocol— those with the highest risk i.e. the elderly, the immunocompromised, and the seriously-ill received immediate intensive care in hospitals. While those with lower risk are treated and monitored elsewhere. It allows healthcare workers to prioritise high-risk patients,” she explains.
Establishing legal boundaries of surveillance and developing best practices through public conversations are two ways through which South Korea is working toward a balance between public safety and individual privacy. Almost 90 percent of the population supports government's tracking strategy, owing to the system’s transparency.
Take-Aways for India
Vivekanand Jha, Executive Director of George Institute for Global Health, points out that even though Singapore and South Korea are Asian countries, they are developed and have robust healthcare. "S.Korea's health system was ready after MERS outbreak of 2015. Despite the spike in the infections initially, S.Korea was able to contain the infection. They quickly jumped to serological testing and didn't depend on the PCR test, where results come late. They also took effective measures to check superspreaders," adds Jha.
For India's ill-equipped public health system and restricted resources, COVID-19 is an ordeal. And Jha says that we cannot blindly adopt features of developed countries like drive-through test stations, adding, “Demography of Indian population is starkly different. India has to develop its policy.
Moreover, developing a response should be in sync with values and preferences of citizens. Nations which are police-states can enforce rules which democracies might not be able to adopt.
"The government should reassure the public and be transparent about where the data will go and protect privacy of patients in a manner that's consistent with the constitution," concludes Jha.