Coronavirus pandemic

Flexible healthcare system needed to tackle 'smart' virus

It is able to target and infect the vulnerable, creating challenges for curbing the outbreak

SPH Brightcove Video
Senior health correspondent Salma Khalik discusses the effectiveness of the circuit breaker with a panel of Singapore’s top infectious diseases experts.
ST senior health correspondent Salma Khalik (far left) moderating a discussion with (on screen, from second left) Professor Dale Fisher, Professor Teo Yik Ying and Professor Leo Yee Sin. ST PHOTO: DESMOND FOO
ST senior health correspondent Salma Khalik (left) moderating a discussion with (on screen, from second left) Professor Dale Fisher, Professor Teo Yik Ying and Professor Leo Yee Sin. ST PHOTO: DESMOND FOO

The outbreak of Covid-19 is caused by a "smart" virus unlike any other, unique in its ability to infect humans and cause disease, a panel of experts said yesterday, adding that it was important for the healthcare system to be flexible so it can take on new challenges that the outbreak will pose.

Professor Dale Fisher, a senior infectious diseases expert at the National University Hospital, pointing to infections at nursing homes and dormitories, said: "I am learning that this virus is really smart.

"It can find our blind spots, it can find vulnerable people, it can find areas where there is high transmission, despite our efforts."

He was one of three experts who spoke at a discussion moderated by The Straits Times senior health correspondent Salma Khalik on how new information about the coronavirus was guiding Singapore's response.

Professor Leo Yee Sin, executive director of the National Centre for Infectious Diseases, noted that while Singapore had picked up important pointers from dealing with Sars (severe acute respiratory syndrome) in 2003, no two outbreaks were alike.

"This is very, very different from Sars," she said, pointing to differences in terms of the scale of infections and the way the disease manifested in patients.

"No matter what system we have put in place, the more important thing is that the entire system must be flexible and be ready to take on whatever challenge, in whatever form and whatever shape."

She said it was important for the public to understand why the month-long circuit breaker period was being extended by four weeks from May 4.

"This is a very smart virus, it will find ways to remain in the human population. So, it is not a simple virus for us to deal with. There is human-to-human transmission, it can transmit when we are not aware," she added.

Professor Teo Yik Ying, dean of the Saw Swee Hock School of Public Health at the National University of Singapore, said that while there have been encouraging signs that the circuit breaker has been effective so far, the numbers of new cases have not fallen as quickly as expected.

The three-day average number of new community cases affecting those who live outside of dormitories has fallen from 48 at the start of the circuit breaker period to around 25 over the past three days, he said.

"Based on those numbers, we know that the circuit breaker is effective... but I am actually a bit disappointed that the numbers have not fallen as low as we were expecting," he added.

This points to "leakages" in the community, whether they involve people who venture out without taking the necessary precautions or essential staff who may have to go to work, Prof Teo added.

"This is why there is a need to perhaps step up the circuit breaker measures to now limit the definition of what is essential services and to further restrict the essential sectors a bit more," he said.


Panel of experts

The three experts The Straits Times brought together on The Big Story to discuss the Covid-19 outbreak and the effectiveness of the circuit breaker measures:

PROFESSOR LEO YEE SIN

Executive director of the National Centre for Infectious Diseases

The NCID has treated more Covid-19 patients than any other institution in Singapore. Prof Leo was also the infectious diseases expert who led Singapore's fight against Sars (severe acute respiratory syndrome) in 2003, the Zika outbreak in 2016 and, more recently, Singapore's first imported case of the monkeypox last year.

PROFESSOR DALE FISHER

Senior infectious diseases expert at the National University Hospital

Prof Fisher arrived in Singapore from Australia during the Sars outbreak.

In 2014, he joined thousands of volunteers around the world to help combat Ebola in West Africa.

In January, he was a member of the joint mission organised by the World Health Organisation and China to study the Covid-19 situation in Wuhan, where the virus is believed to have originated in December before spreading across the world.

PROFESSOR TEO YIK YING

Dean of the NUS Saw Swee Hock School of Public Health

A mathematician by training, Prof Teo specialises in biostatistics, population genomics and genetic epidemiology.

The school has been actively helping the Government study and predict the trends of the Covid-19 pandemic.

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A version of this article appeared in the print edition of The Straits Times on April 23, 2020, with the headline Flexible healthcare system needed to tackle 'smart' virus. Subscribe