Thursday, February 13, 2020

Three shocks in Singapore's COVID-19 fight

Singapore's ongoing fight against COVID-19 could face three stress points that you and I need to watch out for.

The first stress point will come about if and when SG Govt reports the first victim. During the SARS pandemic in 2003, there was a 24-day interval between reports of the first SARS case (1 Mar 2003) and the first SARS death (25 Mar 2003). Singapore reported its first Novel Coronavirus 2019-NCoV (now named COVID-19) case on 23 Jan 2020. While both viruses are different, any COVID-19 fatality that occurs before the 24-day window may lead people to infer (wrongly) that the new virus is more deadly.

Being transparent is important. When communicating complex medical matters, some of which involve patient confidentiality, public comms must be propagated clearly and simply to help people understand the issue. Thus far, Singapore has done well.

Remember too that SARS did not face the onslaught of social media that we see today. The NOKs and family of people being treated need to be shielded from media scrutiny. In their rush for a human interest story and while working under deadline pressure, journalists may inadvertently end up stressing out the NOKs as well as people in the community where the victim lived or worked.

The second shock will occur if COVID-19 proves harder to beat than originally thought. Thus far, the messaging in Singapore has built the impression that while the new virus is more contagious than SARS, it is less deadly. In layperson's understanding, getting it will be like getting hit by the flu bug. News that COVID-19 deaths in China have surpassed China's SARS death toll 17 years ago are unsettling because the grim tally contradicts the messaging that the new virus is "less harmful". If the quarantine period proves to be longer than the 14-day precautionary window, then the public needs to be assured that the various measures at limiting the spread of the virus in Singapore continue to be effective.

The third shock concerns the Disease Outbreak Response System Condition or DORSCON threshold, which many people in Singapore are watching closely. While it is unlikely to move from the current DORSCON Orange to Red (the highest level of alert), people should be told what are the likely triggers for condition Red. This will help the public better understand the data shared almost daily on the COVID-19 situation. People hear a mass of data every day. Thus far, the outlook has been lousy with the number of cases and people in ICU (eight as of 12 Feb 2020) going higher.

These aren't bland statistics. Behind each number are people who care about the patients. Their loved ones are probably wracked with worry as Singapore charts uncharted territory with this new virus.

Help people make sense of that mass of numbers. If people know how far from the Red threshold the (insert a number) COVID-19 cases discovered is, such awareness will help people build up a stronger sense of assurance as it takes away the needless uncertainly and gnawing anxiety from guessing how many more cases will push Singapore to declare DORSCON Red.

Even if the situation is dire and we're one case away from the trigger, it is better for people to know how that threshold was calculated. There's already a fair bit of freelance game theory out there with people guessing how many more cases will need to be announced before we tip into the red. If current projections show it is unlikely, then help people get a reality check while understanding the risk factors that we need to watch out for.

Once people understand DORSCON thresholds, then imagine the groundswell of positive energy that will emerge when Singapore turns the corner and case loads start to drop.

We all hope for the best. But we should all gird ourselves for the likelihood that things may get worse before they get better.

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