Singapore has had an enviable record in handling the coronavirus outbreak. Based on the latest figures, the country has had only 21 deaths, or four per million of population, compared to 137 per million in Canada, 251 in the U.S., 482 in the U.K. and 511 in Italy.
Indeed, Singapore learned lessons from the outbreak of SARS in 2003, when 33 patients died there.
This time, the government was ready with an elaborate testing and contact tracing regime that nearly snuffed out the COVID-19 outbreak at an early stage.
The first case in Singapore was a female shopkeeper who had welcomed a large group of Chinese tourists in mid-January. Health department contact tracers quickly chased down almost everyone she encountered, and ordered them to self-quarantine as a precaution.
“One of the things about Singapore being very small, it is completely wired up, it is all connected through the latest IT system,” said Leo Yee Sin, executive director of Singapore’s National Center for Infectious Diseases. “So it gives this advantage in terms of contact tracing.”
But the COVID-19 wave has a way of exposing a society’s faults. In China, it’s an authoritarian government that covered up the severity of the outbreak. In Canada, it’s a long-neglected long-term care system.
In Singapore, the fault-line has been its guest-worker system.
Reliance on migrant workers
According to Singapore’s Ministry of Manpower, 1.4 million of the country’s 5.8 million residents are migrant workers, mostly from Bangladesh and India.
A large number of them are in construction and other heavy industry such as shipbuilding, and are sometimes paid as little as the equivalent of $20 Cdn a day. These workers live in company dormitories, often 10 to 20 per room in unsanitary conditions.
WATCH | A look at Singapore’s efforts to tame COVID-19
Most work almost as indentured labourers to pay off the debt they incurred to come to Singapore, and are reluctant to do anything that might jeopardize their stay.
“If a migrant worker is ill, he’s not going to say that he’s ill, because he’s afraid of what happens if he takes sick leave,” said Singapore journalist Kristen Han, who recently wrote an article for Foreign Policy magazine entitled “Singapore Is Trying to Forget Migrant Workers Are People.”
“His employer might be unhappy, [the worker] might get fined for taking sick leave, he might have his work permit cancelled and then be repatriated.”
Singapore’s good record on COVID-19 became tarnished when the novel coronavirus entered the migrant-worker population and spread. In early April, the government forced all of the company dormitories to be locked down and the economy ground to a halt.
During February and March, the number of new cases never reached more than 100 per day. But on April 20, it peaked at 1,426.
According to the ministry of health, on May 6, infections in dormitories made up 88 per cent of the cases nationwide.
Political scientist Ja Ian Chong at the National University of Singapore said racism has been a contributing factor.
“The infection in migrant worker dorms, I think, is uncovering a lot of the nastiness and, frankly … racism that have been latent in Singapore society for a long time,” Chong said.
“People [are] saying, ‘Well, these migrant workers, they’re dirty by culture … and, you know, they have it good here in Singapore, why are they demanding more? They deserve their lot.'”
‘We will care for you’
In his May Day address, Prime Minister Lee Hsien Loong seemed to bend over backwards to express his appreciation and concern for migrant workers, saying, “Let me emphasize again: We will care for you just like we care for Singaporeans.”
But that is not quite the case. In fact, special facilities have been constructed to treat infected migrant workers outside of Singapore’s hospitals.
For the most part, the care is administered through robots, which bring food and medicine to patients’ bedsides. Doctor visits are performed through other robots to minimize human contact.
There is even a robot dog to lead quarantined workers from one place to another.
These measures seem to have lessened the second wave of infections. Probably because the workers are young and healthy, the death rate in Singapore is still very low.
Contact tracing app
On March 21, the government began encouraging all citizens to download a new contact tracing app called TraceTogether to their phones.
The app keeps a log on the phone of every other device that shared close contact with the owner over a 14-day period — information that would be turned over to health authorities if the carrier of that phone became infected.
So far, the app has not been a great success.
“We’ve learned that a very small number of Singaporeans, about 1.1 million, downloaded it,” said Han, which “is quite far from the three-plus million that they actually need before it becomes effective in contact tracing.”
Many Singapore residents are concerned about the privacy implications of the app. Unlike a similar app in Australia, the location information gathered is not restricted to use by health officials. It can be shared with the police and army, who could find other uses for it.
Now, because the infection rate among migrant workers is still high, the Singapore government is apparently considering legislation to require all residents to download the app and participate in the program.
But it’s not clear what proportion of migrant workers even have the smartphones necessary to make the app work.
As many countries are learning, there may be limits to technology as a solution to an outbreak.