Do people still blink at the daily new case counts? I think the shock of new restrictions last Friday had a more material impact than just daily numbers.
The Covid pandemic has been here for so long that you’re probably in a routine – either you are in the A. covid-response side (healthcare, support, ancillary, etc), B. industry affected by covid shutdowns (tourism, aviation, f&b), or C. not directly affected by covid that much (banking, finance, or etc).
You should be in a routine, and not have to turn your life upside down with each +/- restriction, because it’s just not over yet. Sure you can be annoyed/upset by the changing of it, but it’s not just in Singapore. Even Germany and other countries reserve the right to adjust the state depending on current situation. The only difference is how often, how much, and how lax the targets.
Of course one very major impact, still, is if you get the virus, or get quarantined, and that’s a major discussion in itself on how it is managed and whether the policies are appropriate and reasonable.
One bizarre thing has been (the probably few number of ) the HCWs being unhappy with the workload, and saying policies are bringing on more work for them. This is in a way, contradictory, or something, I can’t quite put a firm finger on it.
healthcare is busy, much much busier with Covid, no doubt about this
they are busy because of preventive measures, PPE, increased and differentiated treatment protocols
isolation, quarantines, reduction in available staff, physical space, resources
knock-on effect due to having to ‘protect’ other non-covid patients, from covid-patients
I gather that many of them, being in the field, quite thoroughly understand the rationale, risks, and protocols. Of course, understanding something could also lead to even more frustration at not being able to ignore it, as compared to an old uncle at the coffeeshop not wearing his mask properly.
How should we solve this though? short of magically conjuring more personnel.
If healthcare says they have a problem coping with Covid, isn’t that MOH’s problem, and not the public’s problem? What could the public possibly do, to make Covid go away?
Since we established (nowadays) that we can’t eradicate it from SG, from Earth, it means that Covid keeps returning. (I’m just gonna call the virus+disease all Covid because it’s tiring to keep differentiating.) This means the public cannot stop getting infected, sooner or later, this means the public will end up at healthcare, be it self-care, primary-care, tertiary-care, morgue… But what basic tenets can we drop/adjust/ignore/change?
Covid-19 is mild and we need to prevent ourselves or family members from contracting Covid
Is this still true? Do we need to isolate household members from one another? We don’t do that for flu etc, we don’t quarantine active cancer patients etc. We don’t quarantine 90 year old grandparents. We just accept it as a fact of life? So is this a mental vestige of earlier fears?
Or is this a way of reducing the infection rate to protect healthcare staff from being overwhelmed
Covid-19 is generally mild, except for higher risk people, and we need to prevent these people from contracting Covid
Do we need to do extensive isolation for nursing homes? It’s causing a big workload for just a preventive measure. I feel that this is unnecessary even with the increased risk of serious illnesses.
Do we need to do extensive isolation within the hospital setting? Is this to be standard for infectious diseases? How long can this be kept up?
Hospitals are saying that excessive of mild Covid cases come to A&E, and wards.
Look we are barely having 2000 new covid cases a day, it will take ages for people to finish getting infected with Covid. If you can’t handle 2000 cases a day, the solution is not to tell people to stay out of medical care settings, the solution is to properly direct the masses to the appropriate level of care that you want people to go to. Possibilities:
set up dedicated treatment ‘hospitals’ for serious covid (the new CTF concept, which has barely a few hundred beds)
set up dedicated ‘primary-care’ for mild covid (since it’s all the same disease, it makes life easier for the healthcare workers than a normal general care gp or polyclinic setting)
set up self-help conditions for v mild covid
use the expo-concept for mass monitoring/treatment/triage? (is this too low class? how about use this as a primary care?)
set up 24/7 walk-in that are not your A&E for goodness sake. It’s so difficult to get late night treatment for any illness, and the default medical support is the v rare gp clinic, or A&E.
have more extensive use of pharmacists
reduce over-diversion of resources towards eldercare support if the endgame is to reduce the total loss of productive citizens
reduce support of non-vaccinated, simply because of limited resources and outcome probabilities
These are changes that the medical system needs to do on their own, not the public. The public will keep getting covid, and in greater and greater numbers as we open up. It will not get any less. They need to plan for 10X patient counts, not 1.5X. They need to do things like sending oximeters, OTC meds to mailboxes in a big blast, rather than one by one courier.
I wont be surprised if some of these are already in the works.
On one hand, we should only escalate or degrade care if the system is truly not coping, instead of pre-emptively degrading care levels, on the other hand, people feel discouraged to hear of systems being strained.
We seem to have a ridiculous amount of manpower right now on vaccination, move them to do something else. Vaccination people can queue for an hour, no big deal.
It arrived. The latest tranche of changes / restrictions for Covid-19. It wasn’t a surprise that changes were incoming, there were so many clues and indications that things weren’t going well. It was a simple prediction that the next possible scheduled press conference (fridays) was the day to go for, that the news was delayed due to the ongoing press conference, that so many things needed to be changed due to how massively the Covid situation has evolved in the past 1-2 weeks.
So let’s see the latest changes
Social gatherings reduced from 5 pax to 2 pax sizes for 1 month
Dining-in at F&B similarly reduced from 5 pax to 2 pax. No change to 2pax at Hawker centres and coffee shops.
Indoor Mask-off gym and exercise, 2 pax groups
Marriage solemnisations 1000 vaccinated, 50 unvax. Wedding receptions 250pax, 5 per group. Unvax and elderly discouraged
Workplace: WFH as default for 1 month, ART if required to be in office
Workship: 1000pax, 50 unvax. Elderly discouraged
Funerals: 30pax, 2 per group
Home Recovery Program (HRP) is now default for Covid-19, unless you have certain high risk factors.
If unsuitable home environment, push to Community Care Facilities CCF (basically isolation facility)
If need monitoring, push to Community Treatment Facilities CTF (CCF with medical)
If need active treatment of serious breathing or other conditions, push to main Hospitals
CCF capacity expanded from 3500 to 4600
CTF capacity to expand to 1200
Hospital beds to expand to about 1600?
Expand capacity of HRP support/management, with more telemedicine resources, hotline resources, buddy resources, support in Telegram group, print article ads, People’s Association
Covid-19 testing on weekends expanded to Regional Screening Centres
ART rate increased
Primary school HBL extended slightly
Tuition mandatory virtual/remote
Boosters expanded to 50yo and up.
Businesses affected will get additional rental support, wage subsidies
Please refer to StraitsTimes or MOH for the latest correct versions, there are just too many announcements, including add-on announcements by MOM, ECDA etc etc on their respective industry specific adjustments, many of which are more minor, but nevertheless impactful.
Is this the right path?
Since we are at a very ‘open’ state of conditions, there are so many opinions from different parties on how we should proceed, how good/bad a situation we are in. It’s not easy to come to any consensus, or balance.
Infectious Disease experts who believe that high vaccination is sufficient to provide “mild” status to high majority of infected vaccinated individuals
Infectious Disease experts who believe that the current numbers of severe/ICU is still risky
Layperson who believes high vaccination is the endpoint and we have reached it
Layperson who believes Covid is still dangerous and refuses to get infected
Layperson who has kids and is extremely worried about their kid getting it
Layperson who has kids and is more concerned about kids not getting social interaction
Layperson who has elderly parents and is concerned
Vaccinated adults who believe Covid is dangerous for themselves
Infectious Disease experts who believe Quarantine system is overly strict
People under Quarantine who feel that MOH is doing a bad job by poor management of HRP
People with Covid who rush to hospital A&E
People with kids or elderly with Covid, who rush to A&E
People with Covid who are panicking at home
Wow it’s a major mess with a thousand cooks making this soup.
Some premises though:
the most sobering factlet i can offer you in terms of how singapore is handling covid, is that literally nobody in healthcare expected the numbers to go up so quickly. yes. even the most pessimistic and most cynical expected the numbers to go up fairly fast. but this fast? nope
OYK also said that the rise was faster than expected, with insufficient time to ramp up resources.
It would appear to be true, that Singapore’s daily case count curve, is very rapid, higher than a normal modelled 80%(or higher) vaccination rate. But models and stats and predictions are only as good as the source data, and we know that many countries do not have a comprehensive finger on their pulse, they might not know the exact real world statistics, they don’t have insane testing and ring fencing like we do, they might only have had resources to focus on the more serious or symptomatic cases. So it is possible that our extensive testing is throwing up so many more case counts, that we’re off their charts.
Going into 23 Sept, we knew that there was strong public interest in the daily case counts crossing 1000, there was a huge pressure on the hospitalization and A&E tranche, there was a pretty much overwhelmed HRV / QO system. Something needed to be done, something more extensive than some slight adjustments, 250 enhanced CCF beds, primary school HBL. On 22 Sept LHL himself posted about the MOH QO team being beefed up. So obviously 23 Sept is going to be a change and anyone with a brain will be waiting to hear it, don’t make big plans before the weekly friday time.
Question is, did MTF deliver correctly? And what do their plans indicate.
No change to the requirements that Covid positive individuals (PCR positive), need to be Isolated for 10 days. This might sound duh but it’s a huge tenet in the basis of endemic Covid management.
ART positive test is not sufficient for official diagnosis, PCR test is still required for confirmation.
No change to the requirements that close contacts of C+ individuals need to be under Quarantine.
No change to HRW
No change to upgrade of higher risk C+ individuals to CTF and CCF
Hospitalization criteria is much stricter due to handing over of monitoring to CTF. Essentially CTF is covid-hospitalization-lite?
Stricter entry barriers to hotel-or GQF based Quarantine
CCF should have been increased way way earlier, or be able to ramp up even faster. Note LW keeps harping on exponential numbers. Can you double CCFs overnight? or in 1 week for example. Covid can.
CTF should have been active earlier, instead of sending to hospitals. Full ward isn’t optimal? Expo needs to be re-activated. Dumb usage of the facility for entertainment purposes should never have been allowed.
GQF is a toss-up right now, at 80% vax it seems like we should drop this, but there are other competing factors.
The continuation of IO, QO, all means that MTF is still ringfencing and controlling Delta spread. They want to keep Rt number at 1+, not at 5 or 6 in a full blown no quarantine no testing situation. If we go up to full Delta Rt … , wow it’s gonna be over in 2021. If we drop QO, we don’t need GQF. If we drop IO for C+, we don’t need HRP, don’t need admin manpower, don’t need to distribute care packs, don’t need QO society support, we will go straight to managing full CTF-hospitalization-ICU.
Is the general population ready for this? Has anyone tried to convince them that 1. Covid is usually very mild if you’re vaccinated or young, 2. you can just walk around the house and to work if C+, 3. you can self medicate, or go to GP if needed?
Is it right to say we just want you to isolate at home so we reduce the overall speed of spreading, but then once you isolate at home we think that it’s mild and we’re not going to support you? That would feel at odds. So we can’t put that together. We can’t isolate without providing support, test kits, payment, tests.
Can and should we say that if you isolate at home, it’s ok to have your kids and elderly stay together? If we don’t let you roam around in society, why should you risk your kids and elderly? Again it seems at odds. Can we have partial rules or must it be all-or-nothing?
Because of this all-or-nothing, we need to prepare the hospitalization system to also cope with all-or-nothing. Currently it’s not nothing, as they’re already pretty dang busy with real work, but they don’t seem to have bandwidth for ‘all’.
‘All’ in this sense means retain masks, retain dining-in limits, retain event limits, retain travel limits, but without any mass routine ART testing, without mass Quarantine Orders, without sudden workplace WFH requirements. These will have a big impact on the healthcare system capacity, it will reduce the load on the administrative side, and workplace side. However it will increase the load on the treatment side, which is the poorer decision. Because treatment side – doctors, nurses, hcw, support staff, beds, resources – these are very hard to ramp up magically.
So, to protect this resource, they can only do it by reducing the Rt rate and hope the conversion to serious illness stays low. Serious only meaning requiring hospitalization. This is where the new social restrictions come in. They will allow us to see what our special brand of Singapore 80% vaccination conversion rate is going to be, find the comfortable steady state of daily new cases that convert to the serious case rate, and maintain that until the wave dies out or everyone is infected.
I feel that the high vaccination % still doesn’t equate to a safe enough level for full opening. We don’t know the % of people who need medical care. By medical care meaning anything above a 3 day MC and simple flu medication of zyrtec / piriton / paracetamol / cough medication / phlegm thinner. Heck if a high % require basic flu care, it is already overwhelming. But if a large enough % require 14day rest, higher level medication, second follow up, or more, that is bad. And this large enough % is not counted as a % of the population, what we are concerned with, is the % increase workload arriving at clinics and hospitals, and whether they can cope.
If a hospital receives 1000 new patients a day, and in the pandemic now receives 2000 a day. That’s an increase of 100%. This 1000 number, might only be 1000/6million, which is a tiny %, but it’s still bad news.
Every other restriction stems from these numbers. Nothing else matters. The current vaccination rate is not important, the type of vaccine you took is not important, the number of jabs is not important, what is important is at the end of the day, what are the actual numbers of people falling significantly ill and whether the healthcare system is coping.
So I can understand why MOH is still doubling down on the quarantine / test-trace-isolate model, which is undoubtedly painful on a good day and catastrophic when they are overwhelmed. They just really ought to have way more slack and ramp up faster on their procedures, with much more automation.
They should also seriously push out more education info on self-management of covid, manage people’s expectations, change the risk profile ever so slightly, do things that scale.
In hindsight, giving out oximeters to each household doesn’t seem like a dumb thing to still be doing in Q3 2021 now.
Surprised that Temasek hasn’t publicly stepped in to do anything in this wave. They seem to just be happy-happy do things whenever it suits their convenience – at least publicly. I hope the GLCs are doing something on the backend.
WYSIWYG – an old computer acronym meaning What You See Is What You get
If you read the Covid response in the mainstream news, it’s just one side of the story, it’s (mostly) the public mouthpiece that the Gov / MTF wants to put out. That’s not wrong, and largely it keeps the messaging concise, clear, focused, and controlled.
But of course, as with everything, it is important to have independently verifiable data, a healthy dose of skepticism, and proper critical thinking. Not to mention to understand different viewpoints, intentions, and to take care of yourself because nobody else will.
So the other sides of the stories include anything from the pure anti-vax movements, the standard conspiracists, the grassroot WhatsApp chats, the online forums, the coffeeshop chats, scientific community, healthcare community. And of course the actual C+ patients themselves.
It’s not easy to tell who is telling the truth, and how much of the truth. It’s rare for anything to be completely true, or completely false. Anything clearly false would be dismissed immediately, but half truths are more dangerous.
The Current Endemic Mess
So anyways, now we have MOH MTF going headlong into their concept of “endemic” – the dangers of which is that they branded it with this silly name, and over equate it with influenza without the same conditions.
MOH still pursues extensive quarantine and isolation. Not wrong per se. It has great intentions in slowing down spread, flattening the spike, helping hospitals. Really. Slowing down, not reducing to zero. That’s the crux of ‘endemic’, that’s all.
But MOH’s team, despite whatever sugarcoating that LHL/MTF says, cannot micromanage thousands and thousands of home quarantine/patients/phonecalls/home service of swabs+checks+carepacks.
A radical radical radical conceptual change is required. From a top-down to a bottom-up approach. We need to clearly look at the needs vs possibilities and pare it down.
We can guess what is happening at MOH team: anything super critical is attended to: require hospitalization/ICU. breathlessness, low SPO2. everything else is on a best-effort basis. Leads to dropped calls, dropped cases.
The methodology needs to change to prioritize: 1. Entry/registration of C+/QO/IO, 2. Automate entry, followup, exit. Except for escalations and special cases. 3. Digitalize: use of integrated online case status, tracking, QO status etc.
MOH needs to not just resolve 500 caseloads per day. They need to implement new solutions that continuously automate 10% of the above issues per day, at the end of the week, it will lead to scalable solutions that can handle the increasing daily case rates in a sustainable way.
Change in Mindset
It’s incredibly difficult. Firstly the healthcare side themselves do not have the confidence to 100% say that hey if you’re Covid PCR positive or ART positive (somewhat different states here), that you can do some/all the following:
Take MC for 2-3 days (typical flu MC duration), take normal GP medication, continue work/school after that
Monitor own condition (as a layperson) until severe enough to require to go to the GP, or to the Next Escalation Point (NEP), currently A&E.
Stay at home, with isolation, with other vaccinated household members (v v ideal and rare situation)
Stay at home, without isolation, with other vaccinated household members
Stay at home, without isolation, with other ‘vulnerable’ members like unvaccinated kids or vaccinated elderly (common)
Stay at home, without isolation, with other really vulnerable members like unvaccinated adults/elderly with comorbidities
Continue to work or go to school after the initial 2-3 day MC
There are some basic premises we need to establish
Very serious Covid+ patients need to be able to be seen by a doctor at NEP. This can be A&E, or I propose setting up dedicated Covid sites if possible. It will help in triaging.
People should be easily able to self-isolate, basic needs are actually an official MOH policy, an official MOH notification or verifiable certificate just like the MC system, and employer participation in this scheme (voluntary or enforced)
Social support in terms of food supply, logistics, staying alive.
That’s all! It’s so simple. Everything else is ‘good to have’.
Requirement for people to self ART daily while on QO – good to have, but a big $ cost and logistics. Suggestion: Reduce interval
Requirement for entry/exit PCR tests – good to have, but a big $ cost and logistics. Suggestion: downgrade to ART, self submit.
Requirement for isolation room at home – good to have, rare. drop this if we don’t mind community transmission. It’s a huge effort and low use if everyone is eventually going to be infected. if it is “vulnerable” like kids and vaccinated elderly, does MOH have the guts to go ahead?
We know that
Sars-Cov-2 / Delta will still rip through a double-pfizer-vaccinated population. This is now a Known fact that we wished not to happen, but it does. Layman need to realize this and stop thinking vaccination can stop infection.
Sars-Cov-2 infection is layman-mild for most person. Meaning manageable flu symptoms that can self resolve, or with GP visit.
Sars-Cov-2 infection can lead to medical-mild for vaccinated persons. In a layman flu concept, it feels serious enough that we would definitely go to a doctor, or maybe a second visit, an extended MC. In a layman Covid-era concept, we would rush to the Next Escalation Point, and the only thing offered is A&E / hospitalization. I believe in the medical concept, this might still be considered mild.
In the medical ‘serious’ case concept, hospital admission is offered. We all agree this is serious.
Sars-Cov-2 in an unvaccinated person, will have a XX-times higher rate of serious illnesses. Everything tends higher. We really can’t do much for them right now.
MOH’s strategy now is still focused on one end point: juggle hospital capacity for serious cases. We all can say that it’s ‘endemic’ yada yada, but as long as the percentages above lead to a temporary unmanageable spike in hospital load, and I mean hospital load for truly serious cases, then it’s game over and back to a lockdown.
MOH wants to go to a hands-off self isolation no QO concept. But if we do that, how fast is the rise in serious cases, how high does this serious case spike go? We won’t know if the wave is going to stop doubling at 5 cycles, or further! It’s a prediction. Do we wait to 6X, 7X and see? If we don’t measure new/mild cases, we don’t have a predictive value of serious/ICU cases – we’ll be blind until people turn up at A&E.
We currently log 1500 Sars-Cov-2 positive people per day. Unmeasured let’s say 2x this number. And people who got challenged but not infected, … let’s say it all totals 10k exposures a day? 6 million popn, 10k..600 days to finish one round of exposures. If we abandon full QO, exposures a day should go up 10x, say 100k a day. Can we manage serious cases for this rate? This is the true end point question.
So what kind of theoretical public health measures will lead to a manageable serious case load?
And can MOH and society support and implement these public health measures properly?
In an analogy, MOH’s current rules and on the ground implementation is like saying you Must wear a mask outside of your home, but then 20% of people don’t have masks, 20% forget to bring it out, 20% only remember to put it on after 1 hour outside, 20% still fall sick, etc etc. Is it really then still effective?
Recent covid cases have hit the port/marine industry and the airport borders pretty consistently. Low, but consistent occasional cases of transmission from their interactions with foreigners.
Kinda sucks to be them. It’s a constant risk. Maybe it’s not as high profile as the risk of healthcare workers treating and attending to covid patients, but nevertheless it’s a higher risk than other industries that’s walled off.
Because it’s not as recognized, it might not be as appreciated too. I should say hardly anybody’s job description is to deal with this viral outbreak 24/7/365 and ongoing. The general healthcare industry on a normal day attends to medical issues without such risk of transmissions, the port industry just wants to move ships and cargo, the airport industry just wants to check and move people and cargo.
I’d liken it to like a normal policeman is not equipped or supposed to be having to guard against the mafia or a war day in and out. Tough. Hope y’all have an easier time soon.
So we back into “Phase 2” covid measures, sort of. mostly.
The ‘little’ TTSH case, and cluster, seems to have blown up significantly. There are so many reactions to it, so many comments, complaints. Somehow I just feel the measures are both quite-expected, and yet also not-expected. It’s cringe-y to see public’s reactions, many which are just off-the-cuff feelings or layman.
Probably will not be able to cover everything, but:
The presence of a single nurse-case in TTSH – not unheard of in itself, though rare. Not a major concern if a single case.
The presence of a sizeable cluster within the Ward 9D
very alarming as it directly proves that person-to-person retransmission has occurred
the transmission either happened really fast, or the detection has been late
the presence of cases in inpatients, who are already ill, who are very elderly (high risk factor), and have significant medical history
the presence of positive cases in fully vaccinated individuals, which indicates high transmissibility, break-through of vaccination, and even symptomatic infections
On the same day they announced an ICA guy, + transmission into the entire family group that shared a meal
from the above evidence, in day2 of public announcements, it was already clear to me that this was strongly indicative of a large big cluster, very high transmissibility and vaccine breakthrough which is like the strong Indian variant rampaging in India.
It was probably a coincidence that the multiple community cases and clusters all surfaced in the same few days, but it could also show that now we are experiencing influx of the Indian variant, which behaves very differently from the previous variants/clusters/quarantine escapes. At that time they didn’t have evidence yet to say this publicly, and implement community lockdowns, but it was apparent from their actions (by friday) that the situation was intense behind the scenes:
they announced which (ttsh) cases went to which venues, implemented 2 day venue closures and clean-ups. they implemented testing for all inpatients, all staff (mega exercise + cost), they isolated lots of staff. much unprecedented actions compared to all previous advisories, or even any other hospital case.
the announcement and measures were announced so hastily that it was obvious they were rushing and reacting to the situation
I don’t think the strong public outcry is wrong, there are many good points brought up by public, online, media, although we do bear in mind the rule that hindsight is 20/20.
(The media must be having a field day with all the delicious news cycles though)
Before I go through the Phase 2 festivities, between friday and tuesday, things escalated daily, notably:
more ttsh staff, inpatients and visitors were added to the cluster, in sizable numbers daily
multiple hospital wards during lockdown
community-visited places spanned all over Singapore
multiple clusters being fought, with many of them considered as under active cluster period. while likely unrelated and individually manageable, having all of them come under the same period is alarming, stressing (to infrastructure), and potentially a problem (specifically this is a potential but real risk), all of which led to:
The mega Phase 2 announcement on 4 May 2021.
8 person to 5 person restrictions.
this strongly strongly reduces the transmission possibility. social distancing is by far the most effective tool in reducing risk. don’t forget the main idea in infectious disease is reproduction rate. reduction of social contact, regardless of any any other factor (eg variant, severity, vaccination), will 100% cut or reduce transmission.
However it’s a huge impact to Hari Raya and other social events, sizable impact to F&B industry
It’s not as bad as stopping of dining-in, but still quite a headache to industry.
It’s definitely majorly proven by the ICA cluster, very rare has a variant infected the entire dining group.
theoretically this allows economy to continue at near the same levels while reducing transmission, as all companies who can reduce has already known how to do so, while at the same time excluding essential workers.
Reduction of attendance at in-person events like weddings, funerals, museums, libraries, tours.
Very broad measure, odd as we didn’t have proven transmission this way
Closure of gyms.
HK had a real bad case of this. Quite similar to why Karaoke and pub singing are banned. Low economy activity and disproportionate risk, and also affect small target population segment only.
about time to just go ahead and stop dilly dallying on this. Very helpful right now due to large number of cases. Digital tools really help avoid alot of manual labour. Disregard the whiners.
advising all public who have been to venues where ttsh infected cases have been to
big move. something like what Australia does. very tedious and high amount of work for some minor returns. really shows they are worrying and trying hard and throwing everything they have at it
the long queues and ‘lack of planning’. fairly disappointing after so long, poor management, also shows how last minute this decision was
Banning ttsh-exposed visitors from visiting other hospitals
wowzer. understandable as there was one case. Poorly managed as it wasn’t announced clearly to the public. again shows the rush.
Postponement of non-urgent admissions and procedures at all hospitals.
fairly impactful, points more to the temporary loss of ttsh functions, the wide ranging Leave of Absence and Quarantine orders applied
also alludes to their planning and prediction of:
how a cluster (ttsh) develops over time as new infections typically do not test positive for days/weeks
time taken to even complete Round 1 testing of current inpatients and staff (still ongoing after days!)
time taken to complete testing of public
time taken for newly infected to also test and treat
time taken for quarantine periods to end
while the above is taking place, for even round 1 to be secured down, it will take weeks to clear. And then after that there’s still round 2 of confirmatory testing to clean up stragglers.
near complete shutdown of one of our biggest and busiest public hospital, AND the important NCID capacity is highly and disproportionately impactful of their planned covid capacity.
together with their mathematical modelling, prediction of undetected cases, it probably triggered a red line in their warning systems.
14 to 21 day SHN for imports
it seems to be quite painful for incoming persons, both in cost and time. 3 full weeks is a long time to be ‘jailed up’
based on previous % numbers, number of community leaks seemed to be a balanced risk. they know there are leaks, they aren’t stupid, they just want to balance the economic cost and financial cost to employers
Is it possible to even stop leaks? Taiwan and Australia both experience SHN / hotel leaks too. It is important also to not stop 100% of leaks until you can’t detect any leaks and all your internal infrastructure shut down. It’s similar to body immune systems, prime it with vaccines and small infections, build up the capability and strength, remain on heightened alert, shutting down will take time to ramp up, who is paying for the $$ to maintain at high alert level!
banning of India incoming non-citizens and PRs.
overdue. however politically testy, and sends quite a signal. we were among the first countries to ban, but we are also having one of the highest number of incoming from India, and the cleanest internal state (maybe compared to Australia)
still, could be some weeks earlier once India hogged the news with astronomical cases and deaths
never ever wait for WHO to announce anything
Suspension of in-person Meet MP sessions, school activities, nursing home visits, etc etc
delay from Friday to Tuesday
well things always move slower over weekends and public holidays, but this should not be a valid excuse for this. I’m sure they were already working hard to come to a consensus to approve the above painful Phase 2 package
some unnecessary events like May Day Rally should have been cancelled. prevailing advisories don’t count.
Just keep going. There are many logistics and contractual and production limitations. Public should push the govt, but we also know that it probably would not have prevented this cluster really.
Don’t fall into the India trap that vaccination solves everything. Social distance first, everything else later.
hoo-ha that vaccination “didn’t work” – the caveat was always there, people just didn’t realize or read between the lines. We knew. But from a public health perspective, they still had to market vaccinations as Very Helpful etc. You can’t explain the fine print to everyone, not everyone is capable of fully rational and critical thinking. However the evidence is stark and still eyebrow raising. Comes back to the point about vaccine breakthrough and strength of this mutant. Also again it ties into infectious disease modelling.
HK travel bubble
It’s cursed, what else can we say. Glad we’re not the ones with pressing travel plans. Granted some people have strong family reasons etc. In this pandemic, sometimes strong reasons aren’t good enough if confronted with long term disability and death on the other end of the scale.
Shangri-la dialogue event
facepalm, just cancel it. still trying to save face and keep it dicey right now. go away and do video calls like everyone else. political suicide to keep it, prob still trying to spin a story.
Many, many people are just so misled with statistics. Maybe online is just not great for serious discussions, maybe they just don’t know any better.
I’ve been trying to get a feel of the false-negative rates of incoming imports. It’s a little scary. I know/hope someone is keeping an eye on this. Factors include, prevalence of virus in incoming cohort, absolute number of incoming cohort, false negative rates. We know that prevalence is not insignificant, and pretty high or getting higher. This is going to happen regardless of testing skill. A very long SHN should help, but still not guaranteed.
People keep quoting the 93% effectiveness of vaccines. Well there are multiple factors inside there. 1. antibody production of the individual and whether it even worked on your body in the first place. If it didn’t work, you’re screwed 100%. Also this is not black/white, it’s a range of how well your body worked. 2. if you have a shield that works pretty well, but if you using this shield against 100 bashes (covid positive transmission attempts), you’re probably still going to lose 5% of the time. Meaning if you get hit 100 times, you’re still ded. Again, prevalence. 3. if you do all that and your body is having a bad day, meaning weakened immune system, you’re still ded. Also see https://www.youtube.com/watch?v=yhZGAt_SDtc
A significantly sized hoo-ha over WhatsApp privacy is sweeping many countries. WhatsApp has an app / platform has been growing larger and larger over the years, and it’s at a rare weak point.
There are many reasons for WhatsApp, and against WhatsApp, same as for many other messaging apps and platforms. I’ll list them below.
Security is complicated
But while these tools and their characteristics are important, one must remember they are not the end-all of your personal digital security, privacy, or safety. That relies on a holistic care and maintenance of your digital life and habits. Changing from WhatsApp to Signal does not make you a spy. But that’s a story for another time, meanwhile all we can say it 2fa helps.
So which app is better
This isn’t a comprehensive and detailed table as I don’t have the time for that, nor is it a serious IT security analysis, this is just my personal opinion and impression of the apps.
huge network effect, probably near ubiquitous in your circles, free to use, fast app, lots of useful features like audio calls, video calls, location sharing, file sharing, picture sharing, video sharing, tagging, forwarding, web app, chat encryptions
free to use, lots of fancy features, gaining in popularity, one of the more common apps amongst the rest, stickers, large group chats, file sharing, photo and video sharing, web app, not by facebook/apple/google/microsoft/amazon
ugly, bloated app, still mobile number based, russian-linked, new monetization push, not wholly encrypted
free, encryption, audio calls, pretty app, fast
newer and small in network, still mobile number based, few people using, USA influenced, non-profit org
free, chat w fb contacts, instagram
facebook, need fb acct
china network, lots of china features
china gov control, no privacy, irrelevant features
Google Hangouts / Chat
free, google contacts
slow app, poor features, unable to integrate with mobile contacts
not free, no features
low availability, low reliability between sms/data switching, low features
secure within Apple, integration with Apple products
only for Apple, irrelevant to everyone else
if you’re in Philippines
didn’t win the global competition
Why stick to one app
If you are a digital native, you would be super used to commenting/replying/interacting on all platforms, you would have lots of different groups, and that could be interest groups, family, extended family, significant other, friends, close friends, work, colleagues, work contacts. Not just across different apps, different platforms, but also across different phones.
You should keep them separate, don’t use your one facebook account to comment on everything, don’t use your one email account to sign up for everything.
In this (digital) age, where the online world continues to grow, where data sharing is inevitable, data leak is also inevitable, you can only minimize your exposure by hedging your bets.
multiple accounts so that if you lose one, you don’t lose everything. as many as you can keep up with.
have different tiers of security. higher security accounts for important things.
don’t blindly use your real full name on everything online. you might not be untraceable, but at least make it less easy or obvious at first glance.
look for companies with a better commitment / culture / alignment of incentives
some security is better than no security
One big issue here is that WhatsApp new privacy change was very poorly communicated, as characteristic of Facebook, with no proper release, explanation, guarantees.
It did not present a benefit to the consumer. Many other services with privacy tradeoffs like smarthome assistants provide a huge benefit for an intrusion of privacy and heightened risk.
Given how WhatsApp and Facebook behaved, plus the bad history of the split of the WhatsApp founders, most tech savvy individuals knew it was going on a downhill path, down to the Facebook level, which is easily assumed, and nothing else could be believed because of poor behaviour by Facebook towards their other properties.
Will something better appear
My hope is that something else better and more stable appears. It took the world many many years to get to where it was with WhatsApp, and many years with Facebook to ruin it.
But something better can still come along. It’s impossible to say which app or from where. After all Zoom seems so popular, for now.
I really hope that apps can stop being tied to mobile numbers and the contact list. While it’s a quick way to gain users, it’s less flexible, less anonymous, and unable to support multiple identities and privacy.
So what exactly am I using
So many things. I still use alot of WhatsApp, because of the network there, because of work, but I also am almost equally active on Hangouts/Chat (on at least 3 google accounts), I use Telegram for certain groups/stuff, I install wechat only when I need it, I’ll see if anyone really wants to use Signal, but I avoid other platforms.
It kinda feels like she’s no longer a baby, and more of a child. Wasn’t it so many months ago that she was just crawling, and pulling herself up by holding on to a box, that she was cruising along the dining chairs, that she was standing under the dining table, that we had to pull her up by the hands to get her to take some steps.
She’s even past just walking by herself, now getting stronger, more stable, walking further. Still stumbling often for sure.
But now she’s communicating what she wants, doesn’t want, being sticky to people, and just thinking so much more.
It’s 9 December 2020, and many Recaps of the year are coming out. It’s that time of the year to take stock, look back at what happened. What. Happened.
Reddit had an absolutely awesome recap post. It was, in it’s own essence, so very Reddit-like. From the title, the post, the contents, the comments. Everything was so hilariously Reddit. It included a video, animated with highlights of posts and videos taken from Reddit this year, and of a commissioned soundtrack that was so apt. The song is Never to be Forgotten Kinda Year, by Dan Bern, and boy is it apt, and beautiful. It has that touch of whimsy, brevity and uplifting spirit that only a species that has lived through 2020, could appreciate.
Like I said, it’s 9 December 2020, which is barely 22 days to the end of the Gregorian Calendar year. True, it’s an arbitrarily taken period of time, created by humans in this particular day and age, half based on astronomy, and no other species or part of the planet even cares about it, certainly not this virus. But I guess it appeals to our sentimental selves that it’s an period, a substantial period of time that we have lived through, experienced, that draws to a virtual close, and a new year beckons, a new year that supposedly is different, will be different.
It’s 9 December, and the news in Singapore is filled with the top story of the day – a confirmed infected passenger on a cruise ship that departed Singapore a few days ago and has to cut short it’s trip to return. Cruises being one of the early nightmare scenarios of the Covid-19 infection due to early spread and clusters aboard certain ships in other countries, very early on. A nightmare scenario of how easily to be cross infected, of how hard to escape from the ship, of ships being denied berthing and disembarking by many countries. A scenario that was decimated cruise travel for practically the whole year, and hasn’t really recovered.
You would think that we might be past a lot of these, but it seems not! It seems not. It seems that on the 9th of December we are still haunted by the same ghosts. Maybe slightly better, but not gone.
Lots of countries are still struggling.
But perhaps let’s go back to the start of the year, to the bright early morning of January 2020, not the first weeks, but mid to late January, where some bits of rumours and news came out of China about a new virus. I’m sure it was there in the medical, scientific, and especially infectious disease circles, before the news leaked out into the public sphere, of China investigating virus outbreak linked to wet markets (well so we thought), to bats, some coronavirus linked respiratory disorders. The measures in China slowly, slowly ramped up. There was suppressing of information, as usual, and also leaks by China citizens onto their local social media. The thing about 2020 is that the Online is so powerful now, even in China. We watched as more and more details leaked out, independently of news outlets, government announcements (both China and elsewhere), of details of seriously infected numbers in Wuhan and then other cities, of hospitals getting flooded with patients, of medical staff struggling and also getting infected, of doctors leaking the real news out, of brave citizens, of the government reacting, of other governments nearly starting to react – Taiwan, Hong Kong, Singapore, and slower – the rest of the world.
We started to get into February – the Chinese New Year period. We watched in horror as China practically shut down their New Year celebrations – easily their biggest festival of all year. Travel restrictions came into place. It was an environment of close watching and distancing from China. That was the plan.
Well alas we still had some visitors from China – both tourism, business, and social visitors. It reached our shores, in no small numbers. We scrutinised each and every case, cluster, visit, location, spread. Each was taken in shock, surprise, and utmost concern. Was it that serious? It seemed so in China, and there were many deaths as Wuhan and some other cities were overwhelmed in the number of seriously ill cases. More serious conditions than a typical influenza strain, faster spread, novel. A seemingly incredible super mix of amazingly powerful coronavirus that the regular person is trying to understand, mixed up with an horrifying inter species jump from bats to humans.
So we kinda became one node here in Singapore, due to our heavy exposure to China. Well we weren’t alone, the other countries like Japan, South Korea, Hongkong with heavy traffic with China all were hit. Mostly under control as all these countries react overwhelmingly for the short term to stem the tide. It kept things under control. Locked down kinda but at least under control. Was it still February or was it now March? It’s hard to recall as it’s all a blur of news from so many countries, so many new details in China. I suppose the news agencies can do a deeper recap.
It was likened to SARS from old. I guess it was. Quite something to live through two outbreaks. Surprisingly we had a newly opened National Centre for Infectious Disease, almost an entire half hospital specialising in this. Best stroke of luck (the timing) we could have, and probably reduced our mortality rate by quite a few. Our best laid plans, as awesome as they were, still had to adapt to the situation. Well, if you’re used to the Army and tactical situations, I guess that’s the way, but you still can’t help the common citizen throwing criticisms back at ya.
We had lots of people coming out with tracking sites, detailed data built upon the trickle of daily notices put up by the Ministry of Health. I suppose all the govt agencies went topsy turvy handling this situation. Every single person’s work changed, in one way or another, good or bad.
Italy got hit early on, real real bad, with huge numbers and deaths. It spread fast there. Sporadic numbers in Asia in the middle of the year. Some numbers in Europe but not huge. Many areas in Asia put in serious restrictions and closures to bring it down. We had a really long and extensive ‘cluster’ in our worker dormitories that took massive restructuring to clear up. LOL they tried almost everything they could think of, from country wide Circuit Breaker starting in April, to separating dorms, separating rooms, testing testing, isolating, step down care facilities, ramping up hospitals, escalating DORSCON levels, nationwide broadcast addresses, taskforce press conferences, budget handouts, employee salary support. News after news after news.
We started working from home, many many people did. Not many had to go out, except for allowed services. This was incredible. Being able to be home all day long, with my baby, saving on travel time, spending more time with her, having lunch at home. Woot. Staying safely at home while watching half the world burn.
It must’ve been hell for lots of badly affected industries – tourism, travel, airlines, restaurants, supporting industries, and others. So many people with reduced income, job losses, changes. Madness. In such large numbers as well. Four Budgets for the year, with tons of money withdrawn from past reserves. Official government measures, and also lots of interventions by Temasek, the govt-linked entity. Various sanitizer handouts, face mask handouts. So many people did so much.
Then we had a big hooha over a General Election in SG, held during the pandemic, quite unnecessarily in fact, since the situation has stablized further in end 2020 and likely into 2021 (in SG at least). Big wins for Workers Party, a GE held mostly online and over the air.
USA had tons of scandals and ridiculous news, with NYC doing terribly in Covid, and then UK getting into it, other areas in US, Spain, etc. Indonesia, Philippines, India, Russia, where hasn’t it been. It gets quite sad that many countries have huge number of deaths. The worldwide official count is now at 68 million cases and 1.5 million deaths. That’s only official positive counts, with many many more unaccounted for.
Many countries went into partial or temporary lockdowns, hitting their economies hard. Some couldn’t manage well, some had many more infections, many more deaths, some fewer. Most countries ended up isolating themselves to stave off infections from other countries, hopefully. The situation in China cleared up. Well not totally as there are still some recurring infections even in such a tightly controlled country. Tough. Or should we say, impossible.
Singapore entered into a manageable lull, without many cases. Stable. Slowly opening up a tiny bit, a tiny bit. Steps so small you wonder if they’ll ever finish.
Companies started manufacturing face masks to cope with insane demand. Hand sanitizers. Test kids. Different test kits. Hah. From high priced face masks, to cheaper face masks.
Bernadette grew up through all this, from when she was 3 months old, to 4, 5, 6, 12 months old birthday, 13, 14 months old. She finished going to hospital for follow-ups, she had to isolate more from crowds, watch us start wearing masks when outside, from being afraid and associating masks to vaccination injections, to being used to it, and I wonder if she’ll have to keep wearing it when outside in the future.
The malls were shut, dine-in everywhere was stopped, seats were cordoned off, restaurants were closed, shops were closed, food delivery, online shopping delivery. The roads emptied out of cars, buses and trains were empty, taxis were empty, private hire suddenly lost business. ‘Self employed’ was now a problem.
I spent more time with my baking, well there’s time at home. Various tarts. New stuff. New recipes. Watching old shows. Fixing up the house. We set up new cupboards.
Bernadette started crawling around more, faster, further. She played with more toys, new toys. She started pulling herself up, standing. Standing! Toddling. She spoke more, made more sounds, got smarter, and smarter. She started taking solid food, oh what a headache that was, to prepare meals instead of just drinking milk. At least she still sleeps well. Eczema problems, various doctor visits. Busy. So much to occupy one’s time.
Things and habits out there have changed so much, it’s such an odd world.
Now news of vaccines being released, and news of increased second waves in various countries, Australia grappling with it, UK, Spain, Italy again!?!, and probably more who have given up. Now grappling with vaccines, whether it will be effective, whether it will be available, roll out properly. Hah.
It’s a year of lockdowns, 5 person groups, social distancing, face masks, contact tracing, cordons, of video calls, video calls, video calls.
It’s December. December 2020. Almost 2021.
Covid-19, into 20, into 21.
You’ll look back, and wonder how was it possible. How did one survive through that, through that infection rate, death rate. But it happened, and life happened, the virus happened, we humans got through it as usual, survived through a certain adversity? Diversity? Not so easy to exterminate.
So many wars, epidemics, and other insane things that have happened in history. Still alive? But then again, if we all died, I wouldn’t be around to write this.
1 January 2021
And 2020 ended, just like that, almost like any other day at home, with some faint echos of celebrations around the neighbourhood, with us going to bed, tired from another day of taking care of a baby and still having to wake up early the next morning.
It was funny to see the local case numbers jump and spike again in the last 2 days of 2020. Almost like a last jab at you. Hah. You thought you were clear!? It’s not over yet! It was funny to see the vaccine news, supposedly good news, but yet tinged with so many shades of concern it wasn’t funny how bungled it seemed to be. Poor marketing by the western countries that made it, as usual. They’ve never seemed to be able to project any sense of confidence and reassurance this entire year / pandemic. And it flows down. We don’t trust it, because it was a rush job, by countries desperate for something, that’s why. It’s not that we don’t trust vaccines in general, nor our govt. But it wasn’t made by us, and given these countries’ current public track record, it’s not reassuring. Our exact same self-preservation instinct that has kept us relatively safe so far, is doing the same. Call it our own immune system.
I realized that for some months and weeks now I’ve kinda dropped off on the covid news a little, just to not be too crazy about it, and also busy with work and busy with life, and busy with baking! Which I thought was more productive than doing nothing and following numbers of other countries like a busybody.
Still, Australia news of Sydney Northern Beach clusters and new restrictions, Germany’s sudden severe revival, Switzerland falling, Netherlands falling, Belgium falling, US…nothing new to say, UK falling, France falling, India oddly seemingly manageable, Indonesia falling off the news, Philippines off the news, China still grappling a little. It’s a little worrying that the top tier countries have so much bad news that the secondary tier countries really fall off the radar, nobody even has time to think if their numbers are correct and real.
Minor scandals in Singapore of rule transgressions, mostly to little effect. It’s testament to the stable situation that we have time to bother with these, rather than horror stories in the US etc of overflowing ICUs, stuck ambulances, lack of oxygen, rising deaths, lack of compliance, lack of compliance, lack of compliance.
And a sudden concern over a “UK strain” B117, more infectious, supposedly. It might just come to naught, really. But it was a swift closing of borders against UK, poor things. London, who was already suffering just days before Christmas, with nearly everything cancelled at the last minute, now under the scrutiny of the world.
But it wasn’t a hugely horrible year for us. Can’t say that when our jobs weren’t affected too much, when it wasn’t a worry and risk, when our infant mostly grew well and had a great time at home. We spent time together, at home, we spent more time with our infant than otherwise possible, much much much more than otherwise possible. We saved on commute time, we spent less on going out, on travel. We didn’t have to meet people, we didn’t have to think about going overseas, we didn’t have to think about missing out because there was nothing to miss out other than spending time with family. We didn’t have school-going kids, we didn’t have elderly to take care of, we didn’t have regular things we had to keep going out for.
It helped that we were already used to it, through the late pregnancy months, the newborn months, all the staying home, enjoying being at home. In a comfortable amount of space, both physical space in a relatively new flat, and also space for ourselves away from others.
My parents had it good, their shop business did well and also very luckily didn’t have to suspend, and with additional govt support. My sister had a rough year, having been in the travel industry, but at least is ending it okay.
I guess it was the topsy-turvy kind of year, where many people’s concept of the world changes, where things no longer have to be the old way, and it could break the old mould and improve, and improve greatly in a monumental change.
It would be incredible to think back and wow I lived through that, something that was so shattering to the human race in that year. It’s always been how incredible to watch those movies of World War II, how widespread the impact, how long the dang thing lasted. Well now we have Covid-19 and it’s unabating death wave. It’s not that without covid-19 all these people would have been alive and well, because people will still die of other causes, many of them are already terribly old, and there would be more of other illnesses, but it’s still a very fancy number when looked at alone. 83 million confirmed cases and 1.8 million attributed deaths so far. (Wow World War 2 had 70-85 million casualties, so I guess we are still far off.) Given current known Infection Fatality Ratio, Covid-19 would not exceed WW2.
Still, it’s quite scary to have an invisible virus going in your lungs, no matter where you are in the world and just minding your own business, no nuclear bombs needed.
Really shocking that countries that can maintain nuclear weapons can’t get a coronavirus under control…
I was looking through my photos of the year, and I really only had a handful in April that were really reflective of Covid situation. Well that was like the only real Circuit Breaker / lockdown period, soon after that things reopened majorly. That’s the major extent of the extreme disruption to daily life, it was really quite liveable after that, many shops were open, food was never a problem, groceries and supermarkets were great, online shopping platforms covered miscellaneous things.
All the time at home also let us try new food that deliver, to people like us stuck at home with a sleeping baby:
And being at home, also means, improving things at home and working on baking:
It meant many many more sunsets experienced, and more of my neighbourhood explored on long jogs.