For months, this city-state has enforced strict rules to keep coronavirus infections as close to zero as possible. Its border remains largely sealed. In the past two weeks, it has recorded between four and 20 new local cases a day—high enough by its low-risk standards that residents aren’t permitted to eat at restaurants in groups of more than two.
Now, with nearly 40% of its population fully vaccinated, Singapore is making plans to shift to a new phase—one in which it no longer tries to track down every case and end all transmission it can find. Instead, Covid-19 becomes a less threatening disease, like the flu, ceasing to paralyze daily life. In other words, it becomes endemic, as many public-health experts have long said it would.
People are battle-weary, a group of Singapore government ministers wrote in a recent editorial in the Straits Times newspaper. “All are asking: When and how will the pandemic end?” they added.
“The bad news is that Covid-19 may never go away,” they wrote in response. “The good news is that it is possible to live normally with it in our midst.”
The U.S. and several other countries have been easing Covid-19 restrictions at higher rates of infection than Singapore’s to boost economic recovery. The city-state’s planned shift comes as more governments accept that even with vaccines, Covid-19 isn’t going to be wiped out soon, if ever. The original virus has spawned many variants, some of them tougher to stop than earlier versions, and a slow vaccine supply to developing nations is giving the pathogen yet more room to thrive and evolve.
But policy makers also see that vaccines can make the disease far less menacing by sharply reducing severe cases, hospitalizations and deaths.
In the U.S., where 46% of the population is fully vaccinated, daily Covid-19 deaths are down to below 300 a day, their lowest point since March 2020, according to Our World in Data. In the U.K., despite a recent rise in infections fueled by the highly transmissible Delta variant of the virus, deaths have remained relatively low. The U.K. official overseeing vaccine deployment, Nadhim Zahawi, said in May that the government was making plans for next year “to deal with Covid, as we deal with flu, through annual vaccination programs.”
Singapore’s plan to transition from pandemic to endemic looks like this: Most of the city-state’s 5.7 million residents will be vaccinated—it aims to fully cover two-thirds of its population by early August—making it harder for the virus to transmit and, more important, harder for it to kill. Some people will still fall sick with Covid-19, but most will recover at home. Authorities will track and trace much less, quarantine far fewer people and end the daily ritual of tabulating new cases, switching instead to measuring how many Covid-19 patients are in intensive-care units and how many need intubation for oxygen.
Post-pandemic Singapore won’t exactly feel like a throwback to 2019. Travel, for instance, won’t soon be friction-free, though it might become easier for those armed with vaccine certificates. Covid-19 testing will be everywhere—airports, office buildings, shopping malls, universities—but instead of swabs, it will come in the form of quick alternatives, such as breathalyzers.
In planning the shift, Singapore is looking at real-world data from highly vaccinated countries such as Israel, said Yik-Ying Teo, dean of Singapore’s Saw Swee Hock School of Public Health. Of particular interest, he said, was data on the proportion of vaccinated people infected with Covid-19 who were coming down with asymptomatic or mild infections to those facing severe disease or death. So far a recent rise in Israel’s cases isn’t accompanied by a jump in deaths.
“If vaccination works, or indeed if certain vaccines work better than others, in allowing countries to now disentangle infection numbers from hospitalization numbers, that is exactly the type of data that the world needs to get out of the overall pandemic situation,” Prof. Teo said.
Still, the path will be long and messy. Although some wealthy nations are beginning to put the worst of the pandemic behind them, the virus isn’t under control across much of the world. Sparsely vaccinated populous countries such as Indonesia and Bangladesh are battling new surges. India is warning that another wave is possible. Cases and deaths are rising in many parts of the African continent. Globally around 8,000 people are still dying every day.
That means Covid-19’s prevalence and death toll will vary from country to country for a long time.
“Countries which are able to achieve a high uptake of effective vaccines will be in a better state to exit this pandemic,” said Prof. Teo. “For some of the lower- and middle-income countries, they may be forced to continue to adopt a pandemic posture for much longer simply because they have yet to be able to access safe, effective vaccines for the bulk of their population.”
Catherine Bennett, chair in epidemiology at Australia’s Deakin University, said a global effort was needed to help all countries be vaccinated at high levels. “We can’t call off a pandemic because our corner of the world is sorted,” she said, adding that allowing rampant transmission raised the risk that more variants would emerge.
“The worst-case scenario for this time next year is that we have helped create a variant that escapes vaccines and we’re kind of back to square one,” she said.
Assuming that doesn’t happen, she said the disease was on track to becoming endemic, though governments and public-health experts would need to keep an eye on it—not by tracking every infection or even knowing how much virus is in the community, but by staying on top of which variants are circulating, for instance. Newer generations of vaccines might be developed that are better at stopping infections and slowing the mutation clock, she said.
In this phase, countries such as Australia would need to change their zero-tolerance approach to the disease, she said. Australia is currently experiencing relatively low vaccination rates, new outbreaks and fresh lockdowns. “Anyone who is in denial still and thinks it is possible that you don’t need to be vaccinated because you can keep the virus out now has to think differently,” she said.
This story has been published from a wire agency feed without modifications to the text