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Spike in Covid-19 cases raises disturbing questions, but also carries lessons for Singapore

Spike in Covid-19 cases raises disturbing questions, but also carries lessons for Singapore
The only way so many patrons and staff could get affected at former KTV outlets that had supposedly pivoted to serving only food and drinks is that laws have been flouted.
PHOTO: The Straits Times

SINGAPORE - There is an ongoing surge in Covid-19 cases, with 480 people getting infected over the past week. This exceeds the total number of infections reported over the previous month.

Most of the new cases can be traced either to the cluster linked to KTV lounges, or to the one at Jurong Fishery Port. The two clusters are linked, said Health Minister Ong Ye Kung in a Facebook post on Monday (July 19).

Both clusters are of concern - but for different reasons.

KTV cluster

This cluster has 192 cases linked to it so far.

The number will probably continue to increase for some time, since it is quite likely that some who have been infected would prefer to lie low, and hence continue the chain of transmission.

The reason some KTV patrons may not get themselves tested is also the reason why this cluster is so disappointing, from Singapore's perspective.

This has nothing to do with moral issues, which are personal to individuals.

The only way so many patrons and staff could get affected at former KTV outlets that had supposedly pivoted to serving only food and drinks is that laws have been flouted.

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Had they been followed, with two patrons seated at each table and no intermingling between tables - and certainly not with hostesses - it is unlikely there would be close to 200 cases in such a short time.

The presence of hostesses itself is telling. Why would a regular food and beverage (F&B) outlet need hostesses?

In other words, hundreds of people broke the laws - while a pandemic was still raging - with little regard for their own health, the health of their families and friends, and the nation's efforts to contain the spread of Covid-19.

These are the proprietors of the lounges, their staff and patrons.

It is because of these people that the whole nation is now facing stricter measures.

The authorities, too, should have kept a sharper eye on these establishments.

The multi-ministry task force tackling Covid-19 decided to allow nightspots to pivot to F&B outlets to help them earn enough to pay their rents and their staff.

At first glance, it was a laudable move.

But, on deeper reflection, surely there should have been questions about whether it was viable for former KTV lounges to function as F&B outlets. Or whether all of them really wanted to keep their end of the bargain.

Club Dolce at Balestier Point. Photo: The Straits Times file

Most of these places do not have kitchens that can serve hot food. This means they would likely serve drinks and snacks, just as they did when they were nightspots.

How many patrons would turn up with one friend to have a drink and snacks, and leave within the hour?

Furthermore, many karaoke lounges have small individual rooms. There were also open bars crammed with patrons in pre-Covid-19 days. How many spaced-out tables can they accommodate?

Given these red flags, shouldn't such places have been more closely monitored for breaches?

Finance Minister and task force co-chairman Lawrence Wong had explained: "Each time you do an enforcement check, there is a little bit of cat and mouse going on, because the enforcement officers come in... the people who are breaking the rules will be on the lookout, they see someone coming in and then they may start to adjust, and respond accordingly."

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That is true, of course. But it just means that to catch the mouse, the cat has to be smarter. If it was possible for people to run out the back door, someone should have been waiting there to nab them.

It is also likely that the Covid-19 enforcement officers used for such inspections lacked the experience needed in such circumstances.

A police blitz on Saturday (July 17) against unlicensed public entertainment outlets resulted in the arrest of three men, while 36 others are being investigated for possibly breaching Covid-19 rules.

So why weren't the police monitoring these pivoted nightspots all along?

Yes, there are hundreds of nightspots, so the task is not an easy one. But catching and exposing such breaches, including throwing the book at them, would have served as a warning to others.

Or maybe not.

The fact that a police operation after the emergence of the KTV cluster was able to nab 39 potential law-breakers is telling in itself - since infringements continued even after the KTV transmission was made public.

While enforcement is not easy, it will be necessary, if pivoted nightspots that follow the rules are to be allowed to continue with their business.

Fishery port cluster

The cluster that emerged from the Jurong Fishery Port is a different story altogether.

More than a dozen wet markets and food courts have had to be closed and deep cleaned due to the Jurong Fishery Port cluster. Photo: The Straits Times file

There appears to be no major legal breaches here - though some of those who were infected are believed to have patronised KTV outlets - and either spread the virus into that susceptible community, or brought it to the wholesale market.

And yet, because of this cluster, more than a dozen wet markets and foodcourts have had to be closed and deep cleaned. The virus likely spread to these places through people buying fish at the wholesale market and selling them at wet markets or cooked food stalls.

On Monday (July 19), another 106 infected people were diagnosed and linked to this cluster, more than doubling the number to 169.

Safety measures are not foolproof. Neither does vaccination provide 100 per cent protection. So transmission can occur even if all is adhered to.

But again, there were probably breaches in safety measures for the virus to have spread so widely and so quickly.

These are more likely to be unintended breaches, such as masks not properly covering faces, or reused too many times, or being wet and thus not protecting against the virus.

Or someone could have touched surfaces where the virus lurked and then touched their own face without washing or sanitising their hands properly.

And who could blame stallholders concentrating on their work, or shoppers looking for the best deals, possibly in hot and sweaty conditions?

Fishmongers hurriedly storing away their supply of fish after being told by a safe distancing ambassador from NEA to stop selling their fish at Kovan 209 Market and Food Centre on July 18, 2021. PHOTO: The Straits Times

Nevertheless, such breaches allow the virus to spread.

In a sense, this offers a peek into what accepting Covid-19 as endemic will mean to Singapore, especially if the rate of vaccination remains low among seniors.

Mr Ong said in his post: "It reflects the transmissibility of the Delta variant."

Over the past month, 96 per cent of cases here were infected with this more transmissible variant.

Importance of vaccination

On Sunday, the Ministry of Health (MOH) urged all unvaccinated seniors to stay home as much as possible for the next few weeks, to avoid getting infected by the growing clusters, since their risk of getting seriously ill is far higher than that of someone who has been vaccinated.

People who want to see more measures eased should first help convince any older acquaintances to get vaccinated.

According to the MOH data, of the 465 people infected over the last four weeks, the 135 who had been fully vaccinated were all either asymptomatic or showed only mild symptoms. This is regardless of their age.

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True, among the 185 who were infected but not vaccinated, 96 per cent also had mild or no symptoms. But about one in 25 needed oxygen or intensive care.

All but one who needed intensive care over the past four weeks, as well as the vast majority of those who needed oxygen - in other words, those who were seriously ill - were aged 60 years and older.

Today, just slightly more than seven in 10 people aged 70 years and older are protected by vaccines. In other words, the group that is most at risk has the lowest take-up rate among all vaccine-eligible age groups.

Unless this improves, there is a real risk of hospital beds filling up and people dying when measures are eased once the majority of people here are vaccinated by next month.

Professor Ooi Eng Eong, a microbiologist at the Duke-NUS Medical School, said: "The Delta variant is a lot more infectious. Measures that worked in the past may not be as effective."

With a transmission rate of 5 to 8, in other words, one infected person is likely to infect between five and eight people who are not vaccinated (those who have been vaccinated may get infected, but the rate would be much lower), Prof Ooi said vaccination is the best strategy.

That was how smallpox, with a similar transmission rate, was controlled.

ALSO READ: 29 women arrested, 10 to be deported in operation targeting pivoted KTVs

Today, about 2.7 million people, or roughly half the population, have been fully vaccinated, with another 1.5 million partially vaccinated.

Singapore plans to ease restrictions once two-thirds of people here are fully vaccinated. So time is running out for the one million eligible people still dithering over whether to get vaccinated.

This article was first published in The Straits Times. Permission required for reproduction.

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