SARS shaped Singapore pandemic response

Singapore’s relative success in dealing with the COVID-19 crisis was built on its response to the SARS epidemic in 2003.

Flinders University international relations academic Associate Professor Michael Barr, an expert in the country’s politics, says the Singapore Government’s prompt and thorough imposition of social distancing – and ‘Big Brother’-style of contact tracing – are now the envy of health authorities throughout the world.

He says this efficiency stems from the country having faced another health calamity with the previous SARS epidemic, but then Singapore authorities were totally unprepared.

Head of the Singapore Civil Service, Peter Ho, admitted this failure in mid-2005: “We were surprised by SARS. We were surprised by its epidemiology. We were unprepared for it. But we should have been prepared. It was not a fundamental surprise, because we knew that the risk of a highly infectious epidemic existed.”

Associate Professor Barr was living in Singapore in 2003 and remembers the Singapore government’s slow response to SARS.

“I watched the epidemic unfold day by day and felt the initial response was hopeless, until at least halfway through the crisis.

“Ad hoc, inconsistent responses at that time now remind me of how Australia’s political leaders are behaving during the current COVID-19 crisis.

“The SARS outbreak began on 13 March 2003, but it was not until 20 April 2003 that the government started taking it seriously.

“During that five-week period, the government was asleep at the wheel as Singaporean moved towards the 33 lives that were eventually lost to SARS.

“During the crisis, I attended a government-sponsored anti-SARS rally in Singapore.

“The local authorities put up a small marquee in a housing estate, set out hundreds of seats side-by-side, and hosted a family event in the high afternoon humidity, to hear government-sponsored speakers (not doctors) give lectures on the risks of contagion.

“Social distancing did not occur then – nor a week later, when the same marquee hosted a crowded music concert with a local band.

Professor Michael Barr
Associate Professor Michael Barr

This rudderless leadership period only came to an end because SARS threatened Singapore aristocracy: the family of its founding prime minister, Lee Kuan Yew, he says.

“Kwa Geok Choo, wife of Singapore’s first prime minister and mother of the current prime minister, was rushed to hospital with a fever in mid-April.

“She was quickly diagnosed as being SARS-free, but this scare finally galvanised the government into action.”

Lee Kuan Yew was still a member of Cabinet and he kick-started a SARS response by creating two ministerial committees (“combat teams” in the government’s parlance) to handle the crisis – thus sidelining the Minister for Health and getting the response on a serious footing.

Once the Singapore government focused properly, it learned quickly.

Thermal imaging scanners were set up at the airport and at the bridge connecting Singapore with Malaysia.

“I could not enter a public building without a temperature check. School children had their temperature taken every morning and any child with a temperature was sent home immediately.

“Some measures were theatrical rather than practical, designed to build awareness and change personal habits, but the media and government were on the same page with a consistent message.”

Associate Professor Barr wrote of this experience in a book on health policy in the Asia-Pacific, and noted the positive impact of SARS on Singapore’s readiness to deal with epidemics.

As a result of the SARS experience, Singapore now has stringent quarantine laws and protocols, enforceable by large fines and public humiliation, Associate Professor Barr says.

“The uniquely Singaporean system of social monitoring has now been expanded to facilitate routine temperature taking, at short notice, of people with high fevers.

“The military, police and myriad other social instruments are now geared in an emergency to track the movements of suspected disease carriers, and those who they might have been in contact with.

“The Communicable Disease Centre has been upgraded from being rundown, low-tech communal blocks designed to cope with HIV/AIDS. It now includes state-of-the-art isolation wards, ready for the next epidemic.”

Singapore and the rest of the world were lucky that SARS burnt itself out instead of mutating into a mass killer, otherwise its 10% fatality rate would have devastated humanity, he says.

However, while Singapore has learned from its experience about the dangers of epidemics, he says Australia and the rest of the world has not.

“COVID-19 is a much more serious threat than SARS and the cost of dealing with it will be much higher.

“It would have been better to get serious weeks ago, but hopefully it is not too late.

“Singapore has shown how this pandemic can be managed. Now Australian needs to follow suit and save lives.”

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