By Lucia Stein and Rebecca Armitage for the ABC
As millions of Australians endured strict lockdowns this week, Prime Minister Scott Morrison announced the government was still working on a plan to transition to a post-vaccination future.
Masked people wait to buy food in a market in Singapore. Photo: AFP
But with some nations racing ahead with their vaccination schemes, Australia isn't alone in considering a roadmap out of the pandemic.
Singapore, which like Australia has mostly followed a zero transmission model, is now planning an exit strategy that will involve "learning to live with Covid-19".
And while Australia is yet to announce firm dates for its pathway out of lockdowns, Singapore could get there much sooner.
A bold shift: 'It is possible to live normally with Covid-19'
When Singapore experienced a surge in Covid-19 cases last month, it acted as it has before: limiting households gatherings, continuing to encourage people to work from home and even announcing new plans to segregate flights and passengers from high-risk countries.
Glad that the past 3 weeks of tightened restrictions have brought our COVID-19 numbers under control. This was only possible because of everyone’s cooperation. Let’s stay safe and keep working together! – LHL #SGUnited https://t.co/S1Yq8bQZuL https://t.co/PXtRkqXF8k
— leehsienloong (@leehsienloong) June 10, 2021
But as the government started to get a handle on the new outbreak, some within its ranks wondered if there was another way.
"The bad news is that Covid-19 may never go away. The good news is that it is possible to live normally with it in our midst," Trade Minister Gan Kim Yong, Finance Minister Lawrence Wong and Health Minister Ong Ye Kung wrote in the Strait Times.
The ministers suggested that like flu, the coronavirus will continue to mutate and "survive in the community".
"We can't eradicate it, but we can turn the pandemic into something much less threatening, like influenza, hand, foot and mouth disease, or chickenpox, and get on with our lives," they wrote.
The trio then laid out a plan on exactly how Singapore could achieve this goal.
Students getting their vaccinations at the dedicated Ministry of Education (MOE) vaccination centre at ITE College Central, 7 June 2021. Photo: AFP or licensors
Vaccinations are key to Singapore's strategy
Singapore's ministers have proposed one day scrapping lockdowns, home isolation and restrictions.
A key reason they have been able to contemplate such a change is that they're racing ahead with vaccines.
While other Asian nations have lagged behind in their rollout - Thailand has vaccinated just 10 percent of its population and South Korea has hit almost 30 percent - nearly 60 percent of Singapore's residents have received one dose of the vaccine, while 37 percent are fully vaccinated.
Singapore's government aims to have two-thirds of residents fully inoculated by 9 August, and will soon allow children over 12 to get the jab to ensure they hit their goal.
Vaccines don't prevent transmission of the virus, but they do reduce the severity of symptoms.
As of 3 July 2021, there are 4 new cases of locally transmitted COVID-19 infection and 3 imported cases. 113 cases are currently in hospital: most are well and under observation, 9 require oxygen supplementation, 2 are in critical condition in ICU. https://t.co/fcHK7mmH93
— Ministry of Health (@sporeMOH) July 3, 2021
When the highly infectious Delta variant spread through Singapore's Changi Airport in May, 19 of the 28 terminal workers who contracted the virus were fully vaccinated.
However, many of them were totally asymptomatic and those who did have symptoms reported runny noses, coughs and mild fevers.
How Singapore's roadmap compares to Australia
Once the vaccination targets have been hit, the ministers' proposal still aims to keep the coronavirus contained with testing and surveillance, but with some key differences.
Those that do fall sick with Covid-19 will be allowed to recover at home, and citizens will be urged to practise "social responsibility" such as good hygiene and staying away from crowds when feeling unwell.
Tests will be more specifically targeted at the borders to identify those coming in with the virus and at mass gathering events within Singapore. More rapid testing will provide faster results when people are visiting their workplace, pharmacies or shopping centres.
Data from other countries with speedy vaccine drives that have also eased restrictions, such as Israel, UK and the US, will be monitored closely, experts said.
And there are even plans to stop counting the daily Covid-19 cases. Instead of monitoring daily infection numbers, authorities will focus on how many fall very sick and other health outcomes.
Australia, in comparison, is considering four phases as it transitions to managing Covid-19 as an infectious disease like any other in the community. But unlike Singapore, many of the details of what will change in the later stages are still being worked out.
Phase one will include trials of home-quarantine for vaccinated travellers, while phase two will ease restrictions including border controls for vaccinated Australians and use lockdowns only as a last resort.
People wait in queue to register for the China-made Covid-19 Sinovac vaccine on 24 June in Singapore. Photo: AFP or licensors
That phase will depend on a yet-to-be-determined percentage of the population being vaccinated. Unlike Singapore's high vaccination rate, only 7.92 percent of Australia's population is fully vaccinated.
The third phase, which sees Australia dealing with Covid-19 like it does the seasonal flu, more closely resembles Singapore's approach of no longer implementing lockdowns and gradually opening the borders. The final phase will be a return to pre-pandemic travel and life.
For Professor Yik-Ying Teo, the Dean of the Saw Swee Hock School of Public Health at the National University of Singapore, living with Covid-19 is an "aspiration" that every country will eventually have to learn to do.
Having accepted that it's "not possible to eliminate the coronavirus completely," Yik-Ying said it won't be sustainable for countries to keep their borders shut forever.
"And the moment countries lift their border control measures, this is where there will be regular imports of Covid-19 and that will circulate within the community," he told the ABC.
"So given that we are unable to sustain our public health measures or what we call non-pharmaceutical interventions, which include border controls, then we would have to look at what is the next most feasible approach."
'Determined to see through this endgame'
Even as we contemplate a future where coronavirus is treated like the flu, the measles or chickenpox, health authorities say Covid-19 remains a "shape shifting enemy".
Yik-Ying agreed potential new variants continue to pose a risk, adding that one big factor will be monitoring whether the current vaccines being used in Singapore remain effective in protecting the community against infections and hospitalisations.
For countries considering easing restrictions, Yik-Ying added that vaccinations, global surveillance and relying on science will be key.
"We are constantly monitoring the evidence coming out from Israel, from the UK, from the US, because these are places where the vaccination rates have been very high and we are able to learn about the vaccine and those variants," he said.
With a potential path set, Singapore is gearing up for a post-vaccine future.
"While we draw a roadmap, we must be prepared to adapt, to move forward but sometimes reverse if we need to, before we move forward again," Gan said.
"But we are determined to see through this endgame."
- ABC
