Let’s hope that a vaccine will put an end to all this misery and Singapore will be among the first to launch it
It has been six months since the first imported case of Covid-19 virus landed on our shores. The first imported case was diagnosed on Jan 23, 2020, and the first local case was on Feb 4, 2020. We have since come far with 54,797 cases as of yesterday. The community cases have come down to a trickle, averaging about two cases daily in the last week. The migrant worker cases still average about 300-odd cases daily in the last week.
This is really due to the ongoing effort to achieve clearance of the dormitories so the workers can go back to work. There is a herculean effort going on to swab all migrant workers by the day we go to print. To get a better understanding of the situation, I turned to my medical colleagues. These colleagues had founded Crisis Relief Alliance, an NGO that usually does overseas relief missions but could not turn its back on the outbreak in our dormitories at home. My colleagues in full battle order had ventured into the smaller factory dormitories to see, assess and help out.
They had helped to assess the ground situation to feedback to the relevant authorities, distributed fruits regularly to boost morale of the workers and prior to Hari Raya Haji had handed out new clothes, prayer mats and dates obtained from generous donors. There are more than a thousand of these factory dormitories housing anywhere from 20 to 200 migrant workers on their premises. The best way to describe these premises is that if a floor in a factory is empty, you house your workers there. The conditions are basic and spartan with bunk beds and the proximity of these bunk beds has led to rapid transmission.
The toilets are common and the kitchen is shared. Most foreign media have decried them as squalid but I liken them to my bunk bed in the overseas army camps during my National Service days three decades ago. The NGO has visited more than a hundred factory dormitories and the conditions in their premises vary. I have found that the majority of the bosses of these premises have treated their staff well and most workers have been working for the same boss for five to 20 years. Their salaries are paid on time, they received three catered meals daily and all had Internet access or data cards that allowed them to communicate with their loved ones back home.
As for the workers’ fears, they were not worried about the virus as the medical care here is world class, but they were more concerned about the economic damage and the loss of their jobs. In a sense, their fears and emotions are very much aligned with the rest of the population. On the subject of the economic fallout, we have seen devastation to global economies, with our own economy savaged by the virus. The downturn has caused GDP to drop by more than 40 per cent quarter on quarter, and total trade figures contracted by 25 per cent in May 2020. This has prompted a rescue budget totalling 20 per cent of our GDP, probably one of the largest globally in percentage terms.
We have seen our 19 million tourist annual arrivals tumble to a trickle, our airport and our national airline suffer huge downturns. We have really taken for granted in the past that we are truly a global city. The rest of the world has not fared well; we have seen the experience of nations that have done well in the first wave, now felled by the ferocity of the pandemic. We are dismayed by what has happened in Hong Kong and Australia.
Hong Kong is now in the midst of a lockdown and Melbourne is in a state of nightly curfew. Even China, with its herculean efforts in containing the Wuhan/Hubei situation, is now experiencing fresh outbreaks in Beijing, Dalian and Xinjiang. The lessons learnt from these nations is that the virus is unforgiving and penetrates through loopholes created by exemptions from testing, breakdown in quarantine procedures and unexpected contamination of packaging of frozen foods.
As for other nations, we gape in amazement at the politicisation of wearing masks in the US, along with sidelining of experts like Dr Anthony Fauci, a giant figure in the field of medicine. In my weekly Zoom meetings with my Indian colleagues, I hear their struggles about fighting the pandemic without essential resources of Covid-19 swabs or antibody test kits. You can imagine trying to diagnose a Covid-19 patient clinically and telling it apart from other viral or bacteria infections.
In Brazil, the leadership continues to pillory the use of masks, social distancing and promoting the use of hydroxychloroquine without merit; all in a defiant show of maschismo. As the sideshow continues in a desperate spiral of death and misery, this pandemic has really sharply outlined the differences between the first world nations and the rest. The cost of a Covid PCR swab test is estimated to be a hundred US dollars. That has already put a lot of countries out of the league of massive testing.
The next is the much-vaunted vaccine. At the last count we have more than a hundred vaccines in the race with four entering the Phase 3 clinical trials. There are many ways to make a vaccine and the tried and tested method is to use a dead virus or a weakened but live virus. Other ways involved the use of an innocuous virus like a common cold virus to carry the viral genes into the body of the host as in the Oxford vaccine.
The new methods include using messenger RNA or DNA fragments. The messenger RNA is interesting as seen in the Modena vaccine. The DNA is our genetic code and stays in the cell nucleus as it is important to the survival of our species. The DNA sequences when deciphered are able to transcribe proteins. After the DNA helix structure unravels itself to allow messenger RNA to dock alongside to copy the sequences, the messenger RNA then leaves the nucleus to arrive at the protein making sites in the cell cytoplasm.
The vaccine approach is to embed messenger RNA with viral sequences. However, the thought of messenger RNA being able to travel into every cell nucleus in the body gives me some discomfort. In a rush to market, there is talk of reduced liability of vaccine manufacturers for side effects and complications. The regulatory bar may have to be raised higher for novel vaccine approaches as opposed to traditional methods. As for the economics of the vaccine, the US and EU have already put down their interest in the Big Pharma vaccine race. The Chinese, on the other hand, is taking the approach of the vaccine as a global common good.
We all wait in anticipation of the latest trials in the hope that a vaccine will put an end to all this misery. The last vaccine that was only 50 per cent effective did indeed wipe out polio. Interestingly, Singapore was one of the first countries in the world to launch the polio vaccine for all of her children in 1959. We were also one of the first countries in the world to launch Hepatitis B vaccination in 1987. It is with cautious optimism that I hope we will once again take the lead in such an endeavour.