Coronavirus: Why Singapore is so vulnerable to coronavirus spread

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Media captionCoronavirus: Singapore minister says the country is 'vulnerable'

Several international cases of the coronavirus from the UK to South Korea can be traced back to Singapore and some countries are now advising against travel to the international hub. But while Singapore has been commended for its management of the crisis, the tiny city-state faces unique challenges.

Changi airport in Singapore is one of the most interconnected hubs in the world.

In fact, there's a flight taking off and arriving every 80 seconds here, making it more connected than JFK and San Francisco in the US and Dubai in the United Arab Emirates.

But the scenes there these days are very different.

Dozens of thermal scanners dot the terminals, automatically taking the temperature of passengers as they enter and exit Singapore.

Travellers are checked for fever, cold and cough symptoms - airport staff on the lookout for any sign of the coronavirus.

The country's open borders and interconnectedness as well as its pro-active approach to testing means it has reported one of the highest tallies outside mainland China - 50.

"We are vulnerable, but we have to do everything that we can to contain that spread of the virus," says Lawrence Wong, co-chair of Singapore's task force on the coronavirus.

But when a virus comes to Singapore it won't just affect this city. It can and has spread through Singapore to other countries around the world.

The meeting that infected the world

This became painfully obvious when one meeting held in a luxury hotel in mid-January spawned several coronavirus cases around the world.

More than 100 people attended the sales conference, including some from China.

About a week after that meeting, stories of confirmed coronavirus cases began popping up all over the world - from South Korea to Malaysia, the UK and even Spain.

The first Malaysian to catch the virus was a 41-year-old man who had attended the conference along with colleagues from China.

Subsequently, his sister and mother-in-law caught it from him.

Then, South Korea confirmed two infected cases of South Korean nationals who had also attended the meeting.

Singapore reported three cases: two Singaporean nationals and a permanent resident.

British national and super-spreader Steve Walsh was also at the Singapore conference.

After his meetings in the tropical city-state he flew to a French ski resort for a holiday, on his way back home.

He is thought to have infected 11 others while he was there - people who eventually flew elsewhere - leading to five cases in England, five in France, and one in Majorca, Spain.

This one meeting demonstrates how Singapore became a super-conductor for the virus.

And the worry is it's not just one conference.

Singapore is at risk of spreading the virus precisely because it is a top destination for business meetings and international travellers.

The city-state is a big draw for Chinese businesses too, given the close economic links between the two countries - 3.62m Chinese visitors came to Singapore in 2019, making up the largest group.

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Image caption Singapore learnt lessons from the Sars crisis in 2002-3

With Chinese tourists shunning Hong Kong because of the anti-government protests there, many chose to come to Singapore over the Lunar New Year holidays - which coincided with the coronavirus outbreak.

"We are very mindful that we are indeed an open economy, we are an international travel hub," Mr Wong says. "So we are doing all we can to contain that spread. We are putting out information in a very transparent manner and we continue to work with all health authorities overseas."

Steps Singapore is taking

At home, Singapore is stepping up its coronavirus response by taking extreme measures.

It immediately understood the implications of spread in a densely-populated city. Indeed, eight of the 50 cases reported so far have no known links to clusters that had been in contact with Chinese travellers from Wuhan. That is likely to be of concern because it means the linking cases out there could yet pass on the illness to others.

That's why Singapore has put in place a highly sophisticated contact tracing mechanism to hunt down every known possible contact of those infected so they can be quarantined or monitored.

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It was the first country after North Korea and Russia to shut its borders to China and has enforced a strict 14-day leave of absence for Chinese nationals returning from the mainland who are permanent residents or have work permits

It has a zero tolerance approach to any breaches of the measures it has put in - and this is of comfort to many Singaporeans. Employees caught breaking isolation rules saw their work permits revoked and were barred from working in Singapore permanently.

Meanwhile, their employers have been banned from hiring foreigners for two years.

Singapore also distributed masks to more than a million households and has started a government-run WhatsApp group that provides daily updates to subscribers on the number of infected.

It's even cleared out university dorms to make room for quarantined patients, a move that was executed so quickly it took students by surprise.

Panic buying, shortage of masks

But while the measures have been applauded by international health experts, Singaporeans themselves have not always bought the government's messaging.

Social media comments show many Singaporeans don't believe the government's advice to wear masks only when you're unwell, suspecting a shortage of masks instead.

Many also complained Singapore didn't close borders to China soon enough.

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Image caption Anti-fake news laws are being used to combat misinformation

And when authorities raised the health alert level last week, indicating the spread of the disease was severe, scores of Singaporeans rushed to the supermarkets to stock up on rice, instant noodles and toilet paper, worried the country was going into lockdown.

The panic abated only when Prime Minister Lee Hsien Loong released a recorded message assuring his citizens there were more than enough supplies.

This level of control is only achievable in Singapore because of its centralised form of decision-making and the massive parliamentary majority the ruling party enjoys.

There are also strict restrictions on what you can say in the public domain about the coronavirus, with the country's anti-fake news law being used to curtail the spread of misinformation.

Lessons from Sars

Still, the main reason Singapore can move fast and quickly to fight the coronavirus is because it's so small, and it is clear that there is a plan in place - one that has been crafted from the harsh lessons of the Sars (severe acute respiratory syndrome) crisis in 2002-2003.

"You would see your colleagues one day at lunch, and then a few days later, you would hear that they are in the ICU, or worse - dead," says Dr Leong Hoe Nam, an infectious diseases specialist.

A Sars survivor, he was on the frontline treating people with the illness in a period that, he says, "scarred and traumatised Singaporeans".

Some 238 people were infected and 33 lost their lives.

"We are such a vulnerable country, so small and well connected," Dr Leong says.

"You could have a disease one day in China, or anywhere else in the world, and the next minute it could be in Singapore. Containment is actually unrealistic, I don't think China will be able to control it.

"I think a weakened form of the virus will emerge, like a common cold. That will be the eventuality of this virus."

Singapore has no choice but to be extra vigilant and transparent in its fight against this deadly disease. This country is dependent on the rest of the world for its economy, for its food, for its lifeline.

Its strict containment methods managed to stamp out Sars but in the last 10 years Singapore has become more - not less - integrated into the global economy, and more closely tied to China.

The stakes are much higher this time.

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