S’pore is now a global proving ground in the fight against the new COVID-19 wave from China

Disclaimer: Opinions expressed below belong solely to the author.

Just like in the early days of the pandemic, Singapore is again finding itself close to the epicentre of a new outbreak coming from haphazardly reopening China.

But unlike in 2020, the city-state is among the best — if not the best — prepared for the virus, which is why its response to the potential threat is much different than it was three years ago.

In January 2020, Singapore closed its borders to visitors from China; but this time, it has announced with some fanfare a return of a direct connection to Beijing on board Singapore Airlines — resuming today (December 30).

However, given reports from Italy that 50 per cent of passengers arriving on two recent flights from China into Milan tested positive for COVID-19, should we worry that they may cause a new outbreak?

Well, given its geographic location and the timing of the reopening ahead of New Year’s Eve and Chinese New Year, Singapore is inadvertently becoming a global proving ground for COVID-19 response against a possible re-emergence of the virus.

And whatever happens in the tiny city-state will affect what everybody else in the world does.

(In)opportune timing

While COVID-19 was, indeed, detected among Chinese travellers in Europe, the fact is that the number of visitors coming from the PRC relative to local populations in these countries is bound to be quite small.

This is not the case in Singapore, where 75 per cent of resident population is of Chinese descent, with many still maintaining ties with the mainland.

This cultural and linguistic proximity is also what makes it so accessible to Chinese tourists, who can quite freely communicate in Mandarin — not something they can enjoy in many other places abroad.

Before the pandemic, the number of visitors from China reached close to a million for the three months of December, January and February — the typical time of NYE and CNY festivities. That’s one million in a city-state of just 5.5 million people.

The timing of the reopening is, therefore, rather inopportune when it comes to pandemic response — it would be better if it didn’t start with a flood of traffic between both countries, but it is certainly quite opportune for the virus itself. If it ever hoped to get a second chance, it seems like it’s now or never.

The ultimate test

Singapore has, over the past three years, become a kind of a poster child for proper pandemic response. While it maintained strict isolation from the world, it used the time wisely to inoculate local population with the best vaccines available.

Once it completed the process, it reopened its borders, deciding to live with Covid henceforth.

This policy has thus far proved very successful, as it maintains one of the lowest fatality rates in the developed world, matched only by the Persian Gulf countries of UAE, Qatar and Saudi Arabia.

Nobody in the world, however, has been presented with quite a comparable challenge to what China’s reopening brings.

This is because China has remained in near total isolation for the entire three years, while failing to vaccinate its population properly — both in terms of the quality of the vaccines, as well as the numbers of doses administered (particularly amid some hesitant, elderly citizens).

It continues to rely on its homegrown jabs instead of imported mRNA vaccines, which provide superior protection to all variants.

In addition, while national isolation was rather successful, with only very limited, occasional outbreaks, quickly quashed by authorities in respective regions or cities, it also means that far fewer people have been exposed to the virus and developed some sort of natural immunity.

It’s therefore quite likely that mainlanders are more vulnerable to the virus — and also more liable to become seriously ill — than anybody else.

We could see the havoc it wreaked in Hong Kong earlier in 2022, with thousands of people dying in a span of just a few months, catapulting local mortality rates from close to none, to comparable with some European countries.

If the same happened in China, it would mean over one million will be dead by mid-2023.

But what it also means is that Chinese travellers are not only more likely to carry the virus and fall sick or die abroad but, given the huge population of the country, they may also become hosts to new variants of Covid, which may prove better at evading current vaccines.

This has, of course, been happening throughout the pandemic but given various travel restrictions, it was relatively easy to isolate and examine the new strains with some time to spare before some of them began to dominate.

Today, however, given the sheer volume of travel that could be expected out of China, we may simply not be able to do it. Even if any new variant is discovered, with an average of 10,000 arrivals from the PRC into Singapore each day, there’s very little that could be done to contain it.

If the city-state holds out well, even if the number of infections climbs but without a corresponding increase in fatalities, it will be excellent news for the rest of the world, proving that the policies we have all been relying on are still effective.

If it does not, however, it may bring back testing, travel restrictions, lockdowns and, possibly, new vaccines if necessary.

Expert predictions

Fortunately, experts in infectious diseases suggest that such a pessimistic scenario is unlikely, as reported a few days ago by the Straits Times:

Experts here say there is a high chance of new sub-variants emerging in China, given the large number of people getting infected. They also noted that it is not likely to matter.

Dr Sebastian Maurer-Stroh, executive director of the BII, said: “Over the past three years, hundreds of short-lived variants have emerged with very little impact from the majority.”

He said the recent genomes from China are mostly the BA.5.2 and the BF.7, which fit the Asian pattern generally. “With global travel resuming, a more broadly synced lineage pattern would be expected,” he added.

“We would expect new variants globally as a matter of course. China, with millions of people getting infected daily, will add to the likelihood of such new variants and sub-variants arising, but should not be singled out as the sole or even the greatest risk of such an event,” said Prof Hsu.

“There has not been a bona fide new variant since the Omicron variant emerged from South Africa (which has a considerably smaller population than China),” said Prof Tambyah.

“The sub-variants of the Omicron variant have emerged from South Asia and other parts of the world, but none have been associated with surges of deaths, even though there have been more infections.”

I know that faith in what experts have been saying throughout this pandemic globally has been shaken somewhat among some people. After all, we have been told before that the virus might not be transmitted by air or be nothing more than a cold or flu — only to be proven painfully wrong.

However, even if you are sceptical about opinions of medical practitioners, I think we may all take solace in the most objective source of all — data.

You see, Singapore has recorded up to 25,000 infections on some days in 2022, but even that was not enough for the pandemic to sustain itself or kill a much greater number of people.

Currently, that number is down to just 1,000 cases, despite the fact that the city-state receives thousands of visitors from other parts of the world (and hundreds of thousands from neighbouring Malaysia).

This explains the relative optimism of the authorities and specialists about China’s reopening.

It would take an exceptional confluence of factors to trigger an outbreak, which could crack all of the measures undertaken to protect Singaporeans and lead to a new global wave of the virus, which would be hard to contain or more deadly than others before it.

Nevertheless, as long as risks remain (and they do), for the next two months, the eyes of the world will be focused on Singapore and the impact the impending influx of Chinese visitors is going to have on the city.

Let’s hope it’s limited to fond memories of family reunions and long awaited travel. Otherwise, if Singapore has a problem, then the entire world does too.

Featured Image Credit: Thomas Peter via Reuters