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Why S’pore cannot be held hostage by those who refuse to get vaccinated

covid vaccine

(Disclaimer: All opinions expressed in this article belong solely to the writer)

Throughout the ongoing pandemic Singapore has, in its trademark style, borrowed the best practices from both the West and the far East to tackle the crisis.

Like other successful Asian countries, it has embraced many restrictions and practically shut the borders for a year and a half (and counting), keeping both the domestic spread of the virus and fatalities to the minimum.

Like the best performers in the West, however, it was also the first in line to acquire vaccines — particularly the most effective mRNA jabs from Pfizer and Moderna, which were offered for free to all residents and rolled out in one of the broadest, most successful global vaccination campaigns, which has now gotten over 80 per cent of people in the city inoculated against COVID-19.

It has also quickly begun a rollout of follow-up booster jabs this autumn, seeing that protection wanes about six to eight months after completing the original double-shot regimen.

As a result, it is easily one of the countries best prepared for the new “living with Covid” reality.

That said, for all its accomplishments, there is still a sizeable portion of the society that — for one reason or another — has refused to take the vaccines, despite its free and easy availability in the city-state. This group, while a minority, threatens the pandemic recovery for everyone.

The troublesome six per cent

The current population of Singapore is approximately 5.4 million people. 4.5 million are fully vaccinated and an additional 100,000 have received at least one jab (what suggests they will, shortly, receive another one).

This leaves about 800,000 people, around 500,000 of whom are children under the age of 12, who — at this point — are not yet eligible to receive a vaccine and their inoculation may only start early next year, when proper approvals are granted.

While they still are an epidemiological concern — as they may spread the virus between each other and in their families — they are also the least likely to suffer serious adverse effects from it. As such, as long as everybody else is vaccinated, their impact should be relatively small.

Unfortunately, there are still 300,000 people who are eligible for a free jab, but haven’t gotten one yet — and they represent all age groups quite equally.

covid vaccination singapore
Image Credit: MOH

Even at Singapore’s very low fatality rate of 0.1%, their hesitancy may translate into at least 300 deaths and 600 hospitalisations in intensive care units (ICU), given the figures from the recent four weeks. (Please compare that, if you will, to the current total toll of 30 dead and around 40 people requiring ICU care in the past 28 days to see how much worse the situation can get.)

If it was only about the unvaccinated paying the price for their ignorance, I would be quite indifferent about them having to pay it. They knew the risks, so they have to bear the consequences. But the problem is that a society of millions is often only as strong as its weakest links.

Firstly, even fully vaccinated individuals are at risk of contracting the disease and dying from it. It’s much smaller, but it exists.

Given the current figures, continued vaccine hesitancy could add another 100 dead and another 600 people in ICU, bringing it to a grand total of 400 dead and 1200 requiring intensive care. This is still very low by global standards, but unacceptably high domestically.

Secondly, the Singaporean society is generally risk-averse and has gotten used to considering almost any number of local cases as unacceptable, putting pressure on the government to continue with socially and economically crippling restrictions. However, these threaten everything, from employment and education, to timely completion of HDB apartments that thousands are waiting for.

Despite warnings from the multi-ministry task force that daily number of cases can climb to 3,000 in the coming weeks as the country reopens its economy, the authorities faced considerable public pushback which, again, forced them to reapply some pandemic curbs, scale back public gatherings and make work-from-home the default mode for companies able to offer it.

Unfortunately, Singapore is not a country that can remain self-sufficient in unending lockdowns.

The cost of staying isolated

As a small island that thrives on international trade and which imports pretty much all of the goods and food consumed locally, it is always going to face a risk of some seepage of infectious diseases at its ports of entry. Larger countries can feed themselves, but Singapore can’t.

singapore port
Port of Singapore / Image Credit: Maritime Industry Foundation

Having to deal with another 300,000 people, who are effectively stabbing the rest of the society in the back simply because of unfounded hysteria and fear, often perpetuated by conspiracy theorists on the Internet, is simply untenable. A small minority cannot hold the entire country hostage.

Moreover, in the past 18 months, as the rest of the world was consumed by the fires of the pandemic, which killed approximately five million people worldwide, Singaporean policies have kept it very safe in comparison, winning it global praise.

singapore covid-19 death rate
Singapore’s COVID-19 death rate is among the lowest in the world – 100 to 200 times lower than in the West

But today, as the world is reopening — often deciding to live with the new waves of the virus — keeping Singapore’s borders shut would be downright suicidal.

Thus far, Singapore has been winning foreign business over with its pandemic policies — as I wrote last week — in contrast with say Hong Kong, which may be recording fewer cases but is reeling from significant economic pressures, which have only worsened its already bad situation.

It has to stay this course, or else it is not just going to miss out on the emerging opportunities, but its currently strong position may begin to erode as well.

Singapore Airlines (SIA) to raise S$15 billion from existing investors to tide through COVID-19
Singapore Airlines / Image Credit: Head Topics

Let’s take Singapore Airlines as an example. As long as international air travel is in a freeze, the company is in a comparatively good shape versus its competitors. But as they begin flying again and it remains on lockdown, unable to serve its intercontinental routes at full capacity, it is going to be left behind and lose billions of dollars it has raised during the past year.

The extra money has placed it in the pole position to leap ahead once the skies reopen. But if it is forced to operate below its optimal levels, its situation is going to change from one of advantage to one of a potentially lethal burden.

The same is true for other sectors of the Singaporean economy. The very openness and dedication to living with the virus, which is already attracting foreign capital to move to Singapore in the presence of uncertainty elsewhere may quickly end, if the authorities are forced to retain more restrictions than for example, countries in the West.

There’s nothing worse for business than uncertainty. Stability is one of the cornerstones of Singapore’s position in the world and its attractiveness to business. However, the spectre of enduring restrictions may cool positive attitudes and even drive capital away — or, at least, make foreign investors re-examine or postpone their plans in the city-state.

This would cost money, jobs and Singapore’s reputation — all because a handful of people are being baselessly unreasonable, allowing the disease to spread at levels higher than it otherwise would have been able to.

The facts are indisputable — half of ICU cases and three-quarters of recently recorded deaths occurred among the unvaccinated. You may think that the differences are, therefore, not so huge – until you consider that the unvaccinated are only six per cent of the total population eligible for vaccination (with the rest being kids that are the least affected by the disease).

Since these six per cent are responsible for half of all severe cases and about 75 per cent of deaths, it means that refusing to get the jab makes you around 10 to 12 times more likely to suffer and/or die, what is consistent with findings elsewhere in the world (a recent study in the US established the unvaccinated are 11 times more likely to die from COVID; meanwhile data from Israel shows that unvaccinated 60+ year olds are 15 times more likely to leave the hospital in a casket rather than on their two feet).

The virus is here to stay

2021 is much different than 2020 was and, accordingly, we all (globally) need to change our mindsets too. It’s not likely that COVID-19 is going to be wiped out, but thanks to vaccines, we are able to control it and minimise its damage.

While it made sense to obsess about the daily number of infections last year, it is no longer the case today, since (as long as you are inoculated) the risks are considerably smaller.

What we need to focus on is protecting the sick and elderly, track the evolution of the virus, and keep an eye on severe cases and deaths — which are really the only metrics that matter now, as they may overburden the healthcare system.

In a typical year, about 800 people die of the flu in Singapore. This is 10 times the number of deaths that COVID-19 has caused in the past 18 months.

covid-19 icu treatment singapore
Number of patients needing ICU treatment due to COVID-19 remains very low in Singapore / Image Credit: Our World in Data

Even at 30 deaths per month, recorded recently (with three-quarter being unvaccinated patients), it would still be just half of the toll of regular influenza. And much like it, it is the most dangerous for the weakened, elderly and sick. We all need a sense of proportion going forward.

Yes, the virus is a threat, it can lead to a severe disease and, occasionally, death. But it’s not the end of the world.

Vaccines have allowed us to gain an upper hand over it, control it, reduce the risks and, with time, may make it a non-issue at all. However, this can’t happen if there’s a sizeable reservoir of people allowing it to keep re-emerging like a mole the rest of us are trying to whack for good.

Featured Image Credit: Reuters

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(UEN 201431998C.)

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