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Circuit breakers may need to be switched on and off until COVID-19 vaccine is found: Experts

Circuit breakers may need to be switched on and off until COVID-19 vaccine is found: Experts

Man walking in a near empty Chinatown during Singapore's circuit breaker period. (Photo: Jeremy Long)

SINGAPORE: Intermittent rounds of circuit breakers may be needed until a vaccine for COVID-19 is developed, a panel of experts has said.

While Singapore is trying to contain the spread of the coronavirus in the short term, more circuit breaker periods may be needed until a vaccine is found, said Professor Teo Yik Ying, dean of the Saw Swee Hock School of Public Health at the National University of Singapore (NUS).

"It will have to be a series of tapping on the brakes ... once every three to four months, we may have to have a circuit break just to allow the health system to recuperate," he said during a webinar hosted by the Lee Kuan Yew School of Public Policy (LKYSPP) on Tuesday (Apr 14).

This would be necessary until populations gain herd immunity - by letting people be exposed to the virus or through vaccines, said Prof Teo. 

"I see that the vaccine is a viable exit strategy, but that is long-term," he said.

Experts estimate the development of a vaccine may take about 18 months to 24 months.

"In the short term, I realistically see that the natural response has to be a series of locking and unlocking, as well as having a global response on how do we identify countries where we are able to continue trade, to allow economic activity to resume to some degree," he added.

Commentary: Why Singapore is preparing to tap the brakes to slow COVID-19 spread

Associate Professor Joanne Yoong, senior economist and director of the Centre for Economic and Social Research at the University of Southern California, said "our best chance" for an exit strategy lies in a vaccine, but that will take about 18 months.

The problem with such a "stop-and-start strategy" of locking and unlocking is that it will be challenging for businesses and society to manage that risk, she added. 

"We have to comply with these very strict measures ... it's going to be not just a marathon but perhaps a series of repeated sprints, and we're going to have to have that mentality as we go forward," she said.

READ: COVID-19: Worries about pandemic see more calls to mental health helplines

Over time, the virus may become endemic like the seasonal flu, but with occasional outbreaks of severe disease, said Professor Tikki Pangestu, a public health expert and visiting professor at LKYSPP.

"We will have to learn to live with the virus but our health systems must have the capacity to fight fires, where necessary," he said.

A Harvard team's computer simulation on the COVID-19 outbreak also came to this conclusion. In the absence of other treatments, intermittent social distancing periods will be necessary, said one author of that study published in the journal Science.

READ: On-off social distancing may be needed until 2022: Harvard study


Countries must have evidence of control of transmission and the healthcare system must be ready to deal with any "adverse effects" before the "pedal can be taken off the gas", said Prof Pangestu.

To see what is in store for other countries, one can look at China, which still imposes border restrictions to prevent imported cases now, said Prof Teo.

Global leaders should come together to co-ordinate a global lockdown instead of imposing restrictions unilaterally and relaxing them in a staggered fashion, he suggested.

READ: Immediate measures needed to slow COVID-19 even if they take short-term toll on economy: DPM Heng

A staggered approach to relaxing lockdowns is not going to help the global community, with subsequent waves of infections likely to hit, he said.

"Global co-ordination really is important and necessary when it comes to easing lockdown measures ... this is the only way the world can shorten the economic pain."

He added that current trends suggest that the epicentre of the virus may shift back to Asia and that is "of great concern".

Prof Teo also warned against using "immunity passports" that allow people who have been infected and have some antibodies to become active in the community again.

There are still unknowns about the the immune response to COVID-19 and there is also the danger that people will fake such passports in order to go back to work and normal life, he warned.


Prof Teo also said that Singapore is now in its second wave of the COVID-19 outbreak, and that it is among the first few countries in the world to go through this.

He noted that of the roughly 3,000 cases Singapore has seen since January, about half of them emerged in the past week.

He said: "This is really a hallmark of the coronavirus epidemic ... things can change very quickly within a few days, you can suddenly see an explosion of cases." 

But he was optimistic that with a circuit breaker in place, community transmission will start to taper off within the next one to two weeks.

Authorities have announced stricter circuit breaker measures, such as the compulsory wearing of masks for anyone who goes outside. 

READ: Singapore's COVID-19 cases exceed 3,000 with 334 new infections, death toll rises to 10

COVID-19: What the law says about having to wear a mask when outside your home

What was more worrying was the spread of the coronavirus among the country's foreign workers, Prof Teo said.

Despite criticism from some quarters, the quarantining of worker dormitories was a necessary public health response to minimise the spread of the virus, he added.

Healthy workers are being progressively moved out of the dormitories to reduce population density and medical teams have been dispatched to the foreign worker dormitories to care for them there. 

INTERACTIVE: All the COVID-19 clusters at dorms and construction sites

Current measures, combined with continued testing of as many workers as possible and isolating those who have been exposed, will help to improve the situation, he said.  

"Things will look very hairy for the next one or two weeks before they start getting better," he added.

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Source: CNA/hm(mi)


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