Singapore is recording three times the numbers of Covid cases as Australia. It’s a sobering warning about what’s to come.
It’s been more than a month since NSW came out of lockdown and several weeks since Victoria did the same, yet the predicted surge of Covid-19 cases has failed to occur.
Indeed, in both states daily numbers have barely budged or even trended downwards.
But a health expert has said Australia’s covid case “honeymoon” could be short-lived and we only have to look at Singapore to see that cases will almost inevitably rise once more.
It’s likely just a matter of when that surge happens. Some epidemiologists think that rise is already occurring.
On Saturday, Victorian health authorities announced 1221 new local Covid-19 cases and four deaths. NSW saw 250 cases and no deaths.
For Victoria that’s around 100 more from Friday but the trend downwards continues in a state that was seeing more than 2000 cases a month ago.
The 250 cases north of the Murray is the lowest for four days but is higher than the 129 cases on October 31.
Yet in Singapore, a country of 5.6 million – about one million fewer people than Victoria – cases have soared since it memorably declared it would learn to “live with Covid”.
On Friday, Singapore saw 3099 cases and 14 deaths. Although that is down on a high of 5300 in late October.
The country started easing restrictions in August with the surge beginning in September when around two thirds of its population was double vaccinated.
Australia’s Covid ‘honeymoon’ might not last
Talking to ABC News, infectious diseases expert Professor Dale Fisher of Singapore’s National University said the country’s experience should be a sobering lesson for Australia.
“I think you will get a bit of a (summer) honeymoon because people open the doors, windows, go outside for picnics. That’s much safer.
“My concern, in Australia, would be more about March to April, as you’re going back into winter,” he told the ABC.
There are several warnings Singapore could provide to Australia, he said.
One is waning immunity which, globally, is leading to spikes in cases even though vaccinations are still providing good protection against hospitalisations and deaths.
Singapore is now administering booster shoots to help rein in the case rise.
Another reason for Singapore’s post lockdown surge could actually work in Australia’s favour.
A small but significant chunk of older Singaporeans have not got both their jabs. Figures from the country’s health ministry show that while around 95 per cent of people aged between 20 and 70 have had both doses, that drops to 86 per cent for the over 80s.
That’s not the case in Australia. Department of Health data states some 94 per cent of 80-85 years olds in Australia have had both shots. That figure remains above 90 per cent for all but the over 95s.
This stubborn cohort of the unvaccinated is one of the reasons the Singaporean Government made the controversial decision to make those without their two shots pay their own hospital bills.
Singapore and Australia’s Covid similarity
What Singapore and Australian do share, however, is that they are both nations where there has been very little Covid in the community. And that means vaccines are having to do all the hard yards in combating the virus,
Singapore’s Covid minister Lawrence Wong said these countries were “Covid naive”.
“Unlike many other European countries, we have kept infections in Singapore low for a very long time,” Mr Wong said last month.
“Now they have a much higher level of natural immunity and together with the vaccination programs that they have introduced, many of these countries have reached the new Covid-stable situation.”
Mr Wong has warned Singaporeans that “sooner or later” most will end up catching Covid and that further surges could occur.
Curse of countries like Singapore and Australia
Associate professor at the National University of Singapore’s Saw Swee Hock School of Public Health Jeremy Lim told Fortune magazine in October that the curse of countries like Singapore and Australia, which have both essentially kept covid at bay, is that letting down the drawbridge will lead to spikes in cases.
“Countries that reopen from zero covid to living with endemic covid you have to expect massive numbers (of cases) and a small proportion will die. It’s just the nature of the virus.
“It’s a horrendously difficult message to communicate politically,” Prof Lim said.
Nonetheless, like in other highly vaccinated countries, deaths in Singapore as a proportion of cases are far lower than they otherwise would be without vaccinations.
Around 0.2 per cent of covid cases ultimately lead to fatality in Singapore. Of those who have died, 72 per cent were not fully vaccinated.
After the country declared earlier this year it would “live with Covid” it hasn’t exactly lived up to its bold claim of no longer focusing of cases. Restrictions have seesawed in the city as cases have surged and waned.
An easing of restrictions last week allowed five members of the same family to dine out together – still stricter than Australia.
But the country’s government is determined to gradually loosen the rules and allow more overseas travellers in, Covid or no Covid. Lockdowns, for instance, are increasingly out of the question.
Australian cases close to rising
Some Covid watchers in Australia have warned the rise in cases could now be on in NSW and Victoria.
Speaking to news.com.au last week, University of South Australia epidemiologist Adrian Esterman said the reproductive number (Reff) for NSW was hovering around one, meaning each person with covid was passing it onto one other person on average.
As soon as the Reff goes above one, cases are rising.
“It looks like a gentle rise but it may be speeding up a bit,” Prof Esterman said.
“We were pretty sure that when restrictions were relaxed we would see more cases numbers — we more surprised they didn’t come quicker,” he said.
The rising numbers now sets up the states for a covid Christmas with cases potentially surging during the holiday season as families gather to celebrate.
The lesson from Singapore is that the Covid “honeymoon” could be brief for Australia.
Professor Fisher said the advice from Singapore was clear. People shouldn’t take for granted that covid was gone, the country should remain “cautious” around dropping all restrictions particularly when winter arrives and people should get those booster shots when it’s time.
“I think there’s a risk. Everyone is obviously sick of the pandemic and wants it over. But that would be my major warning.”
– additional reporting by Charis Chang.