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Tuesday, Dec 07, 2021 - 19:40 SGT
Posted By: Gilbert

Two Years With Covid

It may be a bit of a cliché, but it's good to return to where one started from occasionally, which brings us to the ongoing coronavirus situation. Having put off any real coverage on the issue for maybe five months, there has been a veritable deluge of happenings since then, to the extent that even starting to pen a recap became rather foreboding. Just my recent curated browser bookmarks on the subject came up to a grand total of 1,470 links, not including those left over from about July, which might give an idea of the scale of the business before us (on this note, one of my colleagues has apparently lost a few weeks' work on her thesis, which brings us to last year's advice on backing documents up). About that, I can't guarantee that all these sources will make it into the final telling (I tend to try and squeeze them in somehow), but there's at least a partial solution to the coronavirus review - present it in parts.

Today's introduction, then, will be on the situation in Singapore these past several months, but before getting into that, a collection of and commentary on this blog's coverage up till now, in the style of previous recaps:

  • 17 Feb 2020: Wuhan Clan Interruption - in which the first early signs emerged from the Orient, a bunch of early information was compiled, and the to-be pandemic was recognized early on as a Game of Trust
  • 22 Feb 2020: SG VS COVID - in which early FAKE NEWS on no lab leak, no call for travel halts, no need for masks and some early flustering was described
  • 29 Feb 2020: Pandemic? - in which the strange reluctance by the WHO to declare a pandemic was emphasized, and more reports began to filter out of China, South Korea, Italy, etc
  • 14 March 2020: Yes, The Suspension! - in which the WHO finally declared the pandemic, at least a fortnight late, as various sport leagues belatedly shut down
  • 1 April 2020: Quis Custodiet - in which the potential of HCQ was first raised, and the concurrent specter of unwarranted censorship by the FAKE NEWS mainstream media apparatus - Twitter in particular - was described
  • 6 April 2020: A Plague On Both Powers - in which the involvement of both the U.S. and China was hinted at with lockdown looming in Singapore, a defence of free speech was made, and sadly all-too-accurate calls of worse days and unbelievable bungling to come
  • 12 April 2020: Lockdown Week One - in which the dynamics of hoarding and in-effect-rationing were discussed, amidst face mask diplomacy
  • 20 April 2020: Four Sig Fig - in which the local caseload first reached four figures (if mostly amongst foreign blue-collar workers), and dodgy figures from China
  • 27 May 2020: COVID In May - in which an early recap was made after the first lockdown period, some advocacy for foreign workers covered, and the beginnings of the reversal of the supposed-science on masks being useless is observed
  • 31 May 2020: "Science" & Facts - in which the reputation of science takes a beating with respect to HCQ, and the geopolitical implications of the pandemic are briefly raised
  • June 2020: the Of Logic, Looting, Twitter & Disinformation series (Part I, Part II, Part 2.5, Part 2.75, Through Glasses Darkly) - in which the dastardly #Lancetgate fraud on discrediting HCQ as a plausible accessible early treatment, was explained in detail as it unfolded. Sadly, sloppy and ham-fisted as the hit job was, it basically worked; early treatment would be tainted in the public mind, arguably up until today
  • 6 July 2020: Politics & Fixes - in which a (on hindsight well-founded) demand to restructure the WHO by POTUS was reported, together with the acceptance of over-US$3000-a-course Remdesivir
  • 11 October 2020: Corona Update (Part I) - in which some subtleties on interpreting coronavirus test accuracies, and possible other considerations involved in drafting policies against such, were discussed
  • 17 October 2020: Corona Update (Part II) - in which the potential of vaccines was explored, and more rumblings on HCQ, Remdesivir and how current science seems to work differently depending on the price of the treatment
  • 21 December 2020: SitRep: Covid - in which good news (and some reservations) on vaccines were reported, with some notes on the reliability of PCR testing
  • 17 January 2021: Enter 2021 - in which research on inter-country trust in terms of vaccine acceptance was presented (recall: Germany won, but partly due to being more ready to smack others down)
  • 7 February 2021: More On Excess Mortality - in which some supposed strangeness in excess mortality figures (recognized as one of the more-reliable metrics to estimate coronavirus impact, given uneven standards on diagnosis internationally) were brought up...
  • 29 March 2021: Vaxxed - ...in which the doubts raised in the above post were answered, and a declaration of my personal vaccination being completed
  • 30 May 2021: The Unbearable Lightness Of Gas - in which the crap that passes for the scientific method in the area of finding accessible early treatments was covered, with next to no progress after a year
  • 2 June 2021: Glory! Glory! - in which accompanying satire on local contributions towards the same came, in the form of quite-rigorous findings that oral HCQ and povidone-iodine throat spray could help against the coronavirus (not that it was ever reported much outside of the local news, from my own experience)
  • 11 June 2021: Communications Of The Social Media Gang - in which the geopolitical implications were updated, a new wave presaged, and the case for and against the newest star on the accessible early treatment block - Ivermectin - was made
  • 20 June 2021: Progress Or Not - in which more vaccines were introduced together with unfortunately falling efficacy observed, fervent establishment censorship on Ivermectin described, and inconsistent public versus private behaviour on masks by politicians illustrated
  • 25 June 2021: Developments For Now - in which more (well-founded) arguments for aggressively pursuing early treatments were made, together with a surge in interest for Ivermectin in the region
  • 11 October 2021: For The Common Good - in which more satire on the illogical (and unethical) approach to accessible early treatments was attempted
  • 27 October 2021: Requiem For A Frame - in which an effort to explain the unexplainable incompetency of global health authorities with respect to subduing the coronavirus was made, with inspiration drawn from the Liar Game manga's Pandemic Game arc

That about covers it, I suppose. A few more posts might have mentioned the coronavirus in passing, but they didn't meet my threshold for inclusion. So, back to the present. Went for my Moderna booster in late October (though there has been some debate on whether it is better to wait, on which more next time) as a deliberate choice to mix boosters from my own research, which seems to have received some official affirmation for now. Note that this does not imply any endorsement of existing messaging and/or policies around vaccines - often unnecessarily opaque - but yes, more on that next time too.

One step closer to victory!
[N.B. The threshold of four jabs might also coincidentally turn out to be largely true from current trends, but that's another discussion to be left for later]
(Original source for bottom: mangakakalot.com)

So, what's been going on in Singapore? The Omicron variant has just made landfall (and seems poised to dominate), but it's not as if things were going swimmingly before that. To recap, we've been mired in a sort of purgatory since early September, after being arguably one of the models for pandemic management last year. After the lockdown last April had stemmed the initial explosion of cases, there would be but a very brief minor resurgence about August, and we would end 2020 with just over 58,000 cases, and 29 confirmed deaths - barely noticeable, frankly. Moreover, the bulk of these early cases were amongst foreign labourers in their dorms, with little direct impact on the wider community; out of sight, out of mind.

Yes, it was all looking great, what more with vaccinations getting a wide roll-out through this year, until July when cases began to pick up again, including at my old wet market. This seemed a mere salacious curiosity at first, with KTV outlets of dubious repute (depending on one's perspective) comprising some of the initial clusters, leading to quips about bankers, enterprising air stewardesses and a satay hawker saviour. Things then quietened down somewhat with reassurances that Delta Plus had at least not been found, before an ominous second uptick beginning late August, that had an outbreak amongst public bus captains described as "transient".

It soon became clear that this was the Real Deal, which many had likely not expected to happen, given all the playing-up of vaccine efficacy, and seeing that some 78% of locals had been fully vaccinated by end-August. As it turned out, they were but 40% effective against transmission (if at least still pretty good against severe illness). Well, key medical figures were soon throwing up their hands at the "not unexpected" surge in the broader community, which recall had never happened last year. 1,000 cases daily - once viewed with such trepidation in April 2020 - was back on the table and reached by the middle of September, worryingly with nursing homes also hit. Human interest stories aside, the sad reality was that deaths from the coronavirus were starting to become more common, if with at least one life (temporarily) saved by a quirk of fate.

Plan endemic would be put on hold as the case load line went near-vertical, which would only be mitigated about mid-October, with positive rapid antigen tests (ART) no longer included in the figures - but to be fair, it seems everyone tinkers with case numbers when it suits them. Near 1,500 would be reached by the 22nd of September, with daily cases projected to soon hit 3,000 a couple of days later, with the next estimates as high as five figures (shades of the stock and real estate markets there). In the end, we topped out at just 5,324 on the 27th of October, following a long run over 3,000, likely helped by tweaked positive case defintions. As things stand, we appear slowly headed towards "a new normal", with the Second Lady warning that restrictions might not be relaxed until mid-2022.

Can't play the game, without the proper gear
[N.B. Local instructions]
(Original sources: mangakakalot.com, nature.com)

There had been a shift towards more-convenient (and less-expensive) tests such as the ART at least, alongside a number of interesting innovations; the Joint Interquartile Algebra Logarithm Analysis Test Modelling (JIALAT) model made some waves on Reddit Singapore in mid-September for its pretty-decent predictions, alongside other modelling attempts, and a fun homebrewed Papers, Please clone. From the more-official end, local vaccination status has been integrated into Google Pay (i.e. a vaccine passport, I suppose), the SafeEntry check-in screen has been otter-animated, and a large number of public healthcare workers have at least gotten something concrete (i.e. S$4,000) for their pains. On the vaccine front, it's been engagement on all ends, so it seems. Sinovac/Sinopharm have been included in the official vaccination programme in August, efficacy notwithstanding, and I was personally heartened by the link-up with AstraZeneca, from how they seem one of the better players in the game thus far. Not that Pfizer-BioNTech is being left out, what with them setting up their regional HQ and manufacturing facility here; a bunch of local kids are then first up to trial their paediatric vaccine.

It cannot be denied that the prior faith in vaccines as the cure-all had not been borne out, despite early suggestions by local experts to let the vaccines do their job, which soon transformed into blaming of the remaining unvaccinated minority, which unavoidably led to musing on why their seeming failures are being pinned on those who haven't taken it. The ratio of deaths and ICU wardees amongst the vaccinated and unvaccinated would also raise some cumbersome doubts, and after some attempts by the 160th-ranked media to sugarcoat the matter, the vaxxed/unvaxxed death ratio would mysteriously disappear from reports by the end of October. Of course, such ratios cannot be used to interpret vaccine efficacy without more information about the individuals involved, but the concealment of this data has done no favours for trust either - not that it has stopped netizens from doing their own calculations.

For those trawling international forums, it can hardly be denied that Singapore's pandemic-handling reputation has taken quite a big blow; yes, I am aware of our "slightly-fascist nanny state, but hey the trains run on time" reputation. After a mostly-stellar 2020 and a near world-leading vaccination rate, however, the bizarre sight of us flattening our infection curve... but along the wrong axis, had to be grist to the mill for doubters of the vaccine-focused approach (and they might not be wrong). With the country now also near the top globally in cases per million and underperforming on fatalities per capita, it has become our turn to be slammed by the U.S. (including the NYT), Germany, New Zealand etc. for mismanagement, with growing rumblings of discontent detected amongst the citizenry as well. This might yet be reflected in an exodus of the wealthy expat population.

Before continuing, to be fair, it should be recognized that there was no good, universal solution to be had, with citizen opinions split right up the middle, depending on one's circumstances. Our reliance on external trade implies that waiting it out indefinitely - as, say, China might be able to try - is untenable, and if so it was between accepting that the coronavirus will become endemic, or continuing to shoot for Covid Zero for as long as the economy could sustain it. When the situation wasn't that bad before September, it felt that "endemic" was the general direction. However, with deaths spiking, this stance had become a lot tougher to maintain, with some pretty loud voices cursing the government for not respecting seniors' lives. The latest course appears something of a middle path (cannot lock down indefinitely, but also cannot let things rip, according to the PM, who has moreover been drawing comparisons with pneumonia), which doesn't seem to have satisfied many either.

Truth in advertising, in truth
(Source: r/singapore)

Overall, with daily cases falling again, we appear gradually trending back towards endemic coronavirus as the norm, with the Ministry of Health to stop their media releases soon. The pandemic has however shown up rare chinks in the armour for the incumbent party, though, and while the PM has maintained that the government's measures have worked due to trust, this is probably less of actual faith in their abilities, and more of fear of punishment. Even on the usually more incumbent-friendly Reddit, there has been a regular stream of posts on the seeming delusion and incompetency of the ministers in charge - in particular those leading the Multi-Ministry Taskforce (MMTF) - mainly for continually being stuck in a reactive posture, due to an apparent lack of foresight and planning.

The most concrete manifestation of this was probably the crunch in ICU beds, with initial assurances that capacity could be ramped up to a thousand if required, turning out to be off by an order of magnitude. This had us down to just sixty ICU beds available at the peak of the surge - a ratio below say Malaysia and Thailand - which had commentators figuring that our healthcare system isn't all it's cracked up to be (personally, it's not that bad lah). Meanwhile, on-the-ground reports were of a deteriorating situation in the hospitals and general confusion on how the burgeoning positive cases were being handled, with healthcare workers copping warnings for speaking up.

This lack of clarity and transparency by the MMTF has been much-lampooned online (special ref. "clear and unambiguous roadmap"), in particular on all the seemingly-illogical and inconsistent policies tangentially relating to public health. For example, concerts, wind instruments and even background music in bars are no-gos, but mass ball pits are a-ok; families can't dine together in restaurants, despite being around each other all the time otherwise in the same household; the big relief monies are going to those at the top instead of commoners... but fine, that happens everywhere. All this has led to some very damning assessments of the MMTF's indecisiveness (other than in meeting vaccination KPIs), though as a consolation, they appear at least aware of this impression.

For an explanation of how to came to this, we will unavoidably have to delve into politics. As a quick-and-dirty primer, Singapore had thrived under the largely astute-if-authoritarian leadership of Lee Kuan Yew, our founding Prime Minister, who held the post in his iron grip for some 31 years (1959-1990; first/pioneer generation). Being an effectively one-party brand of democracy, the PM-ship would pass to current Emeritus Senior Minister Goh from 1990-2004 (second generation), and completely unsurprisingly to LKY's son, current PM Lee Hsien Loong (2004-present, 16 years and counting, third generation)

Triple Threat 4G Match in progress
(Source: asia.nikkei.com)

While PM Lee II has consistently indicated his intent to step down by the age of 70 (i.e. by 2022), this succession - arguably the first not under PM Lee I's very long shadow - has been far more uncertain than the previous two. For quite some time, Chan "Kee Chiu" Chun Sing (rightmost in photo) seemed the hand-groomed anointed one, but this was apparently not an unanimous opinion even within the party. This had then-Minister of Finance Heng Swee Keat become the favourite to be a transitory compromise, but the bullets he took "just as planned" in salvaging East Coast GRC for the party proved too much, and he would remove himself from the conversation for health reasons (having already had a stroke in 2016), come this April.

With this, the MMTF's leadership would have incoming Health Minister Ong Ye Kung (leftmost above) co-chairing it together with Education-turned-Finance Minister Lawrence Wong (middle above), as good an indication of who was in the race as any. Whether or not the MMTF was actually intended as a trial for their future premiership of the nation, it has definitely been interpreted this way by the masses, and the feedback thus far hasn't been swell. The general sentiment has been one of too many cooks spoiling the broth, with OYK pulling for an endemic normal and LW for Covid Zero, and the result being a neither-here-nor-there shambles (in football parlance, a half-arsed gegenpress is simply going to tire your players out to no real benefit, either do or don't, which Rangnick will likely impress). This has led to pleas for LHL and the 3G leaders to sort it out, with CCS happily lying low... for now.

Indeed, it's increasingly looking like active participation in this lousy Pandemic Game may well prove very deleterious to one's political career, as OYK may soon realise. One can't really fault him for some of the flip-flops, but certain positions that he has very publicly committed himself to, look like huge potential minefields. Vaccinations for pregnant women and children being safe is one (note there only being preliminary studies), but the biggest disappointment was certainly his trashing Ivermectin, to the extent of threatening using the POFMA law to stifle discussion, despite it being applied in various other jurisdictions. Well, if ever there was a hill to perish on, advocating accessible early treatment has to be it, and to be frank IVM and HCQ etc. have a lot more support than those only frequenting certain forums might believe. Not that he's avoided coming under heavy fire even without that, however, and talk has already turned to how Mr. Unknown Man will be sacrificed at the right time.

The ruling party were at least thrown a timely lifeline by the Opposition, who had a minority lady MP forced to resign, after admitting that she had lied in Parliament on the details of a sexual assault case used as an anecdote in a speech on empowering women - in particular that a police officer interviewing the victim, had made inappropriate comments. For the Yanks out there, a close parallel would be the Jussie Smollett case, which has just endured fresh accusations of a lunging judge, and the coke-in-bathhouse-together defence. The main takeaway was how unnecessary the embellishments were, in both cases. I mean, if you want to spout forth on gurl power or white supremacy or climate change or whatever, it's not like your opponents can rebut you without being made to look like absolute asses anyway. To top it off, she then went and baotoh the entire party as a parting shot, which I guess throws some weight behind sticking to age-old wisdom here.

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Next: The Importance Of Leading Vowels

Related Posts:
Wuhan Clan Interruption
Déjà Vu
Corona Update (Part II)
Communications Of The Social Media Gang
Corona Update (Part I)

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