REACH - 27. Social Distancing
22 Mar 2020 (8am - 10pm)

[12:21 pm, 22/03/2020] REACH:📢 Topic: What do you think of the enhanced social distancing measures  (eg. keeping a one-metre distance from your colleague, no more than 50% in the office at the same time)? How will these new measures affect you and your workplace? 📢
• Health Minister Gan Kim Yong: "We announced a series of safe distancing measures yesterday (20 March), and we must all take the necessary precautions to keep ourselves and our families safe."
(https://www.channelnewsasia.com/news/singapore/coronavirus-covid-19-47-new-cases-total-432-12563332)
👉 MOH: STRICTER SAFE DISTANCING MEASURES TO PREVENT FURTHER SPREAD OF COVID-19 CASES (https://www.moh.gov.sg/news-highlights/details/stricter-safe-distancing-measures-to-prevent-further-spread-of-covid-19-cases)
👉 ESG: Advisories on Safe Distancing Measures (for Retail and F&B Establishments)
(https://www.enterprisesg.gov.sg/covid-19/safe-distance)
• The Public Service will intensify the implementation of the set of comprehensive measures to achieve safe distancing, while we strive to ensure that public services remain available and uninterrupted. To reduce the local transmission of the COVID-19, the Multi-Ministry Taskforce announced on 20 March that it will introduce stricter safe distancing measures to limit close contact and large gatherings of people in close proximity over a prolonged duration.
👉 PSD: Public sector implements safe distancing measures across the board to prevent further spread of COVID-19 cases (https://www.psd.gov.sg/press-room/press-releases/public-sector-implements-safe-distancing-measures-across-the-board-to-prevent-further-spread-of-covid-19-cases-1)
[12:24 pm, 22/03/2020] ☸️  Danny 心: [Edited]
From 23 March 2359 hours (or 11.59PM), all Short-Term Visit Pass holders will not be allowed to enter or transit through Singapore.
The Manpower Ministry will only
allow the entry/return of work pass holders, including their dependents, for those providing essential services, such as in healthcare and transport.
There has been in sharp increases in cases globally. Over the past 3 days, almost 80% of new COVID-19 cases were imported by Singapore residents and Long Term Pass holders who returned from home from abroad. These cases had travel histories to 22 countries.
https://www.channelnewsasia.com/news/singapore/covid-19-singapore-no-entry-short-term-visitors-12564546
[12:25 pm, 22/03/2020] REACH: [Sent by Gov.sg – 22 Mar]
COVID-19: Additional border control measures
To focus resources on S’poreans
➡ From 23 Mar 2359hrs:
All short-term visitors:
No entry/transit through S’pore
For work pass holders:
Entry/return only for those providing essential services (and their dependents)
All S’pore citizens, PRs and Long Term Pass Holders returning to S’pore
From Hubei province: 14-day quarantine
From all other countries: 14-day Stay-Home Notice (SHN)
👉 Comply with SHN/Quarantine orders to limit spread of virus
Malaysians with S’pore work permits:
- Will continue to be able to work in S’pore during this period, with appropriate accommodation arrangements
- Transport of goods between Malaysia and S'pore will be facilitated
More: go.gov.sg/travel22mar
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[5:17 pm, 22/03/2020] ☸️  Danny 心:
Having been discussing this with a close friend in private chat group - about how to help to slow and stop the rising covid-19 case imported cases into Singapore recently - due to 2nd wave infection from the World (after the 1st wave from Wuhan epicenter).

1. 1st wave of infection is from 1 source (Hubei Wuhan) and mainland China --- where we can do a good border control --- where our checkpoints will just target China visitors or other visitors travelling to China ---- with healthcheck and quarantine for suspected cases ---- thus we can keep our infection rate low --- single digit infection.

2. Now with 2nd wave of infection from the whole World --- where many Countries have been turned into many epicentre sources ---- we see a spike of imported infection coming from Europe, US and possibly ASEAN --- that is why we see a double digit infection and 2 death.

Part 1
Thus 2 enhanced measures will need to be stepped up :-
(1) Enhanced Border measures - just announced by the Govt.
(2) Enhanced measures to prevent Community Spreading
--- in order to keep our infection down locally.

--- aka datang .... to value add on the 2 enhanced meausres

Part 2
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[5:30 pm, 22/03/2020] ☸️  Danny 心: ....
Part 2

(1) As most Singaporeans, PRs and long-term pass holders are returining from overseas travel during the school holidays - it is likely we will see a spike in imported infection.
(Anyway, the statistics show that 70 - 90% are imported cases --- infection result from overseas travel).

(2) It is thus imperative to tighten and enhance our border control ---- to prevent imported cases from infecting the community that lead to community spreading.

(A) Enhanced Border measures
- RIghtly. Govt announced enhanced border measures will be our important strategy to keep imported cases down, quickly identify suspected cases 1st hand and impose strict control on all who travel overseas at home or quarantine to prevent spreading to Community.
- Enhanced border measures include :-
(1) No short term overseas travellers allowed into Singapore or in transit
(2) Deter Singaporeans or residents to go for non-essential overseas travel (especially leisure or tours).
(3) Encourage business to defer their staff from business travelling unless absolutely essential. And for those who travel must undertake all precautionary measures to protect their staff from infection.
(4) All those who return from overseas travel - have to undergo health check, stay-home-notice and quarantine for suspected cases (to prevent community spreading) to the Community.

--- Let us analyse the above measures objectively --- are they sufficient measures to bring in imported cases to infect our Community :-
(1) If residents are prevented from travelling overseas --- no infection from overseas --- passed.
(2) If no short term overseas travellers allowed or in transit --- no infection from overseas --- passed.
(3) If no business travelling overseas and come back --- no infection from overseas --- passed.

(4) But for those who need to travel overseas for business and back ---- possible infection --- immediate healthcheck - compulsory stay-home or quarantine --- possible infection and possible infection to family members ---- fail.
(5) For those that refused to listen but want to travel overseas for tours and leisures ----- possible infection --- immediate healthcheck - compulsory stay-home or quarantine --- possible infection and possible infection to family members ---- fail.

(So point 4 and 5 ---- are the biggest contributors to our imported cases).

My close friend suggest using the infection curves -- a math model --- "spike-cool", "spike-cool" approach --- to break the infection --- to slow the infection and to break the infection momentum --- which can apply to both imported cases as well as to local community spreading.

Part 3 -

aka datang .....

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Part 3
My close friend observation of the Worldwide covid-19 infection trend :-
(1) Explosion into epicentre in Wuhan - and the whole bloc is China
(2) Explosion into epicentre in Italy - and the whole bloc is Europe
(3) Explosion into epicentre in New York - and the whole bloc is USA
(4) Explosion into epicentre in Iran - and the whole bloc is Middle East
(5) There is a fear that ASEAN ---- could be another Bloc.
--- and if all the above Blocs go out of control ----- the whole World including Singapore could be turn into a tsunami that overwhelm the whole world.

Here is my close friend's text :-
Have we observed how living creatures on the beach creatures survive? There are lessons we can learn from them. When the tide rises, these living creatures burrow into sand or take refuge inside the crevices of rocks and hide out. When the tide recedes, they come out to find food. Covid-19 resembles the tide and we are now like these beach creatures finding the optimal way to survive. The first wave was when Wuhan and later China became the first epicentre of covid 19. Subsequently, italy became covid 19 epicentre of Europe and Europe is becoming like second China two months ago. New York city is the epicentre of US and may become another large bloc. Iran is the epicentre of middle east. Our neighbours are seeing large increase in New covid cases which means SE Asia is going to be a bloc. Each time there's a surge of covid cases that affect us, it's like a tide that hit the beach. If all regions' covid cases go out of control, that will be a tsnaumi. Let's assume that the world work hard to contain covid 19 , then we will be seeing waves of tides. Can our measures then be stringent to aim at letting the mild cases clear then relax the measures. Tighten again when cases increase, loosen when numbers fall. This is help us survive through a period until the covid is well contained world wide or when a vaccine is available.
Something like this? Followed by specifics"

Part 4 -- aka datang ...
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[6:41 pm, 22/03/2020] ☸️  Danny 心: ---

Part 4 - Infection Curves Math Model  - "spike-cool", "spike-cool" approach --- to break the infection for Imported cases until vaccines are ready (estimated to be 18 months later)
(1) The "spike-cool", "spike-cool" approach is to reduce the number of infection down - so that it become more manageable - vis-a-vis our MOH/Police contact tracers, enforcers (to ensure people legally required to stay at home or quarantine and finally enough hospital beds, ventilators, medical equipment and logistics to treat infected patients.
(2) The analogy of "spike-cool", "spike-cool" approach - means when spike in infection comes --- tighten with enhanced border control to achieve a math number - that can achieved the manageable infection rate - to prevent overwhelming our resources to manage the infection.
(3) This "tighten and relax", "tighten and relax" --- border control must be done - everytime we see a spike from imported cases from abroad.
(4) As we know, there are new "epicenter" being created all over the World - 1st in wuhan, then in italy, then in new york, then in iran and ASEAN is simmering.
(5) The "tighten and relax", "tighten and relax" rule --- will have to go in tandem to the above world development - with the enhanced border control as mention in Part 2 - using the "Infection curve math model" as the guide to ensure infection curve go below "our medical and enforcement facilities" curve.

Here is my close friend message :-
"Leaders are talking about flattening the infection curves. This is about spike- cool, spike-cool repeatedly until vaccine is available.the spike must be way below the healthcare capacity because we don't know how many asymptomatic people are out there.
Tmr is the start of school term. By June holidays we should aim to second cool wave.
This is like how breach creatures adapt and survive the rising and retreat of tides. Low tide, come out and look for food. High tide, barrow and seek refuge under the sand and amongst rocks
I also disagree with the message that when there are too many cases, mild symptomatic patients can stay at home. That was said when people thought that covid was more similar to h1n1. But covid is much more lethal and very infectious. Focus should be the clear the number of mild symtomatic cases. So this model gives time to clear the easy cases and bring down the total number of active cases"

(6) My close friend is concern with the "asymptomatic mild case" -- that could go undetected but can infect people.
Suggest that any close contact with the confirmed cases --- should also be tested with test kit to sieve out the "asymptomatic mild case"  - so that they will not go around to infect others.

Part 5 -- aka datang .....
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Desmond
[6:44 pm, 22/03/2020] : your close friend must be some leading Epidemiology and Population Health Professor! 😀

[6:45 pm, 22/03/2020] ☸️  Danny 心:
A respectable person.

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[7:04 pm, 22/03/2020] ☸️  Danny 心: ---
Part 5

With the backdrop of more returned overseas travellers, and the likely spike in imported cases --- as well as the need to keep our school children in schools (as students can't stop learning and parents still need to work - and cannot stay at home to take care of the children ---- Enhanced measures to prevent Community Spreading) must be adopted.

(B) Enhanced measures to prevent Community Spreading
(1) Govt just announced social distancing in hawker centre, F&B etc,  split workforce in public service, encourage business to do likewise, avoid 250 participation gatherings in any events, cancel senior activitiers like karaoke, do remote telecommuting, encouraging more virtual tours, or virtual events without crowd congregation etc --- within the Community. These are very good measures ---- and can they stop or reduce infection ---- Analysis :- cannot completely stop ---- but can reduce infection (because there could be "asymptomatic mild case" that have not been detected.

(2) Thus my close friend suggested (and want to "value add" to the above local enhanced measures --- to ensure that those "asymptomatic mild case" must be actively sieved out ---- eg. those who have been served "Stay Home Notice" or "quarantine" --- or those who come close contact with confirmed or suspected cases ----- should all be tested with the test kit.
Better still use the identified effective method of tests eg :-
- nose swab test
- saliva test
- blood test
- faeces test
to sieve out all likely cases --- to cover all "asymptomatic mild case".

(3) Only then, we are sure within the Community ---- all are "healthy" with no hidden cases.

(4) Then we will be very sure "Community Spreading" won't happen.

(5) This is known as the Initial "Spike" to do more coverage local test and then "Relax" --- once we have covered sufficient ground.

Here is my close friend's message:-
"Leaders are talking about flattening the infection curves. This is about spike- cool, spike-cool repeatedly until vaccine is available.the spike must be way below the healthcare capacity because we don't know how many asymptomatic people are out there
Tmr is the start of school term. By June holidays we should aim to second cool wave
I see high end places of interest offering virtual tours, online broadcasting. New business models and adaptations to last a long time not just covid periods
This is like how breach creatures adapt and survive the rising and retreat of tides. Low tide, come out and look for food. High tide, barrow and seek refuge under the sand and amongst rocks
I also disagree with earlier message that when there are too many cases, mild symptomatic patients can stay at home. That was said when people thought that covid was more similar to h1n1. But covid is much more lethal and very infectious. Focus should be the clear the number of mild symtomatic cases. So this model gives time to clear the easy cases and bring down the total number of active cases."

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