27 Apr 2020 (2pm - 8pm)
REACH
[2:03 pm, 27/04/2020] : A total of 10 halls at Singapore Expo are being converted into temporary isolation facilities for Covid-19 patients, with four already completed and occupied, said Prime Minister Lee Hsien Loong in a Facebook post on Sunday (April 26).
"With many more Covid-19 cases, mostly mild, we urgently needed a solution to house the large numbers, and not let our hospitals get swamped," Mr Lee wrote.
📢 Topic 📢
What are your views on the conversion of locations such as the Singapore Expo, Changi Exhibition Centre and Tanjong Pagar Terminal into temporary isolation facilities to allow our hospitals to focus on more serious cases?
👉https://www.todayonline.com/singapore/4-spore-expo-halls-occupied-covid-19-patients-temporary-isolation-facilities-6-more-halls
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[2:05 pm, 27/04/2020] ☸️ Danny 心:
Part 1 - Aggressive Testing
CNA
26 Apr 2020 06:20AM
(Updated: 26 Ap dor 2020 08:43AM)
“AGGRESSIVE TESTING”
Mr Gan has also said that as the country eases circuit breaker measures, it will need to increase testing capability, to make sure that there is no community spread of the virus.
“In order to make sure that there's no transmission in the community, we need to test a lot more,” he said at a virtual press conference held on Tuesday by the multi-ministerial task force tackling COVID-19.
Mr Chan made a similar point in on Thursday, saying: "We hope that in a month's time we will be able to progressively reopen the economy with much more testing for the entire population and at the same time to take on additional safe distancing measures."
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[6:30 pm, 25/04/2020] ☸️ Danny 心:
My close friend comments :-
(1) UK targets to do 100000 tests per day.
(2) What it means is that the longer we delay aggressive testing the more we have to do to catch up because the silent spread is exponential on a daily basis.
(3) In mar south Korea started aggressive testing on a scale of 10000 per day. Our DMS on the contrary said yield little result.
(4) But every asymptomatic case that slip by can turn into a thousand cases in 10days. When it quietly spread until beyond control, we are finished.
(5) Really hope sg is doing aggressive testing.
My comments :-
(1) Yes. Your suggestion of aggressive testing is the right strategy to weed out the unlink cases in Singapore - which remain a stealth reservoir in the Community that are stealthly and silently infecting unsuspecting people in the Community.
My close friend response :-
(1) It's about maximising outcomes, minimising disasters. unless we are poor and cannot afford it. Economic shut costs much much more.
My comments :-
(1) Aggressive testings is the right approach, but to test all 5.6 million residents in Singapore at one go - is a very challenging and daunting tasks.
(2) Thus we need to priorities our testing, I suggest that :-
a. Batch 1 - Dorms for foreign workers are now undergoing aggressive testing. Majority of the infected people have been identified.
b. Batch 2 - Foreign workers outside the dorms are undergoing tests now concurrently - and this form the 2nd largest group after the dorms reported every day.
c. Batch 3 --- Note :- the community local transmission and the unlink cases that are reported everyday --- are coming from this group.
But this group are all the residents in Singapore - citizens, PRs, Long Term Pass Holders. --- which form about 3 to 4 million people.
To conduct aggressive testings to this large pool of people to weed out the 30 to 20 over cases --- will be a challenge.
So I suggest we do the following :-
(i) Batch 3a - Test all essential workers that are working now - as some unlink cases come from this batch - about 300,000 workers.
Batch 3b - Test all nursing homes - where some unlink cases - have been uncovered through this batch - number unknown - but not a big number, I guess.
Batch 3c - Test all pre-school students and staff who will be attending pre-school once circuit breaker ends - as some cases also come from this batch - number unknown --- but i guess quite a big number.
Batch 3d - Test all workers that will be going to work for non-essential services when circuit breakers end - as few cases are reported from this group - a big number - potentially about 1 to 2 million workers?
Batch 3e - Test all school going children eg. primary, secondary, JCs, IHLs - that need to go to schools and pose a risk of cross infection - before circuit breaker ends - potentially about 1 to 2 million students?
(ii) Note :- by testing all the Batch 3a to 3e ---- if there is any discovered cases --- their family members or those living with them or come into with them will be tested --- and these will have weed out the unlink cases.
(iii) Can we take the risk of not testing all those staying at home --- yes i think we can --- because if the above batches are tested - with no infection - very likely that those stay at home are not infected.
(iv) If anyone of the tested batchs have people infected, then likely that those stay with them will be infected - and this stay at home can be tested.
(v) Believe in this way --- we have a systematic aggressive way of testings to weed out all the unlink cases in the Community.
My close friend contribution :-
Pleased to see that community cases are dropping. The next step is enlarged the test criteria for the community to institute testing for
(1) those under quarantined/SHN before lifting their movement restrictions. When the community cases start to clear up, there is no reason to release those close contacts without testing them.
(2) occupationally higher-risk groups should be tested once they showed symptoms e.g. Public facing personnel, healthcare support workers etc
The foreign workers new cases appear to be sliding but the absolute number is still high means infection rate potentially still very fast. There will be some way to go before we see lower numbers. Once the symptomatic workers are segregated, we can practise random testing supposedly healthy group to check on the infection rate. E.g.. Sample x number of workers everyday picking from different floors and different blocks to monitor the infection level.
[2:05 pm, 27/04/2020] ☸️ Danny 心:
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Part 2 - Sneaky Virus
CNA
26 Apr 2020 06:20 TVAM
(Updated: 26 Apr 2020 08:43AM)
To beat 'sneaky' coronavirus, test more and lift circuit breaker gradually when time is right: Experts
Dr Chlebicki pointed out :- “This virus is quite sneaky and it will uncover any blind spots sooner or later,”.
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[6:31 pm, 22/04/2020] ☸️ Danny 心:
(6) So it is important to be on guard all the time and should not allow a lapse of complacency to derail all the efforts of tackling the virus - as this virus will pounce given 1/2 chance.
[3:23 pm, 22/04/2020] ☸️ Danny 心:
(2) He say when a person tested negative for 4 days, the next 4 days, virus load could then surface indicating that he could be infected and able to start infecting others.
(3) This virus is a very sneaky enemy.
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[2:06 pm, 27/04/2020] ☸️ Danny 心:
Part 3 - NO “HAPPILY EVER AFTER”
CNA
26 Apr 2020 06:20AM
(Updated: 26 Apr 2020 08:43AM)
NO “HAPPILY EVER AFTER”
Even if the signs are all positive, there may not be an immediate lifting of all the measures enacted during the circuit breaker period.
“I actually hope we will have a graduated easing of the different measures,” Prof Teo said.
Mask wearing and safe-distancing requirements, for example, are likely to remain for the foreseeable future even after Jun 1, along with restrictions on large gatherings, said Prof Teo. School may resume but workers from sectors that do not require them to be physically present are likely to continue working from home.
“F&B outlets may need to endure further hardship for a while longer by allowing for only takeaways and delivery, and not dining in – but a bright spot will be bubble tea outlets and McDonald’s should be able to resume takeaway and delivery options,” he added.
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[2:57 pm, 26/04/2020] ☸️ Danny 心:
If local transmission drops consistently to single digits and to zero for consecutive period of time, and when circuit breakers period end ---- suggest that the following are the recommended social distancing measures will still need to be put in place.
The reasons being :-
a. No vaccines are available yet.
b. Even for those who have been infected, signs show that they can be re-infected again as their anti-bodies does not guarantee no subsequent infections - whether by the same strain of virus or different mutated strain.
c. Standard treatment are still not available.
Thus the following social distancing measures will still need to be put in place - when circuit breaker period end :-
(1) Compulsory for all to put on reusable washable face mask when step out of the home.
Everyone at work and in schools - need to put on face mask - to prevent cross-infection among different family household.
The resusable washable face mask --- must be the last line of defense as "Personal Social Distancing Tool" - the last mile protection.
(2) 1 metre apart queuing as social distancing measure must also be in place - in public areas (except PT such as bus or MRT - maybe difficult - and have to rely on face mask as the last mile "Personal Social Distancing tool").
(3) Maintain personal hygiene - by washing hands with soap or sanitizer make widely available.
(4) For crowded areas like mall, supermarkets etc ---- crowd control will still be required.
(5) Eat-in in food court, coffeshop, restaurant - must still be disallowed.
Only allow "ta bao" (packet breakfast, tea-break, lunch or dinner) even when circuit breaker ends. Because when we eat, everyone needs to remove their mask.
And then You eat, I eat. You talk I talk, saliva drop ---- and it defeat the purpose of wearing mask - and if anyone infected - community spreading will start again - as it is the most likely source of cross infection --- that will make contact tracing very difficult - as many strangers meet.
(6) When slowly opening place of worship - all the above social distancing measures must be implemented.
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[2:06 pm, 27/04/2020] ☸️ Danny 心:
Part 4 - No Model in the World that Singapore can follow
CNA
26 Apr 2020 06:20AM
(Updated: 26 Apr 2020 08:43AM)
When asked if there are models around the world which Singapore can look to, Prof Teo said that many countries are experimenting and taking tentative steps.
“I do not think there is a rule book that countries can follow,” he said.
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[7:23 pm, 25/04/2020] ☸️ Danny 心:
No government in the world can claim they do well in this virus pandemic - not China, not US, not Japan, not SKorea, not even Taiwan when their warships saga penetrated.
So I suggest not to blame and point fingers in the midst of a prolong battle with a stealth and difficult to defeat enemy but keep providing good workable suggestions.
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[2:06 pm, 27/04/2020] ☸️ Danny 心:
Part 5 - Different segments as potential hotspots
CNA
26 Apr 2020 06:20AM
(Updated: 26 Apr 2020 08:43AM)
Prof Teo said that potential hot spots could be “vulnerable and often-overlooked population segments”, including care homes, nursing homes and orphanages.
“Equally we need to think about other population segments such as prisons, military camps and outfits, mental health institutions … as well as an often-overlooked group such as commercial sex workers,” he said.
“Only by confronting some of the realities that societies have, can we, and other countries, properly and systematically identify any high-risk segment and put in place plans to protect these people.”
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[6:30 pm, 25/04/2020] ☸️ Danny 心:
My comments :-
(1) Aggressive testings is the right approach, but to test all 5.6 million residents in Singapore at one go - is a very challenging and daunting tasks.
(2) Thus we need to priorities our testing, I suggest that :-
a. Batch 1 - Dorms for foreign workers are now undergoing aggressive testing. Majority of the infected people have been identified.
b. Batch 2 - Foreign workers outside the dorms are undergoing tests now concurrently - and this form the 2nd largest group after the dorms reported every day.
c. Batch 3 --- Note :- the community local transmission and the unlink cases that are reported everyday --- are coming from this group.
But this group are all the residents in Singapore - citizens, PRs, Long Term Pass Holders. --- which form about 3 to 4 million people.
To conduct aggressive testings to this large pool of people to weed out the 30 to 20 over cases --- will be a challenge.
So I suggest we do the following :-
(i) Batch 3a - Test all essential workers that are working now - as some unlink cases come from this batch - about 300,000 workers.
Batch 3b - Test all nursing homes - where some unlink cases - have been uncovered through this batch - number unknown - but not a big number, I guess.
Batch 3c - Test all pre-school students and staff who will be attending pre-school once circuit breaker ends - as some cases also come from this batch - number unknown --- but i guess quite a big number.
Batch 3d - Test all workers that will be going to work for non-essential services when circuit breakers end - as few cases are reported from this group - a big number - potentially about 1 to 2 million workers?
Batch 3e - Test all school going children eg. primary, secondary, JCs, IHLs - that need to go to schools and pose a risk of cross infection - before circuit breaker ends - potentially about 1 to 2 million students?
(ii) Note :- by testing all the Batch 3a to 3e ---- if there is any discovered cases --- their family members or those living with them or come into with them will be tested --- and these will have weed out the unlink cases.
(iii) Can we take the risk of not testing all those staying at home --- yes i think we can --- because if the above batches are tested - with no infection - very likely that those stay at home are not infected.
(iv) If anyone of the tested batchs have people infected, then likely that those stay with them will be infected - and this stay at home can be tested.
(v) Believe in this way --- we have a systematic aggressive way of testings to weed out all the unlink cases in the Community.
[2:06 pm, 27/04/2020] +65 9661 0607: Right move or else our hospital will not be able to handle!
[2:08 pm, 27/04/2020] +65 9722 9465: Good move so that capacity in our public hospitals can be use for more serious cases
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[2:11 pm, 27/04/2020] ☸️ Danny 心:
The above 5 part approach will generate alot of mild asymptomatic cases in the thousands that will overwhelm the hospital resources.
Thus setting up mass isolation facilities to commensurate with aggressive testing will be required as more mild asymptomatic cases will be uncovered and need to isolate them with no active medical intervention required.
This is in preparation for opening up the circuit breaker measures while ramping up the testing.
Rama
[2:12 pm, 27/04/2020] : Agree
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Elena Woo
[5:14 pm, 27/04/2020] : I have been suggestive for community testing weeks ago... 🤷🏻♀️
[6:53 pm, 27/04/2020] ☸️ Danny 心:
(1) When planning to conduct aggressive testing in community, which is about 4 million or more people - there is a need for the Government to plan ahead to beef up the supporting infrastructure such as :-
a. Sufficient medical personnel to conduct the tests
b. Sufficient test kits to conduct the tests.
c. Sufficient lab capacity to determine the test result
d. If diagnose positive, enough hospital resources, isolation facilities to house them - we are talking about ramping up spaces, wi-fi, bed, toilet, security, medical care, logistics, food, medicine, ambulance services etc
e. preempt false negatives test result
f. ramping up construction and setup isolation facilities, activate private medical resources (eg. SingExpo - from Raffles Medical Group) etc.
(2) All the above require tremendous planning, resources, personnel and logistic not to mention money to do it --- and at the back of the mind --- not to overwhelm ICU and ventilators in hospital --- that are required to save lives.
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REACH
[6:27 pm, 27/04/2020] : MP Seah Kian Peng explains visit to market after Facebook post on 'playing role of safe distancing ambassador'
Member of Parliament Seah Kian Peng has explained why he was out and about at his constituency on Sunday (Apr 26), after netizens questioned his Facebook post that said he was "playing the role of a safe distancing ambassador".
More: https://www.channelnewsasia.com/news/singapore/seah-kian-peng-explains-facebook-post-safe-distancing-ambassador-12680270
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[7:14 pm, 27/04/2020] ☸️ Danny 心:
(1) I am not trying to defend MP Seah for visiting NTUC, the wet market and feel the pulse of how the food supply is being provision to the supermarket and markets.
(2) The reason being, many people have noticed that quite a number of food like noodles, vegetables, fruits, eggs, chicken, pork and some essentials like toilet paper, detergents, softeners etc --- are quickly being snapped out and though there are attempt to quickly re-supply and re-fill the stocks --- the situation are no longer the same before the virus pandemic hit.
(3) As Chief of NTUC, who has direct responsibility in working with international suppliers for food and essential, working with the Minister MTI to negotiate food and essential supplies - to ensure the people like us - have access to essential food and goods ---- it is not too much for this MP to visit the NTUC supermarket, markets and talk to people (with face masks and safe distancing) ---- to feel the ground.
(4) This MP is not an ordinary MP --- but is also an important person to ensure the ground has sufficient essential food supply and good supply --- to prevent hoarding, insufficient good and food --- and he can only get this information by walking the ground and talk to relevant people --- with safe distancing and face mask.
(5) So let us not be harsh in the criticism --- if we emphatise with his role as NTUC Chief.
Rama
[7:25 pm, 27/04/2020] : Understand
[7:31 pm, 27/04/2020] ☸️ Danny 心:
(1) We are lucky that NTUC has no "run out of stock" or "empty shelves for food and essential goods" --- and even though when such instances do occur --- they are quickly replenish --- due to NTUC good planning, stockpiles and smart sourcing from hundred and thousands of suppliers from many Countries.
(2) We should be grateful and give him as well as MTI the due credit --- to keep our food and good supplies in good stead - despite many lockdown all over the World.
[7:35 pm, 27/04/2020] ☸️ Danny 心:
(1) We must be careful not to shoot down the Generals and frontliners who are working very hard at the frontline - to protect us and keep us going.
Ron Ho
[7:36 pm, 27/04/2020] : What you said is absolutely correct and apt. Kian Peng is chief of Fairprice and has to see the ground for himself. Fully support his actions. He is a good man, excellent MP and full of heart for the people.
Rama
[7:38 pm, 27/04/2020] : Agree
Ron Ho
[7:44 pm, 27/04/2020] : Let me quote some data from CNA report attached and ST this evening. ST said that we have 323,000 FW living in dorms. ST said 11,419 tested positive and they said this is 3.5% of the FW population in Dorms (this % is not relevant in my opinion). CNA said ,according to Mr Gan, we are testing around 3000 daily and have tested some 21,000 FW. Hence, if I put the two sets of reports together, 21,000 tested and 11,419 found infected. This means infection rate is 54% (not what 25% we estimated it to be before). Obviously, we have a problem of having no isolation beds for those tested positive. If we increase testing, we will run out of beds. If we dont, we run the risk of more spreading of infection due to no isolation. That is how I read it. Hope REACH can get authorities to provide, daily, how many tested among FW and how many positive so we dont have to calculate the data and may perhaps be wrong.
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[8:21 pm, 27/04/2020] ☸️ Danny 心:
Part 1 - Testing of Essential Service workers
CNA
27 Apr 2020 07:59PM
(Updated: 27 Apr 2020 08:08PM)
Scaling up the capacity to test for COVID-19 will be a “key enabler” for Singapore to move beyond the “circuit breaker” period, said Minister for National Development Lawrence Wong on Monday (Apr 27).
Speaking at a press conference, Mr Wong said that authorities are starting to test essential workers - such as those in healthcare and in nursing homes - more regularly, particularly those who work with the vulnerable and senior citizens.
Describing this aspect of testing as “critical” as Singapore plans for a phase beyond the circuit breaker, Mr Wong said: “Eventually we will want to gradually relax our restrictions as our community cases come down and resume activities. This needs to be done in a safe manner without us risking new infection clusters from forming.
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[6:30 pm, 25/04/2020] ☸️ Danny 心:
c. Batch 3 --- Note :- the community local transmission and the unlink cases that are reported everyday --- are coming from this group.
But this group are all the residents in Singapore - citizens, PRs, Long Term Pass Holders. --- which form about 3 to 4 million people.
To conduct aggressive testings to this large pool of people to weed out the 30 to 20 over cases --- will be a challenge.
So I suggest we do the following :-
(i) Batch 3a - Test all essential workers that are working now - as some unlink cases come from this batch - about 300,000 workers.
My close friend response :-
(1) It's about maximising outcomes, minimising disasters. unless we are poor and cannot afford it. Economic shut costs much much more.
[8:25 pm, 27/04/2020] ☸️ Danny 心:
Part 2 - Maintain Social Distancing
CNA
27 Apr 2020 07:59PM
(Updated: 27 Apr 2020 08:08PM)
While testing is a key component of Singapore's strategy, Mr Wong stressed that it “cannot be a substitute” for personal responsibility like practising good hygiene and taking safe distancing measures seriously.
For essential workers, they must continue to take precautions, he added. This includes minimising contact with colleagues throughout the day.
---
Thus the following social distancing measures will still need to be put in place - when circuit breaker period end :-
(1) Compulsory for all to put on reusable washable face mask when step out of the home.
Everyone at work and in schools - need to put on face mask - to prevent cross-infection among different family household.
The resusable washable face mask --- must be the last line of defense as "Personal Social Distancing Tool" - the last mile protection.
(2) 1 metre apart queuing as social distancing measure must also be in place - in public areas (except PT such as bus or MRT - maybe difficult - and have to rely on face mask as the last mile "Personal Social Distancing tool").
(3) Maintain personal hygiene - by washing hands with soap or sanitizer make widely available.
[8:34 pm, 27/04/2020] ☸️ Danny 心: ---
Part 3 - Safeguard against unlink cases in the Community
CNA
27 Apr 2020 07:59PM
(Updated: 27 Apr 2020 08:08PM)
Health Minister Gan Kim Yong noted that the presence of unlinked cases means that there is still underlying COVID-19 transmission in the community that has not been detected.
“Because these cases have to come from someone, and that someone has not been identified. And therefore, we have to bear in mind that they will always be transmission that is ongoing in the community," he cautioned.
While there may “still be some risks” with undetected cases in the community, Singapore has to manage and reduce the risk before the circuit breaker measures can be opened up or reduced, he added.
“Even as we remove the circuit breaker measures, we need to do it progressively. We need to do so in a safe way to prevent the resurgence of new cases and new clusters, which will be another problem again,” said Mr Gan.
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[2:57 pm, 26/04/2020] ☸️ Danny 心:
If local transmission drops consistently to single digits and to zero for consecutive period of time, and when circuit breakers period end ---- suggest that the following are the recommended social distancing measures will still need to be put in place.
(1) Compulsory for all to put on reusable washable face mask when step out of the home.
Everyone at work and in schools - need to put on face mask - to prevent cross-infection among different family household.
The resusable washable face mask --- must be the last line of defense as "Personal Social Distancing Tool" - the last mile protection.
(2) 1 metre apart queuing as social distancing measure must also be in place - in public areas (except PT such as bus or MRT - maybe difficult - and have to rely on face mask as the last mile "Personal Social Distancing tool").
(3) Maintain personal hygiene - by washing hands with soap or sanitizer make widely available.
(4) For crowded areas like mall, supermarkets etc ---- crowd control will still be required.
(5) Eat-in in food court, coffeshop, restaurant - must still be disallowed.
Only allow "ta bao" (packet breakfast, tea-break, lunch or dinner) even when circuit breaker ends. Because when we eat, everyone needs to remove their mask.
And then You eat, I eat. You talk I talk, saliva drop ---- and it defeat the purpose of wearing mask - and if anyone infected - community spreading will start again - as it is the most likely source of cross infection --- that will make contact tracing very difficult - as many strangers meet.
(6) When slowly opening place of worship - all the above social distancing measures must be implemented.
The reasons being :-
a. No vaccines are available yet.
b. Even for those who have been infected, signs show that they can be re-infected again as their anti-bodies does not guarantee no subsequent infections - whether by the same strain of virus or different mutated strain.
c. Standard treatment are still not available.
[6:31 pm, 22/04/2020] ☸️ Danny 心:
(6) So it is important to be on guard all the time and should not allow a lapse of complacency to derail all the efforts of tackling the virus - as this virus will pounce given 1/2 chance.
[3:23 pm, 22/04/2020] ☸️ Danny 心:
(2) He say when a person tested negative for 4 days, the next 4 days, virus load could then surface indicating that he could be infected and able to start infecting others.
(3) This virus is a very sneaky enemy.
[8:45 pm, 27/04/2020] ☸️ Danny 心:
---
Part 4 - Bring infection down to single digit consistently and to zero
CNA
27 Apr 2020 07:59PM
(Updated: 27 Apr 2020 08:08PM)
He added that authorities are trying to get the number of community cases down to a single digit.
"It is not there yet - not just single digit in one day but consistently over a period of time," he said. "If we all do our part, I am confident we can achieve this. When this happens, we will gradually ease up measures and resume activities."
--
[6:30 pm, 25/04/2020] ☸️ Danny 心:
We put a caveat to the systematic testing.
If the community spreading and local transmission consistently drop into single digits to zero, then we suggest not begin with the systematic testing - as the Stay at Home and social distancing have shown 100% effective and can dispense with aggressive testing.
However, suggest that we should continue testing for those who are in dorm as well as those foreign workers who are not in dorm as they are still many reported cases.
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[8:49 pm, 27/04/2020] ☸️ Danny 心:
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Part 5 - One lapse will introduce 1 new cluster
CNA
27 Apr 2020 07:59PM
(Updated: 27 Apr 2020 08:08PM)
Mr Wong also stressed that individuals still need to exercise personal and social responsibility even after the circuit breaker.
“We should still try very hard to minimise our social interactions because it only takes one person, interacting in a group in close quarters with many people to cause another cluster from happening,” he said.
“While we can do more tests and we want to do more regular tests, testing is never going to be 100 per cent,” Mr Wong added. “It only takes that one person, that one missed test, that may be infected to cause new clusters from happening.”
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[6:31 pm, 22/04/2020] ☸️ Danny 心:
(6) So it is important to be on guard all the time and should not allow a lapse of complacency to derail all the efforts of tackling the virus - as this virus will pounce given 1/2 chance.
[3:23 pm, 22/04/2020] ☸️ Danny 心:
(2) He say when a person tested negative for 4 days, the next 4 days, virus load could then surface indicating that he could be infected and able to start infecting others.
(3) This virus is a very sneaky enemy.
--
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