2021年8月,新加坡成为全球首个放弃“清零政策”、转而选择“与病毒共存”的国家。但为了与病毒“共存”,该国国民只得生活在极度警惕的状态之中。
在新冠疫情爆发18个月后,新加坡政府首次放开入境隔离要求,一开始只有两个国家可以享受这种待遇,截至2021年12月,这一数字已经增加到24个,不过需要注意的是,并非所有从上述24个国家起飞的航班均无需进行检疫隔离。与此同时,该国国内依然执行着部分管制措施。无论身处室内还是室外,新加坡民众都必须佩戴口罩,无论前往何处,都必须使用接触追踪技术(采集位置信息),并且不能举行超过5个人的聚会。政府的确放宽了部分新冠管控政策,但在日常生活中依然能够感受这些政策的影响。
如今,新加坡的国内疫情正在失控边缘徘徊。2021年12月初,该国发现了首例奥密克戎变异毒株病例,此后,确诊病例数一路飙升。截至1月17日,新加坡单日新增确认病例已经达到1000例之多,而在本月早些时候,该国卫生部预测,到2月,单日新增确诊病例将进一步攀升至1万例至2万例。也有人认为这个数字甚至可能还会更高。
亚历克斯·库克是新加坡苏瑞福公共卫生学院(Singapore's Saw Swee Hock School of Public Health)的副教授,擅长构建病毒传播模型,他说:“澳大利亚的疫情一直在极高位置运行,我不觉得新加坡会有什么不同。”澳、新两国均有超过90%的成年人已经完成新冠疫苗的接种,另有40%的成年人接种了加强针。库克称,澳大利亚的感染率“相当于新加坡单日新增约3万例”。
与其他许多国家相比,这些数字或许“不值一提”,但对新加坡来说,却已经堪称“天文数字”。2020年8月至2021年8月期间,新加坡日均感染人数仅30例出头,而且其中大部分感染者为海外归国人士。与2021年由德尔塔变异毒株引发的新冠疫情相比,奥密克戎变异毒株的新冠疫情高峰预计将高出十倍之多,新加坡政府甚至因此收紧了管制措施。(例如,该国将人群聚集的规模上限从5人减少到了2人。)
那么,面对奥密克戎势不可挡的蔓延势头,新加坡又是如何应对的?在2021年11月下旬出现该变异毒株后,该国政府采取的似乎还是老一套新冠应对策略:猛踩刹车,暂时关闭面向已经接种新冠疫苗人士开通的绿色通道,使用救护车将所有阳性人员集中送往政府管控的设施之中,并对所有密接者进行隔离。在宣布新加坡决心与病毒共存之后,该国似乎又回到了2020年的黑暗时期。
但在做出此种最初反应之后,当局却出乎意料地放松了管制措施。出现这种变化主要有两方面的原因。首先,各方发现,与此前的毒株相比,奥密克戎的传染性虽然更强,但毒性却更低,导致感染者住院、死亡的可能性也大为降低。因此,新加坡卫生部有信心,即使这一波疫情确实达到了预期峰值,该国医疗系统,尤其是重症监护部门依然有能力满足病患的需求。
其次,由于国民大量感染的趋势已经明显不可避免,新加坡政府意识到,公立机构已经无法容纳所有的阳性感染者。于是,该国调整了自己的防疫措施,从政府管控过渡到自我监控。检测结果为阳性的相关人员不再像以前那样需要隔离14天,而是只需居家隔离三天,然后自助采用快速抗原检测试剂盒检测,如果检测结果为阴性,即可重回正常生活。阳性感染者的密切接触者只要连续一周每天检测结果都是阴性,就完全不需要进行隔离。与美国不同的是,在新加坡,快速抗原检测试剂盒的覆盖非常广泛,借助外卖、打车应用程序Grab,在30分钟之内即可送达。
依靠自助检测搜寻感染者意味着将会出现更多的“漏网之鱼”,但当局已经接受了这一现实。苏瑞福公共卫生学院负责全球卫生项目的副院长许励扬(Hsu Li Yang)表示:“奥密克戎变异毒株改变了决策者的想法,他们发现,该变异毒株的社区传播几乎无法避免。现在大家普遍认为,最终,所有人都将感染。”
在官方逐步放松管制措施的同时,公众似乎也放松了绷紧的神经。疫苗接种(有三分之二的新加坡人认为,疫苗接种应该强制推行)降低了民众对新冠肺炎的恐惧。近来一段时间,政府通过整版报纸广告和公共电台对相关政策调整进行了大力宣传。当地一家名为政策研究所(Institute of Policy Studies)的智库最近进行的一项调查显示,有60%的受访者支持当局最近对隔离、检测政策做出的调整。
不过还有两个挥之不去的未知因素值得我们注意。首先,没有人可以保证有关奥密克戎变异毒株感染人数的预测一定准确。库克表示,通过观察其他国家的情况,我们只能在一定程度上对该变异毒株在新加坡的发展轨迹做出评估。另一不确定之处在于,目前无人知晓奥密克戎是否会扰乱医疗系统的正常运行。英国就有过沉痛的教训,虽然入院人数仍然在可控范围之内,但由于奥密克戎造成许多医务工作者无法正常工作,病患可能依然无法得到足够照护。在感染者遍布各处的情况下,使用接触追踪应用程序(搜寻疑似病例)、限制群聚人数似乎显得有些多余,但政府将暂时保留这些措施,冀望相关限制措施能够在短期内缓解相关风险。
但从长远来看,这一波奥密克戎疫情或将带领新加坡重返正常轨道。库克称,在本地传播真正开始之后,输入病例对感染人数的影响将变得微乎其微。在此情况之下,他说:“我认为,届时我们将没有理由继续限制跨国旅行。”
而在各项国内限制措施方面,如果有相当比例的民众感染奥密克戎变异毒株,并因此获得更强的免疫力,那么继续保持现有措施的理由也将变得不再那么有说服力。库克说:“我预计,如果奥密克戎的威胁可以减弱,或者疫情能够见顶,又或者当地数据可以让我们确信医疗系统不会因为相关疫情而崩溃,则各项国内限制措施将会逐步放宽。在承受两年管控之苦后,此种政策转向将给我们一个可喜的喘息机会。”(财富中文网)
译者:梁宇
审校:夏林
2021年8月,新加坡成为全球首个放弃“清零政策”、转而选择“与病毒共存”的国家。但为了与病毒“共存”,该国国民只得生活在极度警惕的状态之中。
在新冠疫情爆发18个月后,新加坡政府首次放开入境隔离要求,一开始只有两个国家可以享受这种待遇,截至2021年12月,这一数字已经增加到24个,不过需要注意的是,并非所有从上述24个国家起飞的航班均无需进行检疫隔离。与此同时,该国国内依然执行着部分管制措施。无论身处室内还是室外,新加坡民众都必须佩戴口罩,无论前往何处,都必须使用接触追踪技术(采集位置信息),并且不能举行超过5个人的聚会。政府的确放宽了部分新冠管控政策,但在日常生活中依然能够感受这些政策的影响。
如今,新加坡的国内疫情正在失控边缘徘徊。2021年12月初,该国发现了首例奥密克戎变异毒株病例,此后,确诊病例数一路飙升。截至1月17日,新加坡单日新增确认病例已经达到1000例之多,而在本月早些时候,该国卫生部预测,到2月,单日新增确诊病例将进一步攀升至1万例至2万例。也有人认为这个数字甚至可能还会更高。
亚历克斯·库克是新加坡苏瑞福公共卫生学院(Singapore's Saw Swee Hock School of Public Health)的副教授,擅长构建病毒传播模型,他说:“澳大利亚的疫情一直在极高位置运行,我不觉得新加坡会有什么不同。”澳、新两国均有超过90%的成年人已经完成新冠疫苗的接种,另有40%的成年人接种了加强针。库克称,澳大利亚的感染率“相当于新加坡单日新增约3万例”。
与其他许多国家相比,这些数字或许“不值一提”,但对新加坡来说,却已经堪称“天文数字”。2020年8月至2021年8月期间,新加坡日均感染人数仅30例出头,而且其中大部分感染者为海外归国人士。与2021年由德尔塔变异毒株引发的新冠疫情相比,奥密克戎变异毒株的新冠疫情高峰预计将高出十倍之多,新加坡政府甚至因此收紧了管制措施。(例如,该国将人群聚集的规模上限从5人减少到了2人。)
那么,面对奥密克戎势不可挡的蔓延势头,新加坡又是如何应对的?在2021年11月下旬出现该变异毒株后,该国政府采取的似乎还是老一套新冠应对策略:猛踩刹车,暂时关闭面向已经接种新冠疫苗人士开通的绿色通道,使用救护车将所有阳性人员集中送往政府管控的设施之中,并对所有密接者进行隔离。在宣布新加坡决心与病毒共存之后,该国似乎又回到了2020年的黑暗时期。
但在做出此种最初反应之后,当局却出乎意料地放松了管制措施。出现这种变化主要有两方面的原因。首先,各方发现,与此前的毒株相比,奥密克戎的传染性虽然更强,但毒性却更低,导致感染者住院、死亡的可能性也大为降低。因此,新加坡卫生部有信心,即使这一波疫情确实达到了预期峰值,该国医疗系统,尤其是重症监护部门依然有能力满足病患的需求。
其次,由于国民大量感染的趋势已经明显不可避免,新加坡政府意识到,公立机构已经无法容纳所有的阳性感染者。于是,该国调整了自己的防疫措施,从政府管控过渡到自我监控。检测结果为阳性的相关人员不再像以前那样需要隔离14天,而是只需居家隔离三天,然后自助采用快速抗原检测试剂盒检测,如果检测结果为阴性,即可重回正常生活。阳性感染者的密切接触者只要连续一周每天检测结果都是阴性,就完全不需要进行隔离。与美国不同的是,在新加坡,快速抗原检测试剂盒的覆盖非常广泛,借助外卖、打车应用程序Grab,在30分钟之内即可送达。
依靠自助检测搜寻感染者意味着将会出现更多的“漏网之鱼”,但当局已经接受了这一现实。苏瑞福公共卫生学院负责全球卫生项目的副院长许励扬(Hsu Li Yang)表示:“奥密克戎变异毒株改变了决策者的想法,他们发现,该变异毒株的社区传播几乎无法避免。现在大家普遍认为,最终,所有人都将感染。”
在官方逐步放松管制措施的同时,公众似乎也放松了绷紧的神经。疫苗接种(有三分之二的新加坡人认为,疫苗接种应该强制推行)降低了民众对新冠肺炎的恐惧。近来一段时间,政府通过整版报纸广告和公共电台对相关政策调整进行了大力宣传。当地一家名为政策研究所(Institute of Policy Studies)的智库最近进行的一项调查显示,有60%的受访者支持当局最近对隔离、检测政策做出的调整。
不过还有两个挥之不去的未知因素值得我们注意。首先,没有人可以保证有关奥密克戎变异毒株感染人数的预测一定准确。库克表示,通过观察其他国家的情况,我们只能在一定程度上对该变异毒株在新加坡的发展轨迹做出评估。另一不确定之处在于,目前无人知晓奥密克戎是否会扰乱医疗系统的正常运行。英国就有过沉痛的教训,虽然入院人数仍然在可控范围之内,但由于奥密克戎造成许多医务工作者无法正常工作,病患可能依然无法得到足够照护。在感染者遍布各处的情况下,使用接触追踪应用程序(搜寻疑似病例)、限制群聚人数似乎显得有些多余,但政府将暂时保留这些措施,冀望相关限制措施能够在短期内缓解相关风险。
但从长远来看,这一波奥密克戎疫情或将带领新加坡重返正常轨道。库克称,在本地传播真正开始之后,输入病例对感染人数的影响将变得微乎其微。在此情况之下,他说:“我认为,届时我们将没有理由继续限制跨国旅行。”
而在各项国内限制措施方面,如果有相当比例的民众感染奥密克戎变异毒株,并因此获得更强的免疫力,那么继续保持现有措施的理由也将变得不再那么有说服力。库克说:“我预计,如果奥密克戎的威胁可以减弱,或者疫情能够见顶,又或者当地数据可以让我们确信医疗系统不会因为相关疫情而崩溃,则各项国内限制措施将会逐步放宽。在承受两年管控之苦后,此种政策转向将给我们一个可喜的喘息机会。”(财富中文网)
译者:梁宇
审校:夏林
Last August, Singapore became the first country in the world to pivot from a zero-tolerance approach to COVID-19 to a strategy of living with the virus. “Living,” however, meant existing in a state of extreme watchfulness.
The government introduced quarantine-free travel for the first time in 18 months, but the scheme began with only two countries, expanded to just 24 by December, and didn’t apply to every flight from those destinations. Meanwhile, some domestic restrictions remained in place. Singaporeans still had to wear masks indoors and out, were required to use contact-tracing technology wherever they went, and could not meet in groups larger than five. The government may have relaxed its policy of stamping out COVID, but its foot still loomed over everyday life.
Now Singapore is facing the prospect of losing control of COVID. The country detected its first cases of the Omicron variant in early December, and since then the numbers have been rising fast. As of January 17, Singapore was reporting 1,000 new cases a day, but earlier this month, the Ministry of Health predicted that figure would climb to between 10,000 and 20,000 by February. Others think the number may go higher.
"When we look at Australia, it's off the charts, and I don't see why it would be different here," says Alex Cook, an associate professor at Singapore's Saw Swee Hock School of Public Health, who models the spread of the virus. Both countries have vaccinated over 90% of adults, and around 40% have had a booster. Australia’s rate of infection “would translate to about 30,000 cases a day in Singapore,” Cook says.
Compared to many other countries, those numbers are paltry, but for Singapore they're vast. Between August 2020 and August 2021, average daily infections barely topped 30, and most of those were among residents returning from overseas who quarantined upon arrival. The height of Singapore’s Delta wave in October and November last year was 10 times lower than the predicted peak of Omicron, and even that surge led the government to tighten restrictions. (It limited group size to two, down from five, for example.)
So how will the country react to Omicron's unstoppable spread? After the variant emerged in late November, the government seemed to follow its usual pandemic playbook: It slammed on the brakes, suspending the vaccinated travel lanes, sending anyone who tested positive to a government facility by ambulance, and isolating all their close contacts. Singapore, which had announced its determination to live with the virus, seemed to be heading back to the dark days of 2020.
But since that initial reaction, authorities have become surprisingly relaxed. There are two main reasons for the shift. First, the world has learned that Omicron is more infectious but less virulent than previous strains, and far less likely to lead to hospitalization and death. Singapore's Ministry of Health is confident that even if the wave rises as expected, the health care system, and, in particular, intensive care capacity can tolerate the demand.
Second, as the inevitable scale of infection became obvious, the government realized it had no hope of accommodating positive cases in state-run facilities. Its approach has transitioned from government control to self-control. If you test positive, you are no longer required to quarantine for 14 days, as before. Now you can stay at home for three days, and then return to normal as soon as you test negative with a self-administered rapid antigen test. Close contacts of positive cases can forgo quarantine altogether provided they test negative each day for a week. In Singapore, unlike in the U.S., rapid tests are widely available and can be delivered within 30 minutes by Grab, a ride-hailing and food-delivery app.
The reliance on self-testing will mean more cases slip through the net, but the authorities have accepted this reality. “Omicron has changed the minds of policymakers,” says Hsu Li Yang, vice dean of global health at the Saw Swee Hock School. “They see that it's almost impossible to stop it from spreading in the community. The current thinking is that everyone will get infected eventually."
The public appears to be loosening up along with officials. Vaccination, which more than two-thirds of Singaporeans thought should be mandatory, has made them less fearful of the disease. A recent survey by the Institute of Policy Studies (IPS), a local think tank, shows 60% support for the recent changes to quarantine and testing, which have been heavily promoted in full-page newspaper adverts and on public radio.
Two lingering unknowns remain, however. For one, there’s no guarantee predictions of Omicron’s spread will be accurate. Its trajectory in Singapore "can only partially be assessed by watching how it affects other countries," Cook says. Whether or not Omicron disrupts the health care system is another uncertainty. As countries like the U.K. have learned the hard way, even if hospital admissions are manageable, Omicron-related absences among hospital staff can create gaps in care. In a world of widespread infection, contact-tracing apps and limits on group sizes may seem redundant. But the government will keep them in place for now, hoping its restrictions will mitigate these risks in the short term.
But in the longer term, the Omicron wave may carry Singapore back to the shores of normality. According to Cook, once local transmission really takes off, imported cases make a negligible difference to the numbers. In that situation, he says, "I don't see a reason to continue to restrict international travel."
As for domestic restrictions, if Omicron leads to widespread infection and increased immunity, the case for keeping them in place weakens. "I would anticipate that once the threat of Omicron has abated, either because the wave has peaked or the local data give us confidence the health care system won't be overwhelmed, domestic restrictions will be pared back," Cook says. "That would give a welcome respite from the last two years."