March 10, 2020
Hopes of quick end to outbreak dashed as number of cases worldwide grows.
The number of people diagnosed with Covid-19 is growing around the world and, as the epicentre of the outbreak shifts away from China, it is unlikely that the disease will taper off the way that Sars did, experts said yesterday.
“We have to be mentally prepared that it is going to be here for months, if not even as a new normal – it is always going to be there with us,” said Associate Professor Kenneth Mak, director of medical services at the Ministry of Health (MOH).
Prof Mak was one of four experts who spoke to The Straits Times’ senior health correspondent Salma Khalik and also answered questions sent in by readers yesterday in an hour-long discussion which was broadcast live on the newspaper’s social media channels.
The other three experts on the panel were Associate Professor Hsu Li Yang, infectious diseases programme leader at the National University of Singapore’s Saw Swee Hock School of Public Health; Professor Leo Yee Sin, executive director of the National Centre for Infectious Diseases; and Professor Tikki Pangestu, a visiting professor at the Lee Kuan Yew School of Public Policy and former director of the World Health Organisation’s (WHO) research policy and cooperation department.
“The virus is here to stay at least until the end of the year,” said Prof Hsu, adding that with the growing number of cases around the world, hopes that the outbreak will be over by next month or May will be dashed. “I think what is increasingly clear is that the epicentre of the epidemic – which is a pandemic in all but name – has spread away from China and has moved to other parts of the world,” he said, pointing to the spread of cases from Iran to the Middle East, and from Italy to other parts of Europe.
Prof Pangestu pointed to three possible scenarios in the world’s battle to control the outbreak.
One, more countries will have outbreaks, including severe cases, and it will continue to be an emergency.
Two, the virus might “disappear completely”, similar to how Sars did, said Prof Pangestu, referring to the 2003 outbreak of the severe acute respiratory syndrome that claimed nearly 800 lives globally.
The third is that the virus becomes endemic, and mankind might have to live with its continued existence, like other viruses such as H1N1 or swine flu.
Prof Pangestu said: “The third scenario is what the WHO is thinking of. It is going to become part of our daily existence.”
Prof Leo said scenario two – that the virus can be “pushed back” – is unlikely to happen as the disease patterns are different.
She noted that Sars and Covid-19 spread differently, with patients with Covid-19 being able to spread the disease earlier.
This made containment a difficult task, she said. The different characteristics of the virus have to be considered in charting the trajectory of the future epidemic.
The Health Ministry’s Prof Mak stressed the importance of continued vigilance as well as personal hygiene, noting that there might be a need to change the way patients are managed if the number of cases continues to grow to free up hospital resources to treat other patients.
He said: “It may well be that when there are many cases in the community, we may have to look whether some patients with very mild disease might be safely managed in the community with adequate measures to isolate them and make sure they are safe and not spreading their illness to other people.”