The situation in Singapore is simple. 80-90% of all cases are from migrant workers who live in managed dorms. Close quarters. And the basic mantra of any epidemic goes, it only takes one person...
The numbers every day is through the roof. 96-98% of every confirmed daily case numbers has been from these dorms. They have been in lockdown for a month now so I am not sure why the migrant worker numbers aren't falling or falling significantly. It may be because of the increase in testing. I am told that they have tested at least 60% of the migrant worker population.
Meanwhile, community spread is like 2-10 people a day max for the past several weeks.
That actually skews the numbers dramatically when you remove the migrant workers' numbers. But nevertheless, after four months since the 1st case of Covid, the death toll has been low, at 21.
There is one key reason why the numbers are low: Institutional memory.
https://www.moh.gov.sg/docs/librari...erim-pandemic-plan-public-ver-_april-2014.pdf
There have been several lessons learnt from the past epidemics incl SARs.
1) Protect healthcare workers first and foremost. I think during the SARs epidemic, 43% of the victims/cases were healthcare workers. Now, the healthcare workers here have been told not to worry about PPEs. A friend of mine who is in the frontline told me that the CMO (Chief Medical Officer of the MOH) was very insistent that change your full PPE kit -- N95s, face shield, gloves, gowns, shoe covers etc every time you remove it when you have to pee, eat or otherwise. So she changes her full PPE kits like FOUR times a day.
Along with the PPEs, they have been stockpiling various medical equipment like ventilators, patient monitoring, tele/remote consulting and even pulse oximeters for years.
2) The system has been built for over-capacity. I have been told that its currently running at 20% capacity or thereabouts of available beds.
3) The reason why the beds capacity is not really taxed -- and in Singapore most ICU or hospitalised patients will have their own individual rooms is because of the segmentation of the patients.
Since at least 40% of patients are asymptomatic or some will be presymptomatic, they are initially put into large community care facilities -- converted exhibition halls like the size of the Excel --- or the chartering of the excess capacity from cruise ships -- to both do the step up and to step down management of the patients.
All of the above would ensure that patients in ICUs are ensured the maximum individualised quality of care which has kept the fatality rates low. There were no fatalities until seven weeks ago.
In fact, the deaths so far have been your stereotypical patients, elderly, preconditions etc. Nothing out of the initial playbook.