They had the vaccines and a plan to reopen. Instead, their feet got cold.

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The country’s experience has become a sobering case study for other countries pursuing reopening strategies without first having to deal with large epidemics during the pandemic. For residents of Singapore who thought the city-state would reopen once the vaccination rate hit a certain level, there was a whiplash feeling and nagging questions about what it would take to reopen if vaccines were not enough.

“In a way, we are victims of our own success, because we have reached the Covid level as close to zero as possible and a very, very low death rate,” said Dr Paul Tambyah, disease specialist. infectious at the National. University Hospital. “So we want to keep the leading position of the class, and that’s very difficult to do.”

Singapore’s cautious, if not overly cautious, approach to reopening contrasts with that of the United States and Europe, where vaccinated people already congregate at concerts, festivals and other big events. But unlike Singapore, these two places had to deal with significant epidemics at the start of the pandemic.

Lawrence Wong, Singapore’s finance minister and chairman of the country’s Covid-19 task force, said the lesson for ‘naive Covid companies’ like Singapore, New Zealand and Australia is to be prepared for large waves of infections, “regardless of vaccine coverage.”

“Once you open up, more social interactions will occur,” he said. “And given the inherently highly transmissible nature of the Delta variant, you will get big emerging clusters.”

Vaccines kept most of the population out of hospital, with 98.4% of cases showing mild or no symptoms. Deaths have occurred mainly in the elderly, usually with co-morbidities, and represent 0.2% of cases in the past 28 days. But injections cannot protect against infection, especially the Delta variant, Wong said.

“In Singapore, we believe that you can’t just rely on vaccines during this middle phase,” he said. “And that’s why we don’t plan an approach where we reopen in a big bang way and just declare freedom.”

The country is expected to review its restrictions on Monday, two weeks after they were put in place, and make adjustments based on the situation in the community. For Mr Wong, a vision of how the pandemic could unfold in Singapore and elsewhere would include face masks, limited travel and social distancing, possibly until 2024.

He stressed that Singapore is still on track to live with Covid and said he recognizes that any form of tightening, however small, will spark anger and frustration because people are eager to move on. “But we have to adjust according to the realities, according to the situation we are facing,” he said.

Authorities rushed to set up community treatment facilities with oxygen tanks last month and asked people with mild or no symptoms to recover at home. Many Singaporeans said there was confusion over what to do and the government appeared ill-prepared.

“If the healthcare system is overwhelmed, that’s when we know from experience everywhere that doctors are unable to cope and death rates start to rise,” Wong said. “So we are trying very hard to avoid that.”

Several doctors have challenged the government’s claim that the health care system is under enormous pressure. Dr Tambyah, who is also chairman of an opposition party that recently devised an alternative strategy to deal with the pandemic, said there was enough buffer in hospitals because Singapore had canceled all surgeries elective.

The problem for Singapore’s leaders, he said, is that they are “essentially making a transition from zero Covid to life with the virus.”

For many, repeated adjustments to restrictions have taken their toll. The number of suicides in 2020 was the highest since 2012, a trend some mental health experts have attributed to the pandemic. People called on the government to heed the mental health issues caused by the restrictions.

“It’s just economically, sociologically, emotionally and mentally unsustainable,” said Devadas Krishnadas, managing director of Future-Moves Group, a consultancy in Singapore. Mr Krishnadas said the decision to reintroduce the restrictions after reaching such a high vaccination rate had made the country an outlier in the world.

“And, most importantly, it moves Singapore 180 degrees, in the opposite direction to that of the rest of the world,” he said. “This brings us to the strategic question of where this will leave Singapore – if we don’t get out of what I call the hamster wheel of open and close.”

Angeline Ng, a marketing manager, says this year has been more difficult than the last. Before her father died in May, she had to overcome the strict limits of hospital visitors, which was emotionally trying. In July, the government’s announcement to tighten social restrictions again added to his weariness.

“I think most of the time we’re so focused on wanting to get good results that we just have tunnel vision,” she said.

Ms. Ng lives in front of a testing center. Almost daily, she has observed a constant flow of people getting tested, a strategy that many public health experts say is a waste of resources in such a highly vaccinated country.

“Freedom Day – as our ministers have said – is not Singaporean style,” said Jeremy Lim, associate professor at the National University of Singapore and health policy expert, referring to the reopening. from England this summer. But going too cautiously about the potential drawbacks of the restrictions is a “bad public health strategy,” he said.

The government must not wait for the reopening of perfect conditions, “because the world will never be perfect.” It’s so frustrating that politicians are almost waiting for better circumstances, ”said Dr Lim.

Sarah Chan, deputy director of the Singapore Agency for Science, Technology and Research, said she had a fleeting glimpse of normal life when she arrived in Italy last month to visit the her husband’s family.

No masks were required outside, vaccinated people could gather in groups, and Dr. Chan and his son could shake their heads to music in restaurants. In Singapore, music inside restaurants has been banned on the grounds that it could help spread the virus.

Dr Chan said she was so moved by her time in Italy that she cried.

“It’s almost normal. You forget what it is, she said. “I really miss it.”


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