Singapore — With 27 deaths out of the more than 57,000 people infected with Covid-19 since the pandemic started, Singapore has one of the lowest case fatality rates around the globe. The worldwide average death rate is 3 per cent, based on data from Reuters of countries that have had more than 1,000 Covid-19 cases.
In Singapore, the fatality rate is far below that at 0.05 per cent.
When compared to countries with a similar number of people, this becomes even more stark. Singapore has around 5.639 million people, 57,532 infections (as at Sept 18) and 27 deaths. Finland has 5.518 million people, 8,799 infections and 337 deaths. Denmark has 5.806 million, 21,393 infections and 635 deaths.
Hong Kong’s case fatality rate, which was very low at the beginning of the pandemic, has now surpassed Singapore’s. The city, which has a population of 7.451 million, has had 4,994 infections and 102 deaths, seeing a spike in both due to the third wave of infections in July.
Another notable fact about Singapore’s handling of the pandemic is that there have been no Covid-19 deaths in the past two months.
Its extremely low death rate can be explained by the following:
1. The demographic of people infected
Since 95 per cent of infections occurred among relatively young and healthy migrant workers, this has kept the death rate low. This followed global trends of younger patients generally not falling as ill as older ones.
2. Aggressive contact tracing and testing
Reuters reported that Singapore has been praised for its thorough contact tracing and testing methods by the World Health Organization (WHO). The country has one of the highest per-capita rates of Covid-19 testing around the world, with more than 15 per cent of the population having undergone a swab test.
The news agency quotes Dr Li Yang at the Saw Swee Hock School of Public Health at the National University of Singapore as saying: “The more we diagnose, then the lower the mortality rate is.”
As for migrant workers living in the purpose-built dormitories where most of the infections were found and spread, residents have been placed on a rostered testing schedule. And vulnerable members of the community have had easy access to testing as well.
3. Medical treatment and care
The hospitalisation of infected persons over 45 years old or who have co-morbidities was practised in Singapore, regardless of whether the patient was symptomatic.
A senior consultant at Singapore’s National University Hospital, Dr Dale Fisher, called the patient care for such patients “conventional but done well”, with “fluid management, anticoagulation and both proven drugs and participation in drug trials”.
Unlike in other countries, Singapore’s hospital systems have never been overwhelmed by the number of Covid-19 patients, which allowed for resources to be directed to helping those who were seriously ill. There have been no Covid-19 patients in intensive care for some time now.
4. Mask culture
Singaporeans have been required to wear masks in public since April, helping curb the spread of the infection, especially on a community level. Studies have shown the effectiveness in reducing not only the rates of infection but also the severity of the illness of those infected.
5. Classification of Covid-19 deaths
Only patients who qualify under the definition from the WHO as Covid-19 deaths have been considered as such, which excludes a number of patients who had been infected with Covid-19 but died of causes related to heart or blood issues.
The National University of Singapore’s Dr Paul Tambyah, Secretary-General of the Asia Pacific Society of Clinical Microbiology and Infection and Chairman of the Singapore Democratic Party, is quoted by Reuters as saying: “I have no doubt that if the WHO revises its case definitions, some of the non-pneumonia deaths will be reclassified and the mortality rate will change.” /TISG