Singapore’s Responses to the COVID-19 Outbreak: A Critical Assessment

Introduction

Over the past few months, the world has struggled desperately with the Coronavirus Disease 2019 (COVID-19) pandemic, which has caused untold damage in terms of both health and economic welfare. Compared with previous pandemics such as the Severe Acute Respiratory Syndrome (SARS) in 2003 and the H1N1 influenza in 2009, starkly higher rates of COVID-19 (re)infection, along with an alarming death toll among patients older than 60 years and those with chronic health conditions, have reinforced the need for much stronger and strategic government intervention to ensure effective public health-related initiatives (Koo et al., 2020). In turn, governments around the world have sacrificed major economic activity to implement a series of measures including intensive temperature screening, travel bans, contact tracing, and stay-at-home (quarantine) orders, not to mention compulsory mask-wearing and social distancing policies.

In view of the worldwide nature of this public health emergency and subsequent financial crisis, Singapore has not been spared. To manage the crisis, “learning” will be especially important for the city-state, both to measure the success of the crisis response and to inform new policies and procedures that may be applied to future incidents (Pearson & Clair, 1998; as cited in Moynihan, 2008, p. 350). We thus suggest that Singapore’s strategic response to the COVID-19 outbreak be classified into three phases of learning: in-between learning, trial-and-error learning, and contingency learning. This three-way classification reflects the extent to which the capacity-building efforts of a responding government and policy actors react to changing situations to manage and minimize potential disruptions or even suspension in public service delivery (see Supplemental Appendix A for a timeline of Singapore’s key chronological responses). Given that public policy choices hinge on the benefits derived from resource distribution given the various political forces at play, Singapore’s responses—and concomitant successes and failures—must be placed in the context of its unique political system and bureaucratic culture.

Singapore’s Political System: Understanding Its Structural Advantages and Disadvantages

The political system in Singapore has been described as a competitive authoritarian state or an illiberal democracy (Levitsky & Way, 2010; Mutalib, 2000). While regular elections take place, they differ notably from elections in the West, primarily in that various institutional impediments are put in place, such as the Party Block Vote system in the form of the Group Representation Constituencies (GRCs), which undermine the competitiveness of the opposition. In the GRC system, political parties must field four to six candidates to challenge in a constituency, increasing the barriers to entry for the opposition. The ruling People’s Action Party (PAP) thus has a distinct advantage, as it is able to marshal more resources to contest in these wards. The GRC ostensibly exists to ensure minority representation, as parties need at least one minority candidate in each GRC team. However, there is little doubt that the GRC system heavily favors PAP (Oliver & Ostwald, 2018), and indeed, the party has held power continuously since Singapore’s independence in 1965. Despite the unique features of Singaporean politics, however, elections are far from meaningless: voters genuinely can, and at times do, vote in the opposition in certain seats. Nevertheless, in addition to restrictions on individual liberties—such as strict regulations on freedom of speech in the name of maintaining racial harmony—in exchange for societal order, Singapore lacks both a confrontational media to hold the government to account and a vibrant civil society sector (Abdullah, 2018; Chua, 2017; George, 2012). Instead, civil society remains a peripheral force, only pursuing causes which the state allows, while the dominance of the PAP extends into almost every sphere of Singapore society, from the health care sector to personal habits (Ramesh, 2008).

All of these characteristics translate into a government with extensive leeway to limit individual freedoms with little popular pushback: as long as citizens’ material needs—economic prosperity and societal stability—are met, and then, the PAP will be the party of choice. The party does not campaign on its ability to provide individual liberties for Singaporeans; rather, its position is that the government has to make difficult decisions that may not be popular but that are best for Singapore in the long-run (Kausikan, 1997). A disciplined and law-abiding population has thus adopted a nonconfrontational sociopolitical culture.

This autonomy of the ruling party is reflected in numerous draconian laws, including the Protection from Online Falsehoods and Manipulation Act (POFMA), passed in 2019. The law, passed despite reservations from some academics and activists, authorizes the government to issue a correction order to any online posting, be it on social media or internet websites, or to order that the post be removed (Tham, 2019). POFMA is just one example of the government’s noted practice of passing legislation that risks curtailing individual freedoms but that is done in the name of the “greater good.”

This political system has produced successive generations of leaders more akin to technocrats than politicians, something in which the PAP takes pride (Rodan & Jayasuriya, 2007). The party is happy to concede that it has leaders who are not particularly adept at playing politics but who are instead more suited to designing good policies. To be sure, the fact that the PAP is more or less assured victory in most constituencies in every election does give it the leeway to field more technocratic candidates who may not necessarily be crowd-pullers or inspiring speakers. Coupled with the party’s emphasis on meritocracy—typically defined via academic achievements—and pragmatism, in terms of not being beholden to any particular ideology (K. P. Tan, 2008), the party has more often than not been able to adopt policies via a science- or data-based decision-making calculus, often viewed as a scientific management approach to bureaucratic and political decision-making (Jones & Brown, 1994). The technocratic approach to governance has been described as cold at times but can also effectively prioritize the best available science and evidence.

These structural conditions form the backdrop of the government’s response to any crisis, including the COVID-19 pandemic. We link this structure to Singapore’s bureaucracy before considering the three-phase approach to learning.

PAP and the Bureaucracy

Due to the wide-ranging power and influence of the PAP, the bureaucracy is inextricably linked to the ruling party. The bureaucracy has been shaped in the image of the ruling party, wielding its influence only as an arm of the party, unlike in countries where the ruling party alternates between two or more entities. In fact, many PAP leaders themselves came from the bureaucracy; the latter has always been seen as a useful breeding ground for aspiring politicians (Singh, 2017). The bureaucracy thus has a smooth relationship with the government, and the messaging from the ruling party rarely, if ever, differs from that of the bureaucratic machinery. In fact, people tend to view the party as the state and the civil service as synonymous with the government of the day. This synergy has been on display throughout the COVID-19 crisis. Senior health officials have appeared at press conferences with members of the Multi-Ministry Task Force, which comprises senior PAP leaders from the Fourth Generation (4G), and their messages have been completely consistent, unlike the evidence emerging from other nations such as the United States.

The centralized nature of authority in the country, coupled with the undisputed dominance of the PAP and its accompanying relationship with the bureaucracy, makes it particularly easy for the government to roll out new policies or, in some cases, to make almost daily changes to existing ones. The bureaucratic apparatus is ever-ready to implement these amendments, and the state-linked media has played an important role in disseminating the messages. For instance, when the decision was made overnight to enforce the wearing of masks (those who did not, except during exercising, were to be fined SGD300 for the first offense), the information was passed on quickly to most of the population. Apart from the structural advantages that being a city-state confers upon Singapore—its small size and highly wired population means that most people can be reached either through mainstream or online media—the factors discussed above help to guarantee that most citizens know what is required and act accordingly. There has been no significant outcry from the public to suggest that the policies may be too punitive; in fact, many citizens have become vigilantes of their own, urging others to stay home, with some even confronting those who do not wear masks. The point is not to glorify or justify such vigilantism; rather, it is to underscore that a culture of ceding liberties in the pursuit of the societal good has led citizens not only to accept such policies but often to enforce them on others.

The relationship between the government and the bureaucracy has ensured a smooth roll out of COVID-related policies more generally. Decisions on testing and contact tracing were all made by the government in tandem with input from public health officials, and there has been no indication that political calculations were prioritized at the expense of health officials’ recommendations. However, there were some complaints by medical professionals on the ground that the instructions were often too mechanical and that there was no communication of the thought processes behind the containment decisions. In the words of a medical professional based at the National Centre for Infectious Diseases:

It would help the people doing the screening for potential patients if we understood “the bigger picture,” and how our work is contributing to the efforts at containing this outbreak through these workflows/protocols. The people on the ground could even give feedback or suggestions on how to improve the protocols. ¹

The issue identified, however, does not represent a conflict of opinion between politicians and public health officials, but rather, the typically top-down method in which instructions are communicated in Singapore.

The Three-Phase Approach

During the first phase (late-January to mid-March), the Singapore government progressively made evidence-based decisions through “learning” from the past (e.g., the SARS outbreak) as well as concurrent international experiences from neighboring states (e.g., Malaysia and Taiwan). It is reasonable to argue that the Singapore government tackled the first phase effectively, in part because of the lessons it had learned from the SARS episode. When SARS first struck, medical professionals and public officials scrambled in disarray, leading to a lack of coordination between agencies. However, beginning with setting up a Multi-Ministry Taskforce and the National Centre for Infectious Diseases, the government’s initial responses to the COVID-19 outbreak facilitated inter-departmental cooperation and communication, ensuring that scientists also maintained a strong working relationship with the public health community. In addition, the government has notably improved its manner of engaging with citizens during the current pandemic. During the SARS outbreak, dissemination of information relied primarily on conventional media such as newspapers, radio, and TV broadcasts. Since then, the channels of social media and messaging applications have transformed communication, and the Singaporean government has taken advantage. For example, public agencies and leaders have engaged with citizens via WhatsApp, telegram, Facebook live, and YouTube to ensure that live updates reach further and enable citizens to remain updated on-the-go.

More notably, to curb virus-infected arrivals from China and subsequent local transmission within the community, Singapore, like other Asian nations, has sought effective control measures. For example, the government quickly undertook highly ordered, strategic policies toward social resilience (see Supplemental Appendix A). Since the first confirmed case in Singapore—imported from Wuhan via a 66-year-old Chinese citizen—was identified on January 23, the government has enforced numerous stepwise policies, which, chronologically, include extending temperature screening to all land and sea checkpoints; issuing a travel advisory against nonessential trips to all of China’s regions; implementing a 14-day quarantine notice (order) for visitors who traveled to Hubei Province (later extended to those who visited China at all); and then issuing a ban on entry and transit for all short-term visitors with a recent history in mainland China. In addition, as soon as the first cluster showing the likely rapid spread of the virus among the island’s communities emerged, the government raised the Disease Outbreak Response System Condition (DORSCON) ² from Yellow to Orange on February 7. The next day, Prime Minister Lee Hsien Loong’s first televised address underscored the seriousness of the evolving situation. Later, already having been praised by the World Health Organization (WHO) as a gold standard for crisis management, Singapore received remarkable global attention in the news media, along with Taiwan, South Korea, and Hong Kong, in tackling the early spread of COVID-19 from mainland China.

However, after facing the first two local COVID-related deaths (a 75-year-old Singaporean woman and a 64-year-old Indonesian) on March 21, 2020, Singapore’s globally lauded record waned. This began the second phase (mid-March to mid-April), a period during which the Singapore government began to struggle with managing the risks of local transmission of COVID-19. One notable decision was that despite an increase in the confirmed cases of returning travelers from abroad, the Ministry of Education (MOE) would proceed with reopening schools on March 23, saying that “[t]here is a body of scientific evidence showing that COVID-19 does not affect the young very much as compared to adults,” in the words of the Education Minister Ong We Kung (Shunmuganathan, 2020). Later, after new nontraceable cases of COVID-19 infections and secondary local transmission were observed within the community—especially, in churches, at least one conference-hosting hotel, and preschools—the MOE’s decision put policy actors in a dilemma. The government responded by closing borders to all visitors, banning all public events and mass gatherings, shutting all schools island-wide and moving classes online in a Home-Based Learning format. Furthermore, the Prime Minister announced a “Circuit Breaker” on April 3, which was to last until May 4, and which was then extended to June 1.

During this second phase, in addition to a Unity Budget that supported various schemes during the first phase, the government approved the Resilience and Solidary Budget of approximately SGD59.9 billion in total to provide financial relief (e.g., levy/rental waivers, tax rebates, and cash payouts) to businesses and workers affected by the crisis (Ho, 2020). Overall, the manner in which the Singapore government has implemented these more stringent control measures and subsequent financial relief and the way it has delivered the information to its people has been exceedingly top-down, consistent with its history and the sociopolitical culture.

From mid-April to early May, the third key phase, confirmed cases of COVID-19 in local communities increased substantially. Most notably, Singapore has witnessed dramatically accelerating new cases among foreign workers on a day-to-day basis. In response, the government has been gradually isolating the foreign workers’ dormitories and conducting mass testing with increasingly tighter surveillance and circuit breaker measures. Nevertheless, as of 8 May, work permit holders confirmed (or suspected) to have COVID-19 accounted for the overwhelming majority of cases, though none of the 20 deaths were classified as COVID-19 related. ³ Foreign worker dormitories thus became the major front in Singapore’s battle against COVID-19, turning this third phase into one of contingency learning. This was not a scenario that the government had necessarily prepared for, as its focus to that point had been on the nondormitory population.

Accordingly, the government’s planning and management system needed to redirect toward contingency plans to a greater extent than before, given the existing quarantine and medical facilities. Questions began to be raised by citizens on the treatment of migrant workers, as the spotlight was shone on their cramped living conditions. Singapore’s Ambassador-at-Large, Professor Tommy Koh, publicly stated that the way migrant workers had been treated was unacceptable (Daud, 2020). The packed nature of the dormitories, where workers were living in spaces in which close contact was unavoidable, created the context for an inevitable and dramatic rise in cases among this group.

Response Inadequacies: Structural Explanations

The structural factors that have helped Singapore in developing a solid response in its initial stages may also represent its Achilles’ heel. Donald Low, a Singaporean behavioral economist based in Hong Kong, identified three mistakes the government made. First was the assessment that COVID-19 was more similar to H1N1 than to SARS in severity; indeed, the Prime Minister had compared COVID-19 to the common flu in terms of its fatality rate in the initial stages. Second was the active discouragement of mask-wearing, a decision that the government eventually reversed. Minister Chan Chun Sing was even caught mocking, in a leaked video, Hong Kong Chief Executive Carrie Lam for wearing a mask to a press conference and inducing unnecessary panic (Daud & Wong, 2020). The third mistake was by far the most consequential, as the government ignored calls by civil society activists to pay close attention to the dormitories (Low, 2020). In his perceptive piece, Low argues that the government should be blamed more for the third mistake than the first two, as the former two were based on time constraints under a situation of imperfect information.

Whether Low’s call for assignment of blame is accurate, two things are worth noting. First, the errors were indeed attributable to the government, and second, they arose out of a specific institutional context. In inaccurately assessing the severity of the virus, drastic measures—such as a lockdown or ‘the circuit breaker’—were not taken as swiftly as in other countries. Neighboring Malaysia initiated its lockdown or Movement Control Order as early as the March 18, while Singapore’s Circuit Breaker was not introduced until April 7. Even then, the restrictions imposed in the latter were not as restraining as in the former and had to be gradually tightened. Likewise, the decision to discourage the wearing of masks was conveyed by no fewer than four Ministers at various points in time, including the Prime Minister and Health Minister, as they explicitly stated that wearing a mask could give a “false sense of security” to healthy people (Lai, 2020). The third mistake, however, was the most consequential, considering that most of the cases have involved foreign workers in dormitories. Singapore’s massive reliance on cheap foreign labor manifests itself in the 1 million low-wage foreign workers in the country. For some time, a small group of civil society actors such as Transient Workers Count Too (TWC2) has been advocating for better living conditions in the dormitories, which are often cramped with workers living in extremely close proximity to each other. On March 23, TWC2 had written a letter that was published in The Straits Times, outlining the problems with the dormitories that could result in the formation of virus clusters (TWC2, 2020). The case of a Bangladeshi foreign worker who was admitted to the Intensive Care Unit (ICU) at a local hospital on February 7 should have been a cause for concern, but the dormitories were not initially considered a priority in the battle against the virus.

Other judgment calls that now appear to have been imprudent include the focus on contact tracing instead of mass testing at the start, and the decision to not send Singaporean returnees from overseas hotspots such as the United Kingdom and the United States for immediate testing. Instead, they were instead asked simply to serve a Stay-at-Home Notice at the start, or later on, in hotel rooms paid for by the government. These decisions were based on an under-estimation of the asymptomatic nature of the virus. Even though some experts elsewhere had postulated that the disease could be spread through asymptomatic persons, up until late-February, the Singapore government and health experts had made the assessment that asymptomatic transmission was not likely or possible (Khalik, 2020).

We place emphasis here on the structural factors that contributed to these decisions. It is precisely the autonomous nature of the state, relatively insulated from civil society pressure and the absence of a critical media, that has allowed these decisions to not only go unchallenged, but to avoid any real form of meaningful scrutiny. Two pertinent decisions are emblematic of the wider structural deficiencies: the relatively late realization that asymptomatic transmission was possible, which led to subsequent scrambling to catch up, and the overlooking of conditions of the dormitories. The absence of any meaningful debate regarding how the virus could be passed on, and the lack of penetrating questions by the media or members of the scientific community, was on display from the start of the outbreak. The country in general was somewhat self-laudatory after its initial success was hailed as the ‘gold standard’; it can be said that most in the country, from the government to the citizens and media, may have thus become slightly complacent. There were no hard-hitting questions toward the government on its strategies; for instance, its reluctance to conduct mass testing or its discouragement of wearing of masks. Press conferences during the COVID-19 period were never contentious affairs. Apart from a few civil society individuals and groups, very rarely has there been sustained opposition and criticism toward existing institutions in the public discourse. This approach has resulted in a political culture of compliance, which in turn has created a mind-set of dependence on the government to solve all problems. It is in times of crises when in fact a culture of dissent and the proffering of alternative viewpoints are needed. Even when other places such as Hong Kong were encouraging residents to don masks, for instance, there was no intellectual pushback against the Singapore government’s stance to discourage such behavior. Even more significantly, for many years, civil society’s calls for better work and living conditions for foreign workers were not addressed, and when the alarm bell was again sounded by TWC2 on March 23, it was ignored. This again needs to be understood within the wider political system and the secure position of the ruling party: it has never felt the need to succumb to pressure from the odd civil society group.

A crucial aspect to this problem is the aforementioned relationship between the PAP and the bureaucracy. A few years ago, a former top civil servant, Ngiam Tong Dow, courted controversy when he said that the civil service had become “tamer” over the years, and even younger Ministers were unwilling to disagree with the PM (J. Tan, 2013). Ngiam later retracted his comments, but the general sense was that what he had said was true of the civil service. The bureaucracy’s subdued role was apparent during this pandemic, as well: casual conversations with civil servants draw out numerous critiques they had of the government’s handling of the crisis, but those insights are quickly followed with requests to keep the conversation private. The matter of “speaking truth to power” is widely absent in Singapore, both from the mainstream media and the bureaucracy.

Lessons Learned From Singapore: Preparation Always Helps

With its structural advantages and the benefit of past experience, Singapore was perhaps better prepared than other countries at the outset to deal with COVID-19 quickly and in a more coordinated manner. However, as uncertainty has mounted in the face of a rapid increase in local secondary infectious cases, the Singapore government has hit a snag. One can argue that this challenge stems from the Singapore government’s somewhat reactive rather than proactive approach to the virus, ensuring that the fallout would remain balanced between total economic collapse and managing infection numbers, unlike some other countries like New Zealand, which believed that strict measures should be implemented from the outset. With the benefit of hindsight, the New Zealand, or even Malaysian approach, may have been better, since Singapore did eventually impose similar measures.

Through trial-and-error learning, however, the Singapore government has adjusted its initial policies more aggressively, in instituting the “Circuit Breaker” that required not only the closure of schools, offices, restaurants, and most public places but also one of the most restrictive social distancing policies in the world, including a restriction on even private gatherings. Of course, each government has reacted to the COVID-19 crisis differently, and time will tell if the Singaporean government’s seemingly draconian circuit breaker policies will prove effective. Regardless of the ultimate outcome of the policies, the authors note that the implementation of such heightened preventive measures represent a very significant change from the Singapore government’s early strategic approaches, and the quick adoption of such restrictive policies has been possible due at least in part to the unique political system and sociopolitical culture that exist in Singapore. Specifically speaking, the long history of very close cooperation between the ruling PAP and the bureaucracy represented by the Multi-Ministry Taskforce appears to have ultimately contributed to higher levels of public trust and confidence in the government’s capacity for crisis management, including in public health matters. Indeed, without a population that trusts its government to do the right thing and that has learned to accept short-term sacrifices in exchange for long-term benefits, it is unlikely that such draconian changes with no resistance or blame could have been implemented.

Another notable point is that, presently, the learning process in the Singapore government is still underway. As noted, the emergence of infectious clusters within the construction-sector migrant community has raised some questions about the government’s approach. In line with the so-called contingency plans and related priorities set by the Multi-Ministry Taskforce (e.g., mass testing, the swift isolation of foreign workers’ dormitories, and strict quarantine orders for workers), the government has actively circulated and communicated information related to public health through local news media in a timely manner. This response seems to play a peripheral role in managing people’s fear and distress of the ongoing outbreak effectively even during the circuit breaker period. In addition, it is expected that newly updated financial and institutional support by the government and on-site monitoring by frontline health care professionals will serve as key drivers to stability in the current public health crisis. Given these collective efforts, one early encouraging sign is that the mortality rate in Singapore remains low compared to that of many other nations, even though Singapore is a geographically small-sized city government with high population density (as of May 3, 2020, according to the statistics by WHO (2020), the global mortality rate is 6.99%, compared to 0.0989% in Singapore).

Although the pandemic is still far from eradicated and the impacts on public health and economic consequences are too early to tell, Singapore’s case points to an important lesson that learning-driven coordinated strategic approaches matter for effective crisis management in the long term. In the words of Moynihan (2008), “[e]ven as crises make learning difficult, they demand that decisions be made” (p. 351). Looking forward, policymakers may have enough reason to devote time to building up a more feasible, comprehensive crisis response plan by proceeding with an integrated learning approach, drawing on its own past experience in global health emergencies, missteps and current mistakes, other countries’ battles with COVID-19, and even researchers and the frontline workers. In doing so, they can identify the weak links in current strategies and more quickly deploy the most effective ones, along with adjustments that will enhance preparation for the next phase (perhaps, the post COVID-19 outbreak). At the same time, by ensuring that leaders, management officials, and scholars work hand-in-hand, structural conditions that encourage a robust contestation of ideas may have gained some currency in debates over how to solve some of the problems the government has faced.

Supplemental Material