Issue #102
May 2020
Controlling COVID-19 in Singapore

Countries around the world have been controlling the spread of COVID-19 in different ways. Whilst we may be familiar with the approach that Australia and New Zealand have taken, we spoke to RCPA Fellow, Associate Professor Raymond Lin to learn how Singapore has handled the outbreak.

A/Prof Lin is Director of the National Public Health Laboratory (NPHL) in Singapore, which moved to become part of the National Centre for Infectious Diseases (NCID) and started operating in January 2019 from NCID’s new building. The NCID serves clinical and public health functions, with research, epidemiology and laboratory units. It was also largely built for national pandemic preparedness.

“We actually started testing for COVID-19 before the causative virus was confirmed and announced. From 2 January 2020, we recognised from the reports of unexplained pneumonia from Wuhan that there were similarities to the SARS experience of 2003. So, whilst we tested a variety of respiratory pathogens in suspect cases, we also focused on implementing pan-coronavirus testing.

“Within one day of the SARS-CoV-2 sequence being released by China, we had designed our SARS-CoV-2 assay. It took another 10 days to optimise the test and obtain synthetic controls, so that the test was ready when our first case arrived on 23 January. Our public sector laboratories progressively implemented COVID-19 testing in the succeeding days and weeks. Initially, laboratory-developed tests were used, then as good quality commercial tests became available and were approved by regulators, these became more widely utilised. Our private sector then joined the effort to increase the national testing capacity,” said A/Prof Lin.

There are currently 14 testing laboratories conducting COVID-19 tests in Singapore. This is largely made up of the NPHL and the public acute hospitals and supported by various private laboratories. Led by pathology specialists, laboratories perform diagnostic PCR tests to support not only patients in hospital, but also those from primary care, from long term care facilities and, recently, foreign worker dormitories. There is also ongoing work to fit out dedicated COVID-19 testing laboratories which require new equipment and new staff, with resources which meet the competency, quality and safety standards expected of clinical laboratories.

“The numbers have varied at each stage of the pandemic and testing objectives have changed with time. However, we have had an incredible sense of the whole diagnostic laboratory community coming together in one enormous effort to test and trace.

“It is important to note that as specialists, our role is not confined to providing testing services, but also to provide virology advice to enable science-based decision making by the government. Pathologists and Scientists are the laboratory specialists who provide policy makers with daily input and professional opinion on a variety of areas, including the use and organisation of testing services, the meaning of different laboratory tests, how to choose among the myriad tests being marketed and promoted, and also to provide biological insight to help in decisions.

“We also help plan how to scale up testing capacity and adopt new testing platforms as they become available, whilst at the same time collaborate with researchers to support evidence-based decision-making,” said A/Prof Lin.

In addition to patients presenting with symptoms, testing in Singapore is also being performed in order to clear patients for discharge and for contact tracing. Expanded testing will eventually include screening of vulnerable groups and staff working with at risk groups.

“This is an evolving situation as we simultaneously continue to test, trace and treat, as well as widen the scope of surveillance. The recent increase in cases in Singapore is due to an outbreak in foreign worker dormitories. Through a vigorous response involving many public agencies, we believe in providing the workers the same level of high-quality testing and treatment that we have provided residents with.

“Testing is without doubt the best way to manage an outbreak. The experience from many countries in all continents show that it is possible to control outbreaks by identifying cases, interrupting the chain of transmission and therefore "flattening the curve". Of course, as with any infectious outbreak, testing must also be supported by a great determination to do contact tracing and isolation, for which we have spared no effort,” said A/Prof Lin.

 

 

Back to Home page >>
Potentially life-saving genetic testing for range of cancers introduced to MBS
FIND OUT MORE >>
Lifeblood joins fight to combat COVID-19 in Australian first
FIND OUT MORE >>
Blood donation: an essential service
FIND OUT MORE >>
Find out more on the RCPA website
www.rcpa.edu.au
Twitter
Instagram
Facebook
LinkedIn
Website
The Royal College of Pathologists of Australasia
Durham Hall - 207 Albion St Surry Hills NSW 2010 AUSTRALIA
Phone: +61 2 8356 5858