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The Effectiveness of Public Health Interventions Against COVID-19: Lessons from the Singapore Experience

15 Pages Posted: 28 Apr 2020

See all articles by John P. Ansah

John P. Ansah

International Monetary Fund (IMF)

David Bruce Matchar

Duke-NUS Graduate Medical School Singapore; Peking University - Center for Healthy Aging and Family Studies

Sean Lam Shao Wei

National University of Singapore (NUS) - Programme in Health Services and Systems Research; Singapore Health Services Pte Ltd

Jenny G. Low

National University of Singapore (NUS) - Department of Infectious Diseases

Ahmad Reza Pourghaderi

National University of Singapore (NUS) - Programme in Health Services and Systems Research

Fahad Javaid Siddiqui

National University of Singapore (NUS) - Duke-NUS Medical School

Tessa Lui Shi Min

National University of Singapore (NUS) - Programme in Health Services and Systems Research

Aloysius Chia Wei-Yan

National University of Singapore (NUS) - Programme in Health Services and Systems Research

Marcus Eng Hock Ong

National University of Singapore (NUS) - Health Services and Systems Research; Singapore General Hospital - Department of Emergency Medicine

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Abstract

Background: This study conducts a counterfactual analysis, using the case of Singapore, a country fairly successful in suppressing community spread of COVID-19, to explore what the trajectory of COVID-19 infection might have been in Singapore had the government intervention not focused on containment, but rather on mitigation or uninhibited spread.

Methods: We developed an SEIR model to estimate the number of COVID-19 infection cases in Singapore and deaths, under different public health intervention compared to the containment interventions implemented in Singapore.

Finding: Under the Singapore containment interventions, we would expect a peak in infected cases to occur 3 months from January 23, 2020 [100% confidence range (CR), 2·2 to 4]. The infected cases of COVID-19 over 8·6 months is projected to be 2,488 [1,814 to 4,510]; representing 0·044% of the total population [0·032 to 0·081]. Deaths is estimated to be 25 [9 to 57]. In comparison, a mitigation intervention with 20% quarantine rate, would delay the time to peak infection by an estimated 5·2 months, prolong duration of the infection by 12·4 months, cumulative infected cases 1,388-fold, and deaths 1,371-fold. Likewise, a mitigation intervention with 40% quarantine rate, compared to the Singapore containment intervention could delay the time to peak infection by 7 months, extend the infection surge by 21 months, and increase cumulative infected cases and deaths 727-fold. Finally, a strategy of uninhibited spread would increase the time to peak infection by 2·9 months, duration of infection by 8 months, increase cumulative infected cases 1,863-fold and deaths 1,840-fold.

Interpretation: Early public health measures in the context of targeted, aggressive containment — such as swift and effective contact tracing and quarantine – was likely responsible for suppressing the number of COVID-19 infections in Singapore.

Funding Statement: The project was funded by the Singapore Ministry of Health’s National Medical Research Council.

Declaration of Interests: There is no conflict of interests.

Keywords: COVID-19; Public Health Interventions; Simulation Modelling; Singapore

Suggested Citation

Ansah, John P. and Matchar, David Bruce and Wei, Sean Lam Shao and Low, Jenny G. and Pourghaderi, Ahmad Reza and Siddiqui, Fahad Javaid and Min, Tessa Lui Shi and Wei-Yan, Aloysius Chia and Ong, Marcus Eng Hock, The Effectiveness of Public Health Interventions Against COVID-19: Lessons from the Singapore Experience (4/9/2020). Available at SSRN: https://ssrn.com/abstract=3576800 or http://dx.doi.org/10.2139/ssrn.3576800

John P. Ansah (Contact Author)

International Monetary Fund (IMF) ( email )

700 19th Street, N.W.
Washington, DC 20431
United States

David Bruce Matchar

Duke-NUS Graduate Medical School Singapore ( email )

Singapore
Singapore

Peking University - Center for Healthy Aging and Family Studies

No.5 Yiheyuan Road
Haidian District
Beijing
China

Sean Lam Shao Wei

National University of Singapore (NUS) - Programme in Health Services and Systems Research ( email )

8 College Road
Singapore
Singapore

Singapore Health Services Pte Ltd ( email )

7 Hospital Drive
Block A, Room #02-01
Singapore, 597627
Singapore

Jenny G. Low

National University of Singapore (NUS) - Department of Infectious Diseases ( email )

Singapore

Ahmad Reza Pourghaderi

National University of Singapore (NUS) - Programme in Health Services and Systems Research ( email )

8 College Road
Singapore
Singapore

Fahad Javaid Siddiqui

National University of Singapore (NUS) - Duke-NUS Medical School ( email )

Singapore
Singapore

Tessa Lui Shi Min

National University of Singapore (NUS) - Programme in Health Services and Systems Research ( email )

8 College Road
Singapore
Singapore

Aloysius Chia Wei-Yan

National University of Singapore (NUS) - Programme in Health Services and Systems Research ( email )

8 College Road
Singapore
Singapore

Marcus Eng Hock Ong

National University of Singapore (NUS) - Health Services and Systems Research ( email )

Singapore General Hospital - Department of Emergency Medicine ( email )

Singapore

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