The world has been battling the COVID-19 coronavirus (also known as SARS-nCov-2) for over two months. Since the alarm was first sounded in Wuhan, China in January the virus has been declared a pandemic. While most of Asia managed to stem the tide from the first wave of cases from Mainland China, things have changed drastically since.
Dealing with the second wave: nudges are not enough
Whatever the criticism about China’s data and level of forthrightness about COVID-19, one fact remains: by shutting down entire cities, China bought the world time to prepare for the coronavirus. Other East Asian and South East Asian nations followed up quickly with infectious disease taskforces, which helped to flatten the curve further.
Since then, the situation has changed. China no longer has the most number of confirmed COVID-19 cases or deaths. Singapore and Hong Kong have been pushed off the leaderboard of confirmed cases.
Total confirmed cases: 685,623
What led to this? Differences in policy-making approaches
- Asia policymakers applied the whole range of policy tools at their disposal (more below)
- The West saw the coronavirus as being too far away, and infecting people who were different from them — different palates and (perceived) hygiene levels. In other words, the Construal-Level Theory of psychological distance
- Over-reliance on behavioural science in policy-making, with the UK as an example.
Here is an example of how the governments and societies of Hong Kong, Taiwan, and Singapore responded. Their approach can be summarised as:
The governments rode on the global rapid and open exchange of epidemiological information on infectious diseases.
Taiwan in particular: Framing epidemics as “issues of national security”, and adopting appropriate responses.
Taiwan in particular: Big data analytics, new technology, and proactive testing. Integrated various national databases to identify high risk cases through AI; Real-time alerts for clinical visits based on travel history and clinical symptoms; QR code scanning to capture travellers’ history and health conditions quickly
Singapore in particular: Multi-pronged surveillance and containment involving general practitioners, centralised disease notification system, and hospitalised patients who were admitted for pneumonia (but not COVID-19).
Contact-tracing using interviews, AI models. In Singapore, the police force was also roped in to review CCTV footage to identify close contacts.
Fines and jail terms for those who lied to the authorities about their travel history or whereabouts.
Taiwan in particular: “name” and shame (no names, but personal details were sufficient for internet vigilantes to track down the individuals in question).
Falling back on the habits developed from SARS
In Hong Kong, people washed their hands more often during the SARS outbreak, and were slow to shake the new habit. Even after SARS ended, Hong Kong people continued washing their hands with a similarly high frequency for the next 22 months. What helped: Reminders from the family and girlfriends or wives.
In Singapore, the government placed posters detailing the 7-steps of hand-washing at the sinks in common toilets, one poster per sink. These posters have been resurrected with COVID-19, with the addition of singing ‘Happy Birthday’ twice. Everyone knows the lyrics, and it’s simple enough for a child to follow.
In Taiwan, the focus was on hand-washing in the hospitals, as a major factor in the spread of SARS came from hospitalised patients who had not yet been classified as SARS patients.
Use of face masks
Before SARS, it was uncommon to wear face masks on the streets of Hong Kong and Taiwan. Face masks were only used by those who were sick, or had something to hide. However, the use of face masks was perceived as a positive action during the SARS outbreak.
Nudges create new habits, and habits take time to develop
Given Singapore’s experience with SARS, one might have thought that it’d be a breeze for the government introduce new nudges. But being from Singapore myself, I can testify that it wasn’t so smooth, because existing habits needed to be broken before new ones could be formed. And so I leave you with a sample of the nudges that the authorities and society are trying to introduce — and how some of them needed other policy tools to be useful.
Supermarket checkout queues
Supermarkets introduced markings to indicate the 1-metre markings. Shoppers initially did not notice the markings or understand it until there was widespread education and social enforcement. Now, they queue right.
Seating arrangements at foodcourts (community food centres)
Alternate seats were marked with tape to indicate that they are not for use. Initially, diners were confused over the markings until there was widespread education and social enforcement, with the threat of official penalties. Since then, there has been better compliance.
Standing on the escalator
Some retailers have introduced markers to remind shoppers, compliance has been observed. At train stations, signs have been put up to remind commuters to stay 3 steps apart. Anecdotally, commuters complied with it.
Social distancing on public transport
With Singapore on its largest work-from-home experiment, the crowds have thinned. However, little change has been observed in terms of public transport habits.
Spending leisure time in the malls
Malls must limit the number of shoppers on their premises. Choke points were seen outside some shopping centres. In a Whatsapp message , authorities advised those in Singapore to defer non-essential trips to the mall.
Nightlife and entertainment venues with crowds
Party-goers thronged the nightspots and organised “farewell parties”. Some clubs ditched their farewell party plans after netizens decried them as being irresponsible, and the Singapore Tourism Board, Enterprise Singapore and Singapore Police Force issued a joint statement urging responsible implementation of safe-distancing measures.
Stay safe, practice good hand hygiene, and may we survive this pandemic well.