Several countries now acknowledge the risk of travellers from “extremely high-risk countries”.
Hong Kong has suspended flights from India, Pakistan and the Philippines, and New Zealand has stopped entry by all travellers, even its citizens, from India.
Singapore has reduced the number of entry approvals and extended the usual 14-day stay-home notice (SHN) at a dedicated facility, with a further seven-day SHN at a place of residence (Singapore cuts quota on travellers from India as cases there surge, April 21), with Covid-19 testing required around days 14 and 21.
The SHN extension acknowledges the fact that infections in some travellers are not picked up by the current 14-day swab test, and that travellers may remain asymptomatic beyond 14 days.
Indeed, recent community cases had been described as home contacts of travellers who had successfully completed both this test and 14 days of SHN.
Whether this is because of the limitations of the test, or because the coronavirus has now changed to sometimes having a longer incubation period, is not as important as immediately stopping this risk.
During the 14-day SHN in a dedicated facility, the traveller is confined to his room and is not in contact with any other person, even hotel staff or monitoring healthcare personnel. He is thus a very low transmission risk.
However, extending this SHN to a place of residence changes the risk profile entirely.
Once unsupervised, he may have contact with others sharing the residence, even if only by accident, such as household members or fellow travellers co-housed by the same employer.
Worse, unless employers are required to maintain different residences for different cohorts, a traveller towards the end of his 21-day SHN may be infected by another, as yet undetected, traveller, just by transferring in from a dedicated facility.
Because of Covid-19’s incubation period of about five to seven days, this person will become an infection risk well after he is released into the community, in spite of successfully completing 21 days of SHN and having two negative swab tests.
Because of these two risks (of infecting other household members, and of picking up a cross-cohort infection just before release), I urge the authorities to reconsider the location of the third week of quarantine.
Travellers from high-risk countries risk sparking an outbreak in Singapore that should not be taken lightly.
The third week of their SHN is indeed necessary, but this should continue to be served in the secure dedicated facility where they currently are.
Expecting an unsupervised “residence” to protect society like a dedicated facility, just because both periods are supposed to be for the same SHN purpose, is a delusion.
Lee Pheng Soon (Dr)