Article Text

Download PDFPDF

Health system resilience in managing the COVID-19 pandemic: lessons from Singapore
  1. Alvin Qijia Chua1,
  2. Melisa Mei Jin Tan1,
  3. Monica Verma1,
  4. Emeline Kai Lin Han1,
  5. Li Yang Hsu1,
  6. Alex Richard Cook1,
  7. Yik Ying Teo1,
  8. Vernon J Lee1,2,
  9. Helena Legido-Quigley1
  1. 1Saw Swee Hock School of Public Health, National University of Singapore, Singapore
  2. 2Communicable Diseases Division, Ministry of Health, Singapore
  1. Correspondence to Alvin Qijia Chua; alvin.chua{at}nus.edu.sg

Abstract

Singapore, one of the first countries affected by COVID-19, adopted a national strategy for the pandemic which emphasised preparedness through a whole-of-nation approach. The pandemic was well contained initially until early April 2020, when there was a surge in cases, attributed to Singapore residents returning from hotspots overseas, and more significantly, rapid transmission locally within migrant worker dormitories. In this paper, we present the response of Singapore to the COVID-19 pandemic based on core dimensions of health system resilience during outbreaks. We also discussed on the surge in cases in April 2020, highlighting efforts to mitigate it. There was: (1) clear leadership and governance which adopted flexible plans appropriate to the situation; (2) timely, accurate and transparent communication from the government; (3) public health measures to reduce imported cases, and detect as well as isolate cases early; (4) maintenance of health service delivery; (5) access to crisis financing; and (6) legal foundation to complement policy measures. Areas for improvement include understanding reasons for poor uptake of government initiatives, such as the mobile application for contact tracing and adopting a more inclusive response that protects all individuals, including at-risk populations. The experience in Singapore and lessons learnt will contribute to pandemic preparedness and mitigation in the future.

  • health systems evaluation
  • public health
  • respiratory infections
  • health policy
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Handling editor Seye Abimbola

  • Twitter @alvinchuaqj, @melisamjtan, @monica_v17, @hsuliyang, @legidoquigley

  • Contributors AQC, MMJT, MV, EKLH and HL-Q conceived the paper and prepared the initial draft. AQC led the writing process. All authors contributed to the original content and revisions to the text. All authors gave final approval of the version to be published.

  • Funding This research is funded through the Singapore Population Health Improvement Centre (SPHERiC) Collaborative Centre Grant from the National Medical Research Council, Singapore (NMRC/CG/C026/2017_NUHS).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.