The importance of quick and rigorous contact tracing in slowing the spread of Covid-19 has been repeatedly emphasised.
When a person tests positive for the virus, Singapore tries to identify and isolate all the close contacts of an infected person within 24 hours, as it keeps the transmission rate down. This is the reason why we have managed to keep our case numbers relatively low compared with other countries, despite being affected by the disease earlier.
A British woman living in Singapore found this out first-hand when she received a call from the Ministry of Health (MOH), informing her that she had to be quarantined — and the official even knew that she took a taxi a few days ago.
A Singapore-based British yoga teacher known only as Melissa told the BBC that she was having a barbecue on a Saturday afternoon when she received a surprising phone call.
This is what the person on the other side asked her:
Were you in a taxi at 18:47 on Wednesday?
The phone call made her panic, she said, in part because it was from an unknown number. Turns out the call was from an officer at MOH.
She described her experience as “surreal”, as she had indeed been in a taxi on Wednesday.
When she checked her taxi app later, she realised that her ride took just 6 minutes.
MOH told her in that phone call that she needed to “stay at home and be quarantined”, according to the BBC — we think that means she was served a Stay-Home Notice or Quarantine Order.
Photo courtesy of Unsplash
MOH wasn’t joking. The next day, 3 officers came to Melissa’s home.
They were wearing surgical masks and jackets, in what seemed to her like a scene from a movie.
She was given a quarantine order, which she described as “a contract” — i.e. meaning an actual legal document.
If you breach the quarantine order by leaving your home, you will face a fine and prison, she added.
Melissa was also quoted by the BBC as saying:
They make it very clear that you cannot leave the house. And I knew I wouldn’t break it. I know that I live in a place where you do what you’re told.
Thankfully, after she had served her 14 days’ quarantine, she did not develop any symptoms and was free to go out.
Till now, she does not know whether it was the driver or another passenger who was infected.
The BBC revealed more about the process that takes place behind the scenes by speaking to Mr Conceicao Edwin Philip, a contact tracer at the Singapore General Hospital who at times works through the night till about 3am when a positive case is identified.
His job is to:
He also told the BBC:
Without this first piece, nothing can be connected. It is like a puzzle, you have to piece it all together.
The process is handed to over an MOH team that gathers more information on the case — a task that can be challenging if patients are too ill to talk to you.
The next step is taken over by the police. The Criminal Investigation Department’s (CID’s) senior assistant commissioner of police Lian Ghim Hua told the BBC:
An average of 30 to 50 officers are working on contact tracing on any given day, and the number has scaled up to over 100 officers at times.
The police effort is an inter-departmental one, with officers from the CID, narcotics bureau and intelligence services helping out on top of their normal duties — thanks to Singapore’s low crime rate.
They also have help from technology like CCTV footage and data visualisation, but sometimes they have to conduct good old fashioned, labour-intensive detective work.
This is what National University of Singapore associate professor Chong Ja Ian was quoted by the BBC as saying on the police’s participation:
To use police for contact tracing in this manner of investigating is quite unique to Singapore.
Here’s a graphic from the BBC that shows the work that needs to be done.
Another Singapore woman, known only as Julie, was interviewed for nearly 3 hours by a contact tracer over the phone when she was diagnosed with Covid-19.
She told the BBC that she had been diagnosed for less than one hour, and was lying in hospital when the received the phone call:
They wanted to know who I was with, what I was doing, what their names were and then their contact numbers.
The definition of “close contact”, according to what Julie said, was someone whom she had spent more than 30 minutes with, within a space of 2m.
There was no interest in someone I had brushed shoulders with even if it was someone that I knew.
In the end, none of the 50 contacts she had identified developed the virus.
Julie (far right) identified 50 people that she had close contact with.
The herculean efforts of our contact tracers are vital to keeping the numbers of cases low by quickly isolating people like Melissa who have come into contact with infected people.
Singapore’s mastery of the system has been praised worldwide, including by Harvard scientists who called it the “gold standard”.
And World Health Organization officials have said they are “very impressed” by our contact tracing efforts and our managing of imported cases with “tremendous rigor”.
While we’re proud that our efforts are being recognised, we also hope that there will soon come a day when they are not needed any more.
Till that day comes, keep up the good work, contact tracers!
Featured image adapted from Facebook and Facebook.
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