Singapore should be a warning to us. They had COVID under excellent control. Now it’s out of control: 728 new cases yesterday. When we relax social distancing measures prematurely we risk a second wave. Places where groups of people work/live close to each other are at high risk.

This is how the last 2 months have been in Singapore. Plateau for 3 weeks. Mar 15- April 3. Then it has taken off. #COVID

Since I’m getting repeated comments on the same point see responses below. https://twitter.com/vincentrk/status/1250889087873146882?s=21 https://twitter.com/VincentRK/status/1250889087873146882

And this. https://twitter.com/VincentRK/status/1250892393416720388

This is a very useful link that should address some questions. https://www.google.com/amp/s/www.nytimes.com/2020/04/16/opinion/coronavirus-reopen-economy-singapore.amp.html

The differences between HongKong and Singapore have also been pointed out. I know there were differences in recommendations and extent of mask use. Maybe someone can comment on what other policy differences are playing a role so we can learn.

Ultimately, the reason for my concern is this: I have been a doctor for 30 years. I work at one of the best medical centers in the world. I have done cancer research for 24 years. COVID is the worst public health problem I have seen. Do not underestimate it. This figure shows it:

This excellent figure from @nytimes @sangerkatz also shows the magnitude of the problem we are facing. When travel restrictions and social distancing is relaxed, COVID will likely move around the country. From what I’ve seen this virus is a danger to any place it goes to.

In response to comments one other thing to realize is that the outbreak in dorms where migrant workers live in Singapore started first from a local store from a local resident. It then spread in crowded dorms. https://www.straitstimes.com/singapore/mustafa-centre-believed-to-be-starting-point-for-hundreds-of-cases

More details on sequence of events in Singapore. https://twitter.com/vincentrk/status/1251205919129718786

Singapore update:

Apr 17: 623 cases; 27 are local
Apr 18: 942 cases; 14 are local

Local cases are lower; but how they reduce transmission not possible in USA:
— Dorms sealed off from local population
— Not wearing mask in public: $200 fine; 2nd offense: $700 fine
#COVID

Thread continues here with update. April 20. https://twitter.com/vincentrk/status/1252301195147911170