Best strategies against virus: Track, isolate, communicate

Singapore, a tiny city-state of less than 6 million people, had one of the earliest and biggest clusters of cases of the coronavirus in early February, before it began its rapid, inexorable expansion around the globe.

Within weeks, the country's tally of infections with the highly contagious virus that causes COVID-19 was overtaken by skyrocketing caseloads in South Korea, several European countries and the U.S.

Some strategies are proving more effective than others in containing the pandemic: pro-active efforts to track down and isolate the infected, access to basic, affordable public health care, and clear, reassuring messaging from leaders.

East Asia's experience with the 2003 outbreak of Severe Acute Respiratory Syndrome, which also originated in China, has likewise helped.

Since testing rates vary widely, it's hard to know for sure. But Singapore appears to be among the handful of places that tick all those boxes, though recent spikes in new cases show that any lapses can have dire consequences.

Singapore's first case, confirmed on Jan. 23, was a 66-year-old man from Wuhan, the Chinese city where the disease was first detected in late December.

By mid-February, the number of recovered patients in the Southeast Asian city-state was outpacing new ones. That changed in early March after 47 cases were tracked to a February 15 dinner gathering. As of Wednesday, Singapore had 266 confirmed cases and no deaths from the virus.

As new infections increased, the government tightened quarantine controls.

Taiwan, a self-governed island off the coast of mainland China, has confirmed just 77 cases and one death. Most recent cases were residents returning from overseas travel.

Hong Kong has reported 167 cases and four deaths. Its leader, Carrie Lam, on Tuesday warned against all outbound travel and said any people arriving from outside greater China will face 14-day home quarantines or medical surveillance.

Of the 13 cases found in the tiny gambling enclave of Macao, 10 have recovered. Casinos have been closed for weeks to battle the outbreak.

Cambodia, which has confirmed a dozen cases, last weekend moved to stop foreigners traveling from France, the U.S., Spain, Germany, Italy and Iran after several new cases were found among travelers.

Thailand, likewise, appears to have kept cases under control with aggressive public health campaigns intended to minimize infections, though new cases jumped recently as stepped-up testing found clusters linked to a boxing tournament and an evening gathering at a bar.

So far, 177 cases have been confirmed among 70 million Thais, even though it's a top destination for travelers, especially from China.

Assuming the numbers reported to the World Health Organization are accurate, many of the countries with lower caseloads are relatively isolated geographically: Singapore, New Zealand, Nepal, Bhutan, Sri Lanka, Mongolia. Some others may be latecomers in testing and reporting: Russia, Indonesia, Vietnam.

For Singapore, Taiwan and Hong Kong, the experience of battling the 2003 SARS outbreak, which infected some 8,000 people and killed nearly 800, helped ensure residents took the risks seriously, experts say.

"Almost everyone played ball and followed accordingly," said Leong Hoe Nam, an infectious diseases specialist at Singapore's Mount Elizabeth Novena Hospital.

"SARS was our baptism by fire and we were forced to learn everything by swimming in the deep end of the pool."