Trust a 'most precious resource' critical in Singapore's Covid-19 response
Trust has probably been the most critical factor in Singapore's pandemic response - and the nation must learn from Covid-19 and not let lessons from it go to waste, said Prime Minister Lee Hsien Loong on Sunday (April 24).
These include upholding Singapore's standards of medical excellence and further developing its expertise in public health.
He was speaking at the Singapore General Hospital's (SGH) Lecture and Formal Dinner 2022, which was held at Shangri-La Singapore.
Addressing some 300 guests on site, as well as about another 1,000 gathered online, PM Lee cited a study in The Lancet which found that higher levels of trust in the government and among the population were associated with greater compliance with Covid-19 restrictions and higher vaccination rates.
"In fact, by these measures, trust levels mattered much more even than the quality of healthcare and access to universal healthcare. I do not believe this means a good healthcare system makes no difference - it is absolutely necessary.
"But it does show how crucial trust levels in the society are to public health and healthcare outcomes," he said, adding that Singapore is fortunate to be a high-trust society.
He said that the strong public trust built up over the decades between Singaporeans and the Government, and in one another, sets the Republic apart from many other countries.
This involves trust that the Government has the best interest of Singapore and Singaporeans at heart, that the Government is competent and will make the right decisions on behalf of Singaporeans, and that every citizen will play their part - not just for themselves and their loved ones, but for others as well.
"This trust is a most precious resource. It is the fundamental reason why Singaporeans were able to come together this pandemic, instead of working against each other," said PM Lee.
He cited four examples of this: People here abiding by "burdensome" safe management measures, patiently enduring repeated rounds of easing and tightening, going for vaccinations and booster jabs, and exercising personal and social responsibility.
"In other countries, precautions as simple and essential as wearing a mask became a heated point of contention between citizens... Fortunately, in Singapore the opposite happened," he noted.
PM Lee said that a big part of this was due to the public's trust in the healthcare system here, which in turn was based on three things.
First, trust that healthcare workers here are professional, and know their job well.
Second, that they are dedicated and selfless, committed to the care, treatment and well-being of their patients.
Third, that the healthcare system is open and honest with the public, even when things fail to go as intended.
For instance, said PM Lee, during the vaccination campaign, the Health Ministry regularly reported statistics on serious adverse events.
He said: "Some may be tempted to think that it would have been easier to keep things quiet, and avoid causing unnecessary alarm with bad news. It would have been expedient, it would have been convenient. But it would have been very unwise. If we kept quiet, it might work once, or twice. But rumours will spread, people will gradually lose faith in the system, and we will eventually pay a high price - the loss of public trust.
"We should always be upfront when we encounter problems and setbacks, and address them honestly and transparently. If we make a mistake - own up, take responsibility, and strive to put things right.
He noted that this is not easy to do, but is absolutely essential to strengthening public trust, especially during crises when stakes are high.
PM Lee said that there is a need to continue nurturing trust in the healthcare system during normal times, by always maintaining high standards of competency, commitment and transparency in the system.
In the next crisis, there will then be a "deep reservoir of trust" that can be drawn upon, he added.
"And of course, even when the going gets tough, and especially when the going gets tough, we must continue to live by these cardinal values, and continue to strengthen the trust that we depend on to stay together and pull through," he said.
'We cannot thoughtlessly revert to the status quo ante'
PM Lee also said that Singapore should make the most of the changes forced on it by Covid-19 to improve the way it does things.
"We cannot thoughtlessly revert to the status quo ante after this crisis, nor can we let valuable lessons, for which we have paid dearly, go to waste," he said, adding that this means two things for the nation's healthcare system.
First, it must keep up its high standards of medical excellence by continually investing in its healthcare workers, and supporting them with good medical facilities and healthcare infrastructure.
At the same time, this also means building up Singapore's scientific and biomedical capabilities, and collaborating with researchers in other countries.
Second, there is a need to further develop an emphasis on public health.
Public health, he pointed out, focuses on the health of the overall population and not of individuals. The priority is to benefit as many people as possible.
That is why, even though the polymerase chain reaction tests are more sensitive, Singapore replaced them with the antigen rapid tests for most cases, to pick up and isolate infectious cases faster and more cheaply. This made a bigger impact on disease transmission.
Noting that in normal times, many other popular medical specialisations are more sought after, PM Lee pointed out that in a pandemic, public health expertise is crucial.
This is because the nation must be able to understand how a new disease is spreading, make sense of disease trends, and devise models to assess and predict them, evaluate alternative public health measures, and devise non-medical interventions that can help bring the outbreak under control.
So there is a need to strengthen skills in these areas, and ensure high-quality public health inputs inform policy making, said PM Lee.
He added: "Singapore must continue to grow in maturity and resilience, learning from our experiences and those of others, and so must our healthcare system."