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Most of us in Singapore would have grown quite accustomed to receiving helpful twice-daily updates from the Ministry of Health (MOH).

Besides the daily numbers, another detail that is closely watched is the list of locations visited by confirmed Covid-19 cases, in the 14-day window before they tested positive for the infection.

Some may have noticed that MOH appends a note about the locations each day:

"There is no need to avoid places where confirmed cases of Covid-19 have been."

Certain places visited by Covid-19 cases have been singled out

It might, therefore, seem like a contradiction that there are some public places that were closed to the public after being visited by Covid-19 cases.

Closure of Basement 2 of Changi Airport Terminal 3, then the entire airport

On May 9, it was announced that Basement 2 of Changi Airport Terminal 3 — which contains its publicly-accessible retail area —would be closed, after reports that several Covid-19 cases visited outlets there.

This was followed by the closure of the entire airport, including Jewel Changi Airport, from May 13.

Airport workers and staff working in Jewel were urged to refrain from going out except for essential work or activities for the next 14 days, or until they have been tested negative for Covid-19.

Places visited by cases in the TTSH cluster closed for two days

Also, in response to the cluster involving patients and staff at Tan Tock Seng Hospital (TTSH), the health ministry announced that public places visited by the cases linked to the cluster at TTSH during their likely infectious period would be closed for cleaning for two days.

Visits to TTSH were strictly restricted to those who were visiting critically-ill patients, on a case-by-case basis.

Government agencies ask staff in Novena to WFH where possible

Furthermore, MOH specifically pointed out that government agency staff who worked in the Novena area (such as those at the Ministry of Home Affairs and the Inland Revenue Authority of Singapore) would be asked work from home where possible.

This stopped short of telling the general public to avoid Novena altogether, but it nonetheless signalled that there was some benefit in avoiding the general area around TTSH.

Why were these locations singled out while others were not?

Changi Airport and TTSH being singled out does not necessarily contradict MOH's line about not needing to avoid places on its list, as there are specific reasons why these locations require different treatment.

Therefore, it appears that there is generally no need to avoid places where confirmed cases have been, but there are exceptions.

We try to explain why, and suggest how members of the public should react when places they visited (or plan to visit) turn up on MOH's list.

So, why were certain places closed to the public?

One factor in common at TTSH and at Changi Airport: multiple staff members tested positive for Covid-19 infection.

Besides cleaning, the closure of the locations visited by cases in the TTSH cluster was also to facilitate the testing of staff at the affected places, for surveillance against further spread, MOH said.

Further measures taken in response to the TTSH cluster include the offer of free testing for all patients and visitors who were at the hospital since Apr. 18. This offer has also been extended to those who visited Terminal 3 from May 3.

In other words, the close contacts of the cases may have already been identified and quarantined, but there could still be other cases who were infected without having close contact, and who would therefore not be quarantined.

And if these "other cases" were patients, staff, or other kinds of regular visitors to the locations, then members of the public would potentially be exposed to them.

Thus, all TTSH staff and patients were immediately tested, while testing for those who work at the airport — including those at Jewel Changi Airport — is similarly being ramped up, even before the announcement that the airport would close.

Staff in food and beverage (F&B) and retail outlets at Basement 2 of Terminal 3 would have to test negative before the outlets can reopen, the Civil Aviation Authority of Singapore (CAAS) and Changi Airport Group (CAG) said in a joint release on May 9, a few days before the airport's closure was announced.

True enough, on May 10 and May 11, more staff who work at Changi Airport were found to be infected, prompting the authorities to take stronger action to prevent members of the public from coming into contact with any potential cases among the airport workers.

Places are closed to the public not because they were visited by confirmed cases, but because they were likely to be visited in the following days

From looking more closely at the above examples, where public places were closed after they were visited by confirmed Covid-19 cases, there was the fact that cases had visited, but also the fact that those locations had become the site where infections were taking place.

With community cases being announced every day now, including unlinked ones, and correspondingly, new locations being added to the list, there is a real chance of another location on the list (a shopping mall, office building, a public swimming pool, perhaps?) turning out to be like TTSH or Changi Airport — the site of a cluster, which then goes on to get closed to the public in a few days.

In other words, no one knows where the next cluster will be discovered.

Which leads us to the question:

Why does MOH still say "no need to avoid"?

MOH explains in its daily update that there is no need to avoid the places on its list because:

• If you were identified as a close contact of a case, you'd already have been notified by MOH.
• If you're unsure, you can check whether you were at these places at the same time as a confirmed Covid-19 case using a dedicated portal (https://wereyouthere.safeentry.gov.sg/)
• The affected premises would have gone through cleaning and disinfection, with guidance from the National Environment Agency (NEA).

Another reason, in light of the developments at Novena and Changi Airport, would be the fact that the public places which MOH deems are best avoided would be closed to the public.

And so you might be wondering:

Why does MOH maintain this list of locations?

The list of locations is produced so that members of the public who visited the places at the specified times are aware of their potential exposure.

Yes, close contacts would have been rounded up by MOH during contact tracing.

But you could have had some exposure to a confirmed case without being a close contact. For example, you could have visited a shopping mall while a confirmed case was there, for example.

There would be no way to know if the confirmed case (in increasing order of potential contact):

• Was in a totally different corner of the mall from you throughout your visits
• Took the same lift as you
• Shopped in the same shop as you
• Touched the same door handle that you used

Thus, you can only hope that it was one of the lower-risk scenarios. You may or may not want to quarantine yourself over this, but the only thing MOH recommends that you do is to monitor your own health closely.

If you subsequently develop respiratory symptoms, fever, or lose your sense of taste or smell, you should then see a doctor and inform them of your possible exposure at the relevant places and times.

How will the sites of future clusters be dealt with?

In the unfortunate event that there are clusters in future, it wouldn't be surprising if the measures taken to deal with them are similar to what was done at TTSH and at Changi Airport, especially if staff or regular visitors are involved.

After all, a "localised lockdown" where particular places are closed to the public is less disruptive than a broader sweep of closures affecting entire categories of places — as we have seen with the current gym closures, and of course, many categories of "non essential" businesses during last year's Circuit Breaker.

But what could surprise us is which locations end up that way, since there is no way to predict exactly where a new cluster will be discovered.

Still, that doesn't mean that we have to wait for MOH to tell us what to do by closing down locations before we avoid them — individual judgment and precautions, along with getting vaccinated where possible, would go a long way in preventing Covid-19 from spreading further.

If you do go out, just take note of where you go and who you are with, check in with SafeEntry, and monitor your health and the news closely in case you find that you are potentially exposed.

The coming weeks will be critical

In Parliament, on May 11, Multi-Ministry Taskforce co-chair Lawrence Wong cautioned that the coming few weeks will be critical for Singapore.

"I think it's very important for us to understand that we are now on the knife's edge, and our community cases can go either way," he said.

Soon after, it was announced that Singapore would be moving into Phase 2 (Heightened Alert), with additional restrictions kicking in from May 16.

By exercising vigilance during this period, we can hopefully nip potential clusters in the bud and avoid the situation deteriorating further into a second Circuit Breaker.

Thus, for the moment, it seems that "there is no need to avoid places where confirmed cases of Covid-19 have been" might have to be interpreted differently from how we have been reading it.

Mothership Explains is a series where we dig deep into the important, interesting, and confusing going-ons in our world and try to, well, explain them.

This series aims to provide in-depth, easy-to-understand explanations to keep our readers up to date on not just what is going on in the world, but also the "why's".

Top image via Changi Airport on Facebook