Last year, German Chancellor Olaf Scholz in a speech on global geopolitics popularised the German word 'zeitenwende', which refers to a 'turning point' and time for change.

The COVID-19 pandemic has likewise brought about seismic change in how the world looks at global health security and brought to the forefront the critical need for public health capabilities nationally and globally. ‘Never Again’ has been the rallying cry of communities, businesses and public officials the world over and this momentum offers opportunities to fundamentally redefine pandemic preparedness and response.

What have we learnt in the last three years?

There are numerous lessons cutting across all sectors of life. We summarise them in five key insights: pre-emptive investment in health security, nimbleness, trust, global cooperation and commitment to equity.

1. Pre-emptive investment

COVID-19 has shown that proactive preparedness remains key to managing future pandemics. Many countries challenged with lesser outbreaks in recent years, preserved the responding infrastructure which positioned them well for the initial containment of COVID-19. South Korea and Senegal, with prior lessons from the Middle East Respiratory Syndrome (MERS) and Ebola respectively, were able to manage well whilst geographies in Asia affected by the Severe Acute Respiratory Syndrome (SARS) such as Hong Kong and Singapore all had regularly rehearsed response plans in place which could be adapted quickly for COVID-19.

2. Nimbleness

No country can afford to maintain standing resources to deal with Disease X (a term popularised by Singapore Prime Minister Lee Hsien Loong to describe the next pandemic) but creativity and nimbleness in adapting and re-purposing existing infrastructure can go a long way. Project Warp Speed harnessed decades of research into mRNA vaccines intended for cancer care and adapted these for SARS-CoV-2, the virus which causes COVID-19. Contact tracing systems deployed globally leveraged geospatial technologies used in ride-hailing and other consumer applications. Locally, physical infrastructure such as hotels, holiday chalets, military camps and convention halls were quickly configured to house thousands of COVID-19 patients to mitigate transmission and prevent overwhelming the healthcare system. The setting up of a community wastewater surveillance programme by the NUS Environmental Research Institute is another example, harnessing existing resources to set up a quick system of detection and enabling rapid ringfencing of infections.

3. Trust

Mahatma Gandhi, India's independence leader, exhorted the world: “The moment there is suspicion about a person’s motives, everything he does becomes tainted”. The pandemic has richly illustrated how corrosive mistrust can be, manifesting in multiple forms such as misinformation campaigns, conspiracy theories and the like. Open communication and collaborative partnerships built on trust between government agencies, public health entities, religious and community groups, and the public are necessary conditions for successfully combating a pandemic. Sadly, many countries did poorly on this front with delays in vaccinations and inappropriate public health interventions all too common. Even more perniciously, some actors ‘politically weaponised’ public health for their own nefarious purposes, worsening the trust deficit.

The reality of fast-spreading disease is that coordinated responses across all fronts are critical, and “trust is the glue”. Trust and the community that trust builds cannot be achieved overnight or only in crises. As Stephen Covey, author of the best-selling ‘The Speed of Trust’ drily notes, “The best time to plant a tree is twenty years ago. The second-best time is today.” Trust barometers show we are, as a world, moving in the wrong direction and this has to be reversed.

4. Global cooperation 

Pandemics can no longer be left to individual nations to handle. Widespread migration and travel mean diseases now spread much more quickly across borders, demanding a collective response internationally. Supranational public health agencies such as the World Health Organisation (WHO) need to have larger roles and responsibilities as well as resources in pandemic surveillance and response. The International Health Regulations, the only legally binding health-related legislation was shown to be woefully inadequate and a new order is needed. That said, international organisations are only as strong as their members want them to be, and member states have to determine they are better together under the central collective leadership and direction of a strong WHO than isolated and apart with an enfeebled WHO whose pronouncements are routinely disregarded.

Beyond strengthening the global peak public health body, public health networks should be developed regionally. Resource sharing among existing regional associations is a good start and it is encouraging that within our region, the Association of Southeast Asian Nations (ASEAN) has agreed to establish the ASEAN Centre for Public Health Emergencies and Emerging Diseases (ACPHEED). At the people-to-people level, the Building Alliances for Pandemic Response (Public Health) Asia [ALPHA] programme hosted by NUS will facilitate greater cooperation amongst leaders in the region, allowing an intersection of public health leadership, strong partnerships, and cross-country collaboration.

5. Commitment to equity

Moving forward, to truly achieve global health security, we must ensure equitable health development. Poignantly in Singapore, despite early laudations of stellar pandemic control, we saw an unprecedented outbreak within the migrant worker dormitories. This reinforced a sobering truth – we are only as secure as the most vulnerable groups among us. United Nations Deputy Secretary-General Amina Mohammed reminded us, “Remember, we are in this together. No one will ever be truly safe until everyone is safe.” And this truism holds at the local, national, regional and global levels.

Operationally, Universal Health Coverage or UHC for short is the right overarching framework to steer towards equitable health for all and all countries should be supported to realise this for their citizens. Globally for health security, the Microsoft co-founder turned philanthropist Bill Gates has proposed a global governance framework. This framework would include establishing a permanent organisation of experts to mount a coordinated response to a dangerous outbreak at any time in any country, conducting resilience and preparedness drills in between, a Global Epidemic Response and Mobilisation (GERM) team, as well as mechanisms to accelerate vaccine and diagnostics developments and availability particularly in low and middle income countries.

The great American epidemiologist Larry Brilliant has said “outbreaks are inevitable, but pandemics are optional”. Early in 2020, a group of public health academics gathered in NUS to discuss whether a two-week global lockdown would avoid the worsts of COVID-19. We decided that it would be highly effective from a public health perspective but that narrow national interests and partisan politics would not permit this reality. We have as a human species learnt so many painful lessons these last three years. Will we do better with the next outbreak?

About the authors

Associate Professor Jeremy Lim is the Director of the Leadership Institute for Global Health Transformation (LIGHT) at the NUS Saw Swee Hock School of Public Health, where he works to enhance cooperation, capacity building, and knowledge sharing across the region. Trained in surgery and public health, Assoc Prof Jeremy attained various postgraduate qualifications including membership in the Royal College of Surgeons (Edinburgh), Master of Medicine (NUS), and Master of Public Health (Johns Hopkins, as a Fulbright scholarship awardee). In addition, he was an inaugural fellow of the Asia Society A21 Young Leaders programme in 2006.

 

Dr Bryan Chow is a Preventive Medicine resident at the National University Health System’s (NUHS) Regional Health System Office. He has worked on population health strategies, healthcare transformation, and healthcare systems planning within the regional health cluster. A graduate of the NUS Yong Loo Lin School of Medicine, he is currently a Master of Public Health (MPH) candidate at the NUS Saw Swee Hock School of Public Health.

Dr Anne Goei is a second-year Preventive Medicine resident at the National University Health System (NUHS) with an interest in Occupational Medicine. She graduated from the NUS Yong Loo Lin School of Medicine in 2018 and completed her Master of Public Health (MPH) in Harvard. She was heavily involved in Singapore’s COVID-19 pandemic response through her work providing clinical care to patients housed at the Expo Community Care Facility and framing the Ministry of Health’s policies related to Singapore's safe re-opening. She was recently awarded the National Award (COVID-19) Commendation Medal for her efforts in fighting the pandemic.

Looking to 2023 is a series of commentaries on what readers can expect in the new year. This is the second instalment of the series.

Click here to read Professor Prakash Kumar's commentary on the search for science-based solutions to ensure food security. 

Facing up courageously to the global health crisis, many members of the NUS family went above and beyond the call of duty to protect Singapore, and the University’s community in its fight against the virus.

These individuals, along with organisations that made a significant impact in the battle, were among those honoured with the National Awards (COVID-19) by the Prime Minister’s Office (PMO) for their outstanding contributions.

“Our heartiest congratulations to the NUS recipients of the National Awards (COVID-19). We celebrate the national recognition of our deserving colleagues, as well as the efforts of the many unsung heroes in the university community who contributed to Singapore’s and NUS’ fight against the COVID-19 virus,” said NUS President Professor Tan Eng Chye.

“To the many in NUS who have worked tirelessly during the pandemic years to ensure the safety of our students, staff, and the wider Singapore community, we send our deepest appreciation. We salute your selfless commitment and service to the University and country,” he added.

The Meritorious Service Medal (COVID-19)

Associate Professor Kenneth Mak, the Ministry of Health’s (MOH) Director of Medical Services and its Chief Medical Advisor, was one of three recipients conferred the top award, the Meritorious Service Medal (COVID-19), for “demonstrating unwavering commitment and exemplary leadership in coordinating Singapore’s response to the pandemic,” according to PMO.

A familiar face at the COVID-19 Multi-Ministry Taskforce press conferences, he guided the taskforce and government agencies in crafting the overall strategy for managing the outbreak and oversaw the public health response to combating the spread of COVID-19 in the community. Assoc Prof Mak is a Duke-NUS Governing Board Member and an alumnus of NUS Medicine. 

The Public Service Star (COVID-19)

Several members of the NUS community received the second-highest award, The Public Service Star (COVID-19), for leading major efforts that significantly managed the impact of COVID-19.

They were Mr Janadas Devan, Chief of Government Communications at the Ministry of Communications and Information and Director of the Institute of Policy Studies at NUS; Dr Fidah Alsagoff, Temasek International's Joint Head of Enterprise Development Group (Singapore) and Head of Life Sciences, also a Duke-NUS Governing Board Member; and Prof Fong Kok Yong, who received it in his capacity as Deputy Group Chief Executive Officer (Medical and Clinical Services) at SingHealth. Prof Fong is a fellow Duke-NUS Governing Board Member. 

Other recipients were Adjunct Prof Vernon Lee Jian Ming, Senior Director (Communicable Diseases Division) at MOH, who is from the NUS Saw Swee Hock School of Public Health; Adjunct Prof Leo Yee Sin, Executive Director of the National Centre for Infectious Diseases, who is also from the NUS Saw Swee Hock School of Public Health; and Prof Ivy Ng Swee Lian, SingHealth’s Group Chief Executive Officer and Duke-NUS Governing Board Member.

Prof Benjamin Ong Kian Chung received the award for his role as Senior Advisor to MOH for the COVID-19 Pandemic and was NUS’ Senior Vice President (Health Education & Resources). He is also a Senior Consultant in the Division of Neurology at the National University Hospital and Chairman of the Health Sciences Authority. 

Rounding up the recipients in this category are Prof Tan Chorh Chuan, MOH’s Chief Health Scientist and Executive Director at its Office for Healthcare Transformation; and Prof Yeoh Khay Guan, Chief Executive Officer of the National University Health System and Senior Consultant in the Department of Gastroenterology and Hepatology at the National University Hospital. Prof Tan, a former President of NUS, is University Professor and Senior Advisor to the President, while Prof Yeoh is NUS’ Senior Vice President (Health Affairs). 

President’s Certificate of Commendation (COVID-19)

NUS also received accolades with the President’s Certificate of Commendation (COVID-19) which honours organisations for their exceptional efforts in the nation’s COVID-19 battle.

It was among the more than 20 organisations recognised with the certificate for having served as one of Singapore’s COVID-19 Isolation and Accommodation Facilities. As part of the national effort to contain the spread of COVID-19, the University’s Prince George’s Park Residences was converted to a Community Recovery Facility in 2020.

The NUS Saw Swee Hock School of Public Health’s Biostatistics and Modelling Domain, and the NUS Yong Loo Lin School of Medicine’s Alice Lee Centre for Nursing Studies also received nods under this category.

The team awards were a testament to the collaborative effort of many others in the NUS community whose various contributions helped Singapore overcome the crisis.

Students and staff had found different ways to play their part, from joining healthcare workers in the frontlines or offering their knowledge and expertise, to pivoting quickly to move lessons online so that learning could continue. Others rallied together to help those in need, such as rendering translation services to medical teams treating migrant workers or providing relief to them in the form of e-lessons and exercise videos as they isolated. Some even took to Zoom to engage remotely with nursing home residents when visits were suspended.

Aside from the National Awards (COVID-19), the COVID-19 Resilience Medal and Certificate will also pay tribute to the many thousands whose contributions helped the nation get back on its feet. Recipients will be announced at a later date.

See the full list of National Awards (COVID-19) recipients here.

Updated as of 6 Jan 2023

The NUS-developed NP swab, IM2, has recently reached another milestone by receiving CE certification, which allows it to be marketed internationally.

Developed by Professor Freddy Boey, NUS Deputy President (Innovation & Enterprise), IM2 features a tip section designed with small blades that extend parallel to its longitudinal axis. When the swab is rotated, the perpendicular motion of these edges will scrape and collect the necessary fluid from the nasopharynx area. A clinical study by the National University Hospital revealed that the IM2 swab was comparable in terms of safety and performance to the standard-of-care swabs used to test for COVID-19.

In order to scale up production rapidly, IM2 swabs were designed in a way that could be injection moulded, which is faster and more cost-effective than 3D printing. 3D printing is another manufacturing process that has also been used to quickly manufacture NP swabs to meet the global shortage. Initially, the 3D printing process was faster, as it did not require one to make a mould. However, once a mould is made, injection moulding proves to be the more cost-effective process, with a considerably faster cycle time for mass manufacturing.

“Injection moulding as a manufacturing process is inherently faster than 3D printing as multiple units of the swabs can be produced in a given cycle. Several hundred swabs can be produced in a few minutes using the moulding process,” shared Prof Boey.

“The use of injection moulding ensures a secure source to supply high volumes of swabs at a low cost, to meet the needs of our community and beyond. This is crucial in our continued fight against the pandemic.”

NUS partnered with local contract manufacturer, Meiban Corporation, to mass manufacture and sterilise the IM2 swabs. Together, the NUS-Meiban innovation team collaborated on the selection of a suitable biocompatible nylon material, and the necessary tests to verify the cytotoxicity level of the material, as well as whether it was able to withstand the sterilisation process. In order to facilitate the commercialisation of these new swabs, Meiban set up a subsidiary, MB Medical & Healthcare, which licensed the technology from NUS and subsequently renamed the IM2 swabs AccuSwab®.

The first customer of AccuSwab® was Temasek Holdings, which has purchased and secured millions of units for the Singapore market. In view of the global demand for NP swabs, MB Medical & Healthcare then applied for CE marking, in order to market AccuSwab® within the EU and globally.

“Getting MDR with CE certification was not a simple process. There was significant documentation to complete, and this process took MB Medical & Healthcare about six months. We were delighted to receive CE marking in January 2022, as it confirmed that our AccuSwab® has met EU safety, health and environmental protection requirements,“ said Ms Helen Ho, R&D Director of Meiban Corporation. 

“In fact, we are one of the first companies to receive CE certification for nasopharyngeal swabs. Now that we have received the certification, we will soon start selling AccuSwab® internationally.”

MB Medical & Healthcare is also in discussions with a distributor in Germany to sell AccuSwab® in the EU this year. In addition, it is also looking to form regional distributional partnerships to handle the Asia market.

“The development, localised manufacturing and sales of AccuSwab® has been a multi-organisational effort. In order to ensure that Singapore had sufficient supply of nasopharyngeal swabs during those pressing times, Temasek Holdings brought Meiban together with NUS, to look at the design and manufacturing of nasopharyngeal swabs. NUS’ proposed design is inventive and ideal for large scale manufacturing. Meiban was delighted to work with NUS on the innovation process to design and develop these swabs, and then with NUH on the clinical trials to demonstrate their safety and efficacy. We are grateful for the opportunity to work with NUS and NUH,” said Ms Ho.

“The AccuSwab® is now manufactured under MB Medical & Healthcare’s ISO13485 facility with 100 per cent quality control, to meet Singapore’s strict manufacturing requirements for medical devices.”

By NUS Enterprise

COVID-19, the third coronavirus outbreak in the past 2 decades after SARS and MERS, has severely tested the global healthcare infrastructure over the past two years and Singapore has not been an exception. We have had waves of infection beginning with imported cases leading to community transmissions and occasionally clusters in health institutions and long-term care facilities and a huge outbreak in our migrant worker dormitories in 2020.

Intensive research by many global institutions including NUS have led to constantly changing paradigms in clinical management and public health policies, as we dealt with a new way of life with social restrictions, digital interactions and unending cycles of evolving safe management measures.

Tight contact tracing, isolation and quarantine were widely used in the “zero covid era” as Singapore and other countries tried to eliminate the virus. Once that proved impossible, the focus was on mitigating the effects of the pandemic by ensuring the smooth functioning of the healthcare system. As with any infectious disease, infection control, vaccines and therapeutics took centerstage.

While oral antiviral therapies such as Paxlovid and Molnupiravir have been licensed for early outpatient use, their real world efficacy has not been proven yet. For outpatient drugs like these, the challenge, is also to ensure that diagnosis is made early in the outpatient setting so they can be used appropriately. Several NUS groups from the NUS Yong Loo Lin School of Medicine (NUS Medicine), NUS Saw Swee Hock School of Public Health and our partners have made great strides in the development and evaluation of COVID-19 test kits.

We have also conducted a large scale prophylaxis study using repurposed agents which waits for reproduction in other settings. This study led by Associate Professor Raymond Seet led to nationwide distribution of a topical povidone iodine product. In the coming year, we can see a more thorough evaluation of these and other antiviral agents for both early treatment and possibly prophylaxis.

One piece of good news is that thanks to the release of patents to low and middle income countries, both Paxlovid and Molnupiravir are more likely to benefit more people globally especially where logistical limitations prevent the early use of intravenous monoclonal antibodies. While these antibodies have the potential for prophylactic and therapeutic use their cost and complexity effectively currently limit their widespread use to higher income countries.

The next steps in vaccine development and distribution

The prevention of COVID-19 has largely been centered around the use of COVID-19 vaccines in addition to infection control. Singapore is one of the most highly vaccinated nations with 89 per cent of the total population fully vaccinated predominantly with the mRNA vaccines or the inactivated viral vaccines. There is currently a further drive to extend vaccinations to children and to roll out boosters for possibly enhanced protection.

However, vaccine inequality in resource poor countries remains a gap which needs to be closed. Next generation vaccine candidates such as protein-based vaccines which do not need a cold chain may make a breakthrough in resource-limited settings. The newer vaccines in addition may be more effective in preventing transmission or disease instead of just reducing the severity of disease. Needle-free vaccines, in the form of nasal spray, oral tablets or patches are in development and again, many NUS multidisciplinary programs are exploring these alternative vaccine approaches.

With emerging variants exhibiting immune escape and rapidly waning immunity from current mRNA and other licensed vaccines, developing multivalent vaccines which protect against multiple variants or ideally using vaccines that prevent transmission of the virus like most other licensed vaccines may contribute significantly to the management of COVID-19 in the future.

The end of the pandemic?

New and more effective vaccines will remain important even if the virus becomes simply the fifth seasonal coronavirus. Older institutionalized individuals are still vulnerable to seasonal coronaviruses and more targeted routine vaccination programs may be rolled out once the World Health Organisation declares this current pandemic over. That declaration that we are all waiting for would depend a great deal on a better understanding of how the virus interacts with humans.

Coronaviruses in general and SARS CoV2 in particular do not appear to mutate as fast as influenza viruses probably due to a viral checking mechanism which prevents mutation causing errors in viral replication. However there are still many factors that need to be taken into consideration about our immunity to the virus from vaccination, disease and possibly other viruses.

All of these have implications as to whether we will need annual COVID-19 vaccinations similar to what is done with influenza or whether a single vaccination series would be adequate as with measles or the bacterial pneumococcal vaccine.

The next pandemic on the horizon

While this pandemic will most certainly end either this year or the next, there is every likelihood that another will soon arise, most likely influenza which has lain dormant for a while.

The question arises about how we will respond – will there be more “circuit breaker” style lockdowns with the first few cases of the next pandemic virus in some country nearby in a bid to flatten the epidemiology curve and to safeguard our healthcare resources and capacity? We have learnt from experience this drastic measure may be detrimental to the economy and morale of people and may also lead to unintended effects on mental health and other medical care.

Rather we will most likely shift to more sustainable and balanced public health approach. This will include a combination of non-pharmaceutical interventions including mask wearing, isolation and quarantine especially in selected higher risk settings such as near the ports and airport, healthcare or learning institutions or mass gatherings, as well as the rapid deployment of rapid diagnostics, vaccines and therapeutics.

These interventions will all take time and the temptation will remain to lockdown hard and fast. Governments will not want to be seen to be taking the next pandemic virus lightly and it will be difficult to come up with a calibrated approach in the face of another novel threat.

Transparency and international data sharing will be critical. Social science thought leaders from NUS have contributed to this discussion but there are few answers readily available.

The open questions

Despite the explosion of knowledge in COVID-19, many questions remain unanswered. It is still not clear why children do not get severe disease; are there other measures of immune protection besides antibody titres that may determine acquisition and the clinical course of COVID-19?

The sequelae of COVID-19 such as long COVID and organizing pneumonia – are also not well characterized. Are these merely the tip of an iceberg of a post-infective inflammatory process triggered by COVID-19?

The mode of transmission of COVID-19 has been described to range from close contact to aerosol routes but the circumstances surrounding the different transmission modes needs redefinition – this has important infection control implications.

Further studies on immunological responses and biology of the virus will be paramount in delineating our understanding in these aspects. The NUS Medicine Infectious Diseases Translational Research Programme brings together clinicians and scientists from across the school of medicine to try to answer these and other pressing questions.

While there are many uncertainties about this virus and the next pandemic, we know for certain, that science has advanced with positive changes such as better vaccine options, better clinical trial networks including one focusing on Asia and based in NUS to evaluate the different treatment options, and more critical evaluation of public health measures.

These will remain crucial in controlling this pandemic and in responding to the next one. Despite the significant human cost and all the negative discourse surrounding this pandemic, hopefully the world is armed with a new level of preparedness and resilience to face the virus when (not if) it comes.

About the authors

Dr Paul Ananth Tambyah is Professor of Medicine and Clinical Programme Lead for the Infectious Diseases Translational Research Programme at the NUS Yong Loo Lin School of Medicine. He is also a Senior Consultant at the Division of Infectious Diseases at the National University Hospital. He is President of the Asia Pacific Society of Clinical Microbiology and Infection, and also President of the International Society of Infectious Diseases.

 Dr Lionel Lum is Assistant Professor and Clinical Tutor at the NUS Yong Loo Lin School of Medicine. He is also a Consultant at the Division of Infectious Diseases at the National University Hospital.

Looking to 2022 is a series of commentaries on what readers can expect in the new year. This is the fifth instalment of the series.

Click here to read Professor Tommy Koh's commentary on three upcoming anniversaries that will be key to international geopolitics.

Click here to read Professor Danny Quah's article on how societies can build back stronger from the pandemic.

Click here to read Professor Freddy Boey's views on opportunities for start-ups in the New Normal.

Click here to read Associate Professor Tan Ern Ser's commentary on enhancing retirement financial adequacy for our seniors.

A potentially game-changing Antigen Rapid Test (ART) technology to diagnose COVID-19 has been developed by scientists in Singapore. Using a proprietary on-kit amplification technique, a person’s saliva can be self-administered or tested for the SARS-CoV-2 virus at the point-of-care with sensitivity higher than current ART tests and close to that of laboratory-based polymerase chain reaction (PCR) tests.

Dubbed the Parallel Amplified Saliva rapid POint-of-caRe Test (PASPORT), the technology produces results in minutes, without the need for additional equipment or specially-trained personnel. The invention was borne out of a research collaboration between Duke-NUS Medical School, Singapore General Hospital (SGH) and National Cancer Centre Singapore (NCCS) — collectively member institutes of the SingHealth Duke-NUS Academic Medical Centre — and the National University of Singapore (NUS).

With the impending availability of oral antiviral drugs against SARS-CoV-2, COVID-19 could potentially be diagnosed and treated in the primary care setting in the future. A test that can be done on-site will enable doctors to diagnose COVID-19 accurately and prescribe the drugs appropriately. Moreover, with its anticipated low cost and ease of use as compared to PCR tests, PASPORT could aid Singapore and countries around the world in making early diagnosis of COVID-19 to initiate appropriate case management. The research was published online on Monday, 6 December, 2021, in the journal Microchimica Acta as a feature article in their series, ‘From Bench to Hand’.

“Testing is an indispensable tool in the management of COVID-19 cases. Although PCR has been the gold standard, it requires trained personnel and laboratory infrastructure,” said lead inventor Dr Danny Jian Hang Tng, Medical Officer at the Department of Infectious Diseases, SGH, and an adjunct Research Fellow at Duke-NUS’ Emerging Infectious Diseases (EID) Programme. Dr Tng, who graduated from Duke-NUS in 2019, added, “A reliable and painless saliva antigen test that is affordable and convenient to perform would encourage more to be tested, and more frequent testing. This may enable us to manage COVID-19 more effectively not only at the point of care, but also in settings such as airports, conventions and even at home.”

Unlike tests that use nasal or throat swabs, saliva-based tests are convenient and are more easily self-administered. But, until now, saliva tests for detecting SARS-CoV-2 have not been considered reliable enough to roll out at large scale. This is because the concentration of viral particles in saliva drops steeply after an individual eats or drinks. As a result, saliva antigen tests are usually only reliable when they are performed first thing in the morning, after an overnight fast and before breakfast or brushing teeth. This makes testing of saliva samples at other times of the day less reliable.

The researchers remedied this by using a two-stage process. Like other ARTs, PASPORT uses nanoparticles to bind the virus. But uniquely, it also adds a second type of nanoparticle that binds the first set of nanoparticles to amplify the signal. This makes testing using PASPORT more sensitive at finding and flagging the virus, and allows it to be used at any time of the day—its sensitivity is not compromised even after eating or drinking. Compared to other amplification techniques, PASPORT is able achieve detection even at much lower viral loads, enabling it to be extremely sensitive. In a clinical study involving over 100 participants conducted at SGH, PASPORT’s sensitivity in detecting the virus was 97 per cent and its specificity, 90.6 per cent, compared to the gold standard PCR test.

Professor Ooi Eng Eong, from the Duke-NUS EID Programme, who is one of the senior co- inventors, said, “Like COVID-19 vaccines, the availability of oral anitiviral drugs will be another game changer in our fight against COVID-19. But these drugs will need to be given as early as possible after illness onset for maximal benefit. A test that can be self-administered or used on-site at the primary care setting may mitigate the need for cases to be managed at the hospitals.”

Professor Soo Khee Chee, Benjamin Sheares Professor in Academic Medicine at the SingHealth Duke-NUS Oncology Academic Clinical Programme, a Senior Advisor to Duke-NUS, and a senior co-inventor, said, “Our invention ticks all the boxes for an ideal rapid test: ease of collection of saliva; highly accurate with very low false negative results, making it an invaluable screening tool; and can be done at any time of the day, making it possible to be used at point of care, with reliable authentication. With this, we hope that more people will do the test as a personal act of social responsibility before engaging, especially, in large-scale events or gatherings.”

Duke-NUS and SingHealth have filed intellectual property protection for the invention, and have entered into a license agreement with Digital Life Line Pte Ltd, a Singapore-based company. The inventors hope that through close collaboration with commercial partners, the product can be out in the market as soon as possible to serve healthcare needs in Singapore and beyond.

The full list of inventors are: Dr Danny Tng (SGH/Duke-NUS), Professor Zhang Yong (NUS Biomedical Engineering), Associate Professor Melvin Chua (NCCS/Duke-NUS), Associate Professor Jenny Low (SGH/Duke-NUS), Professor Ooi Eng Eong (Duke-NUS), Professor Soo Khee Chee (NCCS/Duke- NUS)

A new report by the NUS Energy Studies Institute (ESI), ISEAS - Yusof Ishak Institute, and Newcastle University proposes several decarbonisation pathways that can put Asean member states on track to transition to renewable energy, in light of an increasingly carbon-constrained world. NUS researchers contributed to the report by giving their insights on the opportunities and challenges that lay ahead for Asean member states in achieving their energy transitions towards a low-carbon future.

The report, Energy Transitions in Asean, was prepared in view of the COP26 climate talks in Glasgow in November 2021. It explored the impact of COVID-19 on Asean countries, examined how carbon dioxide emissions could be reduced while maintaining sustained economic growth, and discussed employment and social justice issues following the energy transition. The aim of the report was to provide useful context to governments in Asean to strategise their post-pandemic recovery plans and align their energy policies with the goals of the Paris Agreement. The recommendations in the report can be integrated into the ASEAN Plan of Action for Energy Cooperation for adoption by Asean member states.

"This report is an outcome of international collaboration between the NUS community and universities and research institutes from the UK and beyond. With Southeast Asia being one of the fastest growing regions in the world and requiring energy for development, this partnership comes at an important time to help deliver the strategic aims of COP26 and to fully implement the Paris Agreement,” said Associate Professor Lee Poh Seng, Executive Director of ESI.

A holistic approach to decarbonisation

The report highlighted that Asean’s COVID-19 recovery measures were missing opportunities for a green future. Few countries in the region have tied green components to their stimulus packages, which contain some environmentally harmful measures. Green recovery policies and strategies, including enhancing collaboration and partnerships, could help put Asean countries on the path to economic recovery while bringing environmental and sustainability benefits.

“This report demonstrates that, technically, steep and fast emission reductions in line with the Paris Agreement are feasible for the Asean member states. It’s a matter of showing political courage and leadership to make that transition happen,” added Melissa Low, Research Fellow at ESI and one of the leading co-editors and report’s authors.

Being home to rapidly growing economies, the Southeast Asian region is making more significant contributions to global carbon emissions. The NUS researchers emphasised an increased need for a more holistic approach in ensuring greener, low-carbon developments. This includes effective cross-ministerial coordination within each country which would greatly facilitate energy planning in alignment with climate change mitigation plans. The researchers also added that it was essential to increase the renewable energy share in overall power supply, and implement energy efficiency programmes to ensure a sustainable transition to renewable energy in the long-term.

The NUS researchers elaborated in the report that it was crucial to create a conducive environment to facilitate renewable energy deployment in the short term. This could be done with government support, for example through subsidising initial investments, providing tax incentives, and de-risking investments through power purchase agreements or feed-in-tariffs. The researchers also called for a level playing field for renewable energy to compete fairly with the use of fossil fuels in the long term. This includes addressing the powerful indirect influence of the subsidy of fossil fuels.

Call for cross-country cooperation and social justice

In addition to strong government policy and support, subsidy reforms and carbon pricing, the report also recommended fostering greater cooperation across the Asean region and collaboration with other countries. This would allow countries to leverage each other’s comparative advantages to meet their Nationally Determined Contributions and recover from the COVID-19 pandemic, while addressing developmental priorities. However, this requires support from the developed countries, including in the form of climate finance and capacity building.

The report also proposed that decarbonisation policies and programmes also pay attention ensuring a just transition, such as creating quality jobs and decent work for those displaced by the low-carbon transition. Social inclusion, gender empowerment and sustainable rural development for local communities could serve as key performance indicators to measure the success of renewable energy transition.

The report is part of a series published ahead of COP26 by the British High Commission and the COP26 Universities Network, which comprises over 80 universities in the United Kingdom and Singapore, to discuss the opportunities and challenges in Southeast Asia’s transition to a greener economy post COVID-19.

Click here to read more.

Performances and live events are the lifeblood for a music conservatory, for its students and faculty, and the wider external community it serves.

How did YST keep the music going?

Taking the music online

Amid the implementation of full telecommuting/home-based learning arrangements, YST continued to find new ways in music-making, pedagogy, and production.

While students were unable to perform to in-person audiences, they became more involved in running livestreams and producing their own shows. The graduating Class of 2021 curated, produced, and performed UNMASK 2021, a virtual concert narrating their undergraduate life. It was staged at Victoria Concert Hall and interspersed self-filmed videos with live performance. On the other end of the undergraduate journey, the freshmen cohorts from 2020 and 2021 successfully navigated the challenges of collaborating and making music during the pandemic, presenting imaginative new pieces that they created together for their First Year Creative Projects.

YST began to embrace alternative presentation formats. The on-going Asian Civilisations Museum (ACM) Lunchtime Concerts series, which began in 2007, was put on hold for most of 2020, returning in virtual form in October 2020. The final virtual concert of 2020, titled WARES and WAVES, interweaved poetry and original music created by the Conservatory’s Text and Music class in response to the Tang Shipwreck collection housed at ACM. The GENFREE concert series saw YST students, faculty and alumni exploring fusions of musical genres in a series of livestream-only concerts in collaboration with restaurant and jazz & blues club Maduro.

Associate Professor Brett Stemple, Vice Dean, Ensembles, Research & Professional Awareness, shared, “Before COVID, we were already embracing technology, interdisciplinary connections, student creative agency and collaboration. The pandemic brought numerous pedagogical and production challenges for us, but also spurred us to innovate and further embed these elements in our approach. As a result, we have not only taken our music online, but also been able to energise it with new sparks including storytelling, multimedia, animation and alternative presentation modes.”

Remembering community

Drawing on platforms like Zoom and pre-recorded videos, YST continued with a range of community outreach projects, such as performing at the Singapore Hospice Council’s Silver Jubilee Charity Show, organising a Zoom party for Institute of Mental Health patients, and volunteering at Sengkang General Hospital, Ren Ci Hospital, and more.

“Making music amidst the pandemic has certainly presented a new set of challenges for me, especially as a wind player. Amidst safety measures, events were cancelled, and playing and practicing together was also restricted. This took a hit on my morale initially and I really missed the human connection in music-making,” shared Music & Society-French Horn major Linnet Sim. “Through all this, it has been very meaningful to be able to keep up with music-making and community engagement virtually. I feel fortunate to be able to bring comfort and entertainment to various groups of people through music, and it is a great reminder of why I love doing what I do!”

The Conservatory continued to engage the wider musical ecosystem, staging Symphonies Simple & Philharmonic Friends, where the YST Orchestral Institute performed alongside young musicians (around 10 to 12 years old) from the Kids’ Philharmonic. As a pilot for returning to live audiences, this concert also featured a small, invited audience for the very first time since March 2020 – held with the nod from the Ministry of Education.

Light at the end of the tunnel

As Singapore began transiting to a safe and sustainable re-opening and encouraged by the success of staging Symphonies Simple & Philharmonic Friends, YST was hopeful of organising its first public concert.

Finally, the opportunity came in October 2021. The Conservatory successfully staged two public concerts - Bartók’s Sonata for Two Pianos and Percussion and the faculty recital Of Salt and Pepper..., where up to 200 audience members were allowed. Both were nearly fully subscribed.

Mr Joachim Theodore Lim, YST Artist Faculty, who performed in Bartók’s Sonata for Two Pianos and Percussion, said, “It felt really great to be performing again in front of a live audience; to feel their energy and attention, and to reciprocate in dialogue through our music. That is something that is difficult to replicate in ‘virtual’ performances. Our experience in the pandemic truly reminds us how precious it is to have a stage and audience, even if they may take different forms.”

Since then, YST has managed to hold numerous other public concerts and continued its digital offering. But whether the sound of music continues to reverberate through its concert hall or YouTube livestreams, the Conservatory will be sure to keep the music going.

Many had to quickly adapt to a new environment: the virtual classroom. Lecturers had to fathom how to capture the attention of hundreds of students from tiny laptop screens. Students went from having lively in-person tutorial sessions to seeing their schoolmates as sometimes static, pixelated faces online.

Inevitably, problems arose. Teaching staff experienced technical difficulties such as forgetting to unmute themselves during lessons, and the isolated nature of video lectures also lowered students’ attention spans.

Engaging the students became a priority. “The simplest is making sure that the students are paying attention during the lesson, (but) this is difficult to do in a virtual world because we cannot see their body language,” said Associate Professor Soo Yuen Jien, Deputy Head at the Department of Computer Science at the NUS School of Computing.

Assoc Prof Soo, along with other colleagues from NUS, was sharing some of the pandemic-induced challenges at EDUtech Asia 2021 – a 3-day virtual conference to bring together educators with different experiences and perspectives, with over 250 speakers from global educational institutes.

The topic of mental well-being was also raised. “The pandemic…created different types of stresses internally and it started to show that we might have probably underinvested in the mental well-being of our faculty members and staff,” noted Dr Andrew Epaphroditus Tay, NUS Director and Head of NUS Health and Wellbeing.

Despite the challenges, however, COVID-19 has also paved the way for new opportunities. The University is transforming how subjects are being taught and learnt, thanks to technology, and also ramping up efforts to support the mental well-being of staff and students.

“COVID-19 was the catalyst that kickstarted and pushed a lot of initiatives at a much faster pace,” reflected Assoc Prof Soo. “In education, it is a silver lining pushing us out of our comfort zone – we’re now starting to think of new techniques.”

Promoting mental health at NUS

With a large campus of over 50,000 students and staff, NUS needed to adopt a systematic approach to safeguard everyone’s mental well-being. This is done through the University’s #WellNUS Framework, a guide that identifies potential gaps in the school’s mental health and wellbeing services.

For instance, mental health is assessed on a spectrum that ranges from “Well” to “Recovery”. A series of wide-ranging measures are then recommended accordingly, which can include making work adjustments, peer support, or even seeking medical intervention.

“When we map out a person’s wellbeing journey, it helps us understand what the types of support needed from the various approaches are,” shared Dr Tay. “You can get a sense of the various areas to invest in, and areas we might have missed out on.”

Teaching with technology

NUS also provided support for its teaching staff by rolling out digital training to help them become more accustomed to conducting online classes, particularly in a digital age.

Encouragingly, this training has paid off, as the use of digital tools has boosted student engagement during virtual lessons.

For instance, teaching staff use Archipelago, a classroom response system that increases interaction. Questions are posted online and are immediately answered by the students.

“With this system, we have an idea of how the class is progressing and we can use it to guide the next discussion,” said Assoc Prof Soo.

Technology needs to be used strategically when it comes to learning, shared Ms Kiruthika Ragupathi, Associate Director at the Centre for Development of Teaching and Learning at NUS.

Flipped classrooms, for example, is another key concept that NUS is pushing out during the pandemic. This form of blended classes enables students to learn new content on pre-recorded videos, with actual tutorials or lectures reserved for them and the teacher to delve deeper into the topics.

“Instead of delivering the content, we actually solve problems together,” said Assoc Prof Soo. Over the next few years, NUS plans to have pre-recorded lectures for modules with a class size of more than 100 students.

New world, new roles

With technology set to play a pivotal role in the classrooms, universities will need to shift from simply being passive endorsers of technology to active partners, said NUS Chief Information Technology Officer Tan Shui-Min.

“The pandemic inadvertently highlights the need for more deliberate digital strategies and competitive models,” she explained. Describing her role as a conduit between academics and students, she elaborated on how IT professionals will be the driving force behind this transition.

She shared some ways in which they can do this, including forming strong internal partnerships with the school’s senior leadership to increase the chances of technology adoption, and fostering a culture of innovation on campus.

“Being part of an education institution allows us to participate in the grooming and nurturing of the next generation,” she said. “We should remember this higher calling and lead with passion and compassion.”

One major initiative, kick-started by the student leaders from the Halls of Residence and Residential Colleges, was the #ResilientNUS pledge – a call to concrete action by the University’s staff and students to safeguard public health. Signatories pledge to take steps such as monitoring their own health, being responsible in their social interactions, rejecting misinformation, and complying with safe management measures.

That initiative has in fact ignited interest beyond the University, growing into a national movement with many other local universities adopting it as the #ResilientSG pledge.

“Of course some of my friends have asked me what even is the point of this pledge,” shared Kent Ridge Hall’s Junior Common Room Committee (JCRC) President, Sing Hui.

“While its effectiveness depends on the practical translation and implementation by NUS as a whole, we hope the pledge and frameworks serve to provide a structure and direction for students and staff to follow,” added the Faculty of Engineering undergraduate.

“We hope such a movement can encourage more social responsibility amongst our community.”

Led by the Halls and Residential Colleges

As a means to galvanise their communities and reaffirm their commitment to practising social responsibility in the ongoing fight against the pandemic, some Hall and Residential College (RC) student leaders proposed COVID-19 pledges for their respective communities. Among these were Kent Ridge Hall, Raffles Hall, the University Scholars Programme’s Cinnamon College, and the College of Alice and Peter Tan.

As the ground-up initiative, by students and for students, swiftly gained traction in the various communities, its leaders recognised the potential for expanding the scale of the pledge. Collaborating with the National University of Singapore Students’ Union (NUSSU) leadership, outgoing NUSSU President Wee Su-ann and incoming NUSSU President Lee Yat Bun, student leaders distilled and refined the pledges of the various Halls and Residences into one.

As Sing Hui explained, “We aren’t able to help with the pandemic in big ways like policymakers or frontline workers. But from our end as students, what we can do is to emphasise social responsibility and acknowledge the small ways in which students can do their part to fight the pandemic.”

And thus the #ResilientNUS pledge was born, and staff and students from within the entire NUS community began pledging their commitment to remain vigilant and do their part to safeguard the health and wellbeing of themselves and their communities.

Movement spreads nationwide with the #ResilientSG pledge

Recognising the virtue of the pledge in uniting communities and encouraging a sense of stakeholdership and social responsibility, Minister for Health Mr Ong Ye Kung expressed his support for the ground-up initiative when he met with student leaders during the two-day Halls of NUS (HoNUS) Retreat 2021. Later, four other autonomous universities—Nanyang Technological University (NTU), the Singapore Institute of Technology (SIT), the Singapore University of Social Sciences (SUSS), and the Singapore University of Technology and Design (SUTD) — came on board as well, adapting the pledge for their own communities and giving rise to the evolved #ResilientSG pledge:

Su-ann said, “It’s great to see everyone coming on board to want to do more to protect the community! It is a good starting point to get everyone to recognise that the part they can play in keeping the community safe.”

Emphasising the need for individual responsibility transitioning into an endemic phase, Yat Bun added, “The pledges serve as a reminder for students of NUS and Singaporeans to be vigilant of their health and to be compliant with regulations. Individuals will have to internalise and effectuate what they pledged to ensure a safer environment for everyone to live in and enjoy.”

“I hope that we can all look out for one another's health and mental well-being, and that everyone will stand united in the fight against COVID-19. We need to realise that the only way we can get through this is together. Only when we all play our part in keeping NUS safe, can we then move forward in our fight against COVID-19.”

Read and sign the #ResilientNUS pledge.

A new study by two researchers from the National University of Singapore (NUS) posits the use of residential electricity consumption data as an accurate measure of community response during unprecedented and disruptive events, such as a pandemic. In this context, by tracking how the households’ electricity demands changed during a given time period, the researchers could analyse links between community behaviour and information about the pandemic’s progression as it became publicly available.

The study concluded a strong positive correlation between the household peak consumption, specifically in the evenings, and newly reported COVID-19 cases in Singapore. This suggests that the local community reacted proactively during the early stages of the pandemic by opting to stay in, where possible. Voluntary steps were taken to protect themselves, even before a government-mandated lockdown.

“Our team routinely analyses data on domestic electricity usage, collected using smart energy meters. We wanted to apply this area of expertise to study pandemic response, as we believe this can support policymakers in assessing the people’s willingness towards embracing risk-reduction behaviours, to design effective public health updates,” said Assistant Professor Jimmy Peng from the NUS Department of Electrical and Computer Engineering, who oversaw the research.

The study was first published online in the journal Proceedings of the National Academy of Sciences on 24 August 2021.

Electricity usage as an accurate indicator of population behaviour

Among the most commonly used indicators to study social behavioural changes during the COVID-19 pandemic are population surveys, and anonymised data from mobile phones, including geolocation data and contact-tracing data collected through dedicated applications.

These indicators face a variety of limitations. During the early stages of a pandemic, the use of contact tracing apps has yet to garner traction and may not be used widely. Results can also be skewed when individuals own more than one or no phone at all, while demographics such as elderly and children may be underrepresented in phone usage. Conversely, surveys only present snapshots at a particular time, so the information quickly becomes outdated in a fast-changing environment. There is also human tendency to provide expected answers rather than accurate answers.

Electricity consumption, on the other hand, is objectively measured through smart energy meters, available to policymakers in real time, and not self-reported by users, thus accounting for greater accuracy. The data is also more democratic, given that every household, regardless of demographic, has electricity meters.

With this in mind, the NUS team collected the electricity consumption data of 10,246 households in the city-state from January to May 2020, across a spectrum of income brackets and residential homes, from single-room flats to bungalows.

Cognisant that Singapore residential electricity consumption in a typical non-pandemic environment would be predominantly influenced by the weather and rising temperatures, the researchers’ analysis did not focus on the magnitude of increase. Instead, they looked at how much of the increase could be explained by, or attributed to news of the COVID-19 progression as opposed to common weather factors.

To do this, the team constructed a Vector Error Correction Model (VECM) to capture and account for the COVID-19 data and weather parameters as possible factors that might influence household electricity consumption. Specifically, they looked at the peak value of the aggregated residential consumption from 8pm to 11pm. This allowed the team to determine how much change in each of the influencing factors resulted in a change in the latter. In other words, the study could pinpoint the various factors’ relative influence on electricity consumption.

The VECM was trained for the period beginning 23 January 2020 until 7 April 2020, just before the Singapore government implemented the Circuit Breaker (or lockdown period). In a nutshell:

• Before lockdown: Weather and new COVID-19 cases explained 3.2 per cent and 93 per cent, respectively, of changes in the peak electricity consumption
• During lockdown: Weather and new COVID-19 cases explained 29.6 per cent and 3.3 per cent, respectively, of changes in the peak electricity consumption

The results confirmed that while both COVID-19 progression and the weather influenced the electricity consumption, the most significant factor was the new daily COVID-19 cases – contributing over 93 per cent of the variance – while the weather played a relatively minor influencing role.

Significance of the findings and applications for policymakers

The findings of this study demonstrated that although the government did not implement mobility restrictions prior to the Circuit Breaker, people in Singapore proactively responded to the increasing number of new COVID-19 cases reported. In particular, the increased electricity consumption suggested that people either stayed in to a greater extent, or performed more activities at home rather than outside during the evenings.

“Specific to the local context, our study suggests that authorities were indeed effective in persuading the community about the severity of the disease, and the need to effect immediate behavioural and lifestyle changes to tackle it,” explained Dr Gururaghav Raman, a Research Fellow from NUS Electrical and Computer Engineering, and the co-author of the paper.

“What’s interesting is this proactive response was characteristic across all demographics of society. Despite varying levels of affluence and economic means, collectively, Singapore as a nation was willing to take voluntary steps to mitigate risk and exposure to the virus, at least in the evenings, which could also explain the nation’s relative success in controlling the pandemic,” he added.

The NUS team’s hope is that residential electricity consumption data will provide governments in Singapore and beyond with a useful tool and indicator that can capture populations’ behaviours accurately and dynamically, especially during times of crises. In doing so, national mandates can be more tailored, with targeted interventions for communities that most require them.

“For example, if we could identify specific demographics that aren’t able to reduce mobility, these communities could then be specifically supported by the vaccination programme or given priority,” shared Asst Prof Peng. “We are grateful to the Energy Market Authority Singapore and SP Group for providing us with this data, and the National Research Foundation Singapore for funding this research through the Future Resilient Systems Programme. As shown in this study, these numbers are available to us in real-time and is representative of all demographics. This can be very helpful for policymakers in adapting public health measures in an uncertain and unfamiliar terrain.”

A new study led by researchers from the National University of Singapore (NUS), and conducted at the National Centre for Infectious Diseases (NCID), revealed that severe acute respiratory syndrome coronavirus (SARS-CoV-2) particles can be aerosolised by an infected person during talking and singing. They also found that fine aerosols (less than 5 micrometres, or μm) generated from these two types of activities contain more viral particles than coarse aerosols (more than 5 μm). The researchers concluded that fine respiratory aerosols may play a significant role in SARS-CoV-2 transmission, especially in an indoor environment, and hence, should be taken into consideration when planning infection prevention measures.

“While previous studies have established the relative amount of aerosols (or the amount of particles) produced through similar activities, they did not measure the amount of SARS-CoV-2 virus particles generated. To our knowledge, this is the first study to quantify and compare SARS-CoV-2 particles in aerosols generated through breathing, talking and singing. Therefore, our team’s work provides a foundation for estimating the risk of transmission of infection,” said project leader Associate Professor Tham Kwok Wai, who is from the Department of the Built Environment at the NUS School of Design and Environment.

The study was first published online in the journal Clinical Infectious Diseases on 6 August 2021. Within a day of its publication, the paper was ranked among the top 5 per cent of all research outputs scored by data science company Altmetric, and was given one of the highest attention score after different factors, like the relative reach from social media sites, blogs, policy documents, and more, were taken into account.

Measuring SARS-CoV-2 particles in respiratory aerosols

The study involved 22 COVID-19 positive patients who were admitted to the NCID from February to April 2021. The NCID was the research site that selected and recruited the patients, and performed whole genome sequencing to determine their viral strains of infection.

The participants had to perform three separate expiratory activities on the same day. These activities involved 30 minutes of breathing, 15 minutes of talking in the form of reading aloud passages from a children’s book, and 15 minutes of singing different songs, with rest between activities.

The participants had to carry out these three activities using a specially designed exhalation collection equipment known as the Gesundheit-II. This equipment was made available for this research by its inventor Professor Donald Milton from the University of Maryland, who is one of the co-authors of the paper and a collaborator on the project. In the studies, participants were required to place their head at the cone-shaped inlet of the equipment. This cone served as a ventilation hood where air is continuously drawn around the participant’s head, allowing the collection of expiratory particles into the connecting sampler.

Aerosols were collected in two size fractions, namely coarse (more than 5 μm) and fine (less or equal to 5 μm). The sample viral load was quantified by using a method known as reverse transcription-quantitative polymerase chain reaction.

“We observed that COVID-19 patients who are early in the course of illness are likely to shed detectable levels of SARS-CoV-2 RNA in respiratory aerosols. However, person-to-person variation in virus emission was high. Some patients surprisingly released more virus from talking than singing,” shared project co-leader Dr Kristen Coleman from Duke-NUS Medical School.

"It has thus far been difficult to directly show how SARS-CoV-2 can be transmitted. Through the coordinating efforts of one of our resident doctors, Dr Sean Ong, and the support of our nursing team and patients, we were able to study key high risk activities like talking and singing while ensuring the safety of the patients and staff involved. The end result provides direct measurements to show that besides respiratory droplets, virus particles emitted in exhaled breath and vocalisation activities are likely important mechanisms for transmitting SARS-CoV-2," said Dr Mark Chen, Head, NCID Research Office, National Centre for Infectious Diseases.

The research also involved collaborators from the NUS Yong Loo Lin School of Medicine’s Departments of Microbiology and Immunology, Otolaryngology, and Medicine, Tan Tock Seng Hospital, National University Health System, as well as the Institute of Molecular and Cell Biology at the Agency for Science, Technology and Research (A*STAR). It was supported by the Singapore National Medical Research Council and NUS.

Multi-layered approach for infection control

The findings of this study demonstrated that exposure to fine-particle aerosols needs to be mitigated, especially in indoor environments where airborne transmission of SARS-CoV-2 is most likely to occur. Reducing exposure to fine respiratory aerosols can be achieved through non-pharmaceutical interventions, such as universal masking, physical distancing, increased room ventilation, more efficient filtration and appropriately applied air-cleaning technologies.

In particular, the research team recommended a multi-layered approach of control measures to decrease the risk of airborne SARS-CoV-2 transmission.

“Although our attempts to grow infectious virus in cell culture were unsuccessful, our studies can provide an important baseline to guide infection prevention activities,” explained Professor Paul Tambyah from the NUS Yong Loo Lin School of Medicine, who is one of the co-authors of the research paper.

“In situations involving singing, safe distancing among singers, as well as the averting and filtering of airflow from choir to audience, such as by deploying air curtains, are important considerations. For situations involving talking, determining airflow patterns and minimising exposure through seating and furniture configurations, distancing, and air movement alteration, such as fans, including desk fans are practical options that can be taken to lower the risk of SARS-CoV-2 transmission,” commented Assoc Prof Tham.

Further studies

In view of more recent variants of the coronavirus, especially the Delta variant which has been reported to be more infectious, the researchers plan to use the same methods to determine if the aerosol viral load associated with the new variants, especially the Delta variant, is higher than previous strains.

As talking is the predominant community activity, the research team is also looking to establish the infectiousness of airborne aerosols, or live virus, emitted through talking by infected persons.

Vincent Cai: COVID-19 contact tracing became a calling

Vincent Cai joined the Communicable Diseases Division at the Ministry of Health a month before the first cases of COVID-19 were reported in Wuhan. A natural extension from his past experience with surveillance and reporting of droplet-borne diseases during his postgraduate studies at the NUS Saw Swee Hock School of Public Health, Vincent soon found himself in multiple roles related to Singapore’s contact tracing efforts.

Performing a delicate balancing act, he completed his practicum in school while juggling the demands of contact tracing work at the peak of Singapore's COVID-19 outbreak in 2020. He received his degree of Masters in Public Health (MPH) from NUS on 26 June 2021.

Recounting the challenging period at the height of the global pandemic, Vincent confessed that the journey was a tough one. In the initial weeks, little was known about the new virus. The science behind COVID-19 was constantly evolving, and the challenges that came with each case were also different. In an atmosphere of fear and uncertainty, Vincent had to handle each case with tremendous empathy, building a rapport with the contacts and their families while reassuring them of what to expect in the days ahead.

“Experiencing the rapid changes in the pandemic has made me realise the importance of being nimble and adaptable,” shared Vincent. “However, as a Public Health Officer, I see it both as a privilege and a duty to contribute to Singapore’s national effort of bringing COVID-19 under control.”

Vincent decided to enrol in the MPH programme after witnessing how the work of the School was translated into meaningful changes in healthcare delivery and initiatives, such as the War on Diabetes.

He credited his education for preparing him to handle the challenges of COVID-19. “My studies at NUS exposed me to a diverse range of public health topics, and gave me the opportunity to work with professionals from a wide range of backgrounds. This exposure has prepared me well for my current work, where a single issue, like a global pandemic, will have an impact on many sectors and facets of life,” he said.

Vincent’s current role within the Contact Tracing Task Group is to initiate the contact tracing process by verifying confirmatory laboratory results of patients that test positive for COVID-19. He remains continually inspired by what Singapore has achieved for public health, and is determined to contribute to its continual progress.

Joel Lim: A deep-seated love for humanity imbued in his DNA

Joel Lim Jia Yi comes from a family of doctors, and from young, he has been fascinated by the breadth of medicine, with its many specialties and subspecialties. As a teen, Joel would spend his school holidays shadowing his father, a family physician, in-clinic. He vividly remembers his father’s compassion and being a trusted, well-respected friend to those under his care.

Joel’s maternal grandfather, a paediatric surgeon, also influenced his decision to pursue medicine. He recalls his grandfather as being extremely kind and generous towards his patients who were unable to afford surgery.

Joel’s undergraduate experience in NUS Yong Loo Lin School of Medicine continued to fuel his desire to pay it forward. He volunteered in various NUS Medicine student-led programmes in the community. These include health screening and education for migrant workers under the ‘Working Without Walls’ programme, developmental assessments for children as part of the ‘Neighbourhood Health Service Kids’ initiative, and educating the public on dementia and geriatric depression under ‘Project i-Remember’.

On 3 July 2021, Joel will be receiving his Bachelor of Medicine, Bachelor of Surgery with Honours degree, and he currently serves as a freshly minted house officer at the National University Hospital.

Despite graduating amidst the turbulent COVID-19 pandemic, Joel feels privileged to be part of Singapore’s excellent healthcare system. He shared, "Although the pandemic has changed the frontiers of Medicine, the calling for doctors remains unchanged as we continue to put patients first... to cure sometimes, to relieve often, and to comfort always”.

Sharlyn Ng Jia Yi: Embracing a multi-disciplinary education

A deep passion for learning led Sharlyn Ng to be the first double major graduate from the Alice Lee Centre for Nursing Studies at NUS. Come July, she will be graduating with a Bachelor of Science in Nursing with Honours (Distinction) with a second major in Economics. In addition to her academic achievements, Sharlyn is a cellist who was an active member of the NUS Symphonic Orchestra.

An academic interest in the field of medicine and biology led Sharlyn to explore Nursing as an undergraduate degree. While selecting her modules in her second year, Sharlyn was drawn to Economics as she appreciated how the subject linked mathematical concepts with real-world applications. She decided to pursue a second major in Economics.

“I plan to study Health Economics in future, since it applies to my career in the healthcare industry,” she shared.

During her hospital placements, Sharlyn experienced the fulfillment of nursing particularly when she saw patients discharged. Apart from performing duties like cleaning wounds and administering medication, she also honed her people skills through her interactions with patients and their families, visitors as well as fellow healthcare workers.

Amidst these hospital attachments, Sharlyn also performed with the NUS Symphony Orchestra. Since taking up the cello when she was 13, she has participated in numerous orchestral performances and competitions.

Sharlyn will be starting work as a nurse in the National University Hospital in August 2021. As the first in her family to enter the healthcare industry, she remains clear about her calling as a nurse, and is undaunted by the ongoing pandemic.

“With or without COVID-19, there are patients who need medical assistance. It is my duty as a nurse to care for them,” emphasised Sharlyn.

Wong Jun Ming: Solving ‘teething’ problems with technology

When Wong Jun Ming was in primary school, his desktop computer crashed. His uncle came to the rescue, and restored the system in a jiffy. Jun Ming was intrigued by how the seemingly complex components can be repaired so easily, and that ignited his deep interest in information technology (IT).

Given his keen interest in robotics and computing during his earlier school days, some of his friends were surprised that Jun Ming chose Dentistry when he enrolled in NUS. Jun Ming shared that his interest in Dentistry was sparked when he came to better understand the profession during his regular braces appointments.

“I was amazed at the range of technology that goes into designing and making dental prostheses – intraoral dental imaging, 3D x-rays, and even computer-aided design systems and manufacturing systems!” he recalled.

That made him realise that technology can be applied in other areas of the dental profession to make a positive impact on people’s lives. “I want to use modern technology to come up with solutions to bridge gaps in the dental profession, and advance the practice of dentistry,” he explained. This was one of the main reasons he chose to study Dentistry in NUS.

And he did exactly that during his four years of study at the NUS Faculty of Dentistry, where he developed several solutions that are being used by dental faculty members and students today.

One of them is a mobile app called ‘Cariogram’ which he developed in his second year. It is a resource that helps identify and stratify the risk of a patient developing dental caries, and understand the possible interactions between caries related factors. It was very well-received by the Faculty, and is now used by students as part of their complete examination of patients.

When he was in his final year, Jun Ming worked with his lecturer Dr Lim Li Zhen to design and develop an online resource called PanoAnatomy. The site enables dental students and junior clinicians to learn and practice recognising anatomical structures and landmarks on dental x-rays. It has been shared with 20 other dental schools around the world, and used by both NUS undergraduate and postgraduate students.

Jun Ming completed his Bachelor of Dental Surgery degree in 2020, and is currently working as a Dental Officer at the National Dental Centre Singapore. Graduating at the height of the COVID-19 pandemic, he shared that infection control and patient safety are top priorities for him.

“In dental school, we had to learn about infection control procedures, and had to pass practical and theory tests before we can treat patients. At work, I make sure that the necessary protection measures are in place. It is not just about my safety, but also that of my patients and my colleagues,” he emphasised.

COVID-19 and the road ahead

Despite their varied backgrounds, and the uncertainty the future holds, Vincent, Joel, Sharlyn and Jun Ming are committed to facing the challenges wrought by the global pandemic head-on.

Be it a provision of medical healthcare, contact tracing to curb the spread of transmissions, or even introducing new technologies to enhance the practice of dentistry – COVID-19 is an example of a modern-day problem that will require a synthesis of multi-faceted skills and abilities. It will take young people, such as these four recent NUS graduates, with a strong passion for healthcare, to enable Singapore to emerge stronger from this time of crisis.

Click here to read more.

Rishika's story inspired Mission India — a fundraising project started by the NUS Graduate Students’ Society in collaboration with TIE Singapore, and supported by the NUS Office of Students Affairs. Mission India aims to raise US$1 million towards procuring medical equipment such as oxygen concentrators and building the medical infrastructure in India.

Read more about Mission India and Rishika’s experience here.

Since then, more than 1 billion doses of various COVID-19 vaccines have been administered worldwide, serving as an important line of defence against the virus. But the speed at which the vaccines were rolled out have led to doubts, said NUS President Professor Tan Eng Chye.

“Understandably, there are some questions and concerns among the public on safety and efficacy standards,” he said, adding that the rise of misinformation on social media platforms has further fuelled vaccine hesitancy – a delay in acceptance or refusal of vaccines despite their availability.

This has been one of the biggest challenges in controlling the pandemic, noted Prof Tan in his opening address at the International Conference on Vaccine Confidence and Acceptance, a virtual conference organised by the Asia Pacific Immunization Coalition (APIC) on 28 May. It was jointly hosted by the NUS Yong Loo Lin School of Medicine and NUS Saw Swee Hock School of Public Health (SSHSPH).

Such spread of misinformation is dangerous, added Professor Chong Yap Seng, Dean of NUS Medicine. “We need to ensure that all people, both young and old, understand the value of vaccines, and their crucial role in creating healthier societies. There needs to be an understanding that no one is safe unless everyone is safe,” he stressed.

To fight vaccine hesitancy, more also needs to be done in terms of communication, said SSHSPH Dean, Professor Teo Yik Ying. “Fake news, misinformation and disinformation have worsened in light of COVID-19,” he said. “Most importantly, how do you communicate the benefits and anticipated side effects to people in a transparent, yet informative way?”

The forum went on to discuss the solutions to eliminate vaccine hesitancy, such as harnessing technology and formulating proper communication strategies.

Efficient and Effective

Despite concerns surrounding the speed of vaccine roll-out, there is no denying their effectiveness.

NUS Medicine’s Professor Paul Tambyah, an infectious diseases expert who is also Senior Consultant at the National University Hospital, referred to the recent resurgence of COVID-19 cases in Singapore and cited the Tan Tock Seng cluster as an example.

With only three out of 30 vaccinated healthcare workers from Ward 9D getting infected, the vaccine had maintained an efficacy rate of 90 per cent. In contrast, the SARS outbreak 17 years ago saw 10 healthcare workers infected in a similar-sized ward. This points to a far higher attack rate when no vaccine is available, he observed during a plenary about vaccine adverse-event monitoring.

“To my knowledge, there has (also) never been a transmission of COVID-19 from a vaccinated individual”, added Prof Tambyah.

While there has been reported side effects in vaccines such as rare blood clots and allergic reactions, he maintained that the benefits of mass vaccination outweigh the risks.

“Even if the incidence is 10 per million, that’s 999,990 people who are going to take the vaccine without getting blood clots. You’ve got to weigh up the numbers,” he said.

The 3Cs of vaccine strategy

To assuage concerns about the side effects of vaccines, clear communication is crucial, said NUS Senior Vice President (Health Education & Resources) Associate Professor Benjamin Ong, who is also Chairman of Singapore’s COVID-19 Vaccination Strategy Committee.

With more than one-third of the Singaporean population having received at least one dose of a COVID-19 vaccine, and about one-quarter fully vaccinated, Singapore has been relatively successful in getting its population vaccinated.

Speaking on a panel about public acceptance of COVID-19 vaccinations in Singapore, he shared the city-state’s 3Cs strategy of targeting confidence, convenience and complacency.

Building confidence requires the rigorous testing of the vaccines. “The Health Sciences Authority (HSA) studied the various stages of vaccine trials, quality of trials, and their outcomes,” noted Assoc Prof Ong, adding that this approach offered assurance to the population.

Being transparent also helps to build trust. “(It) gives members of the public, and healthcare professionals the confidence to push ahead. I feel that trusted information is really important to bring the public on board”, he said.

Another crucial factor in promoting vaccinations is making information easily accessible so that people who are undecided are more likely to give it a shot due to the convenience.

Dr Scott Wong, a Medical Officer and Senior Data Scientist at the Ministry of Health, demonstrated how information technology can be deployed to spread awareness about vaccines. He gave the example of chatbots that provided audio and visual information about the virus to Singapore’s migrant workers who had been severely impacted by COVID-19 last year.

A powerful vaccination strategy must also eliminate vaccine complacency. For instance, in countries that have controlled the spread of COVID-19, there are more instances of people opposing vaccines as they may not realise the severity of the pandemic, noted Assoc Prof Ong.

To counter this, Singapore will need to find ways to motivate people into taking the vaccine –

for example, by using incentives such as waivers for COVID-19 tests, or leveraging on a ‘fear of missing out’. “As you can see, over time, the more people get vaccinated, the share of people willing to get vaccinated, has also grown”, he added.

Framing the narrative

Effective communication is not just about choosing the right mode of transmission, but also about crafting compelling content.

Speaking on a panel about global vaccine acceptance, Director of the Vaccine Confidence Project (VCP) Professor Heidi Larson said finding the most engaging way to portray vaccines is critical in shaping how people perceive them.

Based in London, the VCP monitors public confidence in vaccines. Prof Larson explained how certain words like ’moral obligation' can illicit negative responses because they frame vaccines as something forced upon people. Instead, she called for vaccines to be associated with ‘protection’ as it resonates with what people care about.

Ms Karen Alparce-Villanueva, Vice-President of the Philippine Alliance of Patient Organisation (PAPO), who spoke at a plenary that discussed ways to increase public engagement, shared about shifting the narrative from being authoritative to more emotive so as to better connect with citizens.

The “I’m the medical expert, therefore you listen to me” approach is no longer ideal, she said.

Whole of government approach

As with crafting narratives, proposed solutions need to be well-rounded and inclusive. This calls for a whole of government approach, said NUS President Prof Tan and Assistant Professor Reuben Ng, Lead Scientist (Data and Technology) at the NUS Institute for the Public Understanding of Risk.

“Overcoming vaccine hesitancy will require a coordinated interdisciplinary strategy involving not only the health and medical professionals, but equally social scientists, communication specialists, the media and the community”, said Prof Tan.

Asst Prof Ng also called for different ministries to play more prominent roles. Taking a differentiated approach helps determine how best to frame messages, and opens up more channels of communication, he added.

“I think (a whole of government) approach will really push things ahead”.

The way forward

This conference is timely in the fight against COVID-19, as it provided “ample opportunity for learning about the [global vaccination situation]”, said Prof Tikki Pangestu, Co-Chair of APIC and Visiting Professor at NUS Medicine.

The takeaways from the various local and international speakers will shape vaccination strategies in numerous ways, he noted.

Wrapping up the conference, Prof Chong from NUS Medicine reiterated the need to learn lessons from the pandemic that will offer sustainable solutions for the future.

“This pandemic is a defining moment, and we should use it as a lesson to think about how we should proceed with vaccines. It is important that we don't just go back to business as usual after all this,” he said.

As the global community continues to grapple with the fallout from the pandemic, governments, institutions and leaders have also begun to ponder the shape of the world post-COVID. No firm consensus has emerged, but there is general agreement that it will be marked by multifaceted complexities and deep uncertainties.

The profound challenges confronting us will require fresh thinking and bold solutions. Here, universities have a unique opportunity to shape the future, by re-envisioning themselves as powerful enablers of innovation, creativity and enterprise that generate new opportunities, support lifelong learning and development, and advance societal well-being.

There are many ways universities can contribute to promoting innovation and creativity for wider social impact, but here I would like to share three approaches that have proved transformational for the National University of Singapore (NUS).

Entrepreneurship as a distinct learning pathway

For our undergraduates, an immersive entrepreneurship education can be a life-changing experience, seeding a mindset of risk-taking, fortitude and entrepreneurial innovation.

Our flagship NUS Overseas Colleges (NOC) programme, which started in 2001 and immerses students in global entrepreneurial hotspots for up to a year, has produced some 3,000 alumni.

A recent study has revealed the tangible and positive outcomes of the programme, suggesting that NOC alumni are almost 10 times more likely to become entrepreneurs within six months of graduating compared with other NUS graduates. In addition, figures on 665 start-ups launched by NOC alumni reveal that they collectively raised an estimated US$670 million (£490 million) in funding, as of July 2018.

Universities as innovation hubs

For entrepreneurs to realise their full potential, the support of a dynamic innovation ecosystem is essential. Universities play a vital role as anchors in such ecosystems, particularly in research and talent cultivation. There are many examples across the world, with Silicon Valley being the most famous, but others include the Korea Advanced Institute of Science and Technology (KAIST), the Southern University of Science and Technology (SUSTech) in China, and Technion Israel Institute of Technology. NUS is privileged to play a leading role at the heart of Singapore’s start-up environment, which is vibrant and thriving.

Strong government support for research has been a driving force, with US$19 billion committed towards the nation’s Research, Innovation and Enterprise 2025 plan. As a result, NUS has seen a strong upward trajectory in our research funding, reaching US$570 million in 2019.

NUS also supports the growth and development of the ecosystem as a whole, by offering a full suite of entrepreneurship support services, ranging from mentorship and accelerator programmes to funding and global networking opportunities.

Interdisciplinary intellectual frameworks to meet new challenges

Innovation and creativity should not be ascribed only to those with an entrepreneurial bent; instead, these attributes should be actively promoted as general competencies across society.

This is a mindset shift that has gained greater urgency as the world continues to throw up ever more global problems such as climate change, technological disruption and income inequality: challenges that are complex, inter-woven, and that often defy single-discipline solutions.

Historically, universities have been centres of innovative thought because individuals with different skills and abilities gathered and interacted together. The intersection of domains in particular often triggered the most creative insights.

At NUS, we are seeking to nurture this highly adaptive and dynamic interdisciplinary framework not just between groups of people, but within each individual student, with a transformative push towards interdisciplinary studies.

Starting next academic year, 2,000 undergraduates will begin courses in our new College of Humanities and Sciences (CHS). The core aspects of CHS include: a curated common curriculum, which spans multiple disciplines, to broaden intellectual foundations; a learning approach that emphasises synthesis, integration and insight between intellectual domains; and experiential learning through problem-based pedagogies, to encourage working with ideas and knowledge at the interface and interplay between disciplines.

This mode of learning supports real-world problem-solving, which often requires that we develop an understanding of the many complex ways people, institutions and natural forces interact. Interdisciplinary effectiveness is also in line with the expressed preference by employers for graduates who are adaptable and creative and able to apply skills and knowledge in changing environments.

Post-graduation, our graduates will embark on their lifelong learning journeys. With longer life spans and continuous career transitions, interdisciplinary competence will be a key tool to help them navigate evolving workplace demands, and as they seek fulfilment through self-development.

COVID-19 has demonstrated clearly how we need to harness innovation, creativity and a spirit of resilient enterprise to meet complex and important challenges. As we move towards a post-COVID landscape, universities have a profound role as enablers to help unleash societal and individual talent that maximises potential and advances community well-being.

About the author

Professor Tan Eng Chye is President of the National University of Singapore. A passionate academic and educator, Prof Tan is a member of the World Economic Forum’s Global University Leaders’ Forum, as well as Singapore’s Future Economy Council, which is tasked with driving the growth and transformation of the country’s future economy.

This article was published by Times Higher Education on 28 May 2021. Prof Tan will deliver the opening keynote on 1 Jun 2021 at the Times Higher Education Asia Universities Summit. 

20 May 2021

Dear Colleagues and Students

Since late April, we have seen a steep spike in COVID-19 cases in the community, especially the number of unlinked cases. As the situation has not improved, the Multi-Ministry Taskforce recently announced new tightened measures to arrest the increasing number of cases in the community. These measures, one of which includes restrictions on large gatherings, took effect from Sunday, 16 May 2021 and will take us through to Sunday, 13 June 2021.

The current situation is very fluid and the outlook ahead is uncertain. As such, I have shared with both the Class of 2020 and the Class of 2021 that the University can no longer hold in-person Commencement ceremonies for the two cohorts, which were scheduled from 17 June to end July 2021. We will, instead, be moving to virtual Commencement ceremonies, which will retain elements of our traditional proceedings.

The decision to move to online ceremonies was not made lightly. Many of our graduates had registered for the ceremonies and they were looking forward to the celebrative event. Our colleagues involved in Commencement had also proceeded with meticulous plans to organise the event with the necessary safe management measures in place. However, health and safety is critical when planning an event of this scale, and given the prevailing challenging circumstances, we do not wish to place all those in attendance at risk.

The Registrar’s Office will share more information on the online Commencement ceremonies with the graduates of both classes of 2020 and 2021 in due course.

Please keep well and stay safe.

With best wishes

Professor Tan Eng Chye

Click here to read Prof Tan's message to the Class of 2020.

Click here to read Prof Tan's message to the Class of 2021.

What lies ahead? Is the country destined to repeat an endless cycle of tightening and loosening its restrictions – or is there light at the end of the tunnel?

Associate Professor Hsu Li Yang, Vice Dean of Global Health at the NUS Saw Swee Hock School of Public Health, shared his insights in an interview with MONEY FM 89.3. Speaking with DJs Mr Glenn van Zutphen and Mr Neil Humphreys, Assoc Prof Hsu suggested ways to get the situation under control and avoid future restrictions.

In an earlier commentary for TODAY, Assoc Prof Hsu also shared about the strategies that Singapore can use to eventually exit from the pandemic. 

Read the commentary here. 

Recognising that the public would appreciate help navigating and understanding the many new COVID-related laws, rules and regulations, as well as financial relief schemes, the faculty’s students also initiated a website project to provide guidance, useful information, and resources.

These impactful projects were among those recognised at this year’s NUS Law Pro Bono Awards ceremony.

Empowering domestic helpers and migrant workers

Last year, the NUS Law Pro Bono Group developed a legal handbook for the FDWs. The handbook provides them with relevant information on their legal rights, responsibilities, and liabilities.

The Pro Bono Group has been working with partner organisations since 2013 through its Law & You project to conduct legal workshops to educate the FDWs on matters regarding salary, criminal law, negotiation strategies, and renewal of work permits. When the pandemic hit Singapore last year, these face-to-face workshops had to be stopped. In order to continue their efforts, NUS Law students decided to adjust their plans by compiling all the information into a handbook so that the FDWs working in Singapore can still obtain this useful information.

The team, which was led by Shyrie Chopra, Shanon Kua Yan Yu and Andrew Ng Jun De, created and published the handbook in English and Burmese and is currently getting it translated into Bahasa Indonesia. They are working with their partner organisations as well as the NUS Pro Bono Group and their faculty advisor Associate Professor Helena Whalen-Bridge in distributing these booklets to the FDWs working in Singapore. 

Andrew, Shyrie and Shanon shared that they believe that access to justice should be universal. It should not be limited to only citizens in Singapore, but should also extend to FDWs who play a crucial role in supporting households and by extension, Singaporean society.

While COVID-19, may have prevented the conducting of face-to-face legal workshops, they hope that these handbooks will be of help to FDWs in successfully navigating the legal landscape and enhance their working experience in Singapore.

Another group of students created guidebooks for the migrant worker and FDW communities.  The team, led by Charlene Tan and Ryan Young Wei Jie, produced the guidebooks to help the workers understand the safety measures that apply to them as they work in Singapore. The guidebooks were designed in various languages such as Bengali, and included non-legal solutions such as explaining the importance of using TraceTogether and where they may go to remit money.

Charlene said, “This experience has emphasised how the law is a powerful tool that has immense potential to help serve the needs of society. As students who will join the legal profession someday, we recognise that it is a privileged profession and that we want to give back using the skills that we have picked up in school to help the vulnerable in society.”

Enhancing the public’s knowledge on COVID-19 laws

NUS Law students were also behind a meaningful project to raise the public’s understanding of the country’s rapidly-changing COVID-19 rules and regulations.

Last August, on National Day, Anders Seah Nanjie and Mark Tang Yu Zhong officially launched the COV-AID project. The co-founders, along with the rest of the COV-AID executive committee, had taken three months to build up the website resource which many have found to be very informative and helpful.

A one-stop online portal, it includes comprehensive information on Singapore’s COVID-19 laws and measures, covering a wide range from sports and religion to workplace regulations and contracts related to events and tourism.

The team also roped in more than 90 students to help compile opinion pieces and conduct interviews with academics and practitioners, who shared their insights on the impact of the pandemic on industries, regional politics and even mental health.

To date, COV-AID has partnered with the Ministry of Law to author an informative guide on the Re-Align Framework, to help businesses significantly impacted by the pandemic to realign their contracts. Additionally, COV-AID has linked lawyers up with organisations, including the SME Centre, who sought to conduct COVID-related webinars for their members. COV-AID also actively seeks to work with various community centres and grassroots organisations to ensure that this resource benefits the wider community.

NUS Law Pro Bono Awards Ceremony

Over the past year, more than 2,000 hours have been clocked by over 100 NUS Law students to help those adversely impacted by COVID-19. Beyond that, students have also been continually serving and engaging in other projects - assisting in community legal clinics and Criminal Legal Aid Scheme cases; conducting legal awareness talks for family members of Alzheimer's patients; organising workshops for Youth Corps Singapore; volunteering as State Court representatives; and facilitating in-person in Deputyship applications.

These student projects won plaudits at the NUS Law Pro Bono Awards ceremony this year, which handed out awards for three categories. Financial grants were also disbursed to deserving initiatives.

Each year, the Centre for Pro Bono and Clinical Legal Education holds an awards ceremony to celebrate the achievements and leadership displayed by law students in pro bono work. The event was attended by Ms Indranee Rajah, Minister in the Prime Minister’s Office and Second Minister for Finance and National Development, and was held at the faculty’s Wee Chong Jin Moot Court. It was also live-streamed over Zoom to students and guests.

Here are the full list of award winners and projects which received the financial grants:

Pro Bono Special Recognition Award

Charlene Tan and Ryan Young Wei Jie - Migrant Workers’ COVID-19 Guide

Shyrie Chopra, Shanon Kua Yan Yu and Andrew Ng Jun De – The Law & You Legal Handbook for foreign domestic workers

Natania Peh Hui-Ting and Toh Ding Jun - Project Legal Awareness (PLAY) Mentorship

Alvina Chitra Logan and Wong Weitao - State Courts Representatives Programme

Sandra Faith Angelica Tan Wan Lin and Benjamin Ho Kok Hean - NUS PBO In-Person Deputyship Project

Anders Seah Nanjie and Mark Tang Yu Zhong – COV-AID project

Pro Bono Mentor Award 

Professor Alan Tan Khee-Jin - COV-AID project

Mr Allen Sng Kiat Peng - NUS PBO In-Person Deputyship Project

Pro Bono Innovation Award

Anders Seah Nanjie - COV-AID project

Financial grants

Student for Migration – Law & You - NUS Law Class of 1992 Pro Bono Grant and the NUS Law Class of 2017 Pro Bono Grant

NUS Criminal Justice Project - RHTLaw Asia Subhas Anandan Pro Bono Grant

NUS Law Dean Professor Simon Chesterman praised the students for their creativity and their commitment towards pro bono work, and remarked, “Notwithstanding the trying times brought about by COVID-19, you have continued to ensure that access to justice was not denied for needy beneficiaries and also helped others deal with the challenges posed by the pandemic.

“Though the work, through the clients that you have helped, through the experiences that you have and through the values that you have reflected, you remind us all why we got into law in the first place.”

COVID-19 has brought into spotlight the inextricable relationship and potential of the built environment in promoting the health of its inhabitants while adapting to unprecedented changes in the way we live, work, and play in the evolving future.

Well-designed, ‘healthy’ buildings not only improve the physical and mental well-being of occupants under normal conditions, but can help minimise their risk of exposure to transmissible diseases.

This provides a tremendous opportunity for built environment professionals to develop future-resilient solutions to mitigate the other complex challenges confronting us – climate change and resource depletion amidst urbanisation.

Catalysts of change

This movement has received further impetus with the announcement of the Singapore Green Plan 2030 - an important, goal-driven approach to sustainable development in Singapore that fast-tracks existing environmental, social and governmental (ESG) measures, in order to align with the United Nation's 2030 Sustainable Development Agenda.

It sets key targets concerning the future of the urban built environment in a comprehensive ten-year plan. They include an increased green cover to serve multiple ecosystems, and a whole-of-government approach to reducing waste and Greenhouse Gas (GHG) emissions while maximising water and energy self-sufficiency.

They underline the fact that buildings can no more be viewed as mere utilitarian elements to accommodate life functions. They need to be treated as enablers of good environmental quality, that can be harnessed to accelerate positive impacts on health and well-being of the people and the planet.

Models of change

As we contemplate new paradigms of planning and design in a post-pandemic world, it is critical to shift our techno-centric, economic-based perspective of buildings that is predicated on a two-dimensional Gross Floor Area (GFA) metric rather than a three-dimensional volumetric spatial logic.

We need to emphasise a human-centric perspective to design, aligned to the volume occupied by each inhabitant – both indoors within buildings and outdoors in the urban environment. Especially in the hot and humid equatorial climate, the importance of natural ventilation and thermal comfort should not be understated. Non-residential buildings consume some 30 per cent of total electricity in Singapore, of which 60 per cent of this is used for air-conditioning.

The creation of unobstructed urban wind paths at the district level, coupled with intelligent, mixed ventilation modes integrated into building designs, serves to enhance human comfort with minimal energy costs and carbon expenditure.

At NUS, the School of Design and Environment (SDE) is spearheading this movement in conjunction with the “Well and Green” Campus initiative. It promotes new integrated infrastructural design solutions towards creating sustainable symbiotic natural and built environments.

We see evidence in the ongoing transformation of the SDE campus with four flagship buildings: SDE4 – Singapore’s first purpose-built net-zero energy building; SDE1 and 3 – a low carbon and super-low energy adaptive-reuse development; and a proposed SDE2 “hybrid” development which will be net-positive energy and net-zero water use. Special consideration will also be given to the choice of construction methods and materials, to track the total carbon use for the development.

SDE4 has become a major driver of change, a design prototype built on the opportunities of sustainable design and actively addressing the complexities of climate change in Singapore and the region.

The adaptive reuse of SDE1 and 3 demonstrates an effective strategy for renewing existing old buildings by introducing advanced high performance design solutions and optimising operational performance.

These buildings are forerunners in the NUS roadmap for carbon neutrality that aims to achieve a zero-carbon target by 2030, in alignment with the Singapore Green Plan 2030.

They represent aspirations that can positively influence the life cycle operations of future NUS buildings, exhibiting high performance standards and initiating public advocacy for healthy and sustainable buildings.

SDE has partnered with the Delos Well Living Lab, a global wellness pioneer, in catalysing measures for enhanced health and well-being in living spaces. This initiative has led to many other projects within NUS and Singapore embracing similar concepts. NUS is also the first university in the world to register for the WELL Portfolio pilot by the International WELL Building Institute.

SDE has also been working closely with the Ministry of National Development’s Centre for Liveable Cities on the concept of sustainable integrated districts, drawing upon many of the building and infrastructural solutions deployed in the SDE campus, to achieve ambitious urban sustainability goals.

The fundamental physical planning principles remain applicable for the future. The detailed design of certain “traditional” building types will have to be re-evaluated. However, the so-called “new normal” in the way we will live, work, and play in the post-COVID era will need to be carefully studied. We have to understand the impact on the individual and society’s health, which is defined by the WHO as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”.

About the author:

Professor Lam Khee Poh is the Dean of the NUS School of Design and Environment. Prof Lam is an architect, educator and researcher who specialises in computational design support systems for total building performance analysis and building diagnostics. He is a Director of the Centre for Liveable Cities, and Advisory Board Member of Delos, which established the world's first building standard focused exclusively on human health and wellness. He was awarded the 2013 Alexander Schwarzkopf Prize for Technological Innovation from the US National Science Foundation, and was conferred the inaugural iBuildSG LEAD Distinguished Fellow by the Building and Construction Authority in 2020.

Looking to 2021 is a series of commentaries on what readers can expect in the new year. This is the seventh and final installment of the series.

Click here to read about Professor Tommy Koh's seven wishes for the year.

Click here to read about Professor Danny Quah's outlook for the global economy.

Click here to read about Dr Kelvin Seah's analysis of the Singapore economy and labour market.

Click here to read about Professor Freddy Boey's views of the start-up ecosystem.

Click here to read Professor Teo Yik-Ying's commentary on the great unknowns that remain, regarding COVID-19 vaccines.

Click here to read Associate Professor Irene Ng's reflections on the pandemic's impact on society. 

Currently, the Pfizer-BioNTech and Moderna vaccines are being administered at vaccination centres around the nation. Singapore has also received approximately 200,000 doses of the Sinovac COVID-19 vaccine as part of advanced purchases made last year, but these will not be used until the Health Sciences Authority (HSA) has approved it.

In this article, Associate Professor Hsu Li Yang, Vice Dean of Global Health and Leader of the Infectious Diseases Programme at the NUS Saw Swee Hock School of Public Health, gives his insights on some common questions related to the vaccination programme, and the differences between the vaccines available.

Q: What is the difference between the Pfizer-BioNTech and Moderna vaccines?

A: The two mRNA vaccines are very similar, with tiny doses given twice to achieve optimal priming of the immune response against COVID-19. For the Pfizer-BioNTech vaccine, the doses are 21 days apart while the Moderna vaccine is administrated 28 days apart.

The time intervals differ depending on the research done by the companies, but in general, it is not good to have the second dose too early before the stipulated period. A delay of up to six weeks or perhaps longer is thought to be okay, because the immune boost may be blunted if the second dose is given far too early.

Q: Are mRNA vaccines the most effective among the vaccine types?

A: The two mRNA vaccines currently used in Singapore are remarkably effective at protecting against COVID-19. It is not easy to compare vaccine efficacy because the licensing clinical trials were done differently, with different outcomes measured. However, the real-world experience shows that the majority of licensed vaccines are effective at preventing COVID-19, albeit efficacy appears to be reduced against the new variants.

Q: Why does the Sinovac vaccine have a reported efficacy rate between 50 to 90 per cent?

A: This is because the clinical trials were done in three different countries with different protocols and recruitment numbers. The real-world experience of Sinovac has yielded mixed results, with a markedly lower efficacy of under 60 per cent in Brazil and Chile. This could partly be attributed to lower efficacy against new variants, such as the Brazil variant of COVID-19.

Q: Are there any benefits of importing other types of vaccines, like those manufactured by Astra-Zeneca and Johnson & Johnson?

A: Boosting supply is the primary benefit in case supply chain issues develop with one or more vaccines (as has occurred even in the European Union and the United States). For those people who may have harmful reactions to one vaccine, they may yet be eligible for other COVID-19 vaccines because they are really fairly different products.

Q: How do you see the take-up rate for vaccination in Singapore, and are we on track to achieve herd immunity?

A: The take-up rate for vaccination has been far better than I expected, which is great. I do not think we can consider herd immunity as yet, because a substantial proportion of the population, like children, pregnant women, those who are immunocompromised, etc, are not eligible for COVID-19 vaccination until more evidence of the safety and efficacy emerges. Nonetheless, I understand that we are on target with regards to projected numbers to be vaccinated.

Q: Why do people experience side effects after taking the vaccination, and why do the side effects tend to be worse after the second jab?

A: The majority of side effects, especially the common ones like pain, fever and headaches, are reactogenic. This means that they arise because vaccines are specifically engineered to trigger an immune response. These side effects can be worse or manifest with the second dose because the immune system has been primed by the initial dose, resulting in a greater response with the second. There can be allergic reactions, which are much rarer. Individuals can, for reasons that are not well understood, react abnormally and excessively to one or more components of the vaccine, which results in hives, rash, or in extreme cases, life-threatening anaphylaxis.

Q: Are side effects more common among certain groups of people?

A: Reactogenic side effects are more common among younger as opposed to older people, and also among women, because of the stronger immune responses. Those with multiple allergies are probably no more likely to be allergic to the COVID-19 vaccines than the general population unless they are allergic to one of the vaccine components.

Q: How long does the protection from COVID-19 vaccines last, and are they effective against newer strains?

A: We are learning about this as we go along. With the other human coronaviruses, immunity post-infection is not lifelong, with reinfections possible after half a year or longer. This is not the case with COVID-19, where reinfections are still very rare for those who have been previously infected, even in countries where there is a widespread transmission of the virus. It is unlikely that vaccination will result in longer immunity compared to natural infection, and it is also likely that existing vaccines will become less and less effective against newer variants of COVID-19.

Q: Can a vaccinated person still get infected and spread the virus if exposed to COVID-19?

A: With the mRNA vaccines, we know that efficacy against infection exceeds 90 per cent, so perhaps at most one in 10 vaccinated persons will be inadequately protected and can still be infected if exposed. Even in these persons, there will be partial protection and the infection is far less likely to lead to a bad outcome for them. So, these are still significant advantages that accrue with vaccination.

Click here to read more.

The initiative provides up to S$20 million in seed funding each year to support up to 20 interdisciplinary project ideas. These projects would require researchers to work together, and dedicate collective knowledge, expertise and research capabilities towards finding solutions to some of the most challenging questions of our time. The goal is to cultivate 100 forward-looking project teams in five years.

Interdisciplinary education at the University recently took a bold leap forward with the new NUS College of Humanities and Sciences being established last year, now, interdisciplinary research is also being championed with the new Reimagine Research Initiative that funds compelling proposals that tackle a myriad of modern challenges.

The seed funding will allow research groups to build the groundwork of their interdisciplinary projects and to yield initial results. With this strong foundation, they can go on to secure additional funding externally to bring their projects to fruition, and ultimately benefit the wider community.

“We hope to bring about a shift in mindset among our researchers. Today, most multidisciplinary research efforts involved placing disciplinary insights side by side, or with a small degree of integration, to address problems. The Reimagine Research Initiative is conceptualised to motivate our researchers to push the knowledge frontier even further by harmonising their expertise to create powerful, unconventional solutions that we cannot yet imagine,” said Professor Chen Tsuhan, NUS Deputy President (Research and Technology).

A need to reimagine research

COVID-19 has been a turning point in society. As an all-encompassing problem, it not only sent shockwaves through the fields of medicine and public health, but has had major implications in policies, human behaviour, the economy, the environment, and much more.

However, the pandemic is just one example of a modern cross-disciplinary problem. Many more complex challenges on the horizon need collaborative solutions. Tackling pressing issues like climate change, food security, and data privacy will require integrated knowledge, skills, and insights from different domains. Funding, facilitating, and finding solutions to these modern problems is the objective of the Reimagine Research Initiative.

“While the University will continue to invest in basic research, solving these multifaceted challenges for society requires a conversation among researchers of different disciplines. As a comprehensive university that offers a diverse spectrum of specialities, NUS is in the ideal position to initiate integrative approaches to address these problems more effectively, as we have a diverse talent pool to draw from,” Prof Chen added.

Team-based, interdisciplinary, problem-driven research

The new Reimagine Research Initiative will encourage problem-driven research. The initiative also supports multidisciplinary teams, which allows complex issues to be approached from multiple perspectives, and will allow researchers to continue to build cross-faculty networks towards interdisciplinary research.

The initiative promotes research in areas such as environmental sensing for better safety and health, outbreak preparedness and prediction, food security and supply chain resilience, human behaviours and societal impact, systems dynamics, physical and IT security, and more. Since its establishment, 21 projects have been supported.

One such project looks into the development of small wearables for plants using novel sensor technologies. These sensors will collect signals from plants about their well-being and growth, and the data will be used to train AI algorithms. The resulting database will then be used to simulate plant growth conditions in urban farms and to predict their growth outcomes.

This project aims to build an infrastructure where researchers can use the signal database to predict the growth of plants in response to environmental changes. Optimal growth conditions for different varieties can be catered for, while best-fitting varieties can be selected for a set of environmental conditions. This research could be applied in breeding desirable crop plant varieties to improve food security.

Another project seeks to make cities more resilient to disease outbreaks, as well as environmental degradation, social upheavals, supply chain disruptions, and failures in infrastructure.

Due to the multidisciplinary nature of this research, the project team comprises experts from different fields, ranging from public policy and risk management, to computing, engineering and physics, all working together to address the complex issues.

The project’s findings could help policymakers determine the best protections against environmental, societal and technological threats. The researchers hope the work will eventually establish Singapore as a leader in the use of complexity science in the governance of smart cities.

Through the Reimagine Research Initiative, NUS researchers can now make a direct impact by providing solutions to the many needs that are confounding society and the economy.

Economists use letters to describe the shape of recovery from recessions, and the current recovery from the COVID-19 pandemic is given a new letter: K. This depicts a shape where some industries and individuals ascend, but the rest decline. In the midst of wage cuts, job losses and business closings, stock market prices have been rising and the Big Techs have been thriving.

The K-shaped trend is said to reflect existing inequalities. In this essay, I will discuss four types of inequalities in Singapore that have been spotlighted by the pandemic: wage, digital, residency and gender. I would like to suggest going beyond a business-as-usual response to these areas of inequality, failing which we would be wasting the lessons learned from the pandemic and the inequalities that were already there will further divide our society.

Wage inequality

First, wage inequality. Evidently, lowest-income earners have been the hardest hit. The latest income trends report by the Department of Statistics shows that on a per household member basis, earnings of households in the bottom 20 per cent declined the most (See Table 15C). A Beyond Social Service study of 1,231 beneficiaries found that the largest drops in work income were experienced by the lowest earning households.

Thankfully in Singapore, the government has rolled out multiple aid packages that are buffering the pain of the economic sting. At the same time, policy is responding to longer-term structural issues. For example, to uplift low-skilled wages, the progressive wage model (PWM) will be expanded to the retail and food services sector, with more to come. Coming nine years after the PWM was first introduced, this is long overdue.

It is strange to raise wages at a time when many businesses are suffering, but COVID-19 has spotlighted the fact that existing labour market forces are undervaluing essential work such as in the fields of F&B, cleaning and healthcare. Thus, there is no better time than now to extend the PWM to retail and food service workers, two sectors hard hit by COVID-19 restrictions yet whose workers (e.g. delivery riders and retail shop assistants) have to keep working in people-facing roles exposed to the virus. The momentum to correcting wage inequality needs to go beyond these two sectors.

Digital inequality

Second, digital inequality. At the top end, technology companies have been profiting so greatly in the last decades that western governments have mooted technology taxes and other restrictions. Now, COVID-19 restrictions have further boosted their profitability. At the bottom end, some children and adult learners from low-income households became unable to attend classes or do their homework when classes and assignments went online. Some did not have laptops, some did not have internet access at home, and many did not know how to use these resources. Some migrant workers and the elderly did not have the up-to-date devices, language or knowledge to use contact tracing applications and online services such as banking.

The tremendous outpouring of donations, volunteerism and government support has helped bring much-needed digital resources and knowledge to many low-income families, the elderly, and migrant workers. However, they have plugged only the current urgent gaps. As digital transformation accelerates post-pandemic, concerted and continuous actions to help these digitally excluded groups level up are necessary, or digital inequality will worsen the social inequalities that already disadvantages these vulnerable groups.

That is why some colleagues and I are advocating universal digital access, that access to digital devices, internet and digital skills are no longer wants but needs to be provided as public utilities like water, electricity and education. This rethinking of what are necessities in a digital world is but a small sliver of the paradigmatic changes that will be needed as coming digital transformations continue to worsen inequalities, from rehauling tax regimes to including non-traditional workers such as platform workers in labour protection laws.

Inequality in residency status

A third inequality is by residency status. Singapore’s response to the pandemic has been exemplary, except in one aspect which checkered our record. The rapid spread of the coronavirus in migrant worker dormitories highlighted the crammed living conditions in the dormitories. It prompted the building of less densely designed dormitories. At the same time, to contain the spread of the virus, restrictions on migrant workers were harsher and longer than they were for the rest of Singapore. Until end of last year, dormitory residents were not allowed out of their rooms. Till today, they are not allowed outside of the dormitories except to go to work, run essential services and visit specific recreation centres. The plans are for further easing once the workers all have a contact tracing device. In contrast, the rest of Singapore was out of the Circuit Breaker in June, and even when confined at home, our living environments are far superior.

The government has provided help to migrant workers, for example by ensuring payment of wages and working with volunteer groups to provide medical and mental health support. Looking ahead, commentators have called attention to this blight in our COVID-19 response as reflecting the fact that we are only as strong as how we treat the weakest in our land. They have called for a rethinking of our heavy reliance on low-skilled foreign workers, but others have drawn attention to the challenges of doing so, for example in terms of competitiveness and hiring local.

I wonder whether the debate should pivot away from these pragmatic considerations and towards one of considering equality and value as fellow humans. While the tight controls on dormitories are necessary to contain a deadly and infectious virus, it calls into question a stark segmentation in Singapore society. Foreign workers in Singapore make up a particular category of individuals with lower status than those who are residents. They are temporary workers treated differently in employment laws and in terms of access to health and social services.

Can we continue to find the resident-foreign worker duality in our society acceptable? If not, then the practical challenges around foreign worker issues will have to be dealt with no matter what.

Gender inequality

Fourth is gender inequality. 2021 has been declared the year of celebrating Singapore women. This is therefore a year to also dig deep to overcome existing gender fissures. Restrictions from COVID-19 have heightened the uneven distribution of home responsibilities along gender lines and the prevalence of domestic violence, whose victims are predominantly women and children. While social service professionals do the remedial work with families under repair, there is much opportunity for the rest of us in society to prevent the perpetuation of misogynistic and patriarchal ideologies, which underlie the ill-treatment of women.

The privileged in society have a role to play. First, not to perpetuate inequalities; second, to better understand the most vulnerable in society; and third, to use our privilege to speak up for and uplift the under-privileged. There is great influence when employers speak with other employers on behalf of employees; the digital haves advocate for equal access for the digital have-nots; citizens appeal to citizens on behalf of non-citizens; and men tell other men to respect women.

About the author

Associate Professor Irene Y.H. Ng is from the Department of Social Work at the NUS Faculty of Arts and Social Sciences, and is Co-Director of the Social Service Research Centre at the Faculty. Assoc Prof Ng holds a joint Ph.D. in Social Work and Economics from the University of Michigan. Her research areas include poverty and inequality, intergenerational mobility, youth crime, and social welfare policy. She is serving or has served in committees in the Ministry of Social and Family Development, National Council of Social Service, Ministry of Manpower, and various voluntary welfare organizations.

Looking to 2021 is a series of commentaries on what readers can expect in the new year. This is the sixth installment of the series.

Click here to read about Professor Tommy Koh's seven wishes for the year.

Click here to read about Professor Danny Quah's outlook for the global economy.

Click here to read about Dr Kelvin Seah's analysis of the Singapore economy and labour market.

Click here to read about Professor Freddy Boey's views of the start-up ecosystem.

Click here to read Professor Teo Yik-Ying's commentary on the great unknowns that remain, regarding COVID-19 vaccines.

The Vaccine Quest: Part One

A team from the Duke-NUS Emerging Infectious Diseases Programme has spent the last year developing a COVID-19 vaccine. How close are they to producing one?

The Vaccine Quest: Part Two

The Duke-NUS team is closer to producing a viable vaccine. But creating a viable vaccine is just the first step; producing enough for everyone is a different mountain to climb.

The world greeted the arrival of 2021 with hope and anticipation of a return to pre-COVID normalcy, especially given the announcements that a handful of countries, including Singapore, have started vaccinating their populations against COVID-19.

The initial uncertainty over whether the COVID-19 Vaccines Global Access (COVAX) Facility will be able to honour its promise to deliver up to 2 billion vaccine doses to the 190 participating economies has now dissipated, when an announcement was made at the end of January of a concrete timeline to start dispatching vaccines to these economies.

The COVAX Advance Market Commitment also guarantees that the 92 lower- and middle-income countries (LMICs) will be able to equitably access highly subsidised COVID-19 vaccines at the same time as higher-income self-financing countries. This is necessary as LMICs would otherwise be priced out of the market if they have to bid against well-resourced countries for the same limited vaccine supply.

Ensuring an equitable distribution of efficacious vaccines to every country is a necessary step for the world to eventually return to some resemblance of pre-COVID normalcy. However, whether this is indeed as straightforward, the devil, as often the case, is in the details.

Let us examine the ‘three great unknowns’ about vaccines that continue to vex policymakers and public health scientists alike:

1. Does the vaccine prevent infection and transmission, on top of protecting against severe disease?

The present vaccines approved for emergency use by the World Health Organization (WHO) are primarily approved on the basis that they protect against severe disease and death, as those were the explicit outcomes vaccine developers defined in their late-stage clinical trials. What this means is that there is actually limited clinical trial data on whether these vaccines actually prevent a person from being infected in the first instance; or if infection is possible, to prevent infecting other people subsequently.

Without a definitive understanding on the role of vaccines against infection and transmission, governments globally have no choice but to continue the requirements of mask wearing, social distancing, and strict personal hygiene, even for people that have already received the vaccine.

However, encouraging evidence is starting to emerge that COVID-19 vaccines may just be as capable in limiting infections as in decreasing hospitalisations. A Nature article published in February reported an astounding fall in the number of infections and hospitalisations that corresponded strongly with the population rollout of COVID-19 vaccination in Israel, even after accounting for social restriction measures such as the implementation of a national lockdown.

While these are still early days and a careful analysis is needed to confirm this observation, it is clear that scientists view this as an encouraging sign that vaccines may have an effect on limiting infection and transmission, in addition to protecting against severe disease.

2. How long does the vaccine actually stay effective for?

Given that the world is relying on the COVID-19 vaccines to permit a lasting return to normalcy, we are certainly most eager to learn when their protective effects are likely to start waning. After all, this directly impacts national and global strategies on vaccine supply chains and vaccination rollout in the community, not to mention the thorny topic of repeated vaccine financing for LMICs that even COVAX is presently not actively contemplating.

Natural immunity to the four coronaviruses that are responsible for common colds are notoriously transitory, which explains why we continue to be plagued with colds throughout our lives. Should the protective immune response generated by the vaccine similarly wane with time, albeit after a longer period compared to the natural immunity from infection, regular booster vaccinations may become a reality. This was candidly outlined by the British Prime Minister Boris Johnson last month, when he said the British people will have to get used to receiving autumn booster shots to retain the protective effects, either due to waning immunity or against new SARS-CoV-2 variants.

And this leads us to the third great unknown:

3. Mutations of SARS-CoV-2 and vaccine effectiveness

Perhaps the greatest fear now is whether today’s vaccines will continue to remain effective against new variants of the SARS-CoV-2 coronavirus. Viruses continuously evolve to maintain their ability to survive and thrive in hostile competitive environments, and reports of how new emerging strains of the coronavirus are more transmissible should actually not come as a surprise. After all, when humans adapt with precautions such as mask wearing and social distancing, any mutation of the coronavirus that produces a much higher viral load or even allows farther airborne dispersion will grant the mutant strain a Darwinian advantage, thus ensuring a higher chance of successful propagation and reproduction.

Should mutations now permit the coronavirus to evade the protective effects of vaccines, as emerging evidence seem to suggest this to be the case for the South African 501.V2 variant against vaccines from Pfizer, Moderna, and Oxford-Astrazeneca, hopes that were originally pinned on the global distribution of efficacious vaccines for a return to normalcy would now need to be reexamined.

Global inequity will stifle global recovery

Compounding the three unknowns is the present global inequity in vaccine access. While COVAX aims to ensure an equitable distribution of vaccines, the present mandate primarily focuses on delivering vaccine doses to inoculate 20 per cent of the population in each participating country – estimated to be sufficient for the healthcare workforce and the elderly but far from adequate for the whole population.

What this means is that, except for the advanced economies that are capable of self-financing their vaccine purchases, most of the world’s countries may never have sufficient vaccine doses to inoculate 80 per cent of their population – a figure forecasted by infectious disease modelers to be necessary to achieve herd immunity.

How will global commerce and travel look when border restrictions remain for the most parts of the world? Health inequities that already existed before COVID-19 are likely to be compounded, and the divide between the haves and have-nots looks set to widen when economies that have traditionally relied on subsistence-based agriculture, labour-intensive manufacturing, and tourism receipts may just be the ones that will find vaccines to be priced beyond their reach.

Domestically, countries also need to grapple with the challenge of equitably distributing vaccines to oft-neglected segments of the population, which include refugees and migrant workers. The latter is especially tricky in countries with large communities of undocumented migrant workers who do not possess any legal status or health insurance. Extending national vaccination rollouts to include these people may be morally and ethically the right thing to do, but is not straightforward logistically and financially, especially in the absence of a census. How would one even determine the number of vaccine doses required or register the inoculation of these people?

The concern around ‘vaccine refugees’, where people from a resource-poor country illegally cross the border of a wealthier neighbour to be vaccinated as a refugee or undocumented migrant worker, is also a real one. In settings where there are already insufficient vaccine doses for all the citizens, inoculating non-citizens will also be politically tricky to justify.

So, while there is certainly optimism in some societies about an incipient return to pre-COVID normalcy, it is important to realise this optimism is not universal, and a global recovery can and will be thwarted by vaccine nationalism and inequitable distribution.

The journey to the light at the end of the tunnel will continue to be fraught with obstacles and uncertainties, and we would be wise to manage our expectations for 2021.

About the author

Professor Teo Yik-Ying is the Dean of the NUS Saw Swee Hock School of Public Health. Prior to his Deanship, he was the Founding Director of the School’s Centre for Health Services and Policy Research (CHSPR) and also served as the Director of the Centre for Infectious Disease Epidemiology and Research (CIDER) from 2015 to 2017. He is presently a member on the Council of Scientists for the International Human Frontier Science Program, as well as a governing board member of the Regional Centre for Tropical Medicine and Public Health Network for Southeast Asia.

Looking to 2021 is a series of commentaries on what readers can expect in the new year. This is the fifth installment of the series.

Click here to read about Professor Tommy Koh's seven wishes for the year.

Click here to read about Professor Danny Quah's outlook for the global economy.

Click here to read about Dr Kelvin Seah's analysis of the Singapore economy and labour market.

Click here to read about Professor Freddy Boey's views of the start-up ecosystem.

Click here to read the full article. 

The new study, published in Nature Communications, is the first to reveal molecular and serological evidence indicating that SARS-CoV-2-related coronaviruses are not just circulating in China but in animals as far away as Thailand. The findings also reveal that more related coronaviruses are likely to be uncovered in the region.

Click here to read the full article.

Each year, over a billion people celebrate the Lunar New Year worldwide. It’s a centuries-old festival that celebrates familial bonds, and is an opportunity to connect with and gift blessings to loved ones.

Also known as the Spring festival, the Lunar New Year celebrates the turn of the seasons, and the wealth that nature provides: fresh water, clean air, favourable climate and an abundance of food. Even in these modern times, nature continues to underpin all economies and societies through the goods and services it provides. Yet, some choices made this season could reduce its ability to provide the abundance often taken for granted.

While traditions such as Chinese New Year are cherished, should it be at the expense of leaving an inhospitable earth for future generations, or endangering the health of the community, and, by extension, loved ones?

Timely move

The Monetary Authority of Singapore (MAS) and the Association of Banks in Singapore (ABS) last month encouraged the public to use e-hongbaos, otherwise known as e-red packets. MAS has also been working with banks in Singapore to promote the use of recirculated notes instead of new notes for Lunar New Year.

This is a timely move amidst the COVID-19 pandemic, where it is socially responsible to avoid crowds and queues where possible. On top of the new regulations that restrict New Year visiting, it may seem like the hallmarks of the festival are being eroded.

But this would not be the first time that traditions have evolved to better address current needs. For example, few would argue that using reusable, rather than real trees, for Christmas hurts the Christmas spirit, or that customary handshakes should still continue during these COVID times.

The use of e-hongbaos has already gained tremendous traction in China, with WeChat reporting a record 823 million users sending and receiving e-hongbaos in the first six days of the 2019 Lunar New Year. E-hongbaos allow people to gift blessings with greater ease and safety, providing peace of mind for givers.

Each year, banks, retailers and various organisations print millions of red packets to feed public demand. Most of the paper used to manufacture red packets is produced by paper mills.

The paper used is likely to contribute to deforestation, which removes wildlife habitats, and creates unnatural proximity between humans and wildlife. Forest-loss has consistently led to more incidences in the spillover of viruses, such as COVID and SARS, from animal hosts to humans.

Trees cut down

According to a 2017 study, 320 million new red packets are produced in Hong Kong every year, which translates to 16,300 trees cut down to make them. There are no specific numbers yet reported for Singapore, but it is easy to extrapolate that, as a city with a similar population to Hong Kong.

Most, if not all, red packets are used once and thrown away.

It is true that some of these red packets can be recycled, but the reality is that a significant portion put in recycle bins will not actually be recycled. This is because red packets that are printed with large amounts of red ink, gold ink or glitter, or made from mixed materials, cannot be recycled.

Recycling is also not a panacea for sustainability problems, as the recycling process itself is extremely resource intensive. It is prudent therefore to start considering digital alternatives to complement current traditional practices.

Similar to the role e-payments play, there is no need to completely abandon the use of cash in order to embrace e-payment options.

E-hongbaos are simple to use, and allow givers to send their blessings to anyone safely. It also eliminates the need to travel to and queue at banks to deposit physical cash.

It is time for Singapore to embrace digital technology and e-gifting. It is a way of protecting health and traditions in these COVID times, while teaching the next generation the importance of caring for Mother Earth, the source of their future prosperity.

About the authors

Professor Koh Lian Pin is Director of the Centre for Nature-based Climate Solutions at the National University of Singapore, which seeks to produce cutting-edge science that informs climate policies, strategies and actions in Singapore and the Asia-Pacific region. Prof Koh is a Returning Singaporean Scientist, Nominated Member of Parliament, and a member of the Emerging Stronger Taskforce.

Debby Ng is a wildlife disease ecologist and doctoral student at the Centre for Nature-based Climate Solutions. A passionate science communicator and educator, she is a National Geographic Explorer, and founder of Hantu Blog, a volunteer-organisation dedicated to marine outreach and education.

This article was first published in The Straits Times on 5 February 2021.

“Presently, the understanding on the characteristics of the new variants is that they are transmitted in the same manner. People infected with some of these new variants have been associated with having a higher viral load,” said Prof Teo, Dean of the SSHSPH.

Assoc Prof Hsu, Vice-Dean (Global Health) and Programme Leader of Infectious Diseases at SSHSPH, remarked that the UK and South Africa variants of the virus appear to be more efficient at attaching to and invading human cells. However, he noted that the World Health Organisation has not changed its stance to recommend triple-layered masks in the community as yet.

While the public may be feeling worried about increased safety measures, Prof Teo shared, “The issue actually is about people following the current measures properly, including the proper wearing of masks, rather than to add on additional or stricter measures.”

Although some experts in the United States have advocated the use of double face masks as added protection from the new variants, the mass-produced high-quality masks in Singapore should be effective if used correctly.

“Masks on their own do not offer total protection against infection, but wearing one works in tandem with preventative measures such as physical distancing and hand washing,” explained Assoc Prof Hsu.

“In terms of face masks, there has always been a recommendation on three-ply masks, and even the masks distributed by the Singapore government come with specific instructions on allowing additional middle layer filters to be inserted,” Prof Teo explained.

Properly constructed 3-ply surgical masks have been shown in research settings to provide amongst the best performance in terms of serving as a barrier against droplet projections. However, properly constructed reusable 3-ply cotton masks already are sufficiently efficient at minimising droplet projections.

So, what type of face mask should we be wearing? “By all means, use a surgical mask if there is a stable supply that does not compromise on access by healthcare workers and key frontline staff. But there is presently no evidence to suggest that there is a need to switch to higher-quality masks when one is moving about in public spaces. What is more important, is to wear the mask properly,” Prof Teo said.

Click here for more.

This summarised Minister for Education Mr Lawrence Wong’s ambitions for the country, as it recovers from the COVID-19 pandemic.

Mr Wong, also the co-chair of the Multi-ministry Taskforce on COVID-19, noted that Singaporeans face an “acutely changed world” in the wake of the pandemic. Stressing that we have the ability to shape the country’s future, he used the analogy of a software update to highlight three “resets” that must be made in terms of thinking, lifestyle and mindset, in order to “reboot” the damage inflicted by COVID-19.

• Reset 1: Strengthen the social compact for a fairer and more equal society
• Reset 2: Build a greener, environmentally sustainable economy and society which will benefit our children and future generations
• Reset 3: Forge a stronger spirit of solidarity and social cohesion

Mr Wong was speaking on 25 Jan at the closing session of the annual Singapore Perspectives conference organised by the Institute of Policy Studies (IPS), a research centre of the Lee Kuan Yew School of Public Policy at NUS.

Confident that the country will overcome its problems with nimbleness, ingenuity and gumption, and emerge stronger from the pandemic, he rallied the audience. “Most of all, we have seen that as “one united people”, we can achieve exceptional things together. So that’s how, as one united people, we can realise our aspirations and ideals, and build a better Singapore together.” 

Mr Wong also engaged the audience in a dialogue session which was chaired by Mr Warren Fernandez, Editor-in-Chief of The Straits Times. The final conference day also saw panel discussions with business leaders and representatives from the People’s Action Party, Workers’ Party and Progress Singapore Party.

Themed “Reset”, the Singapore Perspectives conference was held over four days, featuring nine online interactive forums on 12, 14 and 19 Jan and culminating in a final hybrid conference day on 25 Jan where in-person plenary sessions were also broadcasted online.

Framed around the key values of the Singapore Pledge – progress and prosperity, happiness, justice and equality, and a democratic society – the conference engaged international thought leaders, academics, activists and community leaders in exploring possible pathways for Singapore in a post-COVID world.

In wide-ranging forum discussions touching on jobs and skills; the environment and sustainability; identities and cohesion; and technology and liveability, panellists discussed pre-existing trends and issues, as well as current challenges caused by the pandemic. These featured prominent speakers, intellectuals and civic leaders such as Senior Minister and Coordinating Minister for Social Policies Mr Tharman Shanmugaratnam; Ambassador Chan Heng Chee; Professor Joel Kotkin, Presidential Fellow in Urban Futures at Chapman University; Professor Jared Diamond from the University of California at Los Angeles; and Ms Janice Koh, actor and former Nominated Member of Parliament.

The conference is part of IPS’ first phase of Reimagining Singapore 2030, a year-long scenario-planning exercise to gather views from global thinkers and Singaporeans on topics such as “living and making a living in 2030”.

At the forefront of the fight against COVID-19, Duke-NUS Medical School is developing a vaccine together with Arcturus Therapeutics. The vaccine’s co-developer, Prof Ooi Eng Eong, draws on his experience to explain how pharmaceutical companies have been able to develop vaccines so quickly. He also addresses queries about the safety of these vaccines and about who should be getting inoculated.

With Singapore’s vaccination programme underway, NUS experts answered the public’s most pressing queries.

The session on 7 Jan was moderated by Professor Teo Yik Ying, Dean of the NUS Saw Swee Hock School of Public Health, and featured the following experts:

- Professor Dale Fisher from the NUS Yong Loo Lin School of Medicine, who is also Chair of the World Health Organization's Global Outbreak Alert and Response Network;

- Professor Ooi Eng Eong, Deputy Director of the Programme in Emerging Infectious Diseases at Duke-NUS Medical School, and co-developer of Lunar-Covid19 vaccine; and

- Associate Professor Alex Cook, Vice Dean (Research) and Domain Leader (Biostatistics and Modelling) at the NUS Saw Swee Hock School of Public Health.

View a video recording of the session, and read the experts’ responses to the 12 most common questions raised by the audience.

Moderated by Professor Loy Hui Chieh, NUS Arts and Social Sciences Vice Dean of External Relations and Student Life, the NUS Giving Webinar Series titled “Understanding and Supporting Low-Income Families during COVID-19 and its Aftermath” provided insights into the challenges that low-income families face and the impact of the pandemic.

“During the Circuit Breaker period, one of the main challenges that low-income families faced was the great income uncertainty,” related Dr Ong Qiyan, Deputy Director (Research) at the Social Service Research Centre (SSR) at NUS Arts and Social Sciences.

“They also faced anxieties about COVID-related risk because for some of them, especially essential workers, it was a choice between not having food on the table or to risk exposing themselves to the virus by going to work.”

Prof Jean Yeung, Founding Director of the Centre for Family and Population Research at NUS Arts and Social Sciences, and Provost Chair Professor at the NUS Department of Sociology, also provided a bigger picture of the pandemic’s impact on families in Singapore.

“What COVID-19 has done is to magnify the pre-existing inequalities among different families. On one side, we have families who experience major income loss or the loss of jobs. On the other side, there are those who are saving or perhaps, even earning more. We need to be concerned about the aftermath of these impacts.”

Bridging the digital divide

Going forward, the emphasis will be on bridging the digital divide so as to empower low-income families.

“Now that we know that digital access is no longer a choice or luxury but a need, the question is how to ensure continued access?” asked Associate Professor Irene Ng, Associate Professor from the NUS Department of Social Work, and Director of SSR.

Issues of digital literacy, information gaps and the stigma of seeking help were also emphasised during the dialogue.

Ms Ang Bee Lian, Director-General of Social Welfare from the Ministry of Social and Family Development pointed out that developing a strong social support network is vital. Low-income families can tap on these networks for assistance and support in their journey during this difficult time.

“Having people on the ground is extremely important. They help to build relationships, provide moral support and even form friendships. People who are struggling are looking for such connections.”

For further information on the NUS Giving Webinar Series, email the Events team.

By the NUS Development Office

It has also been a year where society has needed the most support. NUS students have continued to live up to the spirit of giving this holiday season by contributing to the community in various ways — including a new online donation platform and giving needy households a fresh coat of paint.

Gift for Good

Adopting the concept of an online marketplace, the Developer Student Club, a student group comprising NUS students and alumni, launched Gift for Good — an online platform to galvanise in-kind donations. The platform connects individual donors with charity organisations, allowing donors to make in-kind donations seamlessly and efficiently.

Gift for Good users can donate items in just three simple steps: browse, chat and deliver. Users can browse through the request lists of charity organisations to find one that they can fulfil. Once they have done so, they can start an online chat with a staff member of the charity organisation that they are donating to, and coordinate the delivery of the item.

Year 3 NUS Arts and Social Sciences student Yeo Qin-Liang, who is the Business Lead of Gift for Good, shared, “The platform streamlines the process of registering and requesting for in-kind donations for charity organisations. It also actively engages and retains donors, so that charity organisations can more easily obtain the items that they require.”

He added, “In doing so, we hope to create a more generous Singapore.”

Gift for Good has received an endorsement from the National Volunteer and Philanthropy Centre. Some 25 charity organisations are also already on board the platform to help their beneficiaries obtain the items they need.

The Children’s Aid Society is one of the charity organisations on the platform. “Gift for Good has a meaningful mission of connecting communities and providing a seamless and inclusive platform for coordinating in-kind donations. As a multi-centre social service agency, we have varied in-kind donations needs and we look forward to connecting with donors via Gift for Good to fulfil the needs of our beneficiaries and clients as best as possible,” said its spokesperson.

Project Paint-A-Home

The NUS Students’ Community Service Club (CSC), on the other hand, overcame huge logistical challenges and persevered with its annual Project Paint-A-Home to give a fresh coat of paint to elderly and low income households, and improve their living conditions.

“The planning process has been very tedious this year as there were a lot of uncertainties,” said Year 2 NUS Science student Quek Yong Kang, who is one of the Project Directors for Project Paint-A-Home. “An average of eight volunteers were assigned to paint a unit in previous years. This year, we had to make do with painting smaller homes since we could only have five volunteers painting a unit, to adhere to COVID-19 Safe Management Measures,” he explained.

Despite the challenges, the CSC successfully recruited 145 volunteers who painted 28 units, including one-room and two-room units, over two weekends in December. The Thong Keng Senior Activity Centre and Care Corner Senior Activity Centre supported the outreach and linked the CSC up with the households.

Year 4 NUS Arts and Social Sciences student So Hoi Kay shared her volunteering experience, "Going down to the beneficiaries’ houses and speaking to them has led me to realise how much more can and needs to be done for the underprivileged in Singapore. Although painting their houses is just a minor commitment on our end, I hope that our efforts, in however small a way, will be able to brighten and improve their lives. The smiles and appreciation of the beneficiaries at the end of the day took away the tiredness of volunteering and I am glad that everyone’s collective hard work has paid off.”

To wrap up the year, the Rotaract Club of NUS will be delivering meals to the elderly on 29 December, as part of TOUCH Community Services’ Meals-on-Wheels programme.

Like this story? Join the NUS News Telegram channel or sign up for the email newsletter for regular updates.

Now, researchers from NUS have invented a portable tent-like shield to prevent the spread of saliva and aerosols generated during dental procedures. The Dental Droplet and Aerosol Reducing Tent (Dental DART) can be placed around the patient’s head to serve as a barrier to protect dentists, nurses and patients from direct and indirect exposure to infectious diseases such COVID-19. In addition, the Dental DART limits the spread of aerosols onto environmental surfaces, decreasing pathogen availability and potential cross-contamination.

This device is an adaptation of DART, an earlier NUS innovation that protects healthcare workers when they perform procedures that generate droplets and aerosols, such as intubation and extubation.

“The Dental DART is a design evolution, and has been prepared to protect dentists and their patients from potential infectious agents present in the aerosols that are generated during dental procedures,” said Professor Freddy Boey, NUS Deputy President (Innovation & Enterprise), who is the lead researcher for this project.

How the Dental DART works

The Dental DART is a clear tented shield with a depth of 54 centimetres at its base and is 64 centimetres high. Its width is adjustable to between 60 and 70 centimetres, to suit dental chairs of different sizes. It comes with three access ports, for dentists and nurses to reach in and safely perform dental procedures.

The tent is attached to vacuum pumps that are available on dental chairs. This system safely removes the contaminated air from the tent, directing it to the scavenging system. This decreases the amount of contaminated materials in contact with the clinician’s hands and arms, and instruments.

“It took us three months to come up with an ideal model. We had to design ‘universal hinges’ that allow for the device to suit all models of dental chairs, derive a proper design that allows foldability, as well as incorporate suitable positions for the access ports,” shared Mr Sudarshan Anantharaman who is from the NUS Industry Liaison Office and a co-inventor of this innovation.

The Dental DART has been tested in a clinical setting by measuring the bacterial content on the surface of the dental chair light, and on the face shield worn by the dentist. The tests were conducted before and after scaling procedures – which are known to significantly increase air contamination – were performed.

The results showed that was no increase in the number of viable bacteria on these surfaces after the treatment with the use of the Dental DART. On the other hand, without the use of the tent, there was a significant increase in contamination by 14 times.

“Personal protective equipment, or PPE, can be infected after being exposed to aerosols from dental procedures. The use of the Dental DART can decrease the PPE exposure to aerosols and prevent further environmental contamination at the time the clinicians remove their arms, hands, and instruments from the tent,” said Associate Professor Vinicius Rosa, who is from NUS Dentistry and a co-inventor of the device.

Safer visits to the dentist

The US Bureau of Labour Statistics has categorised dentists within the class of workers with the highest high risk of COVID-19 contamination due to both high proximity to individuals and exposure to disease. Furthermore, other infectious agents responsible for pneumonitis, influenza, hepatitis, skin and eye infections, may also be transmitted during routine dental procedures.

“Dentistry is an essential service and it has suffered tremendously since the beginning of this pandemic. Many dental service providers in Singapore have imposed a complete ban on aerosol-generating procedures during the COVID-19 outbreak. While imposing such extreme measure is understandable, it has also left thousands of people without proper treatment. Our Dental DART can help provide a safer environment in the dental clinic setting, and decrease the anxiety and psychological distresses imposed by the COVID-19 pandemic on all parties involved,” explained co-inventor of the device Professor Mandeep Singh Duggal, who is from NUS Dentistry.

Deployment in dental clinics in Singapore and globally

The four NUS researchers have filed a patent for the design of the Dental DART. They are looking to collaborate with healthcare and industry partners to make this device available to dentists in Singapore and around the world.

With that in mind, the NUS Resilience and Growth Innovation Challenge had invited recent NUS graduates to submit inspiring proposals under three categories:

• Make Our People Better
• Make Our Society Better
• Make the World Better

As COVID-19 remains a threat, initiatives in the “Make Our People Better” category aim to improve quality of life through better home-based learning and promoting sustainable food consumption. The evaluation panel was led by Ms Melissa Kwee, CEO of the National Volunteer and Philanthropy Centre, and Professor Simon Chesterman, Dean of NUS Law.

Projects in the “Make Our Society Better” category aspire to create a more cohesive society. The panel was helmed by Ms Tan Li San, CEO of the National Council of Social Service, and Professor Robbie Goh, Dean of NUS Arts and Social Sciences.

Proposals under the “Make the World Better” category include eco-friendly products and projects to arm youths with the relevant skills to thrive in a globalised world. The panel was co-chaired by Professor Tommy Koh, Rector of NUS Tembusu College, and Professor Phoon Kok Kwang, NUS Senior Vice Provost (Academic Affairs).

“As future leaders of society, our youth carry the responsibility of leaving their mark on the next generation. In this regard, it is heartening to see them championing causes that can positively impact the world,” said NUS President Professor Tan Eng Chye.

NUS is continually reviewing new proposals that are streaming in. The University intends to support 115 projects in all, a nod to its 115^th anniversary that is being celebrated this year.

These six ideas stood out from the 32 projects supported so far.

Encouraging budding home farmers

Lettuce, mint and even tomatoes – Singaporeans may soon be able to grow these vegetables and more in their HDB flats.

Having witnessed “a deep psychological fear” when COVID-19 sparked panic buying here, Toby Fong and his team – superFARM – decided to bolster the nation’s food security. Their plan? Encourage green fingers through home-based farming.

“When we think about food security, it’s usually at a national level so it almost feels like the individual (is disconnected) from the entire food security equation,” said Toby, who graduated with a Master’s from NUS Architecture this year.

Under the “Make Our People Better” category, Toby, NUS Computing graduate Lim Hui Qi and NUS Arts and Social Sciences graduate Ong Jun Ren will design modular farming units that can fit into the smallest of homes. These units can also be customised for bigger spaces.

The plan is to transform niche hydroponics systems into functional mini-farms. In the next six months, half of their $50,000 funding will go to research such as field testing and online surveys, while the rest will be used for prototype development.

The team also wants to expand the individual’s role in food security to make sustainability a way of life. 

“We want to recalibrate people’s attitude and behaviour to encourage responsible food consumption,” said Toby.

Making science fun for kids

Using portable science kits, sci@home is a project that will support community outreach efforts during the year-end school holidays by making science fun for underprivileged children. 

“COVID-19 has unfortunately disrupted physical community engagement and outdoor learning opportunities for children, especially those from disadvantaged backgrounds,” said team member Lau Shi Yun, a NUS Physics graduate.

A $49,000 grant will allow Shi Yun and her four teammates – NUS Life Sciences graduate Chee Min Yee, NUS Psychology graduate Constance Seah, final-year Life Sciences student Pang Seok Mun and final-year NUS Chemistry student Jane Yap – to provide the kits for free. Each comes with the necessary materials and an activity booklet to help users understand the content better.

The five came together for this project that falls under the “Make Our People Better” category.

Faculty of Science undergraduates from Young Educators in Science – a programme that trains students to teach science – will serve as facilitators. They will conduct in-person and online sessions on how to apply scientific concepts such as density and polarity in real life.

With a supplementary YouTube channel, lessons are made more accessible as children can revisit previous experiments and clarify doubts anytime.

The kits will be distributed to beneficiaries by community partners. Sci@home will also use the grant to develop new kits once a month and beef up their online engagement tools and platforms.

“By tackling some of the challenges that these children and their families may face, we hope to help these young children adapt to home-based digital learning,” said Seok Mun.

Connecting generations through collections

At Tiny Museums, Singaporeans can explore an online trove of personal collections – ranging from ancient kerises to vintage vinyls – with guided tours from their owners.

The brainchild of Chua Ying Qing, Bu Dongqing – Master’s in NUS Southeast Asian Studies graduates – and Jamie Lee, the initiative aims to foster intergenerational connection under the “Make Our Society Better” category.

“The divide between older and younger generations is a growing concern in Singapore, and bridging this gap can seem like quite an insurmountable task,” said Jamie, a Southeast Asian Studies graduate.

Seeking a creative approach, the team linked up with The Folklore Archives, a group that organises in-person tours showing private collections of senior citizens to students and members of the public. 

When COVID-19 hit and gatherings were banned, Tiny Museums tapped The Folklore Archives’ projects to build an online platform offering virtual tours. 

While the duration and number of participants per session are still being firmed up, the team has partnered with schools and senior care centres for trials.

To widen their collection, the team has reached out to more senior collectors via Facebook and WhatsApp, and are currently screening potential candidates. There are also plans to use their $50,000 grant to create short films for collectors to showcase their wares.

“(Through this project), we hope to spark organic interactions between individuals of different ages and backgrounds,” said Jamie. "Ideally, we'd like to create a sense of intimacy and offer a chance for connection even in these isolating times."

Building digital bridges for mentorship

Entering the workforce can be intimidating for soon-to-be graduates. But with a helping hand, the transition from student to professional life can be smoothened

For NUS Mechanical Engineering graduate Shaik Jifridin and his team, they realised the importance of networking and value of building a mentorship culture with people who are successful in their own disciplines.

But connecting with the right people was difficult. The restrictions during the COVID-19 pandemic made things worse by curtailing physical interactions.

To bridge the gap, Shaik and his team created With.Network, an online social platform for NUS students that forges seamless connections through sharing of ideas and collaborations.

“We want to redefine mentorship and allow schools to scale mentorship operations,” said Shaik, who counts fellow Mechanical Engineering graduate Mohammad Azfar, NUS Computing Science graduates Shradheya Thakre and Ryan Ang, and NUS Communications and New Media graduate Vivian Ngiam as his teammates.

The platform allows students and alumni to connect in a private network and engage meaningfully under the guidance of NUS. Mentees can view available mentors from various industries such as advertising or IT. The platform’s settings also allow mentors to choose how often they prefer to be contacted.

Its pilot run in February 2021 will include 50 students paired with several alumni of NUS Enterprise, the university’s entrepreneurship arm.

“We found that most alumni who have been in the workforce for at least five years are open to share their knowledge and mentor students from their alma mater if approached,” said Shaik.

By fostering greater collaborations within the school network, the team hopes to create a stronger, lasting mentorship culture.

Bag it up, we’re going green

As clothes and groceries arrived at his doorstep during the circuit breaker period, NUS Engineering graduate Sean Lee soon discovered that his online buys came with piles of plastic bags.

While e-commerce has certainly made his life easier, the amount of packaging waste spurred him and four friends to propose an eco-friendly alternative.

“The items are brought to us, so the extra packaging doesn’t make much sense,” said Sean. “This puts a lot of pressure on the consumer to be responsible (in disposing of) this packaging.”

Together with fellow Engineering alumni Jeremy Chew, Marcus Lo and Cui Wenshuo, and NUS Science graduate Edwin Wong, Sean pitched their ECOPack idea under the “Make the World Better” category. 

Made for online customers, the eco-friendly carrier is designed to be durable, easy to clean and highly functional.

Customers can drop the bags off at easily accessible businesses such as supermarkets and retail stores working with ECOPack. It is a win-win partnership as brands can embrace sustainability while increasing foot traffic.

The ECOPacks will be collected and sent for cleaning, while quality checks will be done at a central location to ensure a longer lifespan to offset the carbon footprint caused by production.

Empowering Asian youth in underserved communities

As children who led nomadic lives in Mongolia, Temuulen Bayaraa and Solongo Batsuren overcame the odds to become successful young professionals today.

Their experience motivated them to empower the next generation through self-development programmes. Together with fellow Mongolians Saruul Khatanbaatar and Binderiya Makhbal, who are all Master’s in Public Policy graduates, they created Equity Lab.

“(Mongolian youth) want to be provided with the opportunities to grow and the ability to be in charge of their future,” said Saruul, whose team participated in the “Make Our People Better” category.

They discovered that nearly one in three Mongolians live in extreme poverty, a systemic issue perpetuated by poor access to quality infrastructure and services. However, the lack of social mobility was something they could address.

From their research, the team found that 15- to 18-year-olds would benefit most from their project. Through workshops, the youngsters will gain financial and communication skills, digital literacy and a better idea of their career prospects. 

With their $50,000 grant, Equity Lab will develop educational resources and activities, and use a digital tool that offers gamified solutions to attract and incentivise students. 

Their prototype will be tested with a partner school on the outskirts of Ulaanbaatar. Once successful, they plan to expand the programme to similar underserved communities across Southeast Asia. 

“We want to see many more youths who are confident in their future and have the will to create positive impact both locally and globally,” said Temuulen, co-lead of Equity Lab.

Remdesivir is a broad antiviral medication that was recently approved by the United States Food and Drug Administration as a treatment for COVID-19. The team showed that a combination of remdesivir with ritonavir and lopinavir led to a treatment that was 6.5 times more effective than the limited effects of remdesivir alone. Ritonavir and lopinavir are drugs used to treat patients with human immunodeficiency virus (HIV), but according to the NUS team’s study, and clinical trials in China, Europe, and United States, the two drugs showed little effects on their own against COVID-19. The team also showed that hydroxychloroquine and azithromycin, which are drugs considered as promising treatment options at the time of the team’s experiments conducted in April of this year, were relatively ineffective as treatment options for COVID-19.

The research team was co-led by Professor Dean Ho, Director of The N.1 Institute for Health and Institute for Digital Medicine (WisDM) at NUS, and they used their platform known as ‘IDentif.AI’ (Optimising Infectious Disease Combination Therapy with Artificial Intelligence) to investigate 12 potential drug candidates, representing over 530,000 possible drug combinations. The identification of this optimal drug combination was completed within two weeks, cutting down the number of tests typically needed by hundreds of thousands.

The work was a collaboration between NUS – including researchers from the Cancer Science Institute of Singapore and Department of Pharmacology at NUS – and researchers from Osmosis (Knowledge Diffusion), and Shanghai Jiao Tong University. The results of the study were published in Bioengineering and Translational Medicine on 10 November 2020.

Using AI to find more effective drug combinations faster

This study used patient-derived, live SARS-CoV-2 to test a 12-drug set. These drugs are: remdesivir, favipiravir, lopinavir, ritonavir (ritonavir and lopinavir are given together for HIV), oseltamivir, hydroxychloroquine, chloroquine, azithromycin, losartan, teicoplanin, ribavirin, and dexamethasone. The drugs used are also utilised in many of the studies that are currently in clinical trials for COVID-19 treatment.

In traditional drug screening, a 12-drug set such as this, with 10 different doses studied for each drug, represents a parameter space of one trillion possible combinations. Using IDentif.AI, the research team was able to determine that testing only three different dose levels were needed for each drug. While this still represents 531,000 possible combinations, the team was also able to reduce the numbers of experiments needed by three orders of magnitude and complete the entire study within two weeks.

“IDentif.AI is unlike traditional AI as we do not use pre-existing data or in silico modeling to train algorithms and predict drug combinations,” said Prof Ho, who is also the Head of the NUS Biomedical Engineering.

Given the diversity of different drug candidates that are being studied, and the need to evaluate different permutations of drug combinations and the respective doses, much of the data needed in order to optimise drug development simply does not exist. “IDentif.AI is unique in that we obtain the data that we need through carefully designed experiments in order to arrive at a ranked list of actionable and optimised regimens,” added Prof Ho.

While AI is being actively explored in the area of therapeutics, current efforts are largely directed towards drug discovery and repurposing. However, repurposed drug candidates are unlikely to be effective on their own.

“With the emergence of an outbreak, there is not enough time to develop a new drug. At the same time, drug repurposing against aggressive infectious diseases is challenging, since truly optimising outcomes often involves efficiently creating combination therapies. As each day passes, more patients will be infected and the numbers can climb rapidly to overburden healthcare systems and economies,” explained Dr Agata Blasiak, a Senior Research Fellow in Prof Ho’s team who is the co-first author of the paper.

IDentif.AI addresses this problem by interrogating extraordinarily large parameter spaces and pinpointing the best possible combinations to give to patients. This can be accomplished rapidly. “Depending on the assay and the viral pathogen, this can all be done within two weeks. In the future, IDentif.AI may also help the community avoid suboptimal drug combinations,” added Dr Blasiak.

Key results of the study

Remdesivir, lopinavir, and ritonavir at specific doses represents the top ranked combination, resulting in an almost total inhibition of infection. While remdesivir alone was the best performing single drug relative to the other drugs, the optimal combination increased the inhibition efficiency by 6.5 times. IDentif.AI was able to harness an unforeseen interaction between remdesivir, lopinavir, and ritonavir that experimentally shown to markedly increase efficacy. Therefore, IDentif.AI may be leveraged to realise unexpected drug combinations based on drugs that are ineffective as monotherapies in order to optimise treatment. 

In addition, the study found that hydroxychloroquine and azithromycin, another widely studied combination, was shown to be relatively ineffective. This is different from the vast majority of previous studies which showed this to be an effective combination against SARS-CoV-2 in vitro. However, these studies used very high doses that would be very toxic for patients. Recent clinical results have suggested that more patients die with this combination compared to standard treatment.

Next steps

The results of this study have demonstrated the power of IDentif.AI to rapidly discover optimal drug combinations for infectious diseases.

To provide broader insight into the extensive range of combinations explored by this study, the research team has developed IDentif.AI Online, an interactive resource that allows users to build different drug combinations online and observe corresponding efficacy and safety data for research purposes. This resource will be updated continuously as additional IDentif.AI studies are conducted with additional therapies and viral strains.

The team is also preparing to expand IDentif.AI towards locally available therapies to develop novel combinations that can be rapidly deployed and administered easily, and may also use it to find optimal treatments against other infectious diseases in future.

“With IDentif.AI, we will always be ready to rapidly find optimal therapeutic solutions for the next outbreak,” concluded Prof Ho.

Click here to read the full article.

These measures are all the more vital as universities face the fierce challenge of the COVID-19 pandemic, added Prof Tan, who was speaking on 26 Nov at a forum featuring higher education leaders from Asia.

“For an institution, there are strategic risks and there are operational risks. A pandemic like COVID-19 actually (presents) both of them,” he said. Fortunately, after the SARS outbreak in 2003, NUS put in place steps to mitigate such risks – steps which have come in handy during the current crisis.

Prof Tan was speaking at this year’s Presidents Forum organised by the Asian Universities Alliance (AUA), a grouping of 15 top regional universities.

Attendees included Dr Nilar Aung from the University of Yangon; Dr Agustin Kusumayati from Universitas Indonesia; Professor Chandrika Wijeyaratne from the University of Colombo; Professor Subhasis Chaudhuri from the Indian Institute of Technology Bombay; Professor Sawako Shirahase from The University of Tokyo; and Mr Shigeo Katsu, President of Nazarbayev University which hosted the event with AUA.

Together, they shared insights on the theme “Knowledge is Power: The Resilience of Asian Universities in a VUCA World”. VUCA is a term used in strategic planning that stands for “Volatile, Uncertain, Complex and Ambiguous“.

This VUCA world, Prof Tan said, requires universities to engage in “futures thinking” – reflecting on the major changes that will occur in the coming decades, and preparing for these macro trends.

“The future is going to be even more uncertain, less predictable, and many more of the unknown unknowns are going to be thrown out,” said Prof Tan.

“I think universities should avoid thinking too much in silos. We should actually think, perhaps, of what others are not thinking. Scenario planning and futures thinking can help universities be more prepared for unexpected incidences, and lay the proper groundwork for us.”

Financial and environmental sustainability are also key to higher education, highlighted Prof Tan.

NUS’ enrolment will be declining from this year onwards, owing to the country’s low birth rate. As a lower student intake will affect revenue, it is important to keep a keen eye on costs.

Prof Tan shared that digitisation is one way for universities to trim and optimise their expenses.

“When I became President in 2018, one of the things that I put in place was to try to digitise a lot of the administrative processes. And before I digitise them, I do a lot of business process re-engineering, because you don’t want to digitise a very clumsy system.”

NUS also treats environmental sustainability seriously.

“We have a programme to lower the ambient temperature around NUS by 4 degrees,” shared Prof Tan. “One easy way is to plant more trees. I committed to planting 8,000 trees every year, so over the next 10 years I’ll be planting 80,000 trees.”

Heat spots are identified at the university, and trees are planted there to absorb heat and lower the ambient temperature by 2 degrees.

To make up the other 2 degrees of the overall 4-degree temperature reduction target, NUS is looking at the paint on the surface of buildings. Certain paints lower the absorption of the ultraviolet that heats up buildings, thus reducing the need for air conditioning.

Prof Tan also shared on the ways that NUS is preparing students for the future workforce. Because problems are complex and require holistic solutions, the University is driving inter-disciplinary learning. And because a four-year university education is no longer sufficient to prepare graduates for a working life that could last five decades, NUS is also focusing on lifelong learning.

“In the past, it was a career for life. Now, we are talking about a lifetime of careers. People are talking about the half-life of knowledge, and competencies are getting shorter and shorter, especially in the technical fields,” said Prof Tan.

“So we have to better prepare our students. They have to be imbued with a mindset that (embraces) learning for 40 to 50 years.”

27 November 2020

Dear Graduating Students of the Class of 2020

In May this year, I had written to you to explain the postponement of Commencement ceremonies for the Class of 2020 to January 2021 because of COVID-19 restrictions.

While the local COVID-19 situation is improving, the country is still taking a cautious approach to social events and gatherings, with selected activities permitted to resume in a safe and calibrated manner.

I write to inform you that we have taken the difficult decision to further postpone the Class of 2020 Commencement ceremonies to a later date in 2021. In a typical year, NUS organises an average of 24 formal ceremonies involving more than 27,000 graduates, family members and friends. The current restrictions on large gatherings have made it challenging to organise physical Commencement ceremonies in a manner that enables you to safely celebrate this milestone with your loved ones.

You will shortly receive an email from the Registrar on how you can keep abreast on the Commencement ceremonies for the Class of 2020, and other details on collection of your degree scroll and transcript, as well as academic dress.

For those in need of help, we have developed the NUS Resilience and Growth Initiative to assist you, so please reach out to us if you need support for jobs and internships or professional development. If you have an innovative idea which can help shape a better future for people, society and the world, I encourage you to take part in the NUS Resilience and Growth Innovation Challenge which is still open for submissions till 31 December 2020.

As the year will soon draw to a close, may I take the opportunity to send you and your loved ones my very best wishes for the holiday season. My colleagues and I look forward to celebrating with you and your families at the Commencement ceremonies in 2021.

With best wishes

Professor Tan Eng Chye

The COVID-19 crisis has exacted a heavy toll on the migrant worker community in Singapore. When approached by an anonymous donor who wished to help, Assoc Prof Tan and the CAPT team were keen to move beyond short-term measures – such as handouts of masks and hand sanitisers – towards rethinking ways of giving back to the local migrant worker community. To help uplift lives in a sustainable way, they decided to shift their focus further upstream – by supporting access to education.

Uplifting through education

Although some of the Bangladeshi migrant workers working here had qualified for university in their home countries, they came seeking better work opportunities in order to support their families back home. Some of them are working so that the women in their family can receive a university education.

Assoc Prof Tan shared, “In speaking with the men, we could feel a sense of pride and joy as they told us of their wife, sister or daughter who is in a top university in Bangladesh. The quiet smile and the sparkle in their eyes said it all. As we spoke, we realised that the migrant worker before us had also scored top marks in his pre-university exams but had his studies curtailed due to poverty – and here he is in Singapore as ‘another construction worker’. It is thus humbling to know his background, his potential and his commitment to labour under the hot sun for his family.”

However, remittances sent home encounter many competing demands, with education and its incidental costs being just one of them. Hence, the CAPT team decided to use the funds to start a “Bangladeshi Worker Dependent Varsity Bursary”, and incorporated the project into the College’s “Hidden Communities” and “Citizenship in a Changing World” modules. These modules are part of the University Town College Programme that allows students to explore a broad range of topics related to the College’s focus area of community engagement and active citizenship.

A community galvanised to help

Kicking the project off in August, the team collaborated with CAPT’s community partner SG Accident Help Centre (SGAHC) to identify migrant workers with female university-going dependents. Subsequently, more than 50 students then worked in teams to engage with migrant workers and their dependents via video calls and WhatsApp messages. Over 10 weeks, they strived to learn more about the lives and personal stories of the migrant workers while also assisting with their bursary application.

CAPT alumni and some members of the broader NUS community were also roped in to translate the application form into Bengali, and serve as interpreters when needed. The CAPT team then worked with SGAHC to remit S$300 each to 16 female dependents in Bangladesh to help defray the costs of their university education this semester. 

Fourth-year NUS Arts and Social Sciences and CAPT student Donovan Liew, who helped roll out the project, said, “We are grateful to our partner SGAHC. Their role was crucial, as they linked us up with their network of migrant workers they have been regularly engaging with. Their support was paramount for the project’s success. This project was also meant to demonstrate the potential for replicability and scalability to non-governmental as well as corporate organisations that may be keen on such initiatives as part of their corporate social responsibility efforts.”

The impact of this initiative – for everyone involved

One migrant worker whose sister received support from this initiative is Nahiduzzaman (Nahid), who came to Singapore in 2013 seeking work. The eldest in a family of four children, Nahid lost his mother in his teens and grew up supported mainly by his farmer father. He had scored well enough in his exams to enter Dhaka University, a top-tier university in Bangladesh, but had given up his dreams of a university education to support the family.

Nahid never stopped believing in the power of education to shape lives. His sister is currently pursuing a degree in music and aspires to a government job after graduation. He sends back the bulk of his monthly income to support his family’s living expenses and about S$300 is set aside each month for his sister’s tuition and hostel fees. Grateful for the additional support that he has received, Nahid shared, “I want my sister to study as she is very good at it. I could not study in the past as my family had no money. Now it is good that I can support my sister. It is much more difficult for girls to study than boys as it is not easy for girls to have part-time jobs while studying.” 

Year 1 NUS Engineering’s Liaw Zheng Kai shared, “Through these opportunities, students can become more aware of the migrant worker community and this also promotes understanding between the two communities. This would help migrant workers understand that they also have the support of the wider community in Singapore. It has also helped me understand the challenges they face and taught me the importance of reaching out to those in need, even if they may not ask for it.”

Assoc Prof Tan surmised, “This project gave an opportunity to our CAPT undergraduates to contact their peers – female students studying in Bangladesh. In doing so, we catch a glimpse of the odds they overcome to stay in their pursuit of education. One day, when the situation permits, our Overseas Service-Learning trips could be to Bangladesh. Instead of building toilets or painting murals, we could go to learn about what these female students do in their own community volunteering, and we join hands, work under their guidance and further our learning.”

The project is set to continue in the next semester.

Click here to read the full press release.

As part of the ongoing efforts to combat the coronavirus, Temasek Foundation brought together NUS, National University Hospital (NUH) and Singapore General Hospital (SGH) to develop an open-sourced system that wirelessly collects measurements of oxygen levels taken from Bluetooth-enabled pulse oximeters, and presents the data neatly on a dashboard. This compilation is quicker and more efficient compared to the current method of manually writing down the readings, which then requires additional manpower to consolidate the data electronically.

The development of this new system was led by Assistant Professor John Ho from the NUS Institute of Health Innovation and Technology, together with Associate Professor Arthur Tay from NUS Electrical and Computer Engineering and Dr Yen Shih-Cheng from NUS Engineering’s Innovation and Design Programme. They worked in consultation with clinicians from NUH and SGH, and took two months, from April to June 2020, to come up with it. This project was also supported by the National Research Foundation.

Using pulse oximeters for COVID-19 monitoring

Pulse oximeters measure the level of oxygen saturation in the blood. Collecting data on oxygen levels is crucial because people with COVID-19 may suffer from “silent hypoxia”, a dangerous condition in which they do not outwardly appear to be short of breath, but are confirmed to be so through a pulse oximeter test.

Currently, workers living in the dormitories are required to measure and record their oximeter readings twice a day, as part of the precautionary measures that are in place at the dormitories. With the NUS system, the time-consuming task of manually collecting and sending pulse oximeter measurements from thousands of individuals could be automated.

"Our aim is to bring the convenience of digital technology to the pen-and-paper process currently being used to take health measurements. We hope that the system helps to address the challenge of monitoring the health of migrant workers during this difficult period," shared Asst Prof Ho.

The NUS system is also suitable for deployment in community care facilities.

A digital solution for more effective monitoring

The NUS system consists of several components: wireless nodes to be installed to capture data from Bluetooth-enabled pulse oximeters, individual Bluetooth-enabled pulse oximeters, WiFi stations, and a dashboard that presents the data to the end-user.

To start the monitoring process, the user must first be within six metres of a wireless node located within the room. The user then clips the Bluetooth-enabled pulse oximeter onto their index finger and leaves it there for 30 seconds for the device to complete the measurement.

Once the measurement is taken, the wireless nodes then send the information collected to the cloud via WiFi stations. The data is then displayed on a single integrated dashboard which will show the users’ names and their pulse oximeter readings. The data can be conveniently accessed via a computer, tablet or a smartphone.

The user will also be informed about the readings taken via text messages. If the readings are normal, the message will indicate so. If any reading is abnormal, a text message will be sent to the users in their preferred language – such as English, Chinese, Tamil, Bengali and Hindi – advising them to retake the measurement after 30 minutes.

If an abnormal reading is returned the second time, or if the user does not retake the measurement within the hour, the user will receive another alert requesting that the user contact healthcare workers for further examination. For users in dormitories, the dormitory operators will also be alerted.

Pilot test

The NUS team conducted a two-month pilot test on the efficacy of the system in four rooms within a dormitory that houses workers from Soilbuild Construction Group Limited.

24 workers who had tested negative for COVID-19 were involved in the pilot. The results showed that the workers could be reliably monitored four times a day with a compliance rate of above 85 per cent with minimal intervention by the dormitory operators.

Mr Tushar Nath, Digital Innovation Lead at Soilbuild Construction Group, said, “With the app and dashboard, I can see all the information at one go. With many workers under our care, the system is able to show immediately who needs attention, and it is easier for supervisors to track the health of their workers.”

Mr Yeoh Keat Chuan, Deputy Head, Singapore Projects and Senior Managing Director, Enterprise Development Group, Temasek, said, “We are glad to have facilitated this pilot project, bringing together NUS, the medical community and the construction sector to trial the early detection of COVID-19 cases in the migrant worker community. The ability to remotely monitor oxygen levels of large groups of people in a timely manner is especially pertinent to provide businesses with peace of mind as the economy reopens. Through Temasek Foundation, we will continue working closely alongside our partners to strengthen COVID-19 screening efforts, enhance the safety of our frontline workers, and safeguard Singapore from the pandemic.”

Next steps

Asst Prof Ho said, "We are continually updating the system to address evolving healthcare needs surrounding care for COVID-19. We hope to add additional sensors, such as those for measuring temperature, to provide an integrated health monitoring system."

Moving forward, the NUS research team plans to work with industry partners to deploy the system in worker dormitories. The team also aims to use the system to automate the monitoring of asymptomatic COVID-19 patients in large settings such as community isolation facilities.

The COV-AID Exco members, including Faculty Advisor Professor Alan Tan (middle row, centre); COV-AID co-founder Mark Tang (bottom row, second from left); and co-founder Anders Seah (bottom row, third from left)

As the COVID-19 crisis evolved, so did the laws that were urgently updated or passed to contain the virus – from stringent workplace regulations to sweeping travel restrictions to strict safe distancing measures.

It is not surprising that many were confounded by the constant changes, a confusion that third-year NUS Law student Anders Seah sought to address with a website that explained all the laws.

“The main problem was that there were so many new laws being passed, but they often contained legal jargon that is hard for the layman to understand,” he said.

He decided to simplify matters. Together with Mark Tang, his former junior college classmate and fellow third-year law undergraduate, they founded COV-AID. The one-stop online portal provides comprehensive information on the ever-changing COVID-19 laws and measures.

“Some laws are quite difficult to understand. This is why law firms try to help simplify matters for their clients,” Mark noted. “But there is nothing much being done for the man on the street, and we saw this as an opportunity to do something good for the community.” 

It took three months to build the website that was officially launched on National Day, featuring a simple layout with clear directions that take users to specific areas of COVID-19 regulations and government grants.

The sections provide updated and detailed guidelines on a wide range of categories, from sports and religion to workplace regulations and contracts related to events and tourism. Users can also seek further clarifications through an FAQ section.

Managed by a team of nine students who also run its social media pages, the website has gone a step further by shedding light on some key legal issues that arose from COVID-19.

Other than articles by 80 other students, the website has two sections – Academics on Pandemics and Conversations with Lawyers – compiling articles by and interviews with academics and practitioners that explain how the pandemic has affected world affairs, regional politics and even mental health.

Notable contributors include NUS President Professor Tan Eng Chye; veteran diplomat and NUS Tembusu College's Rector Professor Tommy Koh; and Law Society President Gregory Vijayendran. Many of them are contacts of Professor Alan Tan of the NUS Law School, who supervises the COV-AID project.

“This initiative is singular testimony to the energy and drive of my splendid students at NUS Law,” he said. “Years from now, they will look back at this crisis of our times with great humility and a profound sense of contentment that they gave something back to the community.”

Win-win project

Within a few weeks of its launch, COV-AID has already made an impact. Recently, a social organisation approached the team to draft a plea bargain for a youth who had breached social distancing measures. Anders and his team then asked the Law Society’s Pro Bono Services arm for help. 

“We found that workers from social organisations were also using our website to get information,” he said.

Working on COV-AID has benefitted the team too. “We devised Conversations with Lawyers to employ an interactive talk show format, so that the students get to interview and interact with the lawyers through Zoom,” said Professor Tan.

“Some of the lawyers even assign research questions to the student interviewers, so the whole experience becomes a mini-internship! I think this has been a beautiful, unparalleled networking opportunity for the students.”

But managing a website that requires frequent updates while juggling a heavy academic workload can be tricky. “It all boils down to discipline, focus and sacrifice,” said Anders. “Thankfully, we have a very dedicated team and system in place to make sure COV-AID runs like a well-oiled machine. All credit must go to them.”

Seeking to make a bigger impact

The team is currently working to expand COV-AID’s reach. While they are ramping up its publicity, they have also contacted organisations such as the Singapore Council of Women’s Organisations and Enterprise Singapore to explore possible collaborations. Discussions are still in the early stages.

But one priority remains clear. “The most important thing is to ensure that the content is relevant, updated and accurate, especially when new laws or amendments to existing laws are passed,” said Anders.

Based on users’ feedback, the team is satisfied with the work so far. “The reception to COV-AID has been very heartening. Many people have found the website to be very informative and helpful,” said Mark.

“I think that’s the best part – that we’ve been able to help some people. It’s been very rewarding.”

Like this story? Join the NUS News Telegram channel or sign up for the email newsletter for regular updates.

Duke-NUS researchers, together with collaborators from the National Centre for Infectious Diseases and A*STAR’s Singapore Immunology Network, have shown that COVID-19 patients infected with a new variant of SARS-CoV-2 had better clinical outcomes https://www.duke-nus.edu.sg/about/media/media-releases/media-releases/researchers-in-singapore-discover-new-sars-cov-2-variant-that-causes-less-severe-infections

Professor Atreyi Kankanhalli and Ms Lai Yi from NUS Computing highlight how SMEs, during the COVID-19 pandemic, can employ digitalisation and technology to stay ahead. https://news.nus.edu.sg/sites/default/files/resources/news/2020/2020-08/2020-08-18/DIGITALISATION-bt-18aug-p20.pdf

Many different vaccines and drugs are being developed and tested at a record-busting pace, thanks to an unprecedented level of worldwide collaboration. Dr Khor Ing Wei from NUS Medicine outlines the latest developments.  https://medicine.nus.edu.sg/newsletters/issue35/covid-19-special/how-close-are-we-to-a-vaccine-or-treatment-for-covid-19/