COVID-19: A Viral Disease with Viral Implications

In the first NBS Knowledge Lab: Interdisciplinary Distinguished Speaker Series of 2022, Professor Laurent Renia, Professor of Infectious Diseases and Director of the Programme in Respiratory and Infectious Diseases at Lee Kong Chian School of Medicine, NTU Singapore, joined us to talk about COVID-19 and how we can be better prepared for future pandemics.

The session was moderated by Professor Xin Chang Simba, Associate Dean (Research), NBS and Assistant Professor Ru Hong, Division of Banking and Finance, NBS.

Effects of COVID-19

Prof Renia began by stating that his views do not necessarily reflect the decisions of the various committees he represents. He said that, overall, the pandemic has been well managed in Singapore, particularly at the start. However, the city-state could not block off the borders completely and the virus broke through as a result. The high human density in foreign worker dormitories also led to a huge spike in cases. One outcome of COVID-19 is that the government is rethinking the way dormitories are organised. To deal with a phenomenon like COVID-19, Prof Renia said there is a need for global and integrated approaches.

Infectious disease as a strategic imperative

Looking beyond COVID-19, Prof Renia pointed out that Singapore’s dense population facilitates the spread of infectious diseases, and this will not change even when the pandemic ends. Thus, the study and management of infectious diseases must be a national strategic imperative for Singapore. SARS-CoV, in 2003, led to the creation of the National Centre for Infectious Disease as well as programmes like PROTECT, which seek to anticipate such outbreaks. Prof Renia stressed the need to expand beyond Singapore to obtain expertise not available locally.

COVID-19 vaccines

We now know a lot more about the virus, especially after two years of living with it. We have rapid detection and point-of-care tests, understand how to treat it, and are implementing the first generation of vaccines. The usual development of vaccines takes about five to 10 years of pre-clinical testing but this whole process became six to nine months for COVID-19, which is unprecedented. Prof Renia noted that this rapid deployment has led to some vaccine hesitancy.

Anti-vaccination sentiments are not new and Prof Renia believes that convincing people about the benefits of vaccines is one way of changing such attitudes. This would help people make informed and educated decisions. For instance, sessions in secondary schools that provide students with knowledge about vaccines help counter misinformation.

Regarding vaccinating children, Prof Renia admitted that he was not initially inclined to the idea of vaccinating individuals below 16 years of age but factors such as the possible death of unvaccinated children due to COVID-19 need to be considered. If one were to view the situation on a population level, the possible detrimental effects of vaccines are minimal and the benefits considerable.

However, Prof Renia said that he understood that parents would not feel the same if their child suffered from any side effects from the vaccine. Nonetheless, he pointed out that the virus is ‘smart’, particularly the Omicron variant. As the virus adapts to the population, vaccination policies will have to change.

On the matter of vaccine booster shots, Prof Renia said that it would not be viable to have the population receive boosters every three months. Therefore, he emphasised the importance of developing vaccine 2.0 (i.e., a new type of vaccine with more long-lasting effects).

COVID-19 healthcare measures

Regarding approaches to COVID-19, Prof Renia said that living with the virus made more sense as it was not politically or economically viable to do otherwise. If the virus were to continue being severe, there was data on at-risk groups, allowing us to focus on them.

While vaccine-differentiated measures limit an individual’s movement, they are needed to control the spread of the virus. However, Prof Renia said this might not be so important with the Omicron variant as the vaccinated get affected too. Again, Prof Renia stressed that this was his own opinion.

Interdisciplinary approaches

On potential collaborations between scientists and business research, Prof Renia touched on medical economics, which concentrates on how much money can be saved (rather than earned) through healthcare measures. As there is a point where healthcare systems cannot grow further, other measures need to be considered to reduce cost and make the pandemic more manageable.

With regard to the finance industry, Prof Renia noted that blockchain can contribute to data integrity, ensuring that data on diseases is accurate. Prof Simba and Asst Prof Ru added that FinTech and portfolio theory are useful when it comes to dealing with pandemic inequality and mitigating the risks associated with vaccine development.

Preparing for the future

Infectious diseases emerge and re-emerge all over the world and tropical regions tend to be hotbeds for these diseases. Consequently, more surveillance of diseases in these regions is required. The effect of travel on the spread of diseases is also high and diseases can come from both domestic and wild animals. The urbanisation of infectious diseases like dengue fever, where the aedes mosquito adapted to urban areas, is also a matter of concern.

However, Prof Renia said that mitigation is possible. In Singapore, work on vaccines and better diagnostics is ongoing, though he stressed the importance of regional cooperation.

On an individual level, Prof Renia mentioned that social distancing, wearing masks, and maintaining personal hygiene are important during a pandemic. Beyond that, he pointed out that modified environments are a major cause of diseases (e.g., bacteria growing in the refrigeration systems of buildings). Knowledge from various fields (such as biology, material science, behavioral and societal sciences, economics, etc) are all needed for the prevention of infectious diseases.

Concluding the session, Prof Renia repeated his call to anyone not vaccinated to do so.

Opinions expressed here are those of the speakers’. We encourage all to read the available literature on the pandemic and make an informed decision.