The worst outbreak so far this year of Covid-19 among dormitory-resident migrant workers began on 24 July 2021 at Westlite Juniper dormitory. The first case was detected on 24 July 2021 from rostered routine testing. As of 12 August 2021, the cluster comprised 48 cases, reported the Straits Times on 13 August. (13 August 2021, Straits Times, First case in Westlite Juniper cluster detected on July 24).

The government has long used the argument that because of high densities in worker dormitories, once a resident is infected, Covid-19 will spread very easily among other dorm residents. To prevent spillover into the wider community, it is necessary to confine migrant workers like prisoners in dormitories. Workers have been confined since April 2020, sixteen months ago, with no end in sight, though there have been murmurings that when vaccination rates are high enough and density low enough, they will let the prisoners workers out.

The rights violation involved does not seem to move anyone in power. They don’t even feel guilty about it.

People might be tempted to point to the Westlite Juniper cluster to say this only proves the validity of the argument.

Quite the opposite. We will demonstrate here that the justification is in fact undermined by none other than this cluster. Since the justification largely relies on vaccination rates, density of accommodation and possible strain on healthcare facilities, we will touch on these aspects in greater detail below.

People might be tempted to point to the Westlite Juniper cluster to say this only proves the validity of the argument.

Quite the opposite. The justification is in fact undermined by none other than this cluster.

We begin by sketching the overall situation:

  • The vaccination rate among workers in dorms is already very high and approximating herd immunity;
  • The density in Westlite Juniper is already close to the new dorm standard announced in June 2020;
  • All the cases in this cluster are asymptomatic or only mildly symptomatic;
  • The cluster has been controlled by other measures like intensified testing and isolation of contacts, not by confining nearly 300,000 workers, most of whom don’t even live near Westlite Juniper;
  • A much larger cluster from Jurong Fishery Port (over 1,100 cases so far) did not involve total shutdown of all fishery ports and markets nor confinement of anyone involved with fish; we applied targetted measures and managed to level the cluster off and life carried on.

Vaccination-wise and density-wise, the situation is in fact nearly as good as we can get. And yet, the outbreak occurred. This suggests a problem with the justification for confining workers until the vaccination and density objectives have been met, for this justification is based on the assumption that should these targets be met, we will be “safe” and can then let the workers out.

Well, we will never be ‘safe”. This cluster shows that even with high vaccination rates and lower density, we will not eliminate the risk of outbreaks. Does that mean we will never open the dorms?

Vaccination rate

None other than Lawrence Wong, Finance minister and head of the multi-ministry task force on Covid-19, told Parliament on 27 July 2021 that vaccination rates among dorm-resident migrant workers is “very high and it is getting higher”. He mentioned this in his in reply to questions from Members of Parliament about the continued confinement of workers.

… we are very, very mindful of the mental well-being of these workers. We know that they have been subject to these restrictions for quite a long time. For now, the concern is that because of the large clusters that we are seeing in our community, we are quite worried about how they might catch the virus if they were to go out.

Having said that, the vaccination rates amongst migrant workers in the dorms are now very high and it is getting higher. So, we are indeed looking at two things. Number one, giving more allowance in the initial, very near term, something that we are doing, but will do more for them to go to the recreational centres, spend more time there, but indeed we are looking at allowing them to have the time to be out in the community as well. That is something that the [Multi-ministry task force] is looking at.

— Lawrence Wong, head of the multi-ministry task force, speaking in Parliament, 27 July 2021.

While we don’t have data about the vaccination rate specifically for migrant workers [new data added, 25 Aug 2021, see Post-script below], we can infer from data relating to the age cohort of 12 – 39 years that the Ministry of Health puts out in its regular updates and charts.

The charts for 14 August 2021 show that for the age cohort in question, 88% have received at least one dose, while 79% are considered to have completed the full regimen. For those who have recovered from Covid-19 earlier (i.e. nearly half of dorm residents) they need only one dose of Pfizer BioN-Tech or Moderna, and this counts as full regimen. We believe the percentages for migrant workers would not be far different from these average percentages because of the sheer number of migrant workers in this cohort.

Since doses are four weeks apart, this means that by the middle of September 2021, something like 88% of migrant workers should be fully vaccinated.

A Channel NewsAsia story from 16 August says basically the same thing, that these cases in the dorms mostly involve vaccinated persons, though providing no figures either:

In response to CNA’s queries, a Ministry of Manpower (MOM) spokesperson said on Monday evening that most of the workers who tested positive for COVID-19 were vaccinated and that the spread of the disease within the dormitories has been “quite limited”.

— Channel NewsAsia, 16 August 2021, 106 COVID-19 infections reported in dormitories in first half of August; most cases were vaccinated

How much higher do we want to get before we open the dorms? And even if we do get higher, does that eliminate the risk of outbreaks?

It is increasingly evident that the Delta variant of Covid-19 can infect even those who are vaccinated or who have recovered from a previous infection. Thus, even at a 100% vaccination rate, we’re still going to see clusters.

Perhaps the concern is not so much about the vaccination rate among migrant workers, but the vaccination rate in the wider community. If the wider community remains vulnerable, then letting migrant workers mix with them would be a recipe for disaster — or so the argument might go (regardless of the moral dimension of rights violations). Yet, the vaccination rate for the wider community is high too. The figures we used above (88% of the 12 – 39 year-olds have received at least one dose as at 14 August 2021) refer to the overall population of Singapore, including migrant workers.

For all age groups, 81% have received at least one dose and 75% have completed the full regimen — figures from the Ministry of Health, as at 14 August 2021.

The same question can then be posed: How much higher do we want to get before we open the dorms? And once more we have to bear this in mind: even if we get a 100% rate among the entire Singapore population, it still will not eliminate the risk of outbreaks.

Therefore, to continue to say that we cannot open the dorms until vaccination rates are higher is a meaningless argument. What real difference does it make anymore since we are already at such a high percentage?

Serious illness

A more general argument — not deployed specifically in relation to dorm lock-downs — is that control measures are needed to ensure that our healthcare facilities are not overwhelmed. This is related to vaccination rates since we know that vaccination is effective in preventing serious illness.

It s worth noting this bit from the Straits Times story about the Westlite Juniper cluster, published 13 August 2021:

In a statement to The Straits Times, MOM said that six other cases in the cluster were close contacts of the first case.

The remaining cases linked to the dorm located in Mandai were detected either through pre-emptive testing at the dormitory and quarantine facilities, or through rostered routine testing.

“They were either asymptomatic or had mild symptoms, and have been moved to a healthcare facility for further care and treatment,” said MOM.

Straits Times, 13 August 2021, First case in Westlite Juniper cluster detected on July 24

In short,

  • The first case had been detected through rostered routine testing;
  • The next six cases were close contacts of the first case and would have been pre-emptively isolated;
  • All the other cases were detected either through pre-emptive or rostered testing.

The above does not paint a picture of any worker coughing and sputtering away, undetected. The cases were so mild or even asymptomatic that they were only detected through testing. These guys would not have needed hospitalisation.

Ring-fencing

The Straits Times story went on to report that all residents of the dorm were put on seven-day rostered routine tests — instead of the usual interval of fourteen days — to quickly ring-fence potential transmission at the dormitory.

Following the detection of this cluster, about 500 residents were moved in batches to government quarantine facilities, it said.

It added that 380 of these residents have since returned to the dormitory, and that all residents currently living in the dormitory have been cleared to go to work.

Straits Times, 13 August 2021, First case in Westlite Juniper cluster detected on July 24

Quarantine or isolation faclities are not the same as hospitals, certainly nothing like intensive care units.

The measures deployed to control the cluster were the same as those used to control the much bigger Jurong Fishery Port cluster — intensified testing, short isolation of contacts and deep cleaning.

Whether or not we locked up nearly 300,000 other migrant workers had little to do with it. So why keep them locked up?

Consider this: the fishery port cluster did spread to seniors, some of whom apparently needed to be hospitalised. Yet, we didn’t feel any need to lock up hundreds of thousands of people who had any proximity to fish.

Density

At the height of the Covid-19 crisis in the dormitories last year, it was revealed that there had not been any mandatory standards for how many workers could be housed in one room in dormitories. Quickly, the government introduced new standards, which by implication one could take to be consistent with infection safety.

Under new specifications announced by the Ministry of Manpower (MOM) on Monday (June 1), dorms will have no more than 10 beds per room, with only single-deck beds and 1m spacing between them. Each room now holds 12 to 16 beds.

8 June 2020, Straits Times, New dorm standards good for workers but will come with inevitable cost hike: Dorm operators

Today, when the government speaks of lowering density, this must surely be the target they have in mind — a ratio of ten men per room, with their own wet facilities. (TWC2 argued last year that there shouldn’t be more than four persons to a room but our concerns were as much about privacy, restfulness and security as about infection.)

We know from the more recent 13 August Straits Times story that Westlite Juniper

housed 1,408 residents last month, about 500 fewer than its licensed capacity of 1,900 people.

That means its current occupancy is about 74% of full capacity. The figure of 1,900 as its full capacity is also stated on Westlite Juniper’s website.

A part of the website for Westlite Juniper (accessed 13 August 2021) is imaged below, and as readers can see, it contains a floor plan for an apartment for workers. This apartment is designed to house 16 workers in eight double-decker beds. The apartment includes its own wet facilities. The webpage does not show any other floor plan configuration; perhaps Weslite Juniper has only one type of apartment.

If the dormitory’s occupancy is 74% of capacity, this means that on average, a 16-bed room now houses 12 persons. It has not quite come down to the new standard of 10 persons, but it is getting close.

Yet, consider this: If a cluster can develop in a situation where men are housed 12 to a room on average, even if we achieved the target of 10 to a room, it might not make that much difference to Covid-19 transmission.

In other words, if we remain so afraid of asymptomatic or mildly symptomatic transmission such that we use any cluster as justification for the continued internment of nearly 300,000 workers in various dorms, then even if all dorms got their density down to the new standards, we would not feel “safe” enough. We would continue to use this justification to permanently lock up our migrant workers.

The density argument is hollow.

“As at Aug 3, more than 90 per cent of migrant workers in dormitories have been fully vaccinated, said MOH’s group director of crisis strategy and operations group, Mr Dinesh Vasu Dash.” — reported in the Straits Times 25 August 2021, in its story about the latest cluster at a dormitory named North Coast Lodge. The story also revealed that all 62 of the North Coast Lodge cases detected as of 23 August were fully vaccinated.