The COVID-19 pandemic has urged nations to prepare for an unknown but deadly Disease X global outbreak (Possas et al., 2021). This is due to the increase of Zoonotic Disease outbreaks in the 21st Century. In recent years, more than 60% of emerging infectious diseases are Zoonotic. Moreover, over 30 new human pathogens have been detected over the last three decades (Jones, et al., 2008). In response, the Centre for Disease Control and Prevention (CDC) in the United States has classified Zoonotic Diseases, such as COVID-19, as “one of the greatest threats towards public health, safety, and security” (CDC, 2017). It thus follows that nations need to strengthen their national healthcare systems in anticipation of a Disease X global outbreak (Iserson, 2020).

 

In Singapore, the government has recognized that a “robust and resilient” healthcare system is necessary to contain potential Disease X outbreaks (Lai, 2021). Importantly, such a healthcare system will be able to effectively respond and adapt to the dynamic public health situation, thus reducing vulnerabilities “across and beyond the system” (Haldane, et al., 2021). This process of improving the healthcare system to prepare for and respond to such global public health threats is known as Healthcare System Strengthening (HSS) (WHO, 2021).

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In this ongoing COVID-19 pandemic, Singapore has responded swiftly (Quah, 2020) by implementing a two-pronged strategy that mixes social distancing, quarantine as well as large-scale contract tracing and testing policies to meet the public health challenges (Ji, 2021). Although Singapore has been commended for her response to COVID-19 (Teo, 2020), there are still several challenges including but not limited to:

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• Capacity of the Healthcare System:

The pandemic has placed “a tremendous strain on the healthcare system, (with) postponed routine elective services, reduced healthcare workforce to non COVID-19 needs”. This has resulted in “difficulty to maintain continuity in the provision of healthcare to medically vulnerable populations, such as the chronically ill patients and functionally impaired adults” (Duke-NUS Medical School, 2021). Moreover, while Singapore has adapted its healthcare capacity in response to the surge of COVID-19 cases in April 2020, the capacity of the existing healthcare workforce has been stretched thin (Goh, 2020).

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• Finite Fiscal Resources:

Fiscal expenses through a series of COVID-19 relief packages to stabilise the economy during the pandemic have amounted to 20% of the nation’s GDP (EDB, 2020), resulting in a record budget deficit of S$64.9 billion for the financial year 2020 (Tan, 2021). In the words of Nominated Member of Parliament Hoon Hian Teck, Singapore’s finite resources necessitate the need to strike a balance between stabilising the economy to avoid a sharp downturn in the pandemic, but also undertaking and investing in structural policies for transformation (Mohan, 2021).

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• Dilemma between Data Collection and Maintenance of Public Trust:

The use of data in Singapore’s healthcare system is a major tool to “improve our capability to respond quickly to evolving situations and contain outbreaks” (MOH, 2020). Through advanced contact-tracing, the government can utilise data to control Disease X outbreaks (Govtech, 2020). However, it is likely that “inconsistencies in information from the government as a precedent” in the case of trace-together and data collection policies, may “impact the efficacy of future government programs (CSIS, 2021).” Therefore, it is pivotal for healthcare policies to consider the fragile balance between data collection as a crucial tool that strengthens the healthcare system; and, the need to protect social norms of individual privacy so as to maintain public trust.