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A Hotbed of SARS Warfare

Mass temperature testing is just one of the tools that the autocratic city-state of Singapore is wielding in its winning assault on the disease.

May 08, 2003|Richard C. Paddock | Times Staff Writer

SINGAPORE — At Singapore Changi Airport, passengers walk past a thermal-imaging scanner that instantly shows whether any of them has a fever.

All over the city, taxi drivers, government workers, waitresses, bank tellers and bellboys take their temperatures at least once a day. So do visitors to government buildings, reporters going to news conferences and women arriving at the beauty parlor.

Many residents proudly wear the country's new badge of honor: a sticker showing they are fever-free.

It is a brave new world here in Singapore, where government-ordered mass temperature testing has become one of the most important measures in preventing the spread of severe acute respiratory syndrome.

The autocratic city-state, which has suffered 27 deaths and huge economic losses from the disease, has moved aggressively to contain the pneumonia-like virus and restore public confidence. So far, the effort appears to be working.

"The government in Singapore can control anything," said cabdriver Tan Boon Hoe, displaying a pile of company-issued stickers that show his temperature has been normal for 10 days.

Checking for fevers is one of the least intrusive measures. The government has quarantined more than 3,100 Singaporeans in their homes for 10-day periods, installing Web cams -- cameras connected to the Internet -- in those residences to monitor people once or twice a day. Those caught flouting the quarantine must wear electronic bracelets that signal their movements. Soldiers and police detectives help track down people who may have come in contact with SARS patients.

Doctors have concluded that fever is the most obvious sign of SARS' onset. To detect cases early, the government is setting up high-tech temperature scanners at all entry points to the country, and it aims to distribute digital thermometers to every schoolchild and household. Officials hope that nearly everyone's temperature in the country of 4 million will be monitored daily by midmonth. The fever checks could continue indefinitely.

"Our social behavior will change in the sense that we will all take our temperature twice a day," said Dr. Balaji Sadasivan, minister of state for health and the environment, "and instead of talking about the weather we will ask, 'What's your temperature today?' "

If SARS persists in pockets around the world, Singapore officials predict that temperature screening at airports will become as commonplace as X-raying baggage for bombs.

The disease has created one of Singapore's worst crises in its nearly 38 years of independence. The wealthy city-state has reported 204 probable SARS cases -- third in number behind China, where the disease originated, and Hong Kong.

Singapore is one of Southeast Asia's most important financial centers and a transportation hub. About 1,300 U.S. companies operate here, and the economy depends on business travelers and tourists.

The government estimates that SARS could cost Singapore $860 million and cut its economic growth by half this year. The number of visitors in late April was 71% less than a year earlier. Singapore Airlines has slashed a fifth of its flights. In many hotels, occupancy has plummeted to 20%. Unemployment went up slightly in March and is expected to rise further. The government has pledged $135 million to help hotels and airlines and is paying some quarantined workers a daily stipend of $40.

Far beyond most cities, Singapore is noted for its cleanliness and order. It is also known for an overbearing form of government that some call "the nanny state." Singapore is famous for banning chewing gum and ordering its citizens to flush public toilets. Individual liberty is second to the greater good. The government has the power to lock up opponents without trial.

In combating SARS, Singapore did not hesitate to impose draconian measures.

"It's a time when a benevolent dictatorship can take action more quickly than a Western democracy," Singapore resident Lawrence Harding said after passing through the airport temperature scanner. "People listen to what the government says and do what they're told."

Some Singaporeans have complained about the strict quarantine measures, but most are reassured by the government's tough response. During the worst weeks, many people stopped going to restaurants and malls, but the temperature checks are helping to bring back confidence and customers.

Singapore's problems began when Esther Mok, a 23-year-old former airline flight attendant, went on a shopping trip to Hong Kong in February.

In Hong Kong, she stayed at the Metropole Hotel on the same floor as a doctor who had recently arrived from southern China. The doctor was highly contagious and apparently spread SARS by coughing or sneezing. He gave it to Mok and at least five other guests, including travelers who carried the bug to Toronto and Hanoi, causing outbreaks there.

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