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How a HfP reader ended up in a Singapore ‘facility’ for four days despite negative PCR tests

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This article is by HfP reader Polly, who some of you may have met at our pre-covid drinks parties. If you read our daily chat threads then you will have seen this story unfold in real time a couple of weeks ago. One of our Singapore-based readers even brought her some supplies.

Now back home in the UK, I can publish this article that Polly wrote during her detention in Singapore.

How can a COVID PCR test be negative and positive? Schrödinger – the theoretical physicist who suggested that under the rules of quantum mechanics a cat might be living or dead at the same time – might have an answer. That question has been of more than academic interest to my other half and me over the past couple of weeks.

The last time we visited the Far East was in February 2020, just as the pandemic was beginning to take a grip. We returned to England a week or two before lockdown began.

Since then, there have been many roadblocks that prevented us from visiting our favourite haunts – Thailand, Malaysia, Bali, Vietnam and Cambodia, Even if we’d wanted to go, given the circumstances we didn’t.

But lately the doors have been opening. Gradually, it’s become possible to visit some of these countries without being imprisoned in a quarantine hotel for a week or more. Until the arrival of Omicron, Singapore was one of those locations.

Although we would often stop off in the city for a few days before heading off for an island somewhere, this time we decided to spend all our time there. After all, Singapore has some islands.

To get there, the city devised a process called the Vaccinated Travel Lane.

You had to complete a number of forms online which required you to upload your vaccination record and provide extensive details ranging from where you’re staying to your inside leg measurement. You also had to do a COVID test before departure, upload the result and then submit to another test when you arrived at Changi Airport. The whole process was lengthy, but doable. We did the needful and duly got our travel permits.

The Changi test takes up to eight hours to process, during which time you’re required to quarantine in a specific area of your hotel until the test result comes back. Not an onerous requirement, especially as we reckoned that with three jabs in us and feeling fit as fiddles, we should pass with flying colours.

The first test, at Heathrow airport, came back negative, as we expected.  The second test, carried out on arrival, also came back negative within a few hours. With one bound, we were free.

Or so we thought.

A day later, things got complicated. I had two calls from officials at the Ministry of Health. The first was cut off, but not before I was informed that my test was “inconclusive”. We ignored that call, thinking that it was some kind of scam. In the second, the official informed me that while my test was deemed negative by the testing lab, according to the ministry it was positive.

Much consternation at this end. How could a test be positive and negative at the same time? Has Singapore invented a quantum PCR?

After much banging of our heads against a bureaucratic brick wall, I was carted off to a “facility” where I was to receive two new PCR tests and a serology test.

The requirement for serology was a mystery. The serology test doesn’t indicate the presence of the virus. It only measures the antibody count, which would be high in both our cases since we’d only received our booster jabs a month ago. We’re fairly well-connected in medical circles. None of the people we spoke to said that the serology test served any purpose in establishing a positive result.

As for the PCR test, it seems that there’s an indicator called a CT cycle, which measures the amount of virus circulating in the body. If the count is low, you could be shedding the virus. If it’s high, you’re not. It all depends on how many replication cycles the tested sample has to go through before it finds some virus. Above a certain threshold, you’re fine, below it, you’re not. More on this here courtesy of Sinagpore’s The Straits Times.

What added to the confusion was that the first caller from the ministry indicated that my test was inconclusive. The second caller maintained that it was positive. So who was right – the testing lab, Caller 1 or Caller 2? It seems that the lab lost the argument by a vote of 2 to 1.

Lucky old husband, despite having spent the previous few days, weeks and years in close contact with me, was not deemed to be a risk, so he could come and go at will, presumably because he was above (or below) the safety threshold.

It didn’t really make sense, since if he was in close contact with someone was positive, wouldn’t that make him more likely to develop an infection? Not that he was volunteering to be isolated, you understand.

So we awaited the test results. I was stuck in a resort near Changi that had been requisitioned by the government, and he was downtown in our original hotel. Not the holiday we had in mind. When I was taken to the “facility”, I was put in a bus which picked up another person, who was showing COVID symptoms.

So if I didn’t have the virus before, what were the chances I’d catch it on the journey? This could have had lethal consequences had I not insisted on sitting in the front, masked up with the window down.

When I got there, I was told I might be required to share my room. With a COVID patient, I wondered? I was determined to refuse outright to share. They did back down on this.

So now I was stuck in a place where, I was told, up to 400 other travellers were locked away.

The paperwork from the Ministry of Health indicated that an order had been issued for my incarceration, and that I might be there for up to ten days. Not good.

On the first day, I had a PCR swab test. This was supposed to be the definitive test. The next day they gave me another one. Why, I asked? Because apparently, “protocol” demanded that two tests should be carried out after arrival. The nurse with whom I had this conversation was under the impression that I had been released from hospital after being infected with the virus. More crossed wires, it seemed.

Which leads me to wonder what was going on here. When I called the ministry, they twice confirmed that my first test at Changi was negative. They and the test centre re-confirmed the result in emails. Yet I was still greeted by three people in hazmat suits and carted off because someone else in the ministry said so.

Does the ministry not trust its contractor, the testing lab, which it presumably licenced to carry out the tests on its behalf? And if the government happily advertises a hassle-free way of getting into the country, why does it lock me up along with several hundred other travellers, despite my and, presumably, a number of others, meeting the advertised criteria for entry? What’s more, the ministry refuses to provide the detailed results of the test for which I had paid, as did the test centre. Why the secrecy?

Now I faced an uncertain number of days in quarantine. I was being asked to pay for all the costs of the accommodation and tests, which amounted to thousands of dollars. The food was indifferent to say the least. The place where I was kept didn’t even provide milk for my tea, a grievous deprivation for someone of my generation brought up on builder’s tea.

We couldn’t go home until the ministry said so. Could our embassies have helped? We were not at the point of asking for help from diplomats and lawyers, but it may have got to that point if my stay had lasted much longer.

On Day 4, after my third negative test, administered by someone who was clearly training to be a brain surgeon, I was finally given permission to leave the facility. After two days of uncertainty, and then three days of involuntary confinement, I was free to enjoy my holiday, or what was left of it.

Let’s be clear. I wasn’t banged up in the local equivalent of the Bangkok Hilton. Nor was I kept within four hermetically sealed walls. I had a balcony. The Ministry Order threatened all manner of sanctions for not cooperating, including large financial penalties and jail. All in all, quite a stressful experience. I should also mention that at all times the people I dealt with were courteous and sympathetic.

It seems, on the basis of conversations I had with fellow inmates on my way out, that there was a rash of false positives. They included an airline pilot who told me that because she wasn’t allowed to fly her plane home, her airline had considerable problems trying to round up a replacement.

While one can understand the authorities being ultra-cautious, incidents like these will deter tourists and business travellers, which serves to defeat the purpose of the Vaccinated Travel Lanes. Had we known that something like this might happen, we wouldn’t have dreamed of coming in the first place. When one government department places a different interpretation on testing from another, the result can only be confusion and frustration.

Will we visit Singapore again? Only after there has been an acknowledgement of the problem and steps taken to ensure that it has been resolved. The Omicron bomb has probably put paid to any plans we might have in the medium term. Even so, newly-weds who have chosen the country for their honeymoon should think again, unless they’re prepared to spend the first few nights apart. So should timorous grannies making a long-awaited trip to see their grandchildren.

That would be a shame, because Singapore, like so many other countries in the region, has suffered economically from the absence of visitors over the past couple of years.

The rest of our holiday was the dream we hoped it would be, until we fell foul of the British government’s new rule on pre-departure testing – but that’s another story.

Anyway, we made it home and survived the Day 2 arrival test. The whole incarceration experience was made much more tolerable because of the support and encouragement I received from members of the Head for Points community. Many thanks to them, and especially to the friend who dropped supplies off at the facility, without whose assistance I would have had to endure the horrors of green tea. Little things make a big difference in such circumstances.”

Comments (105)

This article is closed to new comments. Feel free to ask your question in the HfP forums.

  • numpty says:

    Were you allowed Grab food deliveries to hotel? During the lockdown in KL wearing a Grab tabard was access all areas!

    Ironically, article just makes me miss trips to places like SIN even more.

  • JD says:

    If I could just comment as someone with a medical background with experience working in Covid stuff. I understand all this ordeal must have been extremely stressful, but we must also be a bit objective when reading about Polly’s experience (not to put any blame, and I would also suggest that communication breakdown played a big role here, for which the responsibility lies solely with the medical staff).

    To explain very simplistically, the way PCR tests work is that a sample is put into a machine, and the viral particles are amplified (think of it as photocopying) repeatedly until the “something” is (or is not) detected. Each “cycle” doubles the amount of stuff should it exist, so for example if the sample started off with 1 particle, there should be 2 after the first cycle, then 4, 8, 16, 32… So the more virus in the initial sample, the fewer cycles needed to get enough virus for detection, and the lower the Ct value. Of course, the threshold for when to stop testing, or when to consider the test negative can be arbitrary or a result of limitations of technology.

    The final step is detection, and this is also not simply “positive” or “negative”. Even with PCR tests, a tiny amount of virus may sometimes not be detected. There are also risks of false positives. Sometimes, a result can be “inconclusive” because the reading is not so easy to interpret (say your sample returns with a line at some of the correct points for Covid, but not all): you can Google this, but it is perhaps unnecessary to go into excessive detail. In these cases, repeating tests may be necessary. Testing after a few days may also be helpful, as a patient may then be shedding more Covid and it would be easier to detect.

    From a public health perspective, an inconclusive result suggests that someone may have Covid, and may therefore be treated as one (e.g. confining to the facility in Singapore; being ‘greeted’ by people in Hazmat suits, aka PPE). However, there is still no actual positive test, so it cannot be said your close contact was a contact of a positive case either (yes, loopholes). Antibodies may give an indication of past infection, and in some settings, may also help determine whether a person is still infectious to others or not.

    A lot of this is difficult to explain and the exact mechanisms are beyond what many front line health workers would know, let alone the public. Clearly, healthcare staff need to put more work into explaining these things to “patients”.

    • Brian says:

      So to explain very simplistically, the tests are not fit for purpose and have very little medical point.
      I suppose that must be linked to the fact that the paper which put these tests forward was not peer-reviewed, was co-authored by somebody who was heavily involved in the company producing the tests and was published in a journal for which one of the co-authors was on the editorial board.

      • David says:

        Take your foil hat off, Brian.
        And yes, Bill Gates is observing your day to day life through that jab.

        • jek says:

          @Arch you have been reading too much fake news on Facebook. The CDC has withdrawn one type of PCR test, not PCR tests in general. All other are still approved by the CDC! This would have been obvious if you would have actually read the CDC statement! Please stop spreading fake news.

        • jkay86 says:

          @ Arch, as a frontline doctor my alarm bells always go ringing when I hear the phrase ‘do some research’, only to be confronted by statements from people reading scientific/medical articles with non-existent scientific literacy.

          The CDC statement advises that they are advising the withdrawal of the first approved PCR testing system and recommending the use of more updated detection methods. Had you bothered to click on the link in the CDC article, there is a list of >200 (surprise!) alternative PCR detection methods.

      • Geoff 1977 says:

        😂

      • TGLoyalty says:

        “the tests are not fit for purpose and have very little medical point.”

        The tests are very helpful when confirming that someone who is showing symptoms has the virus.

        Unfortunately these tests are being used for much more than that.

    • AirMax says:

      Thanks for posting JD, this is very useful

    • Track says:

      @JD “From a public health perspective, an inconclusive result suggests that someone may have Covid, and may therefore be treated as one”

      1) This is where the rubbish starts because they put false positives together with very likely COVID carriers (see Polly bus ride). Out of 5,000 travellers there will be say 1% (50 people false positives or “insufficient negatives”). That is why that resort is 400-people occupied at all times.

      2) In practice, the measures themselves contribute to the spread: stuffing people in queues and facilities for hours, yes the personnel wears hazmat suites but how about people.

      3) Healthcare staff is courteous, but the healthcare officials are unaccountable to patients. They even refuse to provide test paperwork, mounting a bureaucratic protective wall.

      There is no second independent review before committing a person to what is effectively a detention of up to 14 days, possibly more.

    • reddot says:

      @JD, thank you for being a voice of reason. The CDC link posted further down was clearly wrongly interpreted.

  • Blair says:

    I cancelled my VTL flight over Xmas when I heard testing on arrival was happening. So glad I did. Great update Polly.

  • Alex says:

    Well, it was always a risk. S**t happens.

  • Terwri says:

    Great read on a terrible experience Polly 👍🏻

  • Flyingred says:

    A grim situation! My son had a similar experience when quarantining for 14 days in South Korea with two ‘inconclusive’ PCR test results. Fortunately he was in an apartment provided by his employer and not in a government facility but it’s undoubtedly stressful.

  • Tom says:

    “ Will we visit Singapore again? Only after there has been an acknowledgement of the problem and steps taken to ensure that it has been resolved.”

    Lol good luck ever getting Singapore to acknowledge they messed up. They would rather implode their country than lose face.

    Yet more bad publicity for a country that once led the region as a travel hub. What a shame….

    • John says:

      Not like there are any other open travel hubs in Asia… Bangkok maybe but similar risks

    • Lady London says:

      It sounds like there is no right to appeal or force disclosure of the test results for someone put in this situation. This is disappointing and brings home actually travelling to places where the culture and rule of law could mean officialdom can treat you badly, and far worse…. We’ve grown used to forgetting about these dangers when travelling to a lot of the world and not just during covid.

      • Polly says:

        Yep Lady London.

        That was my bug bear from the beginning. At no point did l see any evidence of this supposedly inconclusive or positive test result. Wonder what would have happened if l had stood my ground and demanded to see the result before leaving voluntarily. I asked them enough times by email and WhatsApp.
        Perish the thought. They were determined. The one thing that puzzled me was the surety of the last senior MOH lady l spoke to saying, “ we are sure it will be negative, then you can enjoy your holiday” how would she know?????

      • Alex says:

        LL, I get what you are saying and what Polly does professionally it doesn’t matter in this case. You are visiting a country, you comply with their requirements and rules. You like them or not. The whole thing comes across as “Singapore, you are doing everything wrong” and hence my comment. I’m sure Polly complied at the time and did approach it correctly and as you said challenging this would probably lead to a myriad more problems.

  • Jason T says:

    A serology test allows the a level of certainty if any COVID infection was a recent or newly acquired. Those require different containment next steps.
    Honestly, explaining health care policies and processes to a generic “traveller” makes no sense. Apart from having a tad more money than others to burn to travel at trying times, they often lack the empathy or capability to understand the rationale behind trying to protect the general public

    • Alex says:

      Someone else’s fault, except Polly’s, of course.

      • Lady London says:

        Alex Polly does wear it lightly but she does actually know what she is talking about in these matters.

        She could easily have done a professional dykwia when dealing with the people in Singapore and discussing her tests but she didn’t. Because she’s been in other cultures professionally and she’s been enough in Asia to know that an open correct challenge wouldn’t get anywhere due to this being a challenge to govt power and loss of face. In fact the more correct a challenge, the worse it would probably have been. So she rode it out looking cooperative and probably got herself out in the shortest possible time. There’s times when even when you could do a dwykia it’s best not to.

        • Polly says:

          Tnx Lady London,

          That’s exactly the tack we took, ride it out and hope for the best. And yes, l did manage to get out that whole day early! Meant a lot…their policy being to keep you there a further 24 hours after the negative results, taking vitals signs 3 times that day… just in case…hilarious. That one l did challenge, and got out…they just couldn’t justify it!

    • Track says:

      @Jason T “Honestly, explaining health care policies and processes to a generic “traveller” makes no sense”

      If someone is locking you up for 14 days, with rationed food, invasive medical procedures and you paying for it all — don’t you want/think it is reasonable to have the process of independent review.

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