One of the lessons learnt from SARS is that clear leadership and direction is critical to ensure coordinated response across all sectors. Therefore, a Multi-Ministry Task Force was set up before Singapore had its first COVID-19 case to provide central coordination for a Whole-of-Government handling of the crisis. Surveillance and containment measures Singapore’s surveillance for COVID-19 aimed to identify as many cases as possible using complementary detection methods. First, a case definition to identify suspect cases, at healthcare Downloaded from https://academic.oup.com/jtm/advance-article-abstract/doi/10.1093/jtm/taaa039/5804843 by guest on 22 March 2020 facilities or through contact tracing, was established based on clinical and epidemiological criteria, and evolved over time as more information became available. To identify cases in the community that do not fulfill the case definition, an enhanced surveillance system was set up to detect COVID- 19 among all cases of pneumonia in hospital and primary care, severely-ill patients in hospital intensive care units and deaths with possible infectious cause, and influenza-like illness (ILI) in sentinel primary care clinics. Finally, doctors were also allowed to test patients whom they viewed with suspicion for clinical or epidemiological reasons. To support the surveillance system, SARS-CoV- 2 RT-PCR laboratory testing capacity was scaled up rapidly to all public hospitals in Singapore, and is able to handle 2,200 tests a day for a population of 5.7m. Similarly, ROK has also quickly expanded testing capacities, including setting up drive-through testing stations, and has conducted over 200,000 tests to date.3 All suspected and confirmed cases were immediately isolated in hospital to prevent onward transmission. Contact tracing was also initiated to determine their movement history 14 days prior to symptom onset to isolation to determine possible sources of infection and also to prevent onward transmission among close contacts. Any contact with current or recent symptoms after exposure to the case was referred to hospitals for isolation and testing as part of active case finding. Close contacts who were well were placed under mandatory quarantine for 14 days from their last date of exposure, while other lower-risk contacts were put on phone surveillance. As of Mar 10, 2020, over 4000 close contacts had been placed under quarantine, and 8 cases developed symptoms while under quarantine and tested positive. To facilitate compliance and reduce hardship, the Quarantine Order Allowance Scheme provides economic assistance. At the same time, the Infectious Diseases Act provides legal power to enforce contact tracing and quarantine, and to prosecute those who do not comply. Healthcare measures A network of more than 800 Public Health Preparedness Clinics (PHPCs) was activated to enhance management of respiratory infections in the primary care setting, with subsidies extended to Singapore residents to incentivize them to seek care at these PHPCs. As early COVID-19 disease is mild and undifferentiated, medical practitioners were instructed to provide extended medical leave of up to five days for patients with respiratory symptoms. This allowed possible COVID-19 cases to self-isolate at home to reduce the number of undetected cases seeding community transmission. Those with persistent or worsening symptoms are advised to return to the same doctor for evaluation and referral for testing. At the hospitals, infection control measures were strengthened, including strict visitor controls, cohorting of patients with pneumonia or respiratory infection, and maintenance of strict infection control practices across all settings with personal protective equipment levels appropriate for the