'200 cases a day may not be unusual' as Singapore moves to an endemic Covid-19: Ong Ye Kung

Sharon See

Published Mon, Jul 26, 2021 · 03:57 PM

SINGAPORE has already begun to remodel its healthcare protocols as it learns to live with an endemic Covid-19, with greater use of community care facilities and a shorter length of stay for infected individuals, Health Minister Ong Ye Kung said on Monday.

"We cannot carry on with the current healthcare protocols for Covid-19," Mr Ong, who co-chairs the Covid-19 multi-ministry taskforce (MTF), said in a ministerial statement in Parliament during the taskforce's fifth update on whole-of-government responses to Covid-19.

"If Covid-19 is indeed endemic, having 200 or more cases a day may not be unusual at all."

During an influenza season, daily infection can go up to 1,000 a day, Mr Ong said, and the way Singapore treats Covid-19 needs to be closer to the way it treats influenza, that is "without extensive contact tracing and quarantine in dedicated facilities and hospitalising only those who are very ill".

This can only happen when the likelihood of developing very serious or life-threatening disease as a result of Covid-19 infection has been "significantly reduced" through vaccination, especially among the vulnerable groups.

As at July 25, 54 per cent of Singapore's population has received two doses of either the Pfizer-BioNTech or the Moderna vaccines.

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The rate is expected to reach almost 70 per cent by National Day and nearly 80 per cent by early-September.

"This means Singapore will have one of the highest vaccination rates in the world. It puts us in a strong position to transit to a Covid-19 resilient society, where we can live with it as an endemic disease," Mr Ong said.

The health minister outlined three ways the government has made its first transition to remodel Singapore's healthcare protocols.

First, vaccinated individuals aged 45 to 59 who test positive for Covid-19 and show no or mild symptoms can be directly admitted to community care facilities instead of going straight to hospitals. This was already the practice for all cases aged between 17 and 45.

With this change, 60 per cent of infected cases are expected to recover in community care facilities instead of in acute care.

"Meanwhile, we will plan for the next step, where perhaps 80 per cent can be admitted to community care facilities, and some can even recover at home," said Mr Ong.

Secondly, the government is reviewing its policy to allow fully-vaccinated patients to be discharged earlier and to possibly complete the remaining isolation period at home.

This is based on tests that show the viral load in infected persons falling very rapidly to very low levels after nine days. Currently, vaccinated persons are discharged after 14 days with a seven-day leave of absence, even though most were generally discharged only after 21 days previously.

Thirdly, fully-vaccinated persons can now serve their quarantine at home instead of at a government quarantine facility, if their homes are deemed suitable for isolation.

The government is expecting up to 40 per cent of persons under quarantine to serve their obligations at home, and this is expected to go beyond 50 per cent in "the coming few weeks" as more are vaccinated, said Mr Ong.

"In the meantime, what we are experiencing in this current wave of transmission is valuable, for we are also witnessing a palpable shift in our collective psychology," he said.

This includes a shift away from always focusing on infection numbers.

"We used to get a shock when we saw high daily numbers, because that meant more severe illnesses and deaths," said Mr Ong.

"However, in recent days, that mental link is being broken, as we know that with vaccinations, high infection numbers need not necessarily mean more sickness and deaths."

Instead, more people are focusing on the number of people with severe illnesses, he said, noting that the number, which stands at 14 right now, does not threaten Singapore's hospital capacity.

In the last two weeks, Singapore has seen a new wave of Covid-19 cases, with large clusters linked to KTV lounges and Jurong Fishery Port, Singapore's largest.

The cases have since spread to a number of wet markets and food centres islandwide, prompting the authorities to introduce tighter measures - including a ban on dine-ins and a cap on social gatherings to two persons - in a reversion to Phase 2 (Heightened Alert), or P2HA.

During his statement, Mr Ong said the recent clusters have a Delta strain that is more closely related to those detected in imported cases from the immediate region, rather than the one that infected Tan Tock Seng Hospital and Changi Airport.

"Overall, we have seen a high number of daily cases at over 100 for the past few days. But the situation is stabilising, with daily infections falling," said the health minister.

A week ago, only 27 per cent of the 163 cases on July 19 were isolated before detection, but this number now hovers around 40 per cent.

He said the percentage can be raised through tracing and testing, but the MTF's "objective is not to stop transmissions completely".

This is probably no longer possible given how transmissible the Delta variant, which originated from India, is, he said.

"Eradication is therefore not possible nor sustainable. We must instead find ways to live with this virus, safely," he added.

Mr Ong noted that the reversion to P2HA has caused some confusion among the public, even as Singapore is making good progress in vaccinating its people.

"They ask: Are we still committed to the path towards normalcy and living with Covid-19? The answer is a definite yes. For that is the only way for Singaporeans to regain our lives and livelihoods, and for Singapore to reconnect with the world again," said the health minister.

Describing Singapore's reopening as a "controlled" one, Mr Ong said it will not be a "big bang", as is the case in other countries like the United Kingdom.

Instead, the MTF's road map, which promises "packages of measures" will be implemented step by step.

He said: "A high rate of vaccination will provide us with a more solid and stable base as we proceed on this journey. The higher the vaccination rate, the more solid the ground we walk on."

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