Shorter quarantine, home recovery as default for more as Singapore changes protocols in face of rising Covid-19 cases
AS Covid-19 case numbers rise and in light of Delta variant traits, Singapore is changing its quarantine and treatment protocols accordingly: relying more on TraceTogether data; shortening quarantine periods; having earlier discharges; and making home recovery the default for more fully vaccinated cases, the multi-ministry taskforce on Covid-19 announced on Friday.
Firstly, contact tracing resources will be prioritised for preventing large clusters at high-risk and vulnerable settings.
"At these numbers, our contact tracers can no longer interview every infected individual," said Health Minister Ong Ye Kung. "So instead, we will focus our resources to deal with vulnerable settings and large clusters, such as hospitals, schools, nursing homes should they be infected."
Outside these settings and clusters, there will be a greater reliance on TraceTogether data to identify close contacts of Covid-19 cases, who will be issued Health Risk Warnings or Health Risk Alerts and should get tested.
Household members of confirmed Covid-19 cases will also be required to quarantine themselves. More information will be released later on this self-quarantine arrangement and the support to be provided.
Secondly, in light of the Delta variant's shorter incubation period, the quarantine period will be shortened to 10 days from the date of last exposure, down from 14 days currently, provided that the quarantined person tests negative for Covid-19 at the end of the period.
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The Delta variant's incubation period is an average of under four days, compared to six days for the original strain.
Quarantined persons will still need to conduct daily antigen rapid tests after the 10 days, up to the 14th day, to mitigate any remaining risk of infection. This will be implemented from next week.
Thirdly, for confirmed vaccinated cases, discharge dates have been brought forward, based on evidence that vaccinated cases recover faster than unvaccinated cases. Since Sep 7, fully vaccinated Covid-19 cases may be discharged as early as seven days into their illness if they have undetectable or very low viral loads, meaning that they are non-infectious. Unvaccinated persons will continue to be discharged no earlier than 14 days into their illness.
Fourthly, there will be an expansion of home recovery as a default, which is "very important" as case numbers rise to ensure that hospital beds are allocated to those who truly need medical attention, said Mr Ong.
The home recovery pilot was started on Aug 30, allowing fully-vaccinated Covid-19 cases to recover at home if they have a suitable setting where they can be isolated from the rest of the household. Household members must also be fully vaccinated and not belong to any vulnerable groups, such as the elderly or immunocompromised.
There have been 21 individuals on the pilot so far "and the results have been positive", said the MOH, with nine individuals discharged as of Sep 9 and the rest remaining clinically well.
Given the encouraging pilot results, home recovery will be made the default care management protocol for more fully vaccinated individuals from Sep 15.
This will start with younger individuals and be progressively extended to include those aged up to 50 with "no significant co-morbidities or underlying illnesses". Once notified of a Covid-19 positive result, such individuals should immediately self-isolate at home.
Protocols for infected children, who are currently all admitted to hospitals, will also change. In response to requests from parents, infected children will now be allowed to be brought home, if they are at least five years old and do not have co-morbidities or underlying illnesses.
These children will first be assessed by the hospital to be clinically fit for home recovery, before being sent home.
With all these changes, Singapore will be able to handle about 1,000 cases a day, said Mr Ong, adding that there are plans to make further changes and ramp up facilities to handle more cases than that.
MOH director of medical services Kenneth Mak said that hospitals have been instructed to bring their reserve intensive care unit beds to be on standby, and defer non-urgent elective clinical services in anticipation of a possible further surge in patients needing hospital-based care.
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