Singapore to streamline Covid-19 recovery, testing protocols to 'adapt to Omicron'

SINGAPORE is simplifying its recovery and testing protocols for Covid-19 infections, with Health Minister Ong Ye Kung on Wednesday (Feb 16) also asking employers to accept HealthHub documentation in excusing staff from work.

More patients can be managed by primary care doctors under Singapore's three-tier protocols, while close contacts will be monitored for less time and their isolation requirements downgraded from an order to an advisory, said the Ministry of Health (MOH).

Meanwhile, rostered routine testing (RRT) will be mandated for fewer sectors from Feb 18, with a focus on workers who interact with vulnerable groups or deliver essential services.

Ong, who is one of three co-chairs for Singapore's multi-ministry taskforce on Covid-19, noted at a press briefing that "testing remains an essential part of managing the pandemic".

But "our health protocols need to adapt to this distinct characteristic of Omicron of having a very short serial interval", he added, referring to the shorter incubation time and transmission window for the highly mutated and contagious Omicron variant of the novel coronavirus.

Singapore saw a record 19,420 new Covid-19 infections on Feb 15, with case counts expected to remain high in the weeks ahead. The taskforce had previously indicated that daily infections could go up to 25,000, and on Wednesday it reiterated a range of 15,000 to 20,000 daily cases or more.

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The MOH now gives individuals who have tested positive on at-home antigen rapid tests (ARTs) access to government-funded rapid tests at combined test centres and quick-test centres, and Ong observed that the confirmatory results will be recorded in the national HealthHub system.

"The test results can also be used to show the employers, so that they can be excused from work - and employers, please accept those documentations," he said. Employers here typically require medical certificates for outpatient sick leave absences.

Separately, the RRT requirement now covers sectors such as construction, marine and process industries, food and beverage, personal care services, retail, delivery and transport.

But such testing will soon be applied only to staff who serve vulnerable groups - healthcare, eldercare, and childcare workers - and undisclosed essential services sectors.

Companies which still have test kits that had earlier been distributed to them for RRT were nonetheless encouraged by the MOH to continue testing until the test kits are fully used.

The ministry indicated that the RRT regime, which was introduced in August 2020, had been "an important part of our strategy to facilitate early detection and containment of transmission".

"However, we are in a different situation today and our testing strategy needs to evolve. Our high vaccination coverage and the implementation of vaccination-differentiated safe management measures offer good protection to the workforce from severe disease," it said.

From Feb 16 onwards, "Protocol 2" public health measures - which put those with mild or no symptoms under the supervision of primary care doctors - will be expanded to all patients aged 3 to 69 years, regardless of vaccination status, and fully-vaccinated patients aged 70 to 79.

Protocol 2 was earlier available only to the vaccinated aged 5 to 69 years, and the unvaccinated aged 5 to 49 years. Ineligible patients are on Protocol 1, which carries an isolation order.

The latest Protocol 2 expansion "will further right-site the care of Covid-19 patients and ensure that our healthcare capacity is preserved for those who require acute care", the MOH said.

From Feb 18 onwards, close contacts of confirmed Covid-19 patients will have to monitor their health for 5 days under Protocol 3, rather than 7 days. Individuals issued with Health Risk Warnings (HRWs) before that date must fulfil the requirements under the older rules.

Otherwise, HRWs will be replaced by Health Risk Notices (HRNs), which are not binding orders.

While HRNs are not backed by law and do not mandate self-isolation, MOH director of medical services Kenneth Mak said "this is in keeping with our general approach to emphasise a lot more self-responsibility in managing one's health as well as managing Covid-19 infections".

He added at the briefing that the changes "will allow us to continue providing appropriate care for those infected with Covid-19 while ensuring that our hospital resources remain reserved for those who have more severe infections".

"They will enable our public healthcare system to be more resilient and to be able to cope with the increased demands on our healthcare manpower," Mak added.