AN estimated 6 in 10 Singapore residents may have already been infected with Covid-19, said Health Minister Ong Ye Kung in Parliament on Aug 1.

“On record, we have about 1.7 million reported cases, which is about 30 per cent of our population,” he said. “We also systematically monitor blood samples from routine polyclinic cases and other healthy volunteers for signs of previous infection. From these samples, we estimate about 60 per cent of local residents are likely to have been infected with Covid-19.”

Ong was responding to parliamentary questions from several MPs about Singapore’s Covid-19 situation, healthcare capacity, vaccination programme, as well as treatment and vaccination plans for children.

Singapore is still in the middle of an infection wave driven by Omicron variant BA.5, but infection numbers have been falling over the last 10 days, and the week-on-week ratio dipped below 0.9 over the last week, said Ong.

But while social restrictions were not tightened and “everyone went about their lives normally”, life is “not as normal” in the hospitals with the healthcare system bearing the brunt of the current infection wave, he added.

On the supply front, hospitals have cut down on their ‘business-as-usual’ workload by about 5 per cent, comprising mostly elective surgeries. This is less than the 15 per cent cut that had to be implemented during the first Omicron wave in the beginning of the year.

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But as “bed crunches are mainly caused by high case numbers, and how they translate in severe illnesses that need hospitalisation”, there are only 2 ways to minimise demand, said Ong: social restrictions and good vaccination coverage.

“All of us do not want to bring back social restrictions as far as possible, so we need to rely on vaccinations.” He said he was very proud that most people in Singapore “have gotten up-to-date vaccinations”, adding: “The resilience has been further strengthened as many people recovered safely from infections.”

Overall, 1.9 per cent of infected persons needed hospitalisation in this wave, down from 2.4 per cent during the earlier Omicron wave at the beginning of this year.

Though a majority of Singapore residents may already have had Covid-19, Ong cautioned that this does not confer “herd immunity”, which scientists generally do not see as achievable because the virus will continue to mutate.

Instead, what is achievable is “population protection against severe illness” through vaccinations, which ensure that even with high case numbers, there is low translation of infections into severe illnesses.

“Notwithstanding our strong resilience due to good vaccination coverage, the MOH (Ministry of Health) has concerns,” he added.

The first concern lies in coverage of the vulnerable, especially seniors. There are 40,000 seniors aged 60 and above who have not received their booster shots, even though they are eligible. Another 40,000 have not completed 2 doses yet.

The second concern lies in when the vaccine protection will start to wane.

“Our empirical data shows that after 10 months, the protective effect of 3 doses of mRNA vaccines remains very strong in preventing severe illness,” said Ong. That is why the recommendation is for those who are 80 and above to receive their second booster or fourth shot; while protection from the vaccination is not waning, it is generally lower than for younger persons, he said.

For those aged 50 to 79, protection continues to be strong, but this is the age when chronic illnesses start to set in. This is why those who want it will be offered the second booster.

“Our experts are actively studying the benefits of a fourth shot for the 60-79 year-olds in further reducing the likelihood of severe illness. We will announce their recommendations shortly, and once ready.”

Separately, Senior Minister of State for Health Janil Putucheary updated that for children aged 5 to 11 years of age, a third mRNA dose may be necessary at some point to keep protection levels high.

MOH is making the necessary preparations to roll out vaccination booster doses for this age group, in about 2 months’ time, he said.

For children under the age of 5 – currently the last group not yet offered the vaccination – MOH had previously said it is preparing to start vaccination for them towards the fourth quarter of this year.

Ong highlighted his use of the term “up-to-date” vaccinations, rather than a second or third booster shot.

"This is because at some point, just like flu vaccinations, we will have to stop counting the number of jabs we have taken. Instead, we must ensure that we get a jab at a suitable interval – maybe 9 months, maybe a year, and this is something MOH will try to determine in the coming months."

Ong also highlighted the risk that there might emerge a new variant that is more infectious, leads to more severe illnesses, or evades the protection of current vaccines. “If we encounter such a variant, social restrictions will become necessary again.”