SINGAPORE: The return to tighter public health measures under Phase 2 (Heightened Alert) is required, as COVID-19 infections are likely to “rise sharply” at the current rate of transmission, said the Ministry of Health (MOH) on Tuesday (Jul 20).
This comes as several clusters linked to the Jurong Fishery Port have emerged, especially in wet markets and hawker food centres.
“This is very concerning, as it can affect many people in our community all over the island,” MOH said in a press release.
In addition, unlike the KTV cluster, which had spread first among younger segments of the population, the current wave of infections affects “a wider spectrum of the population including many seniors”, said MOH.
“At the current rate of transmission, it is likely that infection cases will rise sharply, and many people in the community will catch the virus.”
Specifically, between Jul 12 and Jul 18, there was an average of 46 community cases detected per day - the highest number of such cases since April 2020, said the ministry.
This comes despite a string of efforts that have been made to contain emerging clusters - such as placing all workers at the port under quarantine, and conducting mass surveillance testing of those working at certain markets and cooked food stalls.
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Contact tracing has been further implemented, while residents living near markets have been advised to minimise their movement and social interactions, and to use self-test COVID-19 kits.
But the ministry said: “The porous nature of wet markets and hawker food centres which serve a range of customers including vulnerable seniors, also increases the risk of undetected cryptic transmission."
In the meantime, as extensive testing continues for individuals exposed to the risk of infection, case numbers can be expected to grow in the coming days, said MOH.
TIME NEEDED TO RAISE VACCINATION RATES
While close to half the population has been fully vaccinated, there are still a number of vulnerable individuals, such as seniors, who have yet to be vaccinated.
This leaves them at higher risk of being infected, and higher risk of being seriously ill if infected, said the ministry.
Speaking at a press conference by the COVID-19 multi-ministry task force, Gan Kim Yong, co-chair of the task force reiterated that seniors are at risk amid the growing clusters.
In particular, out of seniors aged 60 and above who were infected over the last seven days, 12 were unvaccinated. “This is of great concern to us, because almost 30 per cent of the elderly population above 70 years old remain unvaccinated," Mr Gan said.
In its press statement, MOH said it had "act decisively" to contain the current outbreak and minimise the risk of hospital capacity being overwhelmed, while "(racing) ahead to vaccinate those who have not completed or started their vaccination.”
The ministry added that the country is still on track to having two-thirds of Singapore's population fully vaccinated by National Day, and it is aiming for “much higher coverage” amongst seniors.
Mr Gan added that there will not be differentiated measures during this period (Jul 22 to Aug 18) for those who are vaccinated and unvaccinated – but such measures can be considered once the situation has stabilised.
He also acknowledged that this news could feel “like a huge setback to many” who have been observing the rules. It could also be “extremely disappointing and frustrating to many”, in particular, businesses in sectors such as F&B, he said.
“These sectors have been very hard hit, given the earlier restrictions, and have been working very hard to adapt to the changing regulations … We know that the last 18 months have been challenging, and we will provide additional support for the effective businesses, as we make this shift.”
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Mr Gan also said that people have questioned the tightening of measures, given Singapore’s plans to live with COVID-19 in the long-term.
He emphasised that the country's "direction has not changed".
"However, when we outline our plans to live with COVID, we also emphasised that we need to significantly raise our vaccination rate. And meanwhile, we still need to keep the infection under control, to protect the unvaccinated, especially the elderly."
KEY CONSIDERATIONS BEHIND MOVE
At the same press conference, Health Minster Ong Ye Kung said that the Jurong Fishery Port cluster has spread to 28 markets and food centres.
But the silver lining is that while infections are growing, the pace of increase is slowing, and more cases are being isolated before detection, he said.
Explaining the rationale for returning to Phase 2 (Heightened Alert), Mr Ong said that the task force has tried to keep sectors at higher risk of transmission open, but the recent “significant shift” in the public health situation has required them to “rethink (their) posture”.
Key considerations included protecting hospital capacity, as it would be “a disaster” if healthcare institutions were overwhelmed, he said. “We still have the headroom to withstand the pressure. But if the cases keep on rising … it will come under significant pressure.”
He added that there are still more than 200,000 unvaccinated seniors above 60 years old.
Based on past experience, 10 to 15 per cent of them could end up in the intensive care unit, said Mr Ong – which would be a “huge number”.
Community exposure to the clusters is another consideration, along with vaccination rates, he said.
Mr Ong added: “I would say that at that point in time when we're looking at 40, 50, 60 cases a day, if we had no vaccination, I think MOH will immediately call for a Circuit Breaker or at least a Phase One, Phase Two (Heightened Alert), and slam the brake straightaway.”
But Singapore had a “good vaccination rate” of almost 50 per cent at that point, putting it in a much more resilient position than a year ago, Mr Ong said.
Yet when cases grew over the weekend, the decision had to be made to revert to tighter measures, he said.
"NOW IS REALLY NOT THE TIME TO RISK IT ALL"
Mr Ong added: “We are so close, weeks away to a stage where we have two-thirds, or more of our population fully vaccinated around National Day, and then being able to much more decisively transit to a COVID resilient posture.”
“Now is really not the time to risk it all. So we need to bite this bullet ... push through the vaccination efforts.”
When asked about whether insufficient vaccination rates among the elderly would hold back Singapore from re-opening, Mr Ong pointed to certain countries, like the United Kingdom, which have been able to open up with confidence due to the fact that their vaccination rates are higher than Singapore’s.
They have also gone through “waves of very traumatic transmission”, with many having recovered with “natural immunity”, he said.
Most importantly, their rates of vaccination among seniors stand at 90 to 95 per cent, he said, which is why the country is more confident about re-opening up the economy.
“This is also what we should work towards. Will it always hold us back? I don’t think so. It’s a path we will continue we press on.”
But regardless, efforts must be stepped up, particularly in getting those aged above 70 vaccinated, he said.
SCHOOLS TO REMAIN OPEN
Responding to a question about whether there are plans for schools to return to full home-based learning, co-chair of the task force Lawrence Wong said there are “a whole series” of stringent protocols to minimise interaction in the classrooms and prevent COVID-19 transmission.
“And that's why, for the most part of this pandemic, we have been able to keep schools open, ensure that learning continues safely, not just for our students but also for all our educators,” he added.
This is something that should not be taken for granted, said Mr Wong, noting that many other countries have closed schools for extended periods of time.
He added that studies have shown this affects children, with a possibility of "permanent scarring in terms of learning and human capital, which we have tried very hard to avoid".
Thus, based on the current situation, the Education Ministry has decided that schools should remain open.
“Up to now, we have not seen any school-based transmission, so the students who have been infected have been infected through family members, but not in school.”
Commenting on the tighter measures announced on Tuesday, Prime Minister Lee Hsien Loong said this will help slow the spread of COVID-19 cases.
"We hope to avoid multiple subclusters breaking out around each market and food centre, like what happened around the Bukit Merah View Market. It will buy us time to get more people fully vaccinated, especially not yet vaccinated seniors, who are most at risk, he said.
"We are all disappointed by this step back, but COVID-19 is a formidable foe. We have to feel our way forward, and be prepared for setbacks along the way."