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Symptomatic, unlinked COVID-19 cases in the community a 'greater concern' even as number of daily cases fall: Gan Kim Yong

Symptomatic, unlinked COVID-19 cases in the community a 'greater concern' even as number of daily cases fall: Gan Kim Yong

Members of the public queue to enter Ngee Ann City in Orchard on Jun 19, the first day the shopping centre was allowed to reopen after Singapore's circuit breaker. (Photo: Jeremy Long)

SINGAPORE: While the number of daily COVID-19 cases in Singapore has declined, the number of symptomatic, unlinked cases in the community is of "a greater concern" as a significant increase could signal underlying community transmission, Health Minister Gan Kim Yong said on Tuesday (Jul 7).

The number of community cases has remained "low overall", at around 6 per cent to 7 per cent of total number of cases on average, but that number has "increased somewhat" in the last few days, said Mr Gan.

READ: COVID-19: No active plans to go back to Phase 1 after election, says MOH director of medical services

READ: About half of unlinked COVID-19 community cases detected after circuit breaker were from construction sector: Lawrence Wong

A "deeper investigation" found that more than half of the community cases since the start of Phase 1 are linked, with the majority detected through contact tracing. Most had already been in quarantine.  

Of the unlinked cases, the majority were asymptomatic and detected via proactive screening of workers or regular testing of workers as part of MOH's surveillance. 

"What's of greater concern to us are the numbers of symptomatic, unlinked cases that are detected in the community, through routine screening for acute respiratory infection or what we call ARIs," said Mr Gan at a press conference.

"These are cases that emerge in the community with no clear connection to any existing cluster, dormitories or construction sector. 

"They reflect cases of unknown sources of infection. If this number goes up significantly, we should be very careful as it may signal an increase in the underlying community transmission."

In order to detect such cases early and quickly contain the potential for further spread, community testing was expanded to all individuals aged 13 and above who are diagnosed with ARI at first presentation to a doctor.

READ: Increase in number of new COVID-19 community cases in Phase 2 ‘not unexpected’: Gan Kim Yong

"This allows us to detect infected individuals early and to quickly contain further spread by putting them under quarantine or send them for treatment in isolation," he added.

"With this expansion of testing for all individuals aged 13 and above, we do expect the numbers detected to rise - simply because we are now testing more rigorously, even if there is no change in the underlying community transmission. 

"But this will help us set a baseline, for us to monitor the landscape, the situation better."

The Ministry of Health (MOH) on Tuesday reported 157 new COVID-19 infections as of noon, including 20 cases in the community. This brings the total number of cases in Singapore to 45,140.

There are 12 Singaporeans or permanent residents among the new community cases.

READ: Singapore reports 157 new COVID-19 cases, including 20 community infections

"So far since Phase 1, the number of unlinked cases detected through our ARI swabs has remained stable but these are still early days yet and we should watch carefully whether there is an uptrend and if that is so, whether the uptrend is sustained," said Mr Gan. 

"If so, we need to be very careful to look out for community transmission."

Mr Gan noted how it has been slightly more than two weeks since Phase 2 started, and with economic activities and social interaction increasing "significantly".

Taking into account the virus incubation period, it is expected that the number of community cases - especially those detected by enhanced ARI testing - to start to increase over the next few weeks.

"We must therefore remain vigilant," Mr Gan said.

The task force has adopted a "cautious and proactive" stance. If a "possible cluster" is identified, it will move in quickly to impose precautionary measures to break the chain of transmission.

He cited the example of the testing done at Block 111, Tampines Street 11, where nine cases were detected from two households.

Even though the risk of infection was assessed by public health experts to be "low", testing was offered to residents and visitors.

Mr Gan said on Tuesday that 118 residents and visitors have been tested so far and all results have come back negative for the coronavirus.

"I'm also concerned that we must continue to remain vigilant, because if we let our guards down, the virus will creep in, infections will grow, and we will have a bigger problem on our hands," said Mr Gan.

"Therefore, we advise the public to remain on your guard, do abide by the spirit of the rule to limit social gatherings to no more than five persons and continue to maintain a high level of personal hygiene and civic consciousness.

"We can prevent a second wave if we are vigilant and work with one another to keep infections low."


Minister for National Development Lawrence Wong pointed out that the "vast majority" of linked cases originate from household transmissions.

"That's not surprising because again we now know that the nature of the virus is such that it spreads very quickly with close contacts and if you're living together in a household, it is very, very hard to prevent the virus from spreading to your household members," he said.

But Mr Wong also said there were "patterns of transmission" beyond the household, with some infections taking place in workplaces.

"That's one area where all of us can do our part to reduce the risk of transmission further," he said. 

"Businesses, companies, employers all have to step up their safe management practises at work in order to further reduce the risk of transmission at workplaces. Making sure that the majority of their employees continue to work from home is one precaution that every employer should continue to take."

Mr Wong noted that for those who are required to be in the office, measures such as split teams, making sure they do not gather for social activities, are "important precautions" that every employer should continue to be upheld.

Unlike pre-circuit breaker, "very, very" few linked cases in the community have been due to social interactions, added Mr Wong. This has been due to "tight restrictions" on social activities.

But Mr Wong stressed the need to not be complacent.

"The restrictions are helping, but at the same time we should not be complacent. Because I think all of us, many of us certainly, would like to see these restrictions being relaxed over time so that we can engage in more activities," he said.

"But if we want to do that, then all of us again need to be responsible, be vigilant, and do our part to avoid infections from picking up in these social settings."

Watch the full news conference and Q&A session: 

Source: CNA/mt(mi)


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