COVID-19: Concern over unlinked cases even as daily average number of community cases falls, says Health Minister

SINGAPORE: Health Minister Gan Kim Yong on Tuesday (Apr 21) flagged the number of unlinked COVID-19 cases in the community as “concerning” even as he noted a downward trend in the daily average number of community cases.

Speaking at a COVID-19 multi-ministry task force press conference, Mr Gan said that the "circuit breaker" measures that were first implemented on Apr 7 “appear to have helped”.

READ: COVID-19 circuit breaker extended until Jun 1 as Singapore aims to bring down community cases ‘decisively’: PM Lee

“The number of new cases in the community has decreased, from an average of 39 cases per day in the week before to an average of 29 per day in the past week,” he said.

“That said, the number of cases in the community remains worrying for us. What is particularly concerning is that the number of unlinked cases in the community has not fallen, averaging about 20 cases a day."

Mr Gan’s comments echoed Prime Minister Lee Hsien Loong’s speech to the nation earlier in the day. In announcing an extension of circuit breaker measures until Jun 1, Mr Lee raised concerns about the number of unlinked cases.

READ: MOH flags concern over unlinked COVID-19 cases, says tests on patients at primary care facilities indicate 'undetected cases in community

READ: COVID-19: Rise in Singapore’s locally transmitted and unlinked cases, Health Minister stresses importance of safe distancing

“Unfortunately that number has not come down, and this suggests there is a larger, hidden reservoir of COVID-19 cases in the community, and this reservoir is the source of these unlinked cases, which we have not detected," Mr Lee said.

SINGAPORE TO CONTINUE TESTING IN STRATEGIC WAY

Mr Gan said that Singapore will continue to conduct tests and screening for Singaporeans and foreign workers, but in a “very strategic way”.

Different dormitories have different levels of COVID-19 prevalence, with some that do not even have one case, he said.

“For the time being, therefore, our approach, our strategy in dealing with different dormitories that have different prevalence levels will be different, but it allows us to determine what approach we should take,” he said.

There has been a spike in the number of new COVID-19 cases in Singapore in recent days, particularly among foreign workers living in dormitories. 

READ: Singapore's COVID-19 cases top 9,000 after 1,111 new cases reported

In the community, while it is not possible to test millions of Singaporeans, there is targeted testing, for example, for those who continue to go to work, Mr Gan said.

“We need to make sure that our testing is always very targeted, very strategic and serves a specific purpose, and at the same time, we are also continuing to ramp up our testing capability and capacity, so that we are able to be more effective in detecting cases,” he said.

Referring to surveillance programmes and random testing in the community, Mr Gan said the idea was to pick up cases that otherwise would not have been detected.

He said: “These reflect the fact that there are underlying cases, they are transmitting in the community, and that is why we need to put in extra effort, these circuit breaker measures, to make sure that we are able to bring down these community cases, particularly those that are unlinked. This way, we will ... generally ... reduce the risk of transmission.”

PATIENTS “VERY INFECTIOUS” IN FIRST FEW DAYS

Speaking at the multi-ministry task force press conference, director of medical services at the Ministry of Health Kenneth Mak said that the ministry had learnt “a lot more” over the last month or two, in terms of how the virus spreads "very easily and very, very fast”.

“While the mode of transmission remains the same in terms of our understanding, we’ve come to realise that many individuals who are infected are very infectious, particularly in the first few days of being infected,” Assoc Prof Mak said.

“Because they’re shedding the virus very early at a stage when they are just having minimal symptoms or even asymptomatic; it leads to a high risk of spread occurring very fast particularly in settings where there is a lot of communal activity.”

He noted that this happened in the Safra Jurong cluster, and that it was now happening at the dormitories.

"Close proximity and activity is lending itself to a rapid spread of infection particularly in these settings, and it's therefore very important for us to appreciate this - and to minimise our contact," he said. 

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