Preparing for next COVID-19 infection wave: Ong Ye Kung outlines steps on how the healthcare system can be ready

SINGAPORE: Ensuring all healthcare settings are ready to handle COVID-19 patients, ramping up bed capacity and improving booster vaccination rates among the elderly.

These are among the steps Singapore is taking to prepare for the next COVID-19 wave, Health Minister Ong Ye Kung said on Thursday (Jun 2) at his ministry’s work plan seminar.

Noting that South Africa is riding its fifth COVID-19 infection outbreak which is driven by two variations of Omicron, BA.4 and BA.5, Mr Ong said that the next wave will come to Singapore in a “matter of months, maybe July, maybe August”.

The country reported its first three cases of the subvariants on May 15.

While Singapore has safeguards in place, the country cannot be complacent, he cautioned.

“We feel BA.4 and BA.5, this is a wave we can ride through. But don’t be complacent, still be prepared for it,” he said, addressing the audience made up of healthcare workers.

He outlined strategies he described as “the best preparation”.

Among them is ensuring that healthcare settings such as nursing homes, community hospitals and private hospitals are able to handle COVID-19 infections.

“We cannot afford another situation like (the) Omicron (wave) where many healthcare settings are unable to handle COVID patients and they have to send to our hospitals,” he said.

With vaccination, most recover from the disease “uneventfully”, he said.

He added that Singapore has to find more beds “in case pressures start to build up in our hospitals again”.

Besides isolating at home, these beds can also come from COVID-19 treatment facilities which were designed to take in patients infected with the virus, he said.

“We need to change the concept. You must be able to take in any patient that doesn’t require the same level of acute care as a public hospital. It may mean consolidating the beds, consolidating the manpower such that they can take in patients,” he said.

Nursing homes can also provide the necessary beds as many long-term hospital patients were “actually waiting for their nursing home place”, he noted, adding that if there is more space at such homes, they can relieve the load on hospitals “quite a bit” when the subsequent waves come.

Mr Ong also reiterated the importance of booster vaccination jabs among the elderly aged 60 and above, of whom 88 per cent are covered.

“When a wave hits, they are the most vulnerable … if you’re not fully vaccinated, and you're infected, we are still seeing quite a number of people going to ICU (intensive care unit) or dying,” he said.

END-OF-LIFE CARE

Mr Ong also announced Singapore’s move to reduce the proportion of people dying in hospitals instead of at home or in palliative settings.

The country aims to reduce this proportion from 61 per cent to 51 per cent by 2027, he said.

In a survey, 77 per cent of respondents said that they want to die at home, but in practice only 26 per cent do, Mr Ong noted.

He noted that 50 per cent of costs in a person's last year of life are incurred in the last three months.

The top reasons preventing people from dying at home with loved ones are low awareness and receptivity among family members, challenging discharge process and protocols and inadequate caregiver preparedness, he said.

Mr Ong said that while hospitals may be ready to discharge a patient, sometimes the palliative care centre the patient needs to go to may not be ready, citing lack of equipment or lack of beds.

Improving the situation can therefore be achieved, among other things, by smoothening discharge from hospitals, he added.

Other ways include raising awareness of end-of-life care and pre-planning, better support for caregivers at home and scaling up palliative care capability and capacity, he said.

“All these are things that I think we can do and they are quite good low-hanging fruit.”