End of Circuit Breaker Phased Approach to Resuming Healthcare Services

                 The Multi-Ministry Taskforce has assessed the situation and decided to exit the Circuit Breaker when it ends on 1 June 2020. In tandem with the gradual opening of the economy, healthcare services which were deferred will also resume in a controlled and gradual manner.

2.              Even as we resume more healthcare services, managing the current outbreak situation and preventing new large clusters from forming remain our priority.

Phase One (“Safe Re-opening”)

3.              Over the next few weeks, more healthcare services will resume in a gradual and controlled manner to minimise crowding. This carefully considers the need to set aside sufficient capacity, critical resources and manpower in our healthcare institutions to cover ongoing COVID-19 operations. Appropriate safe distancing and precautionary measures remain necessary.

4.              Healthcare providers will triage and prioritise the resumption of healthcare services based on medical necessity, where patients with more urgent medical needs will be attended to first. Services for patients who are well, or whose conditions are stable and whose treatment can continue to be safely deferred will resume in a later phase. Similarly, services which alter the appearance but do not cure or ameliorate disease or illness (e.g. Botox, fillers, threadlifts) will continue to be deferred.

5.              In Phase One, i.e. from 2 June 2020, patients may expect the following services to resume:

   a.   Hospital-based Care.Only specialist outpatient services, medical procedures and allied health services for patients with higher needs will resume. These include care that has been deferred for some months and cannot be deferred further without affecting clinical outcome. Some examples include surgeries for visually significant or advanced cataracts, hearing implants in children, joint surgeries for patients with severe impairment, all in-vitro fertilisation services, surveillance services including scopes for high-risk groups, and diabetic foot screening. Each patient will be assessed based on his individual circumstance.

   b.   Primary, Preventive and Dental Care. Chronic disease management, including the provision of ancillary services, will resume for patients, prioritised by healthcare providers based on medical necessity and available capacity. Preventive health services, such as vaccinations for flu, pneumococcal and other recommended adult vaccinations, and pre-enlistment screening will recommence. Ongoing dental procedures including scaling and polishing, fillings, crowns, dentures and orthodontic treatment can resume, with appropriate precautions.

   c.   Community-based services. Home-based visits will resume for existing clients to serve those who need the services, with safe distancing measures in place. These include clients whose services have been deferred during the circuit breaker period. Services for new clients will be prioritised to those with urgent needs.

   d.   Traditional Chinese Medicine and other Traditional and Complementary Services. TCM needle acupuncture for all conditions will resume. Other Traditional and Complementary Services such as Ayurvedic, chiropractic and osteopathic treatments for the management of medical conditions and relief of symptoms may resume with appropriate precautions.

6.              Please see Annex A for examples of essential services that continue to be provided even during the circuit breaker period, and Annex B for examples of services that have gradually resumed since 19 May 2020, with further services to be resumed from Phase One (i.e. 2 Jun 2020).

7.              In addition, as there is still a need to reduce the risk of community transmissions, physical visits should be minimised whenever possible, with teleconsultation and medication delivery being the preferred mode of review. These consultations, including collection of medications for continual management of existing medical conditions, should be done on an appointment basis as far as possible, and subject to the ability to maintain safe care and safe distancing on the premises.

8.              To ensure the safety of staff and patients in our healthcare establishments, all staff will continue to adhere to necessary precautions including the wearing of masks, maintaining good personal hygiene and ensuring regular cleaning of activity equipment and shared spaces. Patients and caregivers must also do their part by wearing a mask at all times and maintaining good personal hygiene when seeking treatment.

9.              In Phase One, we will also allow visitors from the same or one other household to visit loved ones who have been hospitalised. However, to protect our patients who are still vulnerable, we will allow a maximum of five such visitors to pre-register with the hospital, and only one person will be allowed to visit at a time. Hospitals may also introduce further measures to space out visitations and avoid crowding.

10.              Some of these measures may be adjusted further to reduce risk of infection if necessary. The Ministry of Health (MOH) will continue to reach out to healthcare professionals to share our plans.

Phases Two and Three

11.              The Multi-Ministry Taskforce will monitor the daily infection rates. If the community transmission rates remain low and stable over the subsequent few weeks, and the dormitory situation remains under control, we may then progress to Phase Two (“Safe Transition”), with the gradual resumption of more activities.

12.              In the early part of Phase Two, we expect most healthcare services to resume, with services for medically necessary treatments prioritised. This would still be subject to the need to minimise appointments for physical consultations unless clinically needed, based on the ability to maintain safe distancing. These include recommended chronic disease and cancer screening under the Screen For Life programme, statutory medical examinations, pre-employment medical screening, and selected community based services delivered on a one-to-one basis. Group activities such as senior activities, community health screening and other forms of congregation will resume in later phases.

13.              We will also consider further easing the visitor restrictions, to allow more family members and friends to visit loved ones admitted to hospitals. This will still be subject to overall visitor caps.