OPENING REMARKS BY MINISTER FOR HEALTH MR ONG YE KUNG AT THE COVID-19 MULTI-MINISTRY TASKFORCE PRESS CONFERENCE ON 16 FEB 22
16 February 2022
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1. The daily cases shot up to almost 20,000 yesterday. Today, the indications are that it will be slightly lower. Some members of the public are understandably anxious because of the high topline number.
2. Please be assured the Multi-Ministry Taskforce (MTF) will always look at our pandemic situation closely and objectively. We will not take any deterioration in the situation lightly, but neither should we panic unnecessarily.
3. The Ministry of Health (MOH)’s assessment of the situation is this:
a) First, the 20,000 daily cases are actually within our expectation. In fact, it is in line with the projection of our scientists’ model for the Omicron wave. We have also said before that with the Omicron variant being more infectious, we should expect daily cases to reach 15,000 to 20,000 per day or even higher.
b) Second, our worst fear, which is the ICU wards being overwhelmed, thankfully did not happen, and there is no sign of that happening. As I have said before, we need to look at how the healthcare system is coping – number of patients in the ICU, number needing oxygen supplementation, number needing hospital beds – and not just the headline infection numbers.
Today, ICU occupancy is hovering around 20 to 30 cases. This is a fraction of the beds occupied during the Delta wave. This is because Omicron is inherently a less severe disease, but also very importantly, our vaccinations and boosters are working.
c) Third is that notwithstanding the above, there is stress felt in the healthcare system, especially at the frontend, namely the General Practitioners (GPs) clinics, polyclinics and also our hospitals’ Emergency Departments (Eds).
The GPs and EDs have been telling us that the great majority of patients who go to them have no symptoms or mild symptoms. It is important for us to preserve primary care capacity as well, just as we want to preserve hospital capacity so that care goes to those who need it most.
Hence, yesterday we announced that MOH now allows individuals who suspect they are infected to go to our Combined Test Centres or Quick Test Centres to get themselves tested, supervised. If they are tested positive, they will get an official infection record in their HealthHub. Their test results can also be used to show their employers so that they can be excused from work. Employers, please accept this documentation. Please consider using these avenues or simply recover at home, if your symptoms are mild or you have no symptoms.
4. Given that we are still climbing the epidemic curve, today is not the time to announce any easing of restrictions. It is, however, an important juncture to have an in-depth review of our current rules, and we have done so.
5. This is because if Singapore is like many other countries that have gone through or are going through the Omicron wave, in a few weeks, cases will come down, perhaps even quite dramatically, and then we will be in a position to ease travel rules as well as our domestic Safe Management Measures (SMMs).
6. We have therefore reviewed our rules to further adapt to the characteristics of the Omicron variant. At the same time, with this in-depth review of our rules, we will streamline and rationalise them. These rules have accumulated over the past two years and have become quite unwieldy. By streamlining them, we can adopt a posture that will better enable us to open up when the timing is right.
7. I will therefore cover briefly three areas: health protocols, travel policy, and SMMs, and Director of Medical Services (DMS), Minister Iswaran and Minister Lawrence Wong will further elaborate on the changes that we are making.
Health Protocols
8. First, health protocols. We must remember that almost everything about the Omicron variant is faster than previous variants. So, for example, Omicron patients recover faster, which is why we shortened the discharge period earlier.
9. Omicron also has a shorter incubation duration and an earlier infectious window. The result is that it has a very short serial interval. This refers to the time taken between a first person infected and experiencing symptoms, and the next person that the first person infected also getting symptoms. That is called the serial interval.
10. Based on our studies, the serial interval for Delta is about four days. The serial interval for Omicron is as short as two days.
11. So our health protocols need to adapt to this distinct characteristic of Omicron, of having very short serial interval. DMS will explain some of these changes. I will touch on one, which is the requirement for Rostered Routine Testing (RRT).
12. Testing remains an essential part of managing the pandemic. Because if an individual can use an Antigen Rapid Test (ART) to detect infection early, he can take precautions to avoid transmitting to other people, especially vulnerable persons, such as seniors, the sick, or unvaccinated children.
13. However, because of the characteristics of Omicron, we need to rethink the way we deploy ART.
14. Today, workers in many sectors, such as those working at the airport, seaport, malls, restaurants, hawker centres etc, are required to perform weekly ART, which is what we call RRT.
15. The positive rate for RRT is not high – on average, less than 0.2%. That low percentage is not surprising, because for Omicron even if someone is infected, there is only a very short period when he is infectious and which ART can pick up the infection and become positive.
16. So RRT is no longer very effective to prevent the spread of the virus. Because of the short serial interval for Omicron, by the time you go through RRT and pick up a case, the individual most likely would have already spread to other people.
17. Hence, it is better that we switch to a regime where people are advised to be very vigilant and very considerate. If unwell, immediately take an ART test. Make sure you are tested negative before you go out and especially if you are meeting someone vulnerable.
18. We will therefore stand down the requirement for weekly RRT for most workers. But, we will retain RRT as a precaution for some sectors, namely healthcare, eldercare and pre-school, because these are the three sectors where workers continue to meet vulnerable persons, namely seniors as well as unvaccinated children.
Travel Policy
19. Second area I will touch on is travel policy. Here, we need to pivot our principal consideration.
20. In the past, the objective of travel rules was to prevent the import of infections into Singapore. That is why around the world, it is common practice to test a traveller before he departs, after he arrives, and then it can also be followed by a period of quarantine, that we call SHN or Stay-Home Notice (SHN).
21. Now, imported infections are about 1percent of total daily case counts so they no longer have a material impact on our epidemic situation.
22. Now, the concern is that should a traveller come into Singapore and be infected, is he protected well enough such that he does not become severely ill and burden our healthcare system?
23. Hence, we should actually emphasise less on SHN and tests on travellers, but more on ensuring they are fully vaccinated and boosted.
24. This will require quite a fundamental change to our travel schemes. Instead of having vaccinated travel lanes (VTLs) with selected countries that we think are low risk, we should actually allow SHN-free travel for vaccinated travellers or fully-vaccinated travellers, from all countries.
25. We should make this transition, not now, but after the Omicron wave has peaked and started to subside.
26. Rather than an abrupt change, we should make this transition in steps. We will take the first step now, to put ourselves in a better position to make that subsequent pivot.
27. What changes are we making? Let me briefly explain. Today, we classify countries and regions into four categories, and label them one to four, in ascending order of risk. These categories will no longer be relevant when we move to a vaccinated traveller system. We want the traveller to be vaccinated and protected rather than the country or region’s infection rate to be low.
28. Therefore, in line with these considerations, we will make the following changes:
a) We will create a new ‘General Travel Category’, where we will place all countries and regions currently in Category 2, 3 and 4 into this ‘General Travel Category’.
b) And then within that, we apply a standard home SHN period of seven days for this category, for travellers in this category who are required to serve SHN. Today, travellers are subject to varying durations of SHN depending on which country they are travelling from.
c) Separately create a ‘Restricted Category’. There will be no countries in it at this time. But we need this category to cater for instances such as when there is an outbreak of a new variant of concern, and we need to impose border measures on travellers from those affected countries and regions, while we assess the situation. That is the purpose of the new ‘Restricted Category’.
d) Finally, we will simplify test requirements. As we move from preventing imported infections to ensuring the traveller is fully vaccinated and well-protected against severe illnesses, we should step up checks on vaccination status, and step down test requirements for travellers. We have earlier changed the pre-departure test of travellers coming to Singapore, to accept ART in addition to PCR tests. We will now change on-arrival tests to ART as well.
29. We will also move on-arrival ART test for travellers out of the airport, to one of the 200 Quick Test Centres or Combined Test Centres around the island. Travellers will receive a booking link to take their ART within 24 hours of arrival. Minister Iswaran will speak more about this, as well as changes to the current VTL schemes.
SMMs
30. The final topic I will talk about is SMMs.
31. You would remember that in October last year, we reset our health protocols. At that time, the rules were quite complicated and we simplified and reset all of them into only three rules that is now known as Protocols 1-2-3. Similarly, we also have many SMMs rules now, including unique rules for specific settings.
32. Like health protocols, we have done a reset, to simplify and streamline SMMs to five parameters, that we will call SMMs 1 to 5.
33. Through simplification, we think that people are more likely to understand not just the letter, but also the spirit of the rules. They will then be able to exercise individual responsibility and do their part to help manage the pandemic.
34. Further, it will bring us to a position where we are more nimble and ready. We can ease those SMMs more readily when the Omicron wave subsides, and tighten should the situation worsen, such as the emergence of another variant of concern.
35. SMMs 1 to 5 cover five areas. Minister Gan mentioned them and I will not repeat.
36. Under each parameter, we can adopt a few postures, from tight to relax. Given the pandemic situation, the MTF will decide which combination of postures to adopt across SMMs 1 to 5. Minister Lawrence Wong will elaborate on how they will work and what posture we are taking.
37. These five parameters crystallise what we learn to be the most important aspects of SMMs, for pandemic control.
38. SMMs 1 to 5 will work hand in hand with Protocols 1-2-3. Although SMMs 1 to 5 do not represent a relaxation, but a streamlining and a review of the rules, there are quite profound implications in the way we manage the pandemic from henceforth. Let me cite three implications.
39. Number one, with the reset parameters, should we encounter another new variant of concern and have to tighten up, we can work within these parameters, and adjust the postures instead of coming up with micro rules for different settings, that will add up to be a confusing web of regulations. So it is a lot more nimble. Likewise when we need to ease up, we can also just relax the five parameters.
40. Number two, with the new rules boiled down to five, we no longer forbid practices that actually do not make a material difference to the pandemic, but which we are observing very strictly.
41. For example, so long as people are wearing masks, there is no need to cross out alternate seats on park benches for example, or the urinals in the men’s toilet. Or when people wear their masks and they stand together and take a photo, they don’t have to be 1 metre apart. You can place newspapers or magazines in common areas, hair dryers in public showers, so long as you maintain good hygiene practices.
42. Our people know that we are in a crisis, and we can start to remove these little daily reminders that are not really material anymore.
43. Number three, the third implication involves a shift in mindset, from the current paradigm where there is a prescribed list of things that you can organise and participate in, to being able to proceed so long as we abide by the five parameters that can effectively manage the risks. Sometimes we describe this as moving from a positive list to a negative list system, and there is some element of that here.
44. It means BBQ pits can be opened, so long as people gather together, socialise according to the group size prescribed. You don’t have to divide guests in zones for weddings so long as they keep to their group sizes and do not mingle across tables. There is no need for school assemblies to be restricted to 30 minutes, which is the rule today.
45. And we can also play sports again. The main driver of COVID-19 transmission is prolonged and close contact, like eating together in an enclosed space. Sports, on the other hand, involve transient contact between players on the field or on the court while they are playing.
46. Hence, there has been no compelling international evidence showing that sports participation causes more infections. You are more likely to catch the virus dining with friends than playing sports with them.
47. What is more important is to ensure the players observe group size and masking rules before and after the game and during the breaks, because that is when they will have prolonged and close contact.
48. Two years of SMMs restrictions have taken a toll on the physical and mental well-being of our people. Particularly so for the young, who are in their growing years and should keep active, through sports.
49. Under SMMs 1 to 5, this will be allowed. And we can allow more sporting activities, while keeping infection risks well managed.
50. I hope everyone internalise SMMs 1 to 5, understand their purpose and spirit, and conduct our activities accordingly. I will now hand the floor to DMS. Thank you.