UPDATE ON LOCAL SITUATION AND CHANGES TO ALIGN BORDER MEASURES WITH DOMESTIC PROTOCOLS

It has been about one week since we entered the Stabilisation Phase on 27 September 2021. The vast majority – over 98% - of infected individuals have mild or no symptoms, and 0.3% needed ICU care or died.  This is a result of having vaccinated the great majority of our population, who experienced mild illness even as breakthrough infections occur. Nevertheless, we are ramping up our healthcare and response capacity to cope with the rising cases. We are also stabilising the situation and familiarising people to the new healthcare protocols, such as the Home Recovery Programme and the self-isolation protocol for asymptomatic individuals who test positive on antigen rapid test (ART) self-test kits. This will allow us to focus healthcare resources to care for and treat cases who truly need the medical care. We want to thank the public for their patience and support for these new protocols, and to reassure everyone that Home Recovery is safe and suitable for most individuals, especially if they are younger or vaccinated individuals. 
 
2. We have not yet seen the full effect of the latest tightening measures as it usually takes a week or more before the impact from any tightening can be observed. Nevertheless, while the daily number of cases continue to rise, the rate of increase appears to have slowed down slightly. The time taken for the doubling of community cases has lengthened from about 8 days to about 10 days.  We will continue to monitor this, as well as our healthcare capacity, closely in the coming weeks. 

3. We had earlier reduced the Quarantine Order period from 14 to 10 days, in view of the shorter average incubation period of the COVID-19 Delta variant. In line with this, we will also make consequential adjustments to our travel policies, including to the Travel History assessment period and the Stay-Home Notice (SHN) duration. In addition, as part of the regular review of our border measures to take into account the evolving pandemic situation in other countries, we will also adjust the classification of countries which will apply to travellers arriving from 6 October 2021, 2359 hours.

4. Lastly, we would like to highlight that the Expert Committee on COVID-19 Vaccination (EC19V) has been deliberating on recommending a booster vaccination for additional population groups, such as healthcare workers, frontline workers and persons in other vulnerable settings beyond nursing homes, noting that this has been recommended in some countries and there is a good basis to do so. More details will be released when ready.

Updates on Local COVID-19 Situation

5. Daily case numbers have continued to rise. At the current trajectory, we may cross 3,200 daily cases soon, and may even start to see 5,000 cases daily around mid-October. However, the vast majority are asymptomatic or have mild symptoms, and are suitable for home recovery. The percentage of patients who require ICU care remains low, at about 0.2%.  However, with higher cases, this can translate to a larger absolute number.  Currently 34 ICU beds are occupied and we expect the number to rise. We will continue to monitor the capacity and utilisation closely.  

6. There remains strong evidence that vaccination is protective against severe disease outcomes. The proportion of fully vaccinated cases who needed intensive care or passed away is about 14 times less than that for the unvaccinated (0.12% compared to 1.67%) (Table 1). We are most concerned for the elderly, and in particular those who are unvaccinated. Older persons are at higher risk of severe illness, and most of them tend to have co-morbidities, which then increases the risk further. The proportion of cases who are seniors aged 60 and above has remained stable at about 27% to 32% in the past 28 days. We urge all seniors, especially the minority of unvaccinated seniors, to take extra precautions and avoid crowded places during this period.  

Table 1: Ever in ICU and Death % by age and vaccination status (PR 1 May to 1 Oct)

Active Expansion of Healthcare Capacity

7. Our healthcare workers are committed to providing the best care to all our patients but it is important that we make the best use of our healthcare resources and preserve our hospital facilities and beds for those who truly require them. Fully vaccinated individuals aged 12 to 69 years are encouraged to rest, take plenty of fluids and recover in the comfort of home under the Home Recovery Programme¹. We would like to reassure these individuals that it is safe to do so as vaccination is highly protective against severe illness, as local and overseas data has consistently showed. For those whose home conditions are really not suitable for Home Recovery, we will assess them on a case-by-case basis, and allow some to recover at one of our Community Care Facilities.

8. To augment and complement our hospital capacity, we are actively standing up COVID-19 Treatment Facilities (CTFs)². Over the past week, we have set up four CTFs with a capacity of 580 beds. We are ramping this up further to nine CTFs with an overall capacity of about 3,700 beds by the end of October. The CTFs will be used to care for higher risk patients who needs close observation, but do not need hospital care.  One example will be seniors with co-morbidities who are asymptomatic or mildly symptomatic. This is an important step towards right-siting care and reducing the strain on our acute hospitals which should be preserved for those who require immediate acute hospital care, both COVID-19 as well as non-COVID patients.

Likely Extension of Booster Vaccination to Healthcare and Frontline Workers

9. Booster vaccination enhances our protection against COVID-19 infection and hence also against severe disease. This is an important way we can protect ourselves from COVID-19 and slow its transmission in the face of rising local cases. The EC19V has been deliberating on recommending booster vaccination for a few more population groups, such as healthcare workers, frontline workers and persons in other vulnerable settings. More details will be announced by EC19V when ready. MOH will await the formal recommendations of EC19V, but we stand fully ready to support this extension. All eligible persons are encouraged to receive the booster vaccination when it is offered to them, and those who have yet to be vaccinated are strongly urged to do so. 

Changes to Align Border Measures with Domestic Protocols and the Evolving Situation in other Countries/ Regions  

10. From 6 October 2021, 2359 hours, prevailing border measures for incoming travellers will be determined based on the travellers’ recent travel history in the last 14 days instead of the existing 21 days. The SHN period for those who currently have to serve 14 days, will also be reduced to 10 days, in line with the shortening of quarantine period, which accounts for the shorter incubation period of the Delta variant.  As part of our regular reviews of our border measures, we have also made the appropriate adjustments to the categories of some countries/ regions. Details of the updated country/region classification and their corresponding border measure may be found in Annex A. As the global situation evolves, we will continue to adjust our border measures in tandem with our roadmap to becoming a COVID-19 resilient nation. 

Vaccination as Entry Requirement for Long-Term Pass Holders  

11. To allow the necessary workers and students to enter Singapore’s borders in a safe and calibrated manner while minimising public health risk, we will require all Work Pass³ and Student’s Pass holders to be fully vaccinated⁴ before arrival in Singapore. This will apply to those who are applying to enter Singapore via the Work Pass Holder General Lane and Student’s Pass Holder Lane from 1 November 2021⁵. More details on the vaccination requirement can be found in Annex B.

12. For all travellers applying for entry to Singapore via the Familial Ties Lane from 1 November 2021, priority will be given to those who are fully vaccinated. 

Towards a COVID-19 Resilient Singapore

13. Our aim has always been to minimise deaths while re-opening our social and economic activities progressively. This also requires a collective shift in our mindsets.  We need to learn to live with the virus, and understand that for the vast majority, especially those vaccinated, it is not a serious illness.  At the same time, we must do our part to exercise social responsibility and cooperate with all the SMMs. We seek Singaporeans’ support and understanding to test yourselves regularly, and to see a doctor if you are feeling unwell. Avoid crowded places or social activities if you are unwell. Together, we will be able to get through this current wave and emerge stronger. 

[1] Eligibility criteria are: (a) Fully vaccinated with PSAR mRNA vaccine, (b) age 2-69 years old, (c) no other severe illnesses or diseases and (d) no household members above 80 years old or belonging to the vulnerable group.

[2] To better reflect the higher level of medical care provided to COVID-19 patients, the Community Treatment Facility (CTF) has been renamed as COVID-19 Treatment Facility (CTF).

[3] This includes dependents of work pass holders and work pass holders on in-principle approval. The vaccination condition for entry will not apply to those entering Singapore under the Periodic Commuting Arrangement (PCA).

[4] An individual is considered fully vaccinated two weeks after he or she has received the full regimen of Pfizer-BioNTech/Comirnaty, Moderna or other World Health Organization Emergency Use Listing (WHO EUL) vaccines.

[5] The vaccination condition for entry will not apply to those aged below 18 years old at the point of entry. Unvaccinated individuals aged between 12 to less than 18 years old at the point of entry must complete their full vaccination regimen in Singapore within two months after their arrival.