ADJUSTING OUR APPROACH TO MANAGE THE OMICRON VARIANT

     It has been one month since the emergence of the COVID-19 Omicron variant. Given the uncertainty around Omicron’s characteristics, we had initially adopted a more cautious risk containment approach and introduced targeted measures to reduce the risk of spread of Omicron into and within Singapore. This strategy was effective in delaying the introduction of the variant into our community and slowing local spread. It bought us valuable time to learn about its nature and behaviour based on overseas and local data. 

2.   International evidence indicates that the Omicron variant is likely to be more transmissible but less severe than the Delta variant, and that vaccines, especially boosters, retain substantial protection against hospitalisations caused by Omicron. In the last week, we had several unlinked Omicron cases as well as clusters in the community. This was not unexpected given the high transmissibility of the variant.  

3.   Based on our updated understanding of the Omicron variant, we will adjust our approach to managing Omicron cases. From 27 December 2021, we will allow Omicron cases to follow Protocols 1-2-3 as with other COVID-19 cases. Omicron cases will be placed on the Home Recovery Programme or managed at community care facilities depending on their clinical presentation, instead of being isolated in dedicated facilities by default. Close contacts of Omicron cases will be placed on Protocol 3 where they will be issued a 7-day Health Risk Warning instead of being quarantined for 10 days. Those currently in quarantine will be progressively discharged over the next few days.

4.   To bolster our protection against a large wave of cases locally and to keep our workplaces safe, from 15 January 2022, we will remove the pre-event testing (PET) concession for unvaccinated persons to go to work under the Workforce Vaccination Measures. We will also open applications for a second round of free antigen rapid test (ART) kit distribution for workplaces not on mandatory rostered routine testing (RRT) to implement voluntary weekly testing for two months. This will facilitate early identification of cases and reduce workplace transmission as more return to their workplaces. From 1 February 2022, we will also make vaccination a condition for the approval of new applications for and renewal of existing long-term passes, work passes, as well as permanent residences.

5.   Lastly, with the increasing global spread of Omicron, the travel restrictions we had instituted earlier will need to be updated. In particular we will end the travel restrictions on Bostwana, Eswatini, Ghana, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, and Zimbabwe from 26 December  2021, 2359 hours. All passengers with 14-day travel history to the countries listed above will be allowed to enter and transit through Singapore and will be subjected to border measures for Category IV countries/regions.  

Updates on Detected Omicron Cases and Assessment of Omicron Variant 

6.   As of 25 December 2021, we have detected 546 confirmed Omicron cases comprising 443 imported cases and 103 local cases. In the last week, we have had 13 unlinked community Omicron cases and 78 Omicron cases from local linked community transmission.

7.   The Omicron variant has now been detected in over 110 countries, mainly in Africa and Europe. Current observations from affected countries/regions suggest that the Omicron variant is more transmissible than currently circulating variants. Globally, the Omicron variant has overtaken the Delta variant as the predominant variant in numerous countries, such as the United Kingdom and Denmark.  

8.   Available data thus far suggests that Omicron infections face reduced risks of hospitalisation and severe disease compared to Delta infections. Locally, our Omicron cases have so far not been severe as well – none has required intensive care or oxygen supplementation, although this may be partially due to most cases being fully vaccinated and from younger age groups. Preliminary estimates from overseas studies also indicate that two doses of mRNA vaccines reduce the risk of symptomatic infection from Omicron by about 35%. The risk is further reduced to about 75% lower for individuals with a primary and booster mRNA regimen. These statistics refer to protection against symptomatic infection. There should be better protection against severe infection and death due to cellular immunity and other factors. It is therefore important for us to press on with our booster vaccination programme to enhance protection against infection and severe disease.

Adjusting Our Approach for Managing Local Omicron Cases

9.   Based on our updated understanding and international experience with the Omicron variant, we expect more cases of Omicron infections than for Delta but proportionately fewer severe cases or deaths, due to the lower severity of the Omicron variant and protection from vaccinations and boosters. 

10.   We will therefore shift our approach for managing Omicron cases to the prevailing Protocols 1-2-3 from 27 December 2021. Omicron cases will no longer need to be isolated in dedicated facilities by default. As per Protocol 1, unwell cases will be processed based on both their clinical presentation and underlying risk factors and either be placed under the Home Recovery Programme or managed at COVID-19 treatment facilities or  hospitals. They would follow a time-based discharge of 10 days (for vaccinated persons or children less than 12 years old) or 14 days (unvaccinated persons). Persons who are well but test positive will continue to self-test and self-manage under Protocol 2, including using ART tests to discharge from the third day onwards.

11.   Close contacts of Omicron cases will be placed on Protocol 3 instead of being quarantined at dedicated facilities for 10 days. They will be issued a 7-day Health Risk Warning and be required to self-test with ART daily before leaving their homes. Contact tracing efforts would shift back towards self-reporting by family members and leveraging digital tools such as TraceTogether, and tight ringfencing of vulnerable settings such as hospitals, nursing homes, MSF elderly homes and preschools.

12.   The adjustments in our approach for managing local Omicron cases will allow us to focus our healthcare resources on severe cases and protecting the vulnerable settings. It also allows us to go back to having a single streamlined approach to manage COVID-19, regardless of COVID-19 viral strains, which will facilitate operations on the ground and compliance to the protocols. 

Removal of PET Concession under the Workforce Vaccination Measures

13.   We had earlier announced that Workforce Vaccination Measures would be implemented starting from 1 January 2022[1] and also indicated that we would be reviewing the concession for unvaccinated employees to go back to the workplace with a negative Pre-Event Testing (PET) result.  

14.   Following the review and discussion with tripartite partners, we have decided to remove the PET concession for unvaccinated persons to return to the workplace from 15 January 2022. Partially vaccinated workers (i.e. those who have taken at least one dose of vaccine but are not yet fully vaccinated) will be granted a grace period until 31 January 2022 to complete their vaccination regime. During the grace period, they will continue to be able to enter the workplace with a negative PET result. 

15.   This change will help to protect unvaccinated individuals and to create safer workplaces for everyone.The tripartite partners support the move and have issued an updated advisory on COVID-19 vaccination at the workplace, to provide guidance to employers and employees (www.mom.gov.sg/vaccinationadvisory).

Promoting Regular Self-Testing with Voluntary Distribution of ART Kits to Workplaces 

16.   As more employees return to their workplace from 1 January 2022, this may result in higher risk of workplace transmission, particularly given the higher transmissibility of the Omicron variant. While our workforce is highly vaccinated and hence protected from severe disease, we encourage all firms to implement regular testing for all employees. This will help to detect possible COVID-19 infection early and allow individuals who test positive to take precautions to self-isolate and protect their family, friends and colleagues. Higher risk workplaces are already on mandatory FET RRT and we have extended funding support for vaccinated individuals on RRT until 31 March 2022.

17.   To support lower-risk workplaces in implementing regular testing, we will conduct a second round of voluntary distribution of ART kits for workplaces. Firms with employees that work onsite and are not already subject to mandatory RRT may apply for 8 ART kits per onsite vaccinated employee for weekly testing over a two-month period, if they require the funding support[2]. Applications will open from 3 to 31 January 2022. More details will be made available at www.go.gov.sg/time-limited-rrt-art closer to date. 

Vaccination as a Condition for New Applications for and Renewal of Long-Term Passes, Work Passes and Permanent Residence

18.   To sustain our high vaccination rates, we had earlier introduced the requirement for long-term pass holders to be vaccinated as an entry requirement to Singapore. This has been in place since 1 November 2021. From 1 February 2022, COVID-19 vaccination will be a condition for the approval or grant of new long-term passes, work passes, as well as permanent residence. Vaccination will also be required when renewing existing work passes. More details on the vaccination condition can be found in Annex A.

Resumption of Travel from Botswana, Eswatini, Ghana, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, and Zimbabwe

19.   We had previously announced that long-term pass holders and short-term visitors with recent travel history to Botswana, Eswatini, Ghana, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, and Zimbabwe within the last 14 days will not be allowed entry into Singapore or transit through Singapore for a period of four weeks following initial reports on Omicron cases in these countries/regions. 

20.   The Omicron variant has since spread widely around the world. We will therefore lift the travel ban for these countries, and place them under the Category IV classification.  This means that all passengers with 14-day travel history to Botswana, Eswatini, Ghana, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, and Zimbabwe prior to departure to Singapore will be allowed to enter and transit through Singapore from 26 December 2021, 2359 hours, and will be subjected to border measures for Category IV countries/regions. 

21.   The country/region classification and its corresponding border measures may be found in Annex B. As the global situation evolves, we will continue to adjust our border measures in tandem with our roadmap to becoming a COVID resilient nation. The full list of Safe Travel Lanes for travel to Singapore and prevailing border measures under each lane for different categories and changes to border measures will be updated on the SafeTravel website. Not all lanes may utilise the Category I/II/III/IV health measure framework. Travellers are advised to visit the website to check the latest border measures for their country/region which will apply upon entry into Singapore and be prepared to be subjected to the prevailing border measures upon entry.

Shift Towards Living with Omicron Variant

22.   The adjustments to our measures aim to strike a balance between slowing the spread of COVID-19 and continuing with our plan to live with COVID-19. With the higher transmissibility of the Omicron variant, we must expect a new wave of local cases soon. However, the peak of the wave can be blunted and we can avoid overwhelming our healthcare system again if everyone plays their part to get their vaccinations and booster doses, self-test regularly and self-isolate if tested positive. Those who have recently arrived from overseas or been in contact with an infected person should also be socially responsible and reduce their social interactions. 

23.   With better understanding of Omicron, we also intend to take the next step towards living with COVID-19 by partnering our community GPs in caring for the majority of suitably fit individuals with mild symptoms under an expanded Protocol 2. More details on this expanded Protocol 2 will be released in early January 2022. We seek Singaporeans’ continued support to see us through this next challenge in our fight against COVID-19. 

24.   Given the transmissibility of Omicron and the open nature of our society, it is inevitable that Omicron will spread in our community, as it has in over 100 countries already.  In the coming days and weeks, we should expect more community cases, and rapid doubling of cases. This is again a process we need to go through, in order to live with COVID-19. We have done whatever we can to prepare ourselves for it; especially in administering boosters to our population and starting vaccinations for our children. We seek the cooperation and understanding of everyone, as we weather through an Omicron wave in the next one to two months.

MINISTRY OF HEALTH 
26 DECEMBER 2021

[1] Please refer to MOM’s Press Release on 23 October 2021: https://www.mom.gov.sg/newsroom/press-releases/2021/1023-implementation-of-workforce-vaccination-measures  

[2] The unvaccinated would have to pay for their own PET from 1 January 2022 before returning to the workplace and from 15 January 2022 they will not be allowed to return to office at all. Similarly, partially vaccinated individuals would also have to pay for their own PET tests until such time they are fully vaccinated.