1. I would like to talk about preparing ourselves for the future. As DPM Wong said, there is every likelihood of a next infection wave, and we need to be more prepared, more resilient when it arrives. We also need to be prepared that the next wave may be of a different nature or variant of concern (VOC). Let me talk about this next wave.
The Next Wave
2. In the past, a small proportion of our population had been infected with COVID-19. When a new variant arrived, it infected those who had not been infected with COVID-19 or what we call COVID naïve individuals. This has been the case for Delta, Omicron and now BA.5. But now, based on the latest serology study by the Ministry of Health (MOH), we estimate about 70% of our population has been infected. We have far fewer COVID naïve individuals, which means when the next big wave comes, it must comprise many re-infections.
3. That is why we have been monitoring reinfection numbers closely, as it will give us an idea of when the next wave can happen. So far, our data shows that after an infection, the probability of being infected again eight months later is still low – about 5% that of a COVID naïve person.
4. Nevertheless, reinfections are increasing as a proportion of total daily cases. The last time I updated in Parliament, we reported that 2 to 3% of our total infection numbers are reinfections. This month, it has increased to 5.5% and we must expect this proportion to continue to increase because immunity gained from infections will wane over time, and there are fewer and fewer COVID naïve individuals. So that percentage will rise.
5. The northern hemisphere, in the US, UK and Europe, are prepared for a winter wave at the end of this year, and possibly even having to deal with a new VOC. Our wave driven by BA.5 has just subsided, which will give us good protection for a possible year-end wave. Nevertheless, we should prepare ourselves against a northern hemisphere winter wave coming our way. It may even be a new VOC, with significant immunity escape. We need to be prepared.
6. Our preparation efforts always lie on three fronts: Safe Management Measures (SMMs), healthcare capacity and vaccinations. I will speak on the last two aspects because if we manage them well, we can avoid having more restrictive SMMs.
Healthcare Capacity
7. On healthcare capacity, we found ways to ease the heavy workload in the hospitals, by setting up the COVID-19 Treatment Facilities (CTFs) and transferring lower-risk patients there, and moving long-stay seniors from acute hospitals to nursing homes.
8. What we have not talked about very much is a new category of facilities, called the Transitional Care Facilities (TCF). The TCF is a dual-use facility. It will be useful when we try to live with COVID as an endemic disease. If there is a surge of COVID-19 hospitalisations during a wave, the TCF can become a CTF for lower risk COVID-19 patients.
9. However, as in the recent infection wave, where we noticed that those who are warded are not so much COVID-19 patients, but patients with chronic diseases . Then we use the TCF as a step-down care facility for non-COVID 19 patients, including those who might be staying in the hospital and waiting for nursing home places.
10. We set up the first one with 164 beds using several wards within Sengkang Community Hospital. It worked very well, because it is next to Sengkang General Hospital and the two facilities worked hand in hand to decant many patients to the TCF, reducing the heavy workload at the acute hospital. We are progressively converting Connect@Changi Hall 10 from a CTF to a TCF, making a total of 364 TCF beds by end-September.
11. Our GPs continue to play a vital role. Not only do they look after COVID-19 patients without severe symptoms; many are also prescribing therapeutics like oral anti-virals. These drugs reduce the number of infected persons who go on to develop severe illness, and lessen the load on hospitals.
12. Another improvement in healthcare capacity is telemedicine. It has been very useful in preserving our hospital, polyclinic and GP capacities, allowing people to recover safely at home with medical support. Right now, our telemedicine capacity is about 1,500 consults per day. We are ramping it up to about 9,600 consults per day, to prepare ourselves for future surges.
Vaccinations
13. On vaccinations, it continues to be very effective in protecting against severe disease and hospitalisation. Almost 80% of our population have taken their booster shots, and this is a key reason why we could ride through the current BA.5 wave without tightening SMMs, having many severe cases or having our hospitals overwhelmed.
14. To prepare for a possible year-end wave, we will need to further expand our vaccination coverage. There are three groups.
15. The first group are individuals aged 60 to 79. MOH has accepted the Expert Committee on COVID-19 Vaccination’s (EC19V) recommendation that this age group should take a second booster at least five months after their first booster. This is a strengthening of today’s arrangement, where they are offered if they want to take it. Now they are recommended to take it. Many have taken it, because of concerns over health, frequent travel or they live with vulnerable seniors.
16. Our data shows that after the first booster, vaccine protection against severe illness stayed strong for individuals in this age group. Nevertheless, it has been almost a year since this group had taken their first booster dose, and this age group also commonly experiences the onset of other health conditions and chronic diseases. They should therefore proactively take the second booster before the next wave, and not wait until the protection starts to wane significantly.
17. Further, our data showed that those who were offered and have taken a second booster also acquired stronger protection. For those aged 70 to 79, effectiveness against severe disease has gone up from 94% to 97%. For those aged 60 to 69, this has gone up from 97% to 98%.
18. We will continue to offer the second booster to all persons aged 50 to 59 years who want it. Those who are medically vulnerable and have received their first booster, regardless of age, they are also recommended to receive their second booster.
19. We will be firing out SMSes to eligible groups in the coming days. I urge all who are eligible for their boosters – whether first or second dose – to book your appointments at any of the 10 Joint Testing and Vaccination Centres (JTVCs) when you receive your SMS.
20. I will now move on to the next two groups – both of whom are children. One is extending boosters to children aged 5 to 11 years; the other is primary series for infants and young children aged six months up to five years old.
21. Usually, when we announce a vaccination policy, we will fire out SMSes days after the announcement and you can go and take your vaccination. For these two groups, we are giving very early notice and I will explain why. This is because we know that parents are concerned about their children and we want to give an update on the progress for these two groups.
22. For the first group, the EC19V has reviewed the data on boosters for children and concluded that the benefits clearly outweigh the risks. DMS will elaborate further.
23. The second group of children covers vaccination for infants and young children from six months up to five years. Young children, by and large, are at lower risk of severe illness when they are infected, but I know parents are still worried, as there have been several children below the age of 5 who fell severely ill, including Multisystem Inflammatory Syndrome in Children (MIS-C) after they were infected with COVID-19. We also tragically lost two young children to COVID in recent months.
24. The Health Sciences Authority (HSA) has just authorised Moderna’s Spikevax COVID-19 vaccine via the Pandemic Special Access Route (PSAR) to children, including very young children aged 6 months up to 5 years old. The current data shows that the benefits outweigh the risks. To illustrate, for the Moderna vaccine trial involving 6,000 children, there were zero cases of myocarditis and anaphylaxis, and one case of febrile convulsion likely related to the vaccine. So based on the trial, the incidence of severe adverse reactions has been very low.
25. The EC19V is carrying out an independent review of the safety and efficacy of the vaccine. A decision on the recommendation of vaccination for this age group will be made soon.
26. If all things go well, shipment of this vaccine will reach us in the fourth quarter of this year. This is a two-dose regime administered 28 days apart. Separately, we are also considering the Pfizer-BioNTech vaccine for infants and young children. It is a three-dose vaccine, with the second dose given 21 days after the first, and the third and final dose eight weeks after the second dose. So the Pfizer-BioNTech vaccine will take about three months to complete compared to the Moderna vaccine which will take 28 days.
27. We will time the boosters for those aged 5 to 11 years, as well as the primary series vaccination for infants and children aged six months up to five years old, in the fourth quarter of this year. This will be after their school examinations like the Primary School Leaving Examination (PSLE) and in good time before a potential year-end wave. For the convenience of parents with children in both age groups, vaccination for both groups of children will be available at five new vaccination centres that we will be setting up. We will provide more details later.
28. As I mentioned earlier, we are giving very early notice for vaccination for these two groups of children. In the past, we would have announced HSA’s approval, the EC19V’s recommendations and the arrival of shipments. Then a few days later, SMSes would have been fired out. This time, we are giving very early notice because everyone is concerned. Preparation is ongoing. But whatever we do, it would be in good time before the possibility of a year-end wave.
29. I will now pass the floor to DMS Kenneth Mak.