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07 Nov 2022

5th Jan 2022

1.             I have just given an update on the Delta wave earlier this week through a social media post so I will not repeat that information. In summary, the Delta wave has substantially subsided, and this is despite the resumption of many social activities. This means our society has become a lot more resilient to the virus than before, and we are making strides towards living with COVID-19. This is an important milestone.


2.             This is also the result of everyone’s efforts and our collective will. While cases rose exponentially in many parts of the world, we maintained our discipline, kept our masks on, stuck to our group sizes, got ourselves vaccinated and boosted, and kept our infection levels low.


The Omicron Situation


3.             But an Omicron wave is imminent. Globally, Omicron is already fast displacing other variants as the dominant variant, and there have been record high daily infections in several countries.


4.             What is the situation in Singapore now?


5.             That brings me to a recent US Centers for Disease Control and Prevention (CDC) ruling. It has updated the travel advisory for Singapore to “Level Unknown’.  This is because the US CDC is not aware of our surveillance test numbers. The Ministry of Health (MOH) is engaging the US Embassy as well as the US CDC to provide them with the necessary data.


6.             To be clear: we know our situation very well.


7.             Every week, we administer over 150,000 polymerase chain reaction (PCR) tests. That works out to over 21,000 PCR tests per day. The positive rates for these tests are under 2 percent. 


8.             We also have 145 wastewater testing stations across the island, in housing estates, dormitories, nursing homes etc. Only a very small handful are registering the presence of COVID-19 viral fragments.


9.             So we are sure that the incidence of COVID-19 in our community is currently low and stable. But Omicron is already in our community. While community cases are not high currently, and Omicron accounts for close to 20 percent of local cases, it is a matter of time before it starts to multiply quickly. We must be prepared for that.


Response Thus Far


10.          Let me talk about our response thus far.


11.          When Omicron was first detected in November last year, and scientists around the world were grappling to find out more about the variant, we adopted a cautious containment approach at that time. We closed our borders to affected countries in Africa, stepped up the frequency of testing for travellers, isolated infected individuals at National Centre for Infectious Diseases, and conducted very active and stringent contact tracing and quarantine around Omicron cases.


12.          Those measures helped to delay the introduction of the variant into our community and slowed the local spread. It bought us valuable time to learn more about the nature and behaviour of Omicron variant, so we can better respond to it.


13.          Today, we have reviewed overseas as well as local data, with the time we have bought for ourselves, and we are able to clearly map out the characteristics of Omicron. Let me go through them briefly.   


·      First, Omicron is more transmissible than Delta, so we must brace ourselves for a much bigger infection wave from Omicron compared to the Delta variant. For example, at the peak in late October and early November last year, we were registering about 3,000 Delta infections a day. Omicron could exceed this by a few times. At its peak, Delta infections were doubling every six to eight days, Omicron infections may double in two to three days.


·      Second, the silver lining is that studies coming out from various countries including South Africa, US, UK and Canada, indicate that Omicron infections are less severe than that of Delta - and the data has been very consistent - particularly amongst the vaccinated, and more so amongst those who are boosted. Locally, we have found this to be the case as well. We have so far accumulated 2,252 Omicron cases. Out of the 2,252 cases, three required oxygen supplementation, and all had been taken off oxygen within three days. So all three are now recovering. None has required intensive care unit (ICU) care, as yet. If these same 2,252 infections had been caused by Delta, based on our experience, we would expect about 30 individuals (1.3 percent) to require oxygen supplementation, ICU care or die.


·      Third, vaccines, especially boosters, retain substantial protection against severe disease and hospitalisations for Omicron cases. For example, the UK estimated that effectiveness of vaccines and boosters in preventing hospitalisation is 72% and 88% respectively.


Director of Medical Services (DMS) Associate Professor Kenneth Mak will explain these further.


14.          Unlike the last time I was speaking to you here, Omicron is now a better known enemy. We know how it attacks and among whom it is most likely to inflict the greatest harm, and so we can take steps to protect ourselves better, and then ride the Omicron wave as safely as we can. As a result, we are making a few policy adjustments.


First, Vaccination Validity


15.          First, is vaccination validity. But let me first give you an overview of where we are now in terms of vaccination. International data has shown that protection against Omicron by a primary vaccination series is weaker compared to that against the Delta variant. It also wanes more quickly, typically after five to six months. However, boosters will restore the vaccine protection against infection and severe illness from Omicron.


16.          Vaccination and boosters therefore continue to be our primary response. We are now delivering over 50,000 jabs a day – vaccination and boosters. Let me first talk about vaccination.


17.          By now, over 87 percent of our population has received two doses of their COVID-19 vaccines. Over the past months, we have managed to vaccinate well over 90 percent of every eligible age group.


18.          For example, for seniors aged 60 to 69 years and 70 and above, their vaccination coverage is 96 percent and 95 percent respectively. About 38,000 seniors remain unvaccinated, compared to 200,000 a few months ago. We have also recently started vaccination for children aged 5 to 11 years, and response has been encouraging.


19.          Our high vaccination rates have kept the number of severe cases low. As a result, even at the peak of the Delta wave, our hospitals and healthcare system were under stress but not overwhelmed.


20.          This reflects the resilience of our population – young and old, men and women, Singaporeans as well as Permanent Residents (PRs) and foreigners. We would have been in far worse shape if we were not a high trust society.


21.          For boosters, more than 42 percent of our population have received their booster doses. Amongst those eligible, 78 percent have taken up boosters. Amongst just the seniors aged 60 years and above, 89 percent have taken up boosters. So, this is encouraging.


22.          Even as we accelerate the pace of vaccination and boosting, we must not lose our advantage over the virus and we need to keep our wall of resilience strong. Hence our experts have been keeping a close watch on the immunity levels of vaccinated individuals.


23.          That is why I explained in a previous press conference that we need to treat COVID-19 vaccination as a three-dose regime for the mRNA vaccines. On that basis, the full vaccination status accorded after two doses of mRNA vaccines and three doses of Sinovac/Sinopharm vaccines, cannot last in perpetuity. The protection will wane after a few months and needs to be restored with a booster.


24.          I have therefore earlier indicated that there will need to be an expiry date for full vaccination status, after two doses of mRNA vaccines or three doses of Sinovac/Sinopharm vaccines. We have studied the matter and in line with the recommendation of the Expert Committee on COVID-19 Vaccination (EC19V), MOH will set the expiry to be 270 days or nine months after the last dose of vaccine of the primary series.


25.          So there are two durations to remember. 150 days or five months after you have taken your second dose of mRNA or third dose of Sinovac/Sinopharm vaccine – you will be invited to take your boosters. 270 days or nine months after you have taken your second dose of mRNA or third dose of Sinovac/Sinopharm vaccine and you have not taken your booster, your full vaccination status will lapse. This will amongst other things, affect your access to vaccination-differentiated venues such as malls, restaurants, libraries etc.


26.          This policy will be effective from Monday, 14 February 2022.


27.          Let me explain this new policy with some dates, just to illustrate and make it clear. From now to 13 February 2022, so long as you have taken two doses of mRNA or three doses of Sinovac/Sinopharm vaccines, regardless of how long ago you have received those jabs, you will still be deemed as fully vaccinated.  


28.          From 14 February 2022, if your last vaccine dose was taken before 20 May 2021 (i.e. 270 days or nine months ago), your full vaccination status will lapse. To maintain your full vaccination status, you would need to take a booster vaccine dose before the deadline of 14 February 2022. 


29.          We are setting the effective date of the new policy to almost 1.5 months from now, so that everyone whose vaccination status may lapse from 14 February 2022 has a chance to get their booster jabs early and before that deadline. Those who have not reached the nineth month expiry or who are medically ineligible for boosters will not be affected.


30.          We have been inviting those who have completed their primary series vaccination regime about five months ago to register for their mRNA booster shots. To facilitate bookings for booster appointments, in the coming weeks, we will send out invitations for booster shots for those aged 60 years and above earlier, around four months. We have consulted the EC19V and they are supportive of this administrative move.


31.          I urge all eligible individuals to take their boosters promptly. Let us remain a high trust, resilient nation.


Health Protocols


32.          Another important response is to prepare our healthcare system for a potentially high number of Omicron cases.


33.          DMS will explain the work that we are doing to ready our healthcare capacity. In particular, if indeed Omicron infections are less severe, and hospital stays are shorter, which is what international data is indicating, we can better leverage our COVID-19 Treatment Facilities (CTFs), instead of straining our hospital resources.


34.          The majority of patients though would be able to recover safely at home without the need to be admitted to a hospital or CTF. Here, we will adjust our health protocols. I said at the last Multi-Ministry Taskforce press conference that we want to further empower our primary care doctors, especially our General Practitioners (GPs), to look after their patients who are infected with COVID-19. Let me explain how we are doing this.


35.          Most people are familiar with Protocols 1 and 2.


36.          Just to recap, under Protocol 1, the individual who is not well will be asked to undergo a PCR test, and if tested positive, will be placed under the Home Recovery Programme, or conveyed to Community Isolation Facilities (CIFs), CTFs or hospitals, depending on their disposition and their risk levels.  


37.          Under Protocol 2, the patient is usually asymptomatic or has mild symptoms. They will self-administer antigen rapid tests (ART), and if positive, isolate at home for at least 72 hours. Thereafter, if they test negative with an ART, they may exit self-isolation and resume normal activities.


38.          We will empower primary care doctors to trigger not just Protocol 1, which they currently do, but also Protocol 2. We have since engaged our primary care partners and I am happy to share that they welcome this and the new protocol will kick in progressively from tomorrow, 6 January 2022.


39.          So to explain and illustrate, this means that under the new arrangement, individuals who see a primary care doctor will be clinically assessed based on their symptoms and health status. For low-risk individuals with mild symptoms, the primary care doctors will be able to make an immediate diagnosis and administer an ART on the patient.


40.          If positive, a medical certificate will be issued and the patient will be asked to isolate himself for the next 72 hours. After that, if they test negative on a self-administered ART, they may exit self-isolation and resume normal activities.


41.          At any point in time if they feel unwell, their primary care doctor will be there to support them. Anyone who feels very unwell will always be able to seek medical attention from our hospitals, and also call 995.


Living with Omicron


42.          To be COVID-resilient, we must ride the Omicron wave as another rite of passage, just as we have done so for Delta. At the end of the next wave, we will be even more resilient than now. And we will have achieved another milestone.


43.          Then, it is possible that we ride subsequent waves of COVID-19 just like we do so for influenza every year, without major issues. Getting there will require our collective effort and co-operation, and each of us doing our part and taking care of each other.


44.          Let me now hand the floor to DMS.

Category: Speeches Highlights