You have heard an update on the local situation. A key consideration in our COVID-19 posture is our hospital situation so let me give an update on that.
Update of Local Situation
2. ICU cases remain very manageable, below 30 cases, as of last night. The number of COVID-19 hospitalisation has also been manageable. In fact, it has fallen from about 1,500 at its peak during this wave to about 1,000 now.
3. The strain, however, is mostly felt at the Emergency Departments, with many patients seeking hospital care on a daily basis. And fortunately, these cases are also trending down, but gradually from a seven-day moving average of about 2,800 in early March at its peak to now about 2,500. So we have only come down about 10% to 15%. Fewer healthcare workers are now out of action due to COVID-19. COVID-19 related absenteeism rate has declined from 2.7% in early March to about 2% now, so we really welcome our healthcare workers back to their positions.
4. Nevertheless, hospitals are still very busy. The strain is felt at the Emergency Departments, and the vast majority of the patients are not COVID-19 patients. Most of them have chronic illnesses that may not have had close medical follow-up over the past two years because everyone was just so preoccupied dealing with COVID-19. These are what we call BAU or business-as-usual patients.
5. We now have a BAU debt that has to be repaid one way or another. The BAU debt has therefore become a separate non-COVID related healthcare problem. It also means that whether daily infection numbers go up or down, the impact on BAU workload at the Emergency Departments may not be very significant.
6. We will need a longer-term structural response to address the problem of the BAU debt. At the Ministry of Health (MOH), we are doing four things:
a. One, progressively shift our focus back to serving BAU patients in our hospitals. Hospitals are now freeing up some of the beds and manpower that have been ringfenced for COVID-19.
b. Two, expand the capacity for the long term. After much delay, we are now targeting the opening of three more nursing homes in Pasir Ris, Potong Pasir and Henderson in April 2022. This will help relieve a significant number of patients from hospitals, and these are patients currently in hospitals waiting for their nursing home places.
c. Three, we will continue to make full use of the COVID-19 Treatment Facilities (CTFs). The existing CTF at Tampines will be converted back to a nursing home around April. Sengkang Community Hospital, which has been serving as a CTF, will be reconfigured to swing more to BAU patients, especially serving Sengkang General Hospital..
d. Four, we will continue with our existing collaboration with the private hospitals. Our partners such as Raffles Hospital, Parkway Hospitals and Mount Alvernia have been a tremendous help. They can help admit and manage clinically stable non-COVID patients from the Emergency Departments.
Three Areas of Changes and Public Health Considerations
7. Let me now briefly talk about the three areas of changes we are announcing today – vaccinations, border measures, and domestic Safe Management Measures (SMMs).
8. First, vaccination. MOH has agreed to EC19V’s recommendation of a fourth vaccine dose for those who are immunocompromised, have serious chronic disease, live in aged care facilities or aged 80 and above. The fourth dose will be administered, five months after their last vaccine dose.
9. This is because these groups of individuals have been observed to experience faster waning of protection against infection and, to a lesser extent, severe disease. I should highlight that even if you do not take this fourth dose, we retain your full vaccination status. So it is strongly recommended so as to better protect yourself if you fall into any of the above risks. Based on the current epidemic situation and characteristics of the dominant variant in Singapore, there are no plans to extend the fourth dose to the rest of the population yet, but it is an evolving situation, which we will watch closely with the Expert Committee.
10. Second, border measures. We have earlier talked about transiting to a new Vaccinated Traveller Framework that the Prime Minister has just announced
11. We have taken some preparatory steps that we have announced earlier, and we are now ready to make that transition. And that means that normal travel will resume almost to like pre-COVID times for fully vaccinated persons.
12. I just want to reiterate the public health rationale for this transition. The principal consideration on travel has shifted. In the past, we were worried about the top line infection numbers and we did not want imported infections so we prevented imported infections by imposing tests and Stay-Home Notice (SHN) on travellers.
13. Now, with high local vaccination coverage and having gone through two major infection waves, our main consideration is the bottom line - whether travellers who are infected will burden our healthcare capacity.
14. It is therefore more important to ensure that travellers are fully vaccinated with effective vaccines than to put them through SHN or tests while they are in Singapore. Hence, we will do away with On-Arrival Tests completely. This is because once you are in Singapore, you should see a doctor if unwell, and when you are detected with COVID-19, you should just follow Health Protocols 1-2-3.
15. As for Pre-Departure Tests (PDT), in time we should be able to remove it too, given that imported cases account for a very small percentage of total daily cases and the vast majority of travellers recover very uneventfully.
16. However, given the rising infection numbers in several countries, and our relaxation of many other measures that we are announcing today, we will take a calibrated approach when it comes to Pre-Departure Tests. We will remove Pre-Departure Tests only for land travel and retain it for air and sea travel. We will review the situation again in two to four weeks.
17. There has been feedback that it may be difficult to book a supervised ART test overseas before departing for Singapore. We have therefore set up a remote supervised self-swab ART service for Singaporeans, Permanent Residents and Work Pass holders. Do book your appointments with the providers early. Details are in the press release.
18. With the transition, MOH will remove the categorisation of countries by risk levels. We will instead have only two categories – a General Travel category, where travellers can come here quarantine free, so long as they are fully vaccinated; and a restricted category, for regions where Variants of Concern have been detected and where we may temporarily suspend or slow down travel while we find out more about the Variants of Concern. Currently, there are no regions or countries in the Restricted Category.
19. Minister Iswaran will further elaborate.
20. Finally, the Safe Management Measures. Minister Lawrence Wong will explain this. I just want to highlight that after our streamlining of measures to SMMs 1-5, we did not observe a pronounced rise in cases. In fact, cases continue its downtrend.
21. This is a very significant outcome. It means that moving forward, we will be able to focus on the five most important SMM levers to manage the pandemic. With five rules, people can better understand the rules and do their part to help manage COVID-19.
Pivoting, not Dismantling
22. Finally, let me just talk briefly about living with COVID-19 as an endemic disease. The Multi-Ministry Taskforce set out this strategy last year, and today we are taking a significant step forward. Today’s announcements mark a pivoting, and not dismantling, of our COVID-19 related measures.
23. We cannot abruptly dismantle all our measures because that means letting down our guard and will result in the virus coming back to impact us and hurt us. The COVID-19 virus continues to spread around the world, with new surges in several countries. There is still the risk of new Variants of Concern that may take us back to square one.
24. It is very important for us to remember that the Omicron variant is not a mild disease. It is certainly less severe than Delta, but it is not mild, and can kill infected patients, especially if they are vulnerable and not fully vaccinated. As we speak, we are seeing rising death tolls in several countries around the world.
25. So when we say we want to live with COVID-19 as an endemic disease, remember that endemic diseases like Influenza and Yellow Fever continue to kill a lot of people around the world every year. To live with them, we need control measures such as vaccinations, tests, maybe some isolation, and various health precautions, so that we can manage the risks and live alongside them. Many of these measures can be stepped down as we become more resilient, and the situation improves. But others such as remote working, masking in high-risk areas, recovering from home, performing self-tests, periodic vaccinations may become part and parcel of a new normal.
26. Our approach of going all out to vaccinate people and taking a middle path, neither zero-COVID or Freedom Day has produced good results that distinguished Singapore. Our cumulative incidence of COVID-19 deaths is about 200 per million population. This is a notch lower than other countries such as Australia, South Korea, Japan, UAE, Qatar but far lower than many other countries in various regions around the world, which recorded several hundred or even thousands of deaths per million population.
27. Under our approach, we will restore normalcy progressively and today, we are taking a significant step. With each step, we can monitor the effect of our actions, and move further based on the data. So let’s keep staying true to science, take a balanced approach, watch out for each other, and we will continue to make good progress.