With the recent emergence of the Omicron variant globally, the Multi-Ministry Taskforce (MTF) had introduced travel restrictions for affected countries/regions and subsequently enhanced our testing regime for travellers, including those arriving via the Vaccinated Travel Lanes (VTLs). These efforts have helped stem the flow of Omicron into Singapore, with 16 cases reported to date locally, and will buy us valuable time to better understand the variant and develop our responses.
2. As more Omicron cases are reported globally, it is a matter of time before the Omicron variant surfaces within our community. With preliminary data suggesting that it is at least as transmissible as the Delta variant and may carry a higher risk of re-infection, there is a need for us to put in place additional measures to make sure we are prepared to deal with a spread of the Omicron variant in our community.
3. To this end, we will have to press on more urgently with our booster vaccination programme to enhance protection against infection and severe disease, as preliminary data overseas shows that vaccinated individuals who had received a booster had significant protection against infection by the Omicron variant, and even if they were still infected, significant protection against developing severe disease which required hospital treatment. We will also extend Vaccination-Differentiated Safe Management Measures (VDS) to more settings to better protect the vulnerable and at-risk groups in our population, while allowing specific concessions for fully vaccinated individuals to return safely to the workplace. In anticipation of a potential surge in local Omicron cases, we are also putting in place contingency plans to ramp up our ICU, hospital, and COVID-19 Treatment Facility (CTF) capacities. In addition, we will continue to promote regular testing at the workplace and in the community, to better facilitate early detection and rapid tracing and containment around Omicron cases.
Update on Detected Omicron Cases and Assessment of Omicron Variant
4. As of 14 December 2021, we have detected eight new confirmed Omicron cases, and six previously reported preliminary Omicron cases have also been confirmed by genomic sequencing[1]. This brings the total number of Omicron cases detected in Singapore to 16, with 14 imported cases and two local cases who were airport passenger service staff. All are fully vaccinated, with no or mild symptoms. 13 cases are recovering in isolation wards at the National Centre for Infectious Diseases (NCID), and three cases have been discharged. Thus far, all cases have had minimal interactions in the community prior to being isolated, and we have not detected linked cases in the community. Active contact tracing is being conducted to ringfence close contacts of these cases and reduce onward transmission once infection with the Omicron variant is suspected, through the detection of S-gene target failure in their test results. This includes quarantine at designated facilities. The National Public Health Laboratory (NPHL) subsequently confirms infection with the Omicron variant through genomic sequencing of the test samples.
5. The Omicron variant has now been detected in over 60 countries, mainly in Africa and Europe. Current observations from affected countries/regions suggest that the Omicron variant is at least as transmissible as currently circulating variants. Global observations continue to suggest that most infections with the Omicron variant are either asymptomatic or with mild symptoms, although it is still unclear whether the Omicron variant causes overall less severe disease than other strains. In addition, preliminary real-world studies suggest some degree of immune evasion that could result in an increased risk of breakthrough infections amongst the recovered and vaccinated. Hence, boosters are required to increase one’s immunity and mitigate any effects of immune evasion. We will continue to monitor closely and evaluate the situation as more data emerges.
Maximising Protection through Vaccination and Boosters
6. Vaccinations and boosters are the best protection against an unknown and likely highly transmissible COVID-19 variant like the Omicron variant. To support these efforts and encourage more people to get vaccinated and boosted, the Ministry of Health (MOH) announced on 11 December 2021 that it will begin vaccination for children aged 5 to 11 years before the end of this year, using the paediatric doses of the Pfizer-BioNTech/Comirnaty COVID-19 vaccine. We will also extend the booster programme to individuals aged 18 to 29 years, from 14 December 2021. All eligible persons will be able to receive their booster dose of the mRNA vaccine five months after completing their primary series vaccination regime.
7. Local and international data indicate that there is a lower risk of serious allergic reactions such as anaphylaxis from booster vaccination doses of mRNA vaccines. In view of this, we will streamline the process for administering booster vaccination doses of mRNA vaccines, by reducing the post-vaccination observation time from 30 minutes to 15 minutes.
Updates to Community Safe Management Measures
Reduction of Exemption Period for Recovered Persons to Enter Settings Where Vaccination-Differentiated Safe Management Measures Are Implemented
8. From 1 January 2022, all recovered persons from COVID-19 who are not fully vaccinated will only be given a 180-day exemption after infection[2] to enter settings where vaccination-differentiated safe management measures (VDS) are implemented. This is reduced from the current exemption period of 270 days, and calculated starting from the day of the first positive SAR-CoV-2 Polymerase Chain Reaction (PCR) test, obtained in Singapore. The adjustment is made due to concerns over the transmissibility and heightened reinfection risk of the Omicron variant, and quicker waning of protection acquired through past infections. These recovered persons who are not fully vaccinated should seek to complete their primary series vaccination regime promptly.
9. Non-fully vaccinated individuals who had recovered from COVID-19 infection prior to 1 January 2022 will also have their exemption period reduced from 270 days to 180 days. However, for individuals who will already exceed the 180-day period as at 1 January 2022, they will be granted an additional one month grace period till 31 January 2022 to complete their primary series vaccination regime, so as to continue being able to enter VDS settings. As recovered individuals need only one dose of mRNA COVID-19 vaccine or two doses of Sinovac[3] under the National Vaccination Programme to complete their primary series vaccination regime, they should do so latest by 17 January 2022, to allow an interval of 14 days from the completion of the regimen to be considered fully vaccinated. During the grace period from the date when they have exceeded the 180-day period, these individuals can produce their discharge memo for entry into VDS settings.
Enhancements to Vaccination-Differentiated Safe Management Measures (VDS)
10. We had earlier announced that from 1 December 2021, we will expand VDS to more settings and activities, including in all Libraries under the National Library Board (NLB), and selected activities in community clubs/centres under People’s Association (PA). In addition, the concession for unvaccinated individuals to perform a pre-event test (PET) in lieu of being fully vaccinated would be removed with effect on 1 January 2022. We will expand these VDS settings further.
11. First, from 1 February 2022, we will expand VDS to cover all indoor sports facilities, Institutes of Higher Learning (IHLs), and leisure guests in hotels, hostels and serviced apartments. However, students in IHLs who are completing their full-time NITEC/Higher NITEC, Diploma or Degree programmes will be exempted from the VDS measures requirement when entering their respective educational institutions. More details will be released by the relevant agencies.
12. Second, from 1 February 2022, all events, irrespective of event size, must implement VDS in order to proceed. Currently, only events with over 50 attendees are required to implement VDS. However, even smaller-sized events can spark transmission that can then spread to wider groups of people, especially in view of the Omicron variant. That said, to minimise disruption to events which are already planned for, we will remove the existing concession only in end January 2022. Please see Annex A for the applicable settings.
13. There are presently no plans to introduce VDS measures for children aged 12 years and below, as the focus now is to ensure our children are well protected by vaccination.
14. We had earlier announced on 8 November 2021 the roll-out of “VDS+Test” pilots in sports settings, selected mass sporting events, as well as selected MICE events,where we allowed some further easing of SMMs for fully vaccinated individuals with a valid negative Antigen Rapid Test (ART) result on-site prior to the activity. These pilots have been successful thus far, given strong compliance and enforcement on the ground, and we will continue to expand these pilots where feasible.
Workplace Requirements
15. With the implementation of the Workforce Vaccination Measures[4] starting from 1 January 2022, we are in a better position to ease the current default work from home (WFH) posture, and will allow 50% of those who can WFH to return to the office.
16. Currently, participants in work-related events are capped at 50 persons. We will raise this cap only for events where all participants remain masked and seated, at a safe distance from each other. All participants must also meet the VDS requirements. Social gatherings at the workplace will continue to be disallowed. More details will be provided separately.
Preparatory Steps to Augment Healthcare Capacity and Revise Healthcare Protocols
Plans to Ramp Up Healthcare Capacity
17. Given the likely higher transmissibility of the Omicron variant, a surge in local Omicron cases could risk straining our healthcare system once again. Hence, we are putting in place contingency plans to ramp up capacity in our public hospitals and ICU if necessary. To help manage the load in the public hospitals, we are also prepared to increase capacity in our CTFs, so as to facilitate direct admission or transfer of more stable COVID-19 patients from public hospitals to CTFs for continued monitoring if necessary. To complement these efforts, we are concurrently stepping up efforts to augment the manpower required in our hospitals and CTFs.
Supporting Persons with Mild COVID-19 in the Community
18. Majority of our COVID-19 cases have mild symptoms and can safely recover at home. This has been demonstrated for the Delta variant, and likely continues to be so for Omicron. To further right-site care arrangements for these individuals who do not require acute care in hospitals, MOH will work with our Public Health Preparedness Clinics (PHPCs) to better support these individuals in their recovery and help them return to their normal lives as soon as possible. This would entail expanding the current Protocol 2[5] in January 2022 to cover mildly symptomatic and suitably fit COVID-19 patients who can recover well at home. More details will be released at a later date.
Promoting Regular Testing and Surveillance
Extending Subsidies for Mandated Rostered Routine Testing (RRT)
19. Testing remains key to our early detection and rapid tracing and containment of transmission, especially in light of the Omicron variant. We have thus far mandated an ART-based RRT regime for work settings at higher risk of COVID-19 exposure and spread[6]. With the emergence of the Omicron variant, our airport and other border frontline workers who are at heightened risk of exposure to the variant had recently reverted to a weekly PCR RRT as a precautionary measure. During this period as we step up our efforts to quickly detect and ringfence Omicron cases, all sectors will remain on their existing mandatory RRT regime, until more information is available on the Omicron variant.
20. The Government is currently subsidising companies on mandatory RRT until 31 December 2021. As we step up our efforts to detect and contain potential transmission of Omicron, we will provide continued support to employers by extending the subsidies for sectors on mandatory RRT until 31 March 2022. Beyond that, employers and businesses should be prepared to factor in testing costs as part of their normal business operations.
Expanding our Network of Quick Test Centres
21. On top of mandating regular testing at high-risk work settings, we also encourage everyone, including fully vaccinated individuals, to exercise social responsibility and self-test regularly with ART kits, especially if you are participating in higher risk activities or attending large-scale events. Regular testing should become a way of life as we adapt to the evolving COVID-19 situation. This will be supported by a comprehensive network of testing infrastructure that is easily accessible islandwide.
22. In line with this, the Health Promotion Board (HPB) has set up or partnered private providers to set up close to 60 Quick Test Centres (QTCs) where members of the public can make an appointment to conduct a self-administered ART under supervision by trained personnel. Each test is priced at $15, and can be used to fulfil workplace requirements under the RRT regime, for pre-event or pre-activity tests, or simply for anyone who wishes to get tested before attending a large-scale event.
23. To augment our efforts in providing more accessible QTCs, we have partnered general practitioners (GPs), mall operators, and hotel groups to set up private QTCs (p-QTCs) in selected sites located conveniently across the island. With the strong support of our partners[7], we expect to have at least 60 additional p-QTCs set up within the next few weeks. We will continue to work closely with the industry to grow the network of p-QTCs and would like to encourage interested eligible providers to come onboard this effort. This will go a long way in fostering a culture of testing, which is important for early detection of cases and for keeping our communities safe.
Strengthening our Collective Resilience against Omicron Variant
24. This set of measures serves as important safeguards to prepare ourselves for a potential surge of local Omicron cases, as we continue to evaluate the situation and ringfence around detected cases to slow, if not eliminate, any potential spread in the community during this period. We seek everyone’s continued effort and cooperation to exercise social responsibility and comply with all the measures that have been put in place. Test yourself regularly and follow the health protocols. Take up vaccination or boosters straightaway when these are offered to you, as they will likely protect you from severe disease. Only by doing so can we strengthen our collective resilience against the evolving COVID-19 situation.
MINISTRY OF HEALTH
14 DECEMBER 2021
[1] These are Cases 273611, 276363, 276223, 276794, 276796 and 276839. Separately, two other cases, 271487 and 271598 were previously reported as confirmed cases on 6 December 2021.
[2] This exemption does not apply to entry into VDS+Test events or activities i.e. individuals will still have to do ART prior to these events.
[3] For non-fully vaccinated recovered persons, it is recommended that you receive one dose of mRNA COVID-19 vaccine (two doses if Sinovac under the National Vaccination Programme or Sinopharm under Special Access Route) at least 3 months after the date of diagnosis of COVID-19 infection.
[5] Protocol 2 refers to the management protocol for those who are well and test positive for COVID-19. Today, asymptomatic patients who test positive are to self-isolate at home for the next 72 hours. After 72 hours, they can re-test using an ART kit. If tested negative, they may exit isolation and resume normal activities. If they become unwell at any time, they should see a doctor.
[6] Those currently on ART-based RRT includes: COVID-19 frontline workers, staff interacting with vulnerable population (e.g. healthcare/eldercare workers, children aged below 12 years old), those living in migrant worker dormitories, Construction, Marine and Process workers, staff in dine-in F&B establishments, personal care services, gyms and fitness studios, retail mall and supermarket staff, last-mile delivery workers (including parcel and food delivery personnel), public and private transport workers, and workers in essential services. Note: since 2 Dec 2021, border frontline workers have reverted to a weekly PCR RRT regime.
[7] These include mall operators such as CapitaLand, Frasers Property Retail, hotels under the Far East Hospitality Group, Intercontinental Hotel Group, Accor Hotels, as well as Resorts World Sentosa.