Combined reply on developments in Singapore's transition to a COVID-resilient nation

Name and Constituency of Member of Parliament
Mr Yip Hon Weng
MP for Yio Chu Kang SMC

Question No. 1913

To ask the Minister for Health (a) with the exponential rise in COVID-19 infections observed since the end of August 2021, more than three weeks before the Stabilisation Phase was implemented, why did the Ministry not provide advance notice about tightening of restrictions to give businesses time to adjust; and (b) what are the concrete plans on preventing the abrupt reversal of safe management policies in future.

Name and Constituency of Member of Parliament
Mr Xie Yao Quan
MP for Jurong GRC

Question No. 1823

To ask the Minister for Health (a) how are the younger and fully vaccinated COVID-19 patients being triaged for other home recovery criteria, such as having no severe co-morbidities or vulnerable household members; (b) whether such triaging typically occurs within 24 hours of confirmation of polymerase chain reaction (PCR) test results; and (c) in the longer run, what is the target time to pick these patients up for conveyance to a government facility from the time they are deemed unsuitable for home recovery.

Name and Constituency of Member of Parliament
Mr Yip Hon Weng
MP for Yio Chu Kang SMC

Question No. 1159

To ask the Minister for Health (a) how is the Ministry addressing the confusion and lack of follow-up from authorities for COVID-19 home recovery patients; (b) when a COVID-19 patient is to be admitted to a community care facility or hospital, how soon will they be notified and picked up; and (c) what is the Ministry doing to ensure clear communication of COVID-19 recovery protocols to all individuals including those who are illiterate or not internet savvy.

Name and Constituency of Member of Parliament
Ms Ng Ling Ling
MP for Ang Mo Kio GRC

Question No. 1813

To ask the Minister for Health with regard to Home Recovery being the default care management model for eligible COVID-19 patients from 15 September 2021 (a) what is the number of Persons under Quarantine (PUQ) who are COVID-19 positive and are under Home Recovery; (b) of these, how many are subsequently found to be ineligible for Home Recovery; and (c) how long is the waiting time for them to be sent to a hospital or dedicated care facilities.

Name and Constituency of Member of Parliament
Mr Dennis Tan Lip Fong
MP for Hougang SMC

Question No. 1855

To ask the Minister for Health in what circumstances can COVID-19 patients request the Ministry to have their recovery in community care facilities or hospitals after a positive diagnosis, instead of a quarantine at home.

Name and Constituency of Member of Parliament
Ms Cheng Li Hui
MP for Tampines GRC

Question No. 1870

To ask the Minister for Health (a) what is the current number of people on Home Recovery for COVID-19; (b) whether there is a set of guidelines and instructions shared with these individuals so they are aware of what to do; (c) if so, how are these conveyed to them; (d) how frequently does the Ministry contact these individuals to monitor their health situation; and (e) what are the key milestones in the Home Recovery process.

Name and Constituency of Member of Parliament
Ms Sylvia Lim
MP for Aljunied GRC

Question No. 1831

To ask the Minister for Health whether the Government is reviewing the manner of implementation of COVID-19 Quarantine Orders and Stay-Home Notices so as to improve communication with affected households while safeguarding public health. 

Name and Constituency of Member of Parliament
Dr Wan Rizal
MP for Jalan Besar GRC

Question No. 1838

To ask the Minister for Health regarding the Home Recovery scheme (a) what is the efficacy of the Home Recovery scheme; (b) how many persons have completed the Home Recovery scheme without affecting other family members; (c) what is the average response time for someone who has received a Quarantine Order; (d) whether the current manpower to support the scheme is sufficient; and (e) whether the disbursement of antigen rapid test kits has been timely and sufficient for families under the scheme.

Name and Constituency of Member of Parliament
Mr Yip Hon Weng
MP for Yio Chu Kang SMC

Question No. 1912

To ask the Minister for Health whether the Government is reviewing the manner of implementation of COVID-19 Quarantine Orders and Stay-Home Notices so as to improve communication with affected households while safeguarding public health. 

Name and Constituency of Member of Parliament
Dr Lim Wee Kiak
MP for Sembawang GRC

Question No. 1639

To ask the Minister for Health (a) in light of the US Food and Drug Administration’s approval for the Pfizer COVID-19 vaccine to be administered to persons aged 16 years and older, whether HSA will be looking into granting such similar approval for vaccines under the National Vaccination Programme; (b) if so, how long will this process take; and (c) what is its impact on getting more people to go for vaccination.

Name and Constituency of Member of Parliament
Mr Dennis Tan Lip Fong
MP for Hougang SMC

Question No. 1871

To ask the Minister for Health whether HSA has received the recent data from Pfizer regarding the efficacy of the Pfizer vaccine in children aged five to 11 years old and, if so, whether the Government can share its views on Pfizer’s findings for this age group.

Name and Constituency of Member of Parliament
Mr Yip Hon Weng
MP for Yio Chu Kang SMC

Question No. 1160

To ask the Minister for Health in light of the approvals for various vaccines (a) whether persons who opt for the Sinovac or Sinopharm vaccine will be given the option to take the COVID-19 booster jab under the Government's vaccination programme; (b) how many more vaccines are now under consideration for inclusion into the national programme to be covered by the Vaccine Injury Financial Assistance Programme (VIFAP); and (c) whether those who have taking the Sinovac or Sinopharm vaccine will be included under VIFAP.

Name and Constituency of Member of Parliament
Ms Ng Ling Ling
MP for Ang Mo Kio GRC

Question No. 1146

To ask the Minister for Health to date, what is the number of individuals who have taken their Sinovac vaccine in public hospitals through the dedicated public health programme.

Name and Constituency of Member of Parliament
Ms He Ting Ru
MP for Seng Kang GRC

Question No. 1769

To ask the Minister for Health in relation to the Vaccine Injury Financial Assistance Programme (VIFAP) (a) whether the findings of the independent VIFAP Clinical Panel can be released to applicants and, if not, whether this can be done; (b) what avenues are available to applicants to appeal against decisions to reject claims made under the VIFAP; and (c) what are some of the most common grounds for rejecting applications.

Name and Constituency of Member of Parliament
Ms Ng Ling Ling
MP for Ang Mo Kio GRC

Question No. 1145

To ask the Minister for Health with regard to the rollout of the national COVID-19 vaccine booster programme (a) what is the number of individuals who are eligible for the vaccine booster; and (b) whether there is an estimated timeframe for the completion of the booster shots for those aged above 60 years.

Name and Constituency of Member of Parliament
Mr Darryl David
MP for Ang Mo Kio GRC

Question No. 1796

To ask the Minister for Health (a) whether the Government can provide an update on the COVID-19 vaccine booster programme; and (b) whether there have been any adverse reactions to those receiving the vaccine booster so far.

Name and Constituency of Member of Parliament
Mr Yip Hon Weng
MP for Yio Chu Kang SMC

Question No. 1843

To ask the Minister for Health (a) when will the Ministry decide on using viral vector or other combinations of vaccines for the third COVID-19 vaccine booster jab; (b) how will this decision impact the booster jab programme for seniors; (c) whether the definition of "fully vaccinated" will be changed to differentiate those who have taken the third booster jab; and (d) if so, how will this be reflected in the TraceTogether app.

Name and Constituency of Member of Parliament
Ms Jessica Tan Soon Neo
MP for East Coast GRC

Question No. 1807

To ask the Minister for Health (a) with the increasing number of COVID-19 cases, whether the current measures are effective in ensuring that Singapore is prepared for COVID-19 to be treated as “endemic”; (b) whether the healthcare system has adequate capacity; and (c) whether new measures are required.

Name and Constituency of Member of Parliament
Mr Yip Hon Weng
MP for Yio Chu Kang SMC

Question No. 1884

To ask the Minister for Health as Singapore opens up and moves towards an endemic management model for COVID-19 (a) whether the reporting of COVID-19 cases and the KPIs related to the managing of COVID-19 cases will shift towards availability of COVID-19 management facilities in relation to the number of infections nationally; (b) if so, when will it take place; and (c) what are the plans to effectively communicate this shift to the public.

Name and Constituency of Member of Parliament
Assoc Prof Jamus Jerome Lim
MP for Sengkang GRC

Question No. 1169

To ask the Minister for Health in light of the move to “living with COVID” and scaling down the routine publication of COVID-19-related public health data, whether the Ministry will consider establishing a portal where such information, to the extent that they are collected, may nevertheless be made available for scrutiny and analysis.

Name and Constituency of Member of Parliament
Mr Xie Yao Quan
MP for Jurong GRC

Question No. 1164

To ask the Minister for Health what are the Ministry’s plans to recognise healthcare workers for another challenging year of managing COVID-19.

Oral Answer

1. Mr Speaker, may I request that I answer questions for oral answers 1-9 and questions for written answers 32-36 together. Thereafter, Senior Minister of State Dr Janil Puthucheary will answer questions for oral answers 10-20 and questions for written answers 27-30, and both of us will then take supplementary questions together after our respective answers please? 

COVID-19 Resilient Plans

2. Mr Speaker, the recent move to quickly tighten safe management measures was a difficult but necessary decision. We are committed to our plans to opening up and transit to a COVID-19 resilient nation. Hence, lockdowns like Circuit Breakers are no longer an option.  Many workers, families, students and businesses are going to suffer for it, and it will affect our ability to earn ourselves a living in the long term.  

3. With the great majority of our population – over 83% – fully vaccinated, we are one of the most highly vaccinated countries in the world.  As a result, during this wave of infections transmission, over 98% of infected individuals experienced mild or no symptoms, 1.7% require oxygen supplementation in hospitals typically for a few days, 0.2% required ICU care and unfortunately, 0.1% passed away.  

4. Although only a small percentage of infected individuals require hospital or ICU care, we also admit many more others for observation, because they are at risk of developing serious illnesses. When infection number rises, all these translate to a larger number of hospital patients, which put considerable strain on our hospitals and healthcare workers.  

5. Hence, even as we continue our journey to transit to a COVID-19 resilient nation, we should also have a care for our hospitals and healthcare workers, and ‘tap on the brakes’ to slow down the rate of transmission. This is why we had to implement the measures under the Stabilization Phase last week.  

6. Unfortunately, in this rapidly changing situation, we have to stay agile, adapt and respond quickly.  We will try to give as early a notice as possible to businesses, but there is a practical limit to that, and we seek your understanding. 

Home Recovery Programme

7. The Home Recovery Programme (HRP) is an important part of our response, given that the vast majority of infected individuals has mild or no symptoms.  These do not need special medical care and can therefore recover safely at home. 

8. Mr Dennis Tan asked if individuals can request to be sent to an isolation facility instead.  We have been considering and accommodating such requests, taking into account the medical conditions of the individuals and their family circumstances.  But it is also important to emphasize that individuals and families should make some adjustments to their living arrangements to make HRP possible.  Because it is only with a high take-up of HRP, that our hospitals can focus resources on those who may require greater medical attention, including non-COVID 19 patients who need acute hospital care.  This will enable our healthcare professionals to concentrate those who need hospital care. 

9. In response to Mr Xie Yao Quan, in the initial days of HRP, a fair number of patients without serious symptoms did make their way to the Emergency Department of hospitals. We did not compile the numbers, but it had led to over-crowding of the Emergency Departments. We understand the anxiety of these patients.  It is therefore important for us to iron out all the teething issues of HRP, so that there is a strong sense of assurance as they undergo HRP.  Over the past few days, such incidences have been significantly reduced.        

10. Over the past week, and with the SAF overseeing and operating the programme end-to-end, we have been ironing out the teething issues, resolving service lapses, including those relating to timeliness of notification and conveyancing, and improving communications. Things are improving day by day. 

11. In response to Ms Cheng Li Hui, currently, there are about 9,800 people on the HRP, and they are recovering well. Over 2,800 has been discharged as of 3 Oct 2021. Every day, over half of infected individuals will be onboarded on HRP, and we expect the proportion to continue to rise. In recent days, for those eligible for HRP, 93% are contacted promptly and smoothly onboarded.  But we still have difficulties contacting the remaining minority, because there was either no response, or contact details are not inaccurate.  This is another teething issue that we are ironing out.  

12. As for those who are illiterate and do not understand the SMS notifications from MOH, we hope family members, neighbours and volunteers can give them a hand.  That is why our partnership with the People’s Association is very important.  Over the weekend, volunteers have been mobilised to reach out to residents who have been served HRP notifications – checking that they are well, that they know what to do for HRP, and also if they have other needs, such as arranging for food deliveries.  

13. As they are generally well, we have also kept the involvement of telemedicine providers light, and have patients call the providers only when they need medical attention. 

14. In response to Mr Xie Yao Quan, typically, after a person is detected as COVID-19 positive, MOH will contact him within 24 hours, where triaging will be done, and a decision will be made on whether he will be on HRP or needs to be conveyed to a care facility.  In response to Ms Ng Ling Ling, among those on HRP, as of 26 Sep, about 400 are Persons under Quarantine who subsequently tested positive for COVID. 95% of them are eligible for HRP and have recovered or are recovering well at home. 5% needed to be conveyed to a care facility, and this was generally done within 24 hours of the request for conveyance. 

15. I would like to assure the House that MOH and SAF are working hard, devoting a lot of attention and resources, to continue to improve the processes. 

16. Ms Sylvia Lim’s also asked about a related issue, concerning the procedures of quarantine and Stay Home Notices for travelers. There have been some changes to the SHN procedures, which was announced last week, namely to align SHN duration with the quarantine duration. As I have explained at the MTF press conference last week, the healthcare protocols developed over the past months have become complex and confusing to most people.  We are undertaking a holistic and comprehensive review to simplify them, so that people can understand them, do their part in the fight against COVID-19, and also help others who are in need of assistance and guidance.

Vaccination and Boosters

17. Vaccination remains key to our battle against COVID-19. Those who are fully vaccinated with Pfizer-BioNTech or Moderna vaccine are about 40% protected from against the Delta variant. Nevertheless, this is protection against infection and both vaccines remain very effective in protecting against severe illnesses due to COVID-19 infections.

18. As for the Sinovac vaccine, the number of people who have been administered with the vaccine is low, at less than 2% of our population, and we do not yet have meaningful data to gauge its effectiveness.

19. The member is probably interested to know about the relative effectiveness of the vaccines.  There has been some international data available, including a fairly extensive study done early this year in Chile, which uses a mix of vaccines.  Our neighbouring countries too have released some data.  The data showed that just like the mRNA vaccines, breakthrough infections are not uncommon amongst individuals vaccinated with the Sinovac vaccine.  But it does accord protection against severe illnesses.

20. For those who are not fully vaccinated due to concerns over medical complications, or because they experienced severe side effects after their first dose of mRNA vaccine, they may take the Sinovac vaccine at public hospitals.  As of 3 Oct, under this public health programme, more than 1,900 individuals have taken the first dose of the Sinovac vaccine, and around 1,300 individuals have completed the full vaccination regimen.

21. To Dr Lim Wee Kiak’s question on whether we intend to grant full registration to the Pfizer-BioNTech vaccine, this is something we are looking into, once the longer-term follow-up data is fully available to us, and HSA has completed its evaluation. To Mr Dennis Tan’s question, we are also waiting for Pfizer-BioNTech to file their data with HSA to extend the use of the vaccine to include children aged five to eleven years old.  These are areas we are proactively working with the pharmaceutical companies on. 

22. We have also commenced our booster programme. To date, about 550,000 individuals have been invited to take their boosters. 350,000 of them have taken their jabs or booked an appointment. Of these, 240,000 have completed their jabs. So we are off to an encouraging start. 

23. To Ms Ng Ling Ling’s question, the Expert Committee has recommended, and MOH has accepted, that individuals eligible for boosters will include those aged 50 and above and all who are immunocompromised. The Expert Committee continues to review international data to assess the efficacy and safety of booster shots for younger groups, as well as those exposed to higher risk environments, such as healthcare and frontline workers.

24. In time, we will also be inviting eligible individuals who have taken the Sinovac or SinoPharm vaccine, or other WHO EUL vaccines, to take their mRNA booster shots.  However, most of them are not due yet.

25. For policy consistency, Vaccine Injury Financial Assistance Programme (VIFAP), will only applies to the vaccines used under our National Vaccination Programme.

26. Ms He Ting Ru asked whether VIFAP applicants would have access to the findings by the Panel as well as avenues for appeal if their applications are rejected. The VIFAP Clinical Panel assesses applications based on two considerations.  First, whether the patient’s conditions are related to the COVID-19 vaccination. Second, the severity criteria. The reasons for rejected applications are made known to the applicant, and unsuccessful applicants may apply for a reassessment if there is new supporting medical information. 

27. At this stage, individuals’ vaccination status as listed on the TraceTogether app will not change regardless of their booster dose status.  We are administering boosters in good time, and so the issue of expiring vaccination status has not arisen.  But in time, this is an issue that we will need to review.

28. Mr Yip Hon Weng asked about the possibility of exploring a combination of vaccines to be used for the booster jab. The Expert Committee on COVID-19 vaccination (EC19V) is still studying the heterologous strategy of administering a non-mRNA booster shot that is different from the first two primary series mRNA doses as data emerges. In the meantime, we will administer the PSAR-authorised mRNA vaccines under the booster programme as the best available data utilize these vaccines for boosting with good effect.

Conclusion

29. Ms Jessica Tan asked if our current measures are effective in ensuring that Singapore is prepared for COVID-19 to be treated as ‘endemic’.  Our transition journey to living with COVID-19 is unique in the world, in the sense that we did not allow ourselves to go through big waves of transmission last year which many countries did, and suffered tremendous loss of lives.  Today, when we see other countries opening up and living lives more normally, let’s not forget the heavy price that they have paid.

30. We commenced our transition journey only after we have vaccinated the large majority of our population, so that for the vast majority of infected persons, they now have no or mild symptoms.  I believe our plan is as comprehensive and effective as it can be.  SMS Janil will elaborate on other parts of the plan.  But it is still a long battle ahead, which we will prevail as one Singapore.

31. It has been a challenging 20 months for all of us, especially our healthcare workers. Although it was posed as a question, I fully agree and thank Mr Xie Yao Quan’s suggestion to recognize healthcare workers.  We have enhanced their salaries, but I think recognition needs to go beyond that.  In good time, when the pandemic is over, we must properly express our gratitude to them, and make sure that generations of Singaporeans will be inspired by their bravery and dedication during the COVID-19 pandemic.