SPEECH BY MR ONG YE KUNG, MINISTER FOR HEALTH, AT THE LAUNCH EVENT FOR THE PROGRAMME FOR RESEARCH IN EPIDEMIC PREPAREDNESS AND RESPONSE (PREPARE), 3 NOVEMBER 2022, AT THE MINISTRY OF HEALTH

Prof Leo Yee Sin, Executive Director, National Centre for Infectious Diseases

Prof Wang Linfa, Executive Director, PREPARE

Friends, colleagues

Ladies and Gentlemen

1.     Adaptability has been a hallmark of Singapore’s response to COVID-19. For example, the healthcare system quickly ramped up capacity with COVID-19 wards and COVID-19 Treatment Facilities; our people adopted socially responsible practices and behaviour, watched out for one another; and the government swiftly established health protocols and changed them when we had to, set up contact tracing operations, set up systems such as TraceTogether and rolled out the National Vaccination Programme, just to name a few things we have done.

2.     At every step of the way, what people may not realise is we always make our decisions based on science and data. This is why we are confident when we argue against the anti-vaxxers, because we have data and Science behind us. Our decisions and actions are always guided by that. The COVID-19 pandemic exemplified how science and research can be harnessed to support public health responses. As the world starts to resume normalcy of life, it is timely to reflect on the role of research and science in underpinning our pandemic responses. Who are the people involved, and the lessons we learnt from that whole experience?

Responding in the Fog of War

3.     Let me recount some of the great work that has been done. Shortly after the outbreak of COVID-19, local researchers and government agencies came together to form the National COVID-19 Research Workgroup, to conduct collaborative research to improve our understanding of SARS-CoV-2.

4.     The leading researcher is Professor Wang Linfa from Duke-NUS Medical School. Linfa is a world-renowned coronavirus expert. He studied viruses in bats for 20 years, and is known as the “bat-man”. He and his team were able to isolate the SARS-CoV-2 virus within days of the first local confirmed COVID-19 case, which  laid the foundation for subsequent COVID-19 research. These studies provided important insights to help the Ministry of Health (MOH) formulate and adjust policies throughout the pandemic.

5.     Detection. Three weeks after the published SARS-CoV-2 genomic sequence, our research and clinical teams were amongst the first in the world, to produce and deploy an approved COVID-19 diagnostics test on 7 February 2020. The test kit is a product of close collaboration between Dr Sidney Yee from the Diagnostics Development Hub, Dr Masafumi Inoue from the Experimental Drug Development Centre, Dr Sebastian Maurer-Stroh from the Agency for Science, Technology and Research’s (A*STAR) Bioinformatics Institute, Dr Timothy Barkham from Tan Tock Seng Hospital, and Ms Wong Woei Jiuang and Dr Rama Sethuraman from the Health Sciences Authority.

6.     Prof Wang Linfa’s research also led to breakthrough inventions. In collaboration with the National Centre for Infectious Diseases (NCID), A*STAR, and GenScript, a global biotech company, the team developed a “first-in-the-world” SARS-CoV-2 serology test (called cPass^TM) to detect neutralising antibodies without the need of a Biosafety Level-3 containment facility.

7.     Transmission. In a further study, lead researchers from A*STAR, namely Prof Lim Keng Hui, Prof Loh Xian Jun, Dr Kang Chang Wei and Dr Ivan Tan, used modelling techniques to understand flight trajectories of droplets spread. I remember that research vividly because I was Minister for Transport at that time, and the team did a detailed presentation to me on how the virus can spread in planes, buses and MRT trains. One lesson I learnt that is that if the train is moving and you are sitting next to a person who is infected, you are not the most likely person to be infected, but the person three seats down because the train is moving. This science-based approach enabled public sector agencies and event providers to adopt suitable Safe Management Measures (SMMs) in locations such as theatres and conference halls, as well as for flights and public transport.

8.     Another example is a study by NCID and A*STAR led by Associate Prof Barnaby Young and Prof Lisa Ng, who together with international data, showed that the viral load dropped to relatively low levels a few days after the onset of symptoms, and the virus could not be cultured when the Antigen Rapid Test results turned negative, so that indicates that the virus is no longer able to replicate, and the person is no longer infectious. This finding was critical. When we saw the data, we jumped because  it enabled us to move away from the practice of discharging COVID-19 patients only upon two consecutive days of negative PCR results, which can take many days or weeks, and we shifted to a policy of discharging a patient after a maximum of seven days.

9.     Modelling. Then there is Professor Alex Cook, an expert in infectious disease modelling, from the Saw Swee Hock School of Public Health. I personally met him a couple of times, sharing with him our policy considerations, and the data and findings we need to help guide the policies. Alex worked very closely with MOH throughout the pandemic, to provide projections of the COVID-19 disease trajectory, which turned out to be quite close to actual observed rates. Of course, recently during the XBB wave,  the projections were more conservative than how the actual situation turned out. But through his projections, we have a sense of the adequacy of our healthcare capacity, and whether it will come under pressure, and if it will, we may decide if we need to tighten or if we can afford to relax our SMMs.

10.     Vaccinations and therapeutics. Researchers from the Research Workgroup also studied the development of immunity in our local population, following infection and after COVID-19 vaccination. For example, local and international research data provided robust evidence that vaccination continued to provide strong protection against severe illnesses 10 to 12 months after three shots of mRNA vaccines. This information helped us develop the definition of ‘up-to-date’ vaccination that we announced recently, where we recommend that individuals who have attained minimum protection take an additional shot five to twelve months after their last shot.

11.     Prof David Lye from NCID actively engaged the US National Institutes of Health, to include Singapore as a global COVID-19 clinical trials site. This allowed Singapore early access to therapeutic drugs such as remdesivir. David was also a member of the COVID-19 Therapeutics and Vaccines Expert Group which engaged vaccine manufacturers and recommended promising SARS-CoV-2 vaccines for early procurement by Singapore. This is a prescient move that allowed us to be ready when the pandemic broke out.

Building Up Resilience

12.     Our years of investment in biomedical research, and accumulation of experts across diverse fields paid off during the COVID-19 pandemic crisis. Without that reservoir of capabilities and talent that was built up over the years, we would not have been able to respond to the pandemic as effectively as we have.

13.     Our experience in pandemic crisis management also portends modern policy making – that it has to be grounded on scientific evidence and data, informed by research findings. This is applicable not just only for healthcare policies or public health responses, but is also applicable across all fields, including education, social and economic policies.

14.     These pandemic preparedness and response capabilities should be consolidated and built upon further. This is the main motivation for MOH to establish PREPARE, or the Programme for Research in Epidemic Preparedness and REsponse, a very clever abbreviation.

15.     PREPARE is a dedicated research programme supported by MOH’s National Medical Research Council and administered by NCID. Led by Linfa and David, PREPARE consists of five multi-disciplinary co-operatives, underpinned by two essential core capabilities. It has the immediate task to work with MOH to develop a national epidemic Research and Development (R&D) plan. Linfa will introduce the programme in greater detail shortly.

16.     By having a dedicated research programme, we can pull together multi-disciplinary experts throughout the pandemic research ecosystem in a very coordinated fashion. We will further strengthen our existing capabilities, including by forming research networks, working closely with various government agencies, developing necessary tools, methods and products to respond to future infectious disease outbreak threats. Singapore will then be better prepared for future pandemics, which will come.

17.     Internationally, PREPARE will strengthen research partnerships, share information and knowledge, and collaborate in clinical trials with various institutions in the region. PREPARE will be Singapore’s connection into international pandemic research forums and platforms, such as the Coalition for Epidemic Preparedness Innovations.

Closing

18.     After the SARS outbreak, Singapore stepped up its pandemic preparedness, and the key initiative at that time was to set up NCID. Fortunately we did. The new facility and acquired expertise proved to be essential during the COVID-19 pandemic.

19.     Similarly, with the experience of the COVID-19 pandemic, there are things we need to do, to further enhance our preparedness against future infectious disease outbreaks. PREPARE will be one of the key initiatives. I would like to congratulate the PREPARE team on your successful launch of the programme. I wish the team all the best in your continued good work. Thank you.