Tuesday 28 April 2020

Singapore’s COVID-19 testing capacity ramped up - from 2,900 tests a day to more than 8,000

1 in 15 migrant workers tested so far: Health Minister Gan Kim Yong
By Linette Lai, Political Correspondent, The Straits Times, 28 Apr 2020

Singapore has ramped up testing for the coronavirus in order to curb its spread and bring the outbreak under control.

It has also boosted its testing capacity and can now carry out more than 8,000 tests a day, up from 2,900 at the start of this month.

This will provide its citizens an extra layer of protection. Essential workers, such as those caring for the vulnerable elderly, are currently being tested, and the plan is to gradually expand testing to a wider pool so that critical services can continue, Health Minister Gan Kim Yong said at a media conference yesterday.

Its robust capacity has also enabled Singapore to test about 2,100 people per 100,000 in its population. In comparison, the United States has tested 1,600 per 100,000, and Britain has tested 1,000 per 100,000.

Mr Gan also rejected suggestions that the Government has reduced testing of migrant workers, leading to a drop in the number of confirmed cases.

"This is not true. Our testing capacity for migrant workers is about 3,000 a day," he said. "We have not reduced it. Instead, we have been increasing the capacity of testing of our migrant workers. The rate of testing has not slowed down."

A total of 21,000 workers living in dormitories - or one in 15 such workers - have been tested since the start of the outbreak. Every positive test is added to Singapore's case count, he said.

The testing capacity will also be critical as the country works towards the eventual easing of circuit breaker measures.

That will happen after daily new cases in the wider community have dropped consistently to the single digits over a period of time, National Development Minister Lawrence Wong said at the same media conference.

Meanwhile, Singaporeans must press on with measures to stop the virus from spreading, said Mr Wong, on a day when 799 new virus cases and two deaths were reported.

"Testing, as critical and important as it is, cannot be a substitute for personal responsibility and safe distancing measures," he said.

"So we go back to the fundamentals and ask everyone, during this period, to stay home and uphold good personal hygiene."

Mr Wong said the Government has also made plans to house workers who have recovered from COVID-19, with both short-term and longer-term plans being studied.

In the wider community, he said, restrictions would be eased in a "very calibrated manner" only after the number of new cases consistently came down to single digits over a period of time.

Scaling up testing and implementing technology to track people's movements and help in contact tracing will be two key elements of this strategy, Mr Wong said.

"We are developing plans around both of these areas and we will be able to share more details when we are ready," he added. "But these are critical enablers for us to progressively open up the economy.

He stressed that people should still exercise personal and social responsibility even after the circuit breaker period is over.

"We should still try very hard to minimise our social interactions because it only takes one person interacting in a group in close quarters with many people to cause another cluster," he added.

Yesterday, the offices of Leader of the House Grace Fu and the Clerk of Parliament announced plans to amend the Constitution to allow Parliament to sit in more than one location at the same time, or virtually. The Bill will be introduced in Parliament next week.

Coronavirus: Testing not a substitute for safe distancing, personal responsibility, says Minister Lawrence Wong
By Olivia Ho, The Straits Times, 28 Apr 2020

Testing cannot be a substitute for safe distancing and personal responsibility when it comes to reducing the spread of the coronavirus, Minister for National Development Lawrence Wong said yesterday.

Speaking at a media conference by the multi-ministry task force, he said there is a chance one might test negative for the virus but in fact be incubating it.

"The test will not pick up the virus during that phase," he said.

"So, we go back to the fundamentals and ask everyone during this period to stay home and uphold good personal hygiene."

He added that though the Government is stepping up testing of workers in essential services, these people should still continue to take precautions and minimise contact with their colleagues.

"Don't go to work and then end up socialising during lunch break or during break times at the pantry or outside the workplace," he cautioned.

"Minimise all contact, go to work, go back home."

On Sunday, about 70 people were caught breaching safe distancing measures, down from more than 240 the Sunday before.

The Government will be doing more regular testing of workers in essential sectors, particularly those in vulnerable sectors such as healthcare workers, nursing home staff and front-line officers who come into close contact with confirmed cases.

Mr Wong added that it is critical that those who are not feeling well do not go to work.

They must ensure that they do not have symptoms, even mild ones, or they could potentially end up infecting their colleagues.

He said: "These are reminders that we have been telling everyone, and it is very important that we all continue to uphold these very basic precautions and safeguards, together with a ramped up testing regime.

"All of these things have to be done as part of a holistic strategy in order for us to suppress and slow down the spread of the virus and, ultimately, defeat COVID-19."

Testing for COVID-19 also aids surveillance of high-risk groups
By Lim Min Zhang, The Straits Times, 28 Apr 2020

Testing for COVID-19 allows for surveillance of groups of people that are at higher risk of contracting or transmitting the disease.

This is in addition to diagnosing patients so they can be cared for appropriately, and facilitating contact tracing to contain the virus' spread.

Health Minister Gan Kim Yong yesterday outlined these three purposes of testing in a virtual press conference by the multi-ministry task force set up to handle the coronavirus outbreak.

Singapore conducts tests for surveillance across hospitals, polyclinics and general practitioner clinics, such as among patients who have already been diagnosed with pneumonia or have prolonged symptoms of an acute respiratory infection.

A random testing programme, known as sentinel surveillance, is also used to pick up cases in the community that may otherwise go undetected. This programme is aimed at finding those who have the virus, but have very mild symptoms or none at all.

Such testing has revealed that there are still cases of COVID-19 being transmitted in the community, with some of these remaining infectious despite their mild symptoms.

Singapore has been expanding its testing capacity, and can now conduct more than 8,000 tests per day, compared with an average of 2,900 tests a day early this month, said the Ministry of Health yesterday.

Mr Gan said targeted testing for selected groups is also in place - for instance, for essential workers who were moved out of dormitories to ensure they are free from infection, as well as for staff of institutions such as nursing homes where there is close contact with seniors.

"We intend to gradually expand testing to a wider pool of essential workers in order to ensure the continuity of critical functions and services. This is also important as we start to open up after the circuit breaker measures."

The authorities have also been widely testing foreign workers for the coronavirus, even those who are well and have no symptoms, following a spike in the number of cases involving such workers in dormitories, who have accounted for the majority of new cases confirmed daily for about two weeks.

They disclosed yesterday that more than 21,000 migrant workers staying in dorms have been tested, with many of them showing no symptoms when they were tested. Close to 3,000 workers have been tested per day.

Mr Gan added that while testing remained a key prong of Singapore's strategy in the fight against COVID-19, "what is more important than testing is for everyone to play our part to prevent transmission by observing circuit breaker rules and guidelines".

Coronavirus numbers: Figuring out what to watch
Look not at the hundreds of new cases daily but at the number of cases in the community
By Salma Khalik, Senior Health Correspondent, The Straits Times, 28 Apr 2020

Two days of falling infections raised hopes that were soon dashed.

From 1,037 new cases on April 23, the numbers dipped sharply to 897 and then 618 over the following two days. Just when Singaporeans were hoping the worst might be over, the number of new COVID-19 cases jumped to 931 on Sunday, while 799 new cases were announced yesterday.

One reason for the fluctuating numbers is that all workers in dormitories with symptoms are immediately isolated and treated.

That is especially true of dorms with high infection rates, explained Health Minister Gan Kim Yong. Testing can come later and the chances are high that they do have the disease. And when they are eventually tested and most likely found infected, they add to the daily count.

Indeed, the high numbers of cases in the dorms in recent weeks have been precisely because of Singapore's "aggressive" and "strategic" testing, and this continues.

Giving a different take on the numbers, Mr Lawrence Wong, Minister for National Development and co-chair of the multi-ministry task force, said the circuit breaker measures are working as the number of cases in the community has been going down.

The measure of success is not the hundreds of new cases identified daily - mostly foreign workers in dormitories - but in the number of cases in the community.

While these are not as low as hoped for, they are gradually falling, and point to one infected person infecting less than one other person. On Sunday, there were 43 such new cases - 18 among residents and employment pass holders, and 25 involving work permit holders who do not live in dormitories.

The Ministry of Health (MOH) recently split the cases of non-dormitory infection into the two groups when reporting the local figures:

• Singaporeans, permanent residents and foreigners on an employment pass.

• Foreign work permit holders not living in dormitories.

Both these numbers are important when looking at whether there is spread in the community.

The first is obvious and there can be no debate about why it is necessary to contain the spread before Singapore can breathe free.

The second group is smaller but equally important as it includes domestic workers living with local families, as well as workers living in Housing Board flats and shophouses.

But a large number are workers in the construction sector, said Mr Wong, who may interact more among themselves. There is a different strategy in keeping infections among them low, including having them stay home.

Mr Gan added that splitting these cases into the two groups helps the authorities to "better understand the way the virus transmits, the epidemiology behind it".

"Some foreign workers who are living in the community may not have family members, so their infection could be from the workplace."

Residents, on the other hand, usually live with family, so transmission could occur among family members.

The unlinked cases remain a worry as it means that someone with the disease has not been identified. Mr Gan said such cases need to be reduced to as low as possible.

On Sunday, there were 25 unlinked cases in the community - 10 among residents and 15 work permit holders.

Then there are the vast majority of new cases which are occurring among foreign workers living in dormitories.

They can almost be viewed as a separate outbreak as they have been isolated from the rest of society. Those still working because they are in essential services have mostly been moved out of dormitories, and are given priority testing and isolated if they have COVID-19.

All dorm workers have been isolated. This means the virus has been contained within this group.

At least for now, the exact numbers of those getting infected each day are not of critical importance in terms of policy decisions, as all non-essential work has been put on hold.

But those numbers will become important when Singapore wants to ease the current measures - and these dormitory workers start working again.

This is because, unless infections have been sharply checked or rooted out among this group of foreign workers by the time the circuit breaker measures are lifted, anyone mildly infected and not identified could pass the infection to the rest of the population once it is business as usual - unless these workers continue to be isolated.

As to when the current measures will likely ease, Mr Wong said that will happen when the number of new cases in the community can be contained to a single-digit number over a period of time.

He said: "When that happens, we will gradually start easing up measures and resuming activities."

This has to be done carefully and in a calibrated manner, as the risk of infection may come back. Then the priority will be rapid diagnosis and contact tracing to quickly ring-fence close contacts to prevent it from getting out into the community.

More workers in essential services getting tested for COVID-19
They include front-line officers who have interacted with confirmed cases as Govt expands testing capabilities
By Toh Ting Wei, The Straits Times, 28 Apr 2020

More healthcare workers, staff in nursing homes and other workers in essential services, in particular those working with vulnerable groups, are now getting tested for COVID-19.

The stepped-up tests for these workers, who also include front-line officers who have interacted with confirmed cases, come as the Government goes "all out" in expanding its testing capabilities, Minister for National Development Lawrence Wong said yesterday.

"We want to do this, to ensure the well-being of our essential workforce and also to protect seniors and vulnerable members of the public," said Mr Wong, who co-chairs the multi-ministry task force fighting the COVID-19 outbreak.

"Each time we do these tests, it will help us to detect early and also to prevent any clusters from forming through this early detection... This aspect of testing is critical particularly as we plan for a phase beyond the circuit breaker."

Mr Wong said all countries are grappling with the challenge of moving out of their lockdowns and relaxing measures in a safe manner.

A scaled-up testing capacity will be a key enabler to Singapore lifting such measures and opening up its economy again, he added.

"That is why we are ramping up and scaling up our testing capacity; not just doing this with existing PCR (polymerase chain reaction) tests, but also looking at new technologies that might be available including, potentially, point-of-care test kits that can be scaled up more rapidly," said Mr Wong.

The second key enabler to open up the economy would be the use of technology. "We can do more to identify, track people's movements, particularly if a case were to emerge, then we will be able to quickly move in to do contact tracing and ring-fencing of the close contacts," he added.

The Government is working on plans in these two areas and will announce more details when they are available.

But Mr Wong said that even as more essential workers get tested, they should still continue to take precautions. These include minimising contact with colleagues, not socialising during break times and not going to work if unwell.

"It is very important that we all continue to uphold these very basic precautions and safeguards, together with a ramped-up testing regime," he added.

"Testing cannot substitute for all of these... There is a chance that you can test negative but you are in the incubation phase, and so the test will not pick up the virus during that phase."

Health Minister Gan Kim Yong, who also co-chairs the task force, said Singapore will have to reduce the number of unlinked cases - whether among foreign workers or in the community - to as low as possible before easing the restrictions that are in place.

"While there may still be some risks, we will need to manage that risk and reduce that risk to the extent possible before we are able to begin to open up and to remove the circuit breaker measures," he said.

"It is important to understand that those unlinked cases mean that... there are underlying transmissions in the community that have not been detected because these cases have to come from someone, and that someone has not been identified."

He reiterated that any easing of circuit breaker measures will be done in phases to prevent the resurgence of cases.

In the meantime, Mr Wong called for patience in complying with the enhanced circuit breaker measures that will last until May 4. He noted that the impact of these measures, announced on April 21, will take up to two weeks to show.

"It is not easy, but we really call on everyone to hunker down during this final stretch, at least till May 4," he said.

"We have said that we are trying to get our local, our community cases down to a single digit. It is not there yet, and not just single digit in one day, but consistently over a period of time... When that happens, we will gradually start easing up on the measures and resuming more activities."

Plan for new sites to house recovered migrant workers
By Lim Min Zhang, The Straits Times, 28 Apr 2020

New sites will be developed with dormitories to house migrant workers who have recovered from COVID-19 and these will include longer-term facilities that will be ready in a year or two, said Minister for National Development Lawrence Wong yesterday.

He disclosed this when asked at a virtual press conference whether the workers would go back to staying in their previous dormitories or elsewhere.

Mr Wong also said there was a "whole pipeline of (housing) arrangements" from the short, medium to long term, and that plans will be unveiled soon.

"We do have a plan to house the recovered migrant workers. It is quite extensive and it will involve new sites, new spaces that we will build," he said at the multi-ministry task force press conference.

Some of the spaces will have short-to medium-term housing, but longer-term facilities are also on the cards, he added. "So, it is a whole pipeline of arrangements for the short, medium to long term, (as we think) through holistically what's the ideal arrangement for housing our migrant workers."

As of yesterday, there were 12,183 confirmed coronavirus cases in Singapore who are dorm residents, out of a total of 14,423 cases.

Most of these cases have mild symptoms and are being monitored in the community facilities or general wards in hospitals.

Experts have said that placing these patients in such facilities will prevent acute hospital beds from being unnecessarily filled by relatively well COVID-19 patients.

Mr Wong, who is co-chair of the task force to fight the coronavirus, had highlighted before the need for recovered workers to be housed separately.

In a Facebook post on April 17, he said community care facilities at the Singapore Expo and other sites were being expanded rapidly to take care of infected workers, and additional facilities were being prepared to accommodate them after they have recovered fully and tested negative for COVID-19.

Dorm residents have accounted for the vast majority of new cases confirmed daily for a fortnight.

The Ministry of Health's daily report on confirmed COVID-19 cases shows that there are a total of 323,000 dorm residents. Most of them, or about 200,000, are housed in larger purpose-built dorms meant for communal living.

There are 43 such dorms in Singapore, and 38 of them have known clusters of infected cases.

About 95,000 workers are housed in about 1,200 smaller factory-converted dorms, most of which have fewer than 50 residents. The others stay in on-site housing, which includes temporary quarters at construction sites.

Since last week, about 10,000 foreign workers in essential services have been taken out of dorms and put up at alternative abodes, such as vacant Housing Board flats, floating hotels and military camps.

The move is to reduce the density of workers in dorms while allowing them to continue working.

Tough decision had to be made to shut down construction sites quickly: Josephine Teo
Manpower Minister responds to some employers' concerns over tighter measures
By Irene Tham, The Sunday Times, 26 Apr 2020

The Republic had to make a hard decision and suspend all construction work as part of tighter measures that kicked in last Wednesday, 20 April.

This was done to stem the risk of wider transmission of the COVID-19 virus, said Manpower Minister Josephine Teo in a Facebook post yesterday.

Reiterating a point she had made earlier, Mrs Teo wrote: "If we act fast, we're aware there's little time for employers to adjust. If we act too slowly, there is risk of wider transmission.

"This is the difficult trade-off."

Her explanation comes in the wake of social media posts and text messages that had circulated over the preceding two days highlighting the frustrations of some employers.

The tighter measures, which kicked in on April 22, mean that migrant workers will not be allowed to step out of all dormitories for any purpose, including going to work.

The measures will apply to all companies, even those that had earlier obtained licences to operate.

Stay-home notices have been given to all 180,000 construction work permit and S Pass holders and their dependants.

"But without it, they could still be out and about. Should we have avoided this move? Should more time have been given? We will never really know, but time is not on our side.

"Given how quickly and widely the virus spreads, can we afford to wait? If there's anything we have learnt about the virus, taking action sooner is probably better than later," Mrs Teo said.

The updated measure is aimed at curbing the spread of the coronavirus among foreign workers, who have been the hardest hit, and those they come in contact with.

Epidemiological findings of infected migrant workers are already showing links at common construction work sites.

"Even if their workers did not live in the dorms, cross-infections at the work site may already have occurred," Mrs Teo added.

The Ministry of Manpower (MOM) also had to nudge the 24 per cent of employers who are still paying salaries in cash to move to electronic payment for faster settlement and to prevent salary disputes down the road.

"More importantly, we have to reassure the workers and not risk them becoming anxious and restive over salaries," Mrs Teo said, noting that their families too are depending on them to continue to put food on the table.

More than 2,700 employers recently applied for bank accounts for about 35,000 migrant workers.

There has been some discussion on whether the authorities should have tested foreign workers earlier to contain the spread of COVID-19.

Mrs Teo said MOM had sent out an advisory in February to ask employers not to send workers who were healthy for testing. This was done at the request of the Ministry of Health.

"Why? Because at that time, healthy workers were going to hospitals in droves to ask for tests.

"The worry was that thousands would show up and overwhelm healthcare workers," she said.

In a Facebook post on Friday, Senior Minister Tharman Shanmugaratnam said that many migrant workers are Muslims - mainly from Bangladesh but also some from India - who are fasting in the month of Ramadan.

"Many in the local community have wanted to support them and show gratitude for the important jobs they are doing," he said.

Mr Tharman said some of these healthy workers in essential services have moved into Housing Board blocks in Taman Jurong, where he is an MP for Jurong GRC, and the residents in the community distributed packs of new clothes and prepared a special meal for them on Friday.

He added that the Government is sparing no effort to help the migrant workers.

"But what's really encouraging too has been the many individuals and groups all over the island who are rallying to help the workers through this difficult period, just like for any Singaporean in need," he said.

Singaporean man charged with posting fake information on COVID-19 circuit breaker measures
By Shaffiq Alkhatib, Court Correspondent and Jean Iau, The Straits Times, 28 Apr 2020

A 40-year-old Singaporean man has been charged over false claims he allegedly made that supermarkets would open only two days a week as part of enhanced measures here.

Kenneth Lai Yong Hui is accused of posting the false information on Facebook group "Taxiuncle", saying he had received information that enhanced COVID-19 circuit breaker measures would be rolled out on April 18.

The Singaporean was hauled to court yesterday and charged with communicating a false message.

The Straits Times understands that Lai is a taxi driver.

He is believed to be the first person to be charged with the offence during the coronavirus outbreak.

Those convicted can be jailed for up to three years and face a maximum fine of $10,000.

According to court documents, he allegedly posted the false message saying he had "intel" that extended measures in Singapore would purportedly be imposed on April 18.

Police revealed details of his alleged message yesterday.

They said that between April 15 and 16, Lai wrote: "Food courts, coffee shop (sic) all to close. Supermarkets will only open two days a week.

"Better go stock up your stuff for the next month or so. Government officials (were) in (a) meeting yesterday and will finalise measures tomorrow."

He is said to have done this in a Bishan flat.

Yesterday, Lai told the court that he intends to plead guilty, and regrets his actions.

He said: "I am very sorry and remorseful for what I had done."

He will be back in court on May 27.

In their statement, police said they will not hesitate to take action against those who transmit or communicate falsehoods.

"Members of the public should refer to official sources for information and avoid spreading unsubstantiated information or false rumours, as these may cause fear and public alarm," police added.

The circuit breaker period started on April 7 to curb the spread of the coronavirus here, and has been extended to June 1.

However, supermarkets, as well as foodcourts, coffee shops and restaurants providing takeaways, remain open.

All standalone food and beverage outlets, hairdressing salons and barber shops were shut from April 22.

Singapore ramps up facilities, manpower for coronavirus battle
COVID-19 bed capacity to more than double within months; more staff will come on board
By Lim Min Zhang, The Straits Times, 29 Apr 2020

Singapore will have far more capacity both inside and outside of hospitals to deal with COVID-19 patients, as it goes about ensuring that the healthcare system can meet the demands imposed on it by the outbreak.

Not only will the bed capacity to accommodate COVID-19 patients more than double within months, but intensive care unit facilities will be ramped up as well. More medical staff will also come on board to run these facilities as part of a wider strategy to counter the outbreak, the authorities said yesterday.

By the end of June, Singapore aims to have some 41,000 beds for isolation and care, including at community care and recovery facilities.

"We have created more than 18,000 bed spaces for isolation and care needs, with another 23,000 in the pipeline," said the Singapore Armed Forces' director of joint operations, Brigadier-General David Neo, at a media briefing yesterday.

Later, outlining Singapore's broad medical approach to the outbreak while speaking to the media, Health Minister Gan Kim Yong said that a range of facilities had been set up to meet the different needs of COVID-19 patients.

About 30 per cent of patients require closer medical observation because of underlying health conditions or old age. There is also a very small number who require ventilation support and care in the intensive care units, he said. These will be cared for.

But so far, most cases have had relatively mild or no symptoms and they do not require extensive medical intervention, Mr Gan said. They will be housed in community care facilities such as Singapore Expo, where they will be cared for by medical teams. The 10,000 bed spaces at such facilities will be doubled and new sites will be announced soon.

Meanwhile, studies have shown that patients who remain well on the 14th day of their illness are likely to remain stable, and such patients may be transferred to recovery facilities that do not need to have medical services, said Mr Gan. These facilities will also be expanded from the current 2,000 to more than 10,000 bed spaces.

The Health Ministry's director of medical services Kenneth Mak said these plans are being put in place to make sure that if the numbers continue to grow, there is enough capacity to look after patients.

A bump in numbers is expected as active screening among workers in essential services and seniors is stepped up.

Mr Gan said: "As we step up our screening and testing... we are likely to see more cases being detected which otherwise would not have been detected."

Other than increasing bed capacity, technology is being used to enhance outcomes, with medical kiosks and teleconsultations providing round-the-clock care in community care facilities.

To meet the need for manpower, said Mr Gan, 3,000 healthcare professionals have signed up under the SG Healthcare Corps initiative, which will be expanded to include more healthcare professionals and non-healthcare professionals.

Associate Professor Mak said: "This includes some from the private sector, and those who were previously in healthcare... who have now come back, taking on their previous roles."

Singapore confirmed an additional 528 COVID-19 cases yesterday, 28 April, bringing the total to 14,951. A total of 1,689 patients are currently in hospital, with 21 in intensive care units, and 12,120 isolated and cared for at community facilities.

3,000 healthcare professionals volunteer to help in coronavirus battle
By Cheow Sue-Ann, The Straits Times, 29 Apr 2020

About 3,000 healthcare professionals have signed up to the SG Healthcare Corps since it was launched earlier this month to marshal volunteers in the fight against the coronavirus.

The Ministry of Health (MOH) is also calling for more current and former medical professionals to step up and be on standby as Singapore prepares to handle a continued increase in the number of confirmed virus cases.

Medical staff from the private sector, retired medical professionals as well as those who are medically trained but no longer practising have signed up as volunteers since the programme began on April 7.

Health Minister Gan Kim Yong told a briefing yesterday that the ministry wants to ramp up the number of volunteers to ensure there is adequate manpower.

It hopes to have allied health professionals, such as audiologists, dietitians and physiotherapists, medics and individuals with laboratory experience on board.

The SG Healthcare Corps is also looking for non-medically trained volunteers, said MOH medical services director Kenneth Mak.

"For them, we prepare specific training packages to make sure that they are able to fulfil their roles competently as they step into a variety of different tasks," he noted.

"Some of the roles that they play include forming swab testing teams that support and augment expanding the roles and capabilities of our medical teams which are deployed for caring for foreign workers, for example, in dormitories."

The SG Healthcare Corps website noted that some of the roles also include operations support, community care ambassadors and healthcare assistants.

Mr Gan said: "All are welcome because going forward, we will need a lot more help from people.

"If you are interested, sign up with us and we will look for opportunities that we can tap your expertise, your experience or just simply your willingness to participate in this. We welcome anyone who is keen to... fight this battle together with us."

More information and registration details can be found at the SG Healthcare Corps portal.

Mr Gan added that the ministry is also redeploying manpower from industries affected by COVID-19 to enable them to take on new roles at hospitals.

One collaboration involved Singapore Airlines activating cabin crew as care ambassadors in some public healthcare institutions.

MOH said in a Facebook post: "We are very encouraged by the response to the launch so far and are deeply appreciative of your enthusiasm, which is reflective of the spirit of #SGUnited."


2,000 SAF personnel deployed in fight against COVID-19
100 soldiers from SAF Medical Corps deployed to care for COVID-19 patients at Singapore Expo
By Lim Min Zhang, The Straits Times, 1 May 2020

Private Terrenjit Gill was excited when he found out that he would be deployed to the Singapore Expo to care for COVID-19 patients. This was an opportunity to put his training as a Singapore Armed Forces medic to good use.

The full-time national serviceman, who enlisted last July, underwent a two-day refresher course on the use of personal protective equipment.

"I felt this would be a really good experience - this is what national service is about. As a medic, this is where I can practise what I've learnt and put it to good use in a real-life scenario," said Private Gill, 19, who will be studying medicine overseas after his national service.

He is among about 100 soldiers from the SAF Medical Corps deployed at the Expo community care facility since April 22, looking after some 1,800 COVID-19 patients.

Six Expo halls have been converted for COVID-19 patients and SAF servicemen are in charge of two of them. Staff from Parkway Pantai and Woodlands Health Campus are taking care of the patients in the other four halls.

Defence Minister Ng Eng Hen, who was at the Singapore Expo yesterday, spoke about the need to be constantly vigilant as he visited the SAF deployment. "Thankfully, so far despite a number of weeks in which we've been dealing with infected or potentially infected patients, the SAF personnel have kept well," he said.

"We'll constantly remind them to be vigilant, but yes personal safety is always a concern. This is a sacrifice, but it's a sacrifice that we all have to make," he told reporters. "I think it's very important because if we take care of the patients in these community care facilities, it will give our hospitals a lot of space to take care of other patients... So we want to make sure that we continue to get the hospitals to also continue with their core functions," he added.

He disclosed that there were currently about 2,000 personnel from across the SAF involved in the national effort to combat the coronavirus, including in contact tracing operations and at foreign worker dormitories.

Community care facilities like the Expo are meant for COVID-19 patients with relatively mild or no symptoms and do not require extensive medical intervention. Most patients fall into this category.

Senior Lieutenant-Colonel Daryl Tam, 47, who commands the SAF task force at Singapore Expo, said morale among the men was high. "When I ask the guys on the ground, they feel engaged and fulfilled, and they want to do their part for the nation."

Unwell foreign workers in dorms with high rate of infections isolated first and tested later, says MOH
Priority now is to isolate those with symptoms who are in dorms with high infection rates
By Toh Ting Wei, The Straits Times, 29 Apr 2020

Foreign workers living in dormitories with high rates of coronavirus infection are immediately isolated from others if they display symptoms, even if they have yet to be tested for the virus.

The Ministry of Health's director of medical services Kenneth Mak yesterday said: "We eventually will need to test all of them but the first priority is really to get them out, make sure they are properly isolated, given the high rate of infection within those dormitories."

Strategies differ across different dormitories based on the rate of infection, Associate Professor Mak said, adding that isolating those who are symptomatic is a key method to disrupting the coronavirus' chain of transmission.

He said: "We have also seen in some dormitories that practically every foreign worker who presents to our medical team with symptoms of acute respiratory syndrome tests positive."

Therefore, in these dormitories where the rate of infection is very high, Prof Mak said it makes a lot of sense to prioritise isolating those who are symptomatic away from their roommates.

On the foreign workers who display symptoms but are yet to be tested, Prof Mak said the majority are "very, very well" and most have just minimal symptoms.

"Therefore, most of the time when we place them in these isolation facilities and we keep a close eye on them, there isn't really much else we need to do other than the monitoring that we put in place."

He said that the monitoring of workers with symptoms who have not been tested may mean that the actual number of COVID-19 patients in dormitories is larger than the number of cases officially reported by the Ministry of Health.

"But there will always be a catch-up, because once we are able to settle these priorities, we will come around to make sure they are properly tested, because we want to make sure that they indeed do have an infection and confirm that, so that we can make a decision on whether to return them to the community of foreign workers in the dormitories when they recover," said Prof Mak.

He stressed: "It is not an issue of fudging or dodging or trying to hide numbers.

"It is really a question of making sure that our priority in testing matches the needs on the ground and making sure that we report as transparently as we can."

In response to a question about the number of foreign workers who have symptoms but are not tested yet, Prof Mak said the joint task force managing the situation in dormitories is compiling the figures.

It will provide an update on the figures when possible.

On where the workers with symptoms are isolated, Prof Mak said they are first assessed on what their risk is from COVID-19.

"And those, for example, who are much older foreign workers or whom we regard as perhaps having a high risk of having symptoms and deteriorating, we want to be particularly vigilant in those cases, and we transfer them to our hospitals for further monitoring and further care."

Where the other workers are isolated will depend on the facilities available.

"For example, if there are facilities available within the dormitories that allow for them to be properly looked after and isolated, separate from those who are well and without any symptoms, then we would be accommodating them in these facilities," Prof Mak said.

Separately yesterday, the Singapore Land Authority said the former Anderson Junior College Hostel has been repurposed to house foreign workers who test negative for COVID-19 but may have other illnesses.

The site has around 350 beds and started receiving foreign workers last week.

Beyond isolating workers, the authorities are also continuing with active case finding and isolating close contacts of confirmed cases to reduce COVID-19 transmission.

Prof Mak added: "We use testing a lot more strategically also to target those dormitories where we are intent on finding out a little bit more about where the level of infection is... as well as to focus particularly on the dormitories where there may only be an isolated number of cases."

That is where the chances of success are greatest in trying to disrupt the chain of transmission, he added.

On the issue of foreign workers who have recovered from COVID-19, Prof Mak said the work is under way to help accommodate fully recovered workers and integrate them back into their community.

Singapore's COVID-19 death rate low, but seniors vulnerable
Among those 80 and older who tested positive, about one in five has not survived infection
By Shivraj Rajendran, The Straits Times, 29 Apr 2020

Singapore's COVID-19 death rate is among the world's lowest, with only about 0.1 per cent of patients succumbing to the illness here.

But the figure turns grim when it comes to older patients.

For those who are 80 and older here who tested positive, about one in five has not survived the virus infection.

At least 39 people in this age group have been infected, and eight have died, accounting for more than half of the 14 deaths that Singapore has suffered so far.

In addition, all 14 deaths involved people aged 64 to 95, showing just how vulnerable older people are to the disease.

Dr Sitoh Yih Yiow, a geriatrician at Age-Link Specialist Clinic for Older Persons, said that seniors are at risk because they have a higher chance of developing severe complications from the virus.

This risk stems from several factors, including a weaker immune system, and a higher prevalence of multiple medical conditions such as heart disease, diabetes, hypertension and chronic obstructive lung disease, he pointed out.

"Older persons tend to have diminished physiological reserves, meaning they are less able to accommodate stressors to the body and, hence, succumb more easily," he explained.

In recent weeks, cases among older persons have emerged from nursing homes and homes for the destitute, where residents are even more vulnerable because they live in groups.

On Monday, the Ministry of Social and Family Development announced a new cluster of infections at Acacia Home, a welfare home for the destitute in Admiralty.

Fifteen cases are now linked to the cluster, which comprises 13 residents and two staff.

While the vast majority of the more than 14,000 infected in the country are workers living in dormitories, these individuals are generally young and healthy, with very few needing oxygen or intensive care.

In addition, through extensive contact tracing and ring-fencing efforts, as well as strict circuit breaker measures, Singapore has been able to ensure that intensive care unit (ICU) facilities have the capacity to cope with any patient who needs such treatment.

But cases in nursing homes and other such care facilities could easily flare up.

In Europe and the United States, for example, they were death traps for residents when infections spiralled out of control.

Associate Professor Kenneth Mak, director of medical services at the Ministry of Health, said yesterday that vulnerable groups are identified quickly, before being removed from an environment where they are at an increased risk of being exposed to the virus.

Nonetheless, some will not do as well, may develop complications, end up in the ICU, or even die, he noted.

"It is therefore important for us to keep a close watch, look for people who are deteriorating, get to them as soon as is possible, and look after them as best as we can."

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