Thursday, 14 May 2020

COVID-19: Singapore to test all 300,000 migrant workers living in dormitories

20,000 migrant workers to recover and be discharged by end-May 2020
By Yuen Sin, The Straits Times, 13 May 2020

By the end of the month, 20,000 migrant workers who were infected with COVID-19 will be discharged from care facilities, and more are expected to recover in June, National Development Minister Lawrence Wong said yesterday.

This is about 80 per cent of the total number of infections here currently, which reached 24,671 yesterday, 12 May.

"Our aim is to make sure that as far as possible, all migrant workers are free of infection before resuming work when their sectors gradually reopen," added Health Minister Gan Kim Yong at the same press conference.

So far, 1,735 migrant workers have recovered and been discharged, and significantly more are expected to enter the recovery phase in the coming weeks, said the Ministry of Health (MOH).

There are more than 300,000 workers in dorms and the authorities plan to test them all "to make sure that they are free from infection", Mr Wong said. The testing process is under way and may be completed only by June or July.

More than 32,000 workers from dorms have already been tested. How long the process takes will depend on how much Singapore can ramp up its testing capacity, for example, said Mr Wong.

Discharged workers will return to their dorms or be transferred to other temporary accommodation.

Brigadier-General Seet Uei Lim, who leads the inter-agency task force handling the outbreak in dormitories, said that more than 20,000 workers have been moved into alternative sites so far.

This includes healthy workers in the essential services, workers who have completed quarantine orders and some recovered workers.

By the end of June, about 40,000 workers can be housed in such temporary accommodation, BG Seet said.

All foreign workers in dorms to be tested for COVID-19
By Yuen Sin, The Straits Times, 13 May 2020

All 323,000 foreign workers staying in dormitories will be tested for COVID-19 to ensure they are free of the virus before they resume work in the community and return to their dorms, said National Development Minister Lawrence Wong.

This will be done through the use of mass polymerase chain reaction (PCR) tests and mass serological tests, said Mr Wong, as he outlined the Government's "systematic" approach to ensure that dormitories are clear of the coronavirus.

First, serology tests, which can detect if an individual has had COVID-19 in the past, will be applied to dorms with high infection rates, he said at a virtual press conference yesterday.

The Ministry of Health (MOH) said workers with a positive serological test would have been infected in the past - at least 10 to 14 days ago - and would no longer be infectious after a period of isolation.

"After a period of isolation, we can assume they've recovered from the virus," said Mr Wong, who co-chairs the multi-ministry task force tackling the pandemic.

Serological tests detect the presence of antibodies to the virus in the bloodstream. Antibodies are evidence of the body's reaction to an infection, and show that a person was previously infected. Their presence might also suggest the person is now immune to the virus.

PCR tests will be done on workers who test negative in the serology tests, and for those in other dormitories without high infection rates.

PCR technology detects the presence of viral genetic material in patient samples. Such tests will be applied individually or in batches.

MOH said such pooled tests involve combining swabs of up to five individuals in one laboratory test, which does not affect the sensitivity of the tests.

Where a pooled test is positive, the original five individuals could be retested individually to identify the infected person. This is an effective strategy if used where infection prevalence rates are likely to be low, said MOH.

Since such dormitories are not likely to have many infected, this approach should reduce the number of tests required.

As a PCR test cannot detect the virus when it is in incubation, a worker who tests negative the first time will be subjected to a 14-day isolation period, said Mr Wong.

The worker will need to have a second negative result after the isolation period to be confirmed clear of the virus.

About 3,000 tests are now being done daily in the dorms, and that number will be stepped up in the coming weeks, said the minister.

So far, more than 32,000 workers in dorms have been tested - about 10 per cent of such workers.

It could take several weeks - going into next month or July - to complete the testing process, said Mr Wong.

How quickly the testing can be completed hinges on several factors, including the extent to which Singapore can ramp up its testing capacity and whether the workers need to be isolated or quarantined.

This testing is being done dormitory by dormitory, rather than by sectors, Mr Wong added.

Asked for an estimate of the percentage of workers in dorms who would have tested positive for COVID-19 by the time the testing process is completed, Mr Wong said the true underlying prevalence rate will be known only when all tests have been completed.

If the true prevalence rate is low, the dormitories can be cleared of the virus faster, he said.

But if it is high, more steps will need to be taken to isolate and quarantine workers.

When the workers in dorms resume work, the Government will put in place a regime to test them on a regular basis, Mr Wong added.

This testing regime will also apply to workers in the construction sector who are living outside dorms and serving stay-home notices, he said.

"(This is) because we do not want to have a recurrence of clusters forming among construction workers in particular, now that we have identified this as an activity that could potentially result in large clusters forming," he said.

Government to absorb additional operational costs for dormitory operators during circuit breaker
By Tan Tam Mei, The Straits Times, 12 May 2020

The Government will be footing the bill for the increased operating costs incurred by dorm operators due to the dormitory lockdowns and stay-home notices imposed on some 300,000 foreign workers across Singapore.

Restricted movement measures that confine this group to their places of residence have resulted in additional costs, with dorm operators reporting a spike in utility bills and difficulties in finding manpower to support the sanitation and safe distancing measures required.

Responding to queries from The Straits Times, the Ministry of Manpower (MOM) said yesterday that the Government will offset the increase in operating costs for operators of purpose-built dorms, factory-converted dorms and construction temporary quarters owing to the longer hours workers now spend in their residences.

These include additional costs for manpower, cleaning, maintenance, utilities and infrastructure incurred because of the restrictions imposed on the workers as part of the efforts to stem the spread of COVID-19 in the dormitories.

However, the support is only temporary and "in view of the ongoing COVID-19 infections in the dormitories", said the ministry.

Said the MOM: "When the support is eventually withdrawn, it will be necessary for dormitory operators to recoup many of these additional costs from their tenants."

According to a notice sent out to dorm operators last week, the support will last until the end of the circuit breaker which is scheduled to be lifted on June 1.

To get the subsidies, dorm operators will have to provide receipts for their "business-as-usual" expenses as well as for the months that saw increased operating costs.

To qualify, dorm operators will also have to declare that they did not raise rental fees throughout the circuit breaker period.

The subsidies come as a relief for dormitory operators as many have had to scale up cleaning, security and administrative operations and take on new tasks, like food dispatching, often on short notice.

Operators that ST spoke to in the last few days said they have experienced rising operational costs but would not be increasing rental fees.

Mr Stephen Ong of Draco Venture, which operates North Coast Lodge, was initially worried about the increasing overheads.

In the last two months, the purpose-built dorm near Woodlands that houses 7,000 residents has seen its utility bills double. Garbage disposal expenses have also increased seven times, noted Mr Ong.

Mr Kong Chee Min, chief executive of Centurion Corporation, which manages the Westlite dorms, said the pandemic forced a steep learning curve on dorm operators.

It has not been easy to employ additional manpower in dorms at such short notice, especially because they are considered high-risk locations. Centurion has instead employed some of its residents to help out, said Mr Kong.

The risk of COVID-19 infection has also caused some of Labourtel Management Corporation's employees in its four purpose-built dorms to resign, said its director Shaik Mohamed.

"We have staff who face increased pressure from their families to not report to work given the risks and we have also had a fair amount of resignations," he said.

These fears were not unwarranted.

Already three of North Coast Lodge's staff members have tested positive for the coronavirus and one of them is over 60, said Mr Ong.

"Our team members can never be compensated for the life-threatening infection risk they are taking every day," he added.

Foreign workers living in dorms account for the vast majority of COVID-19 cases in Singapore.

There were 486 new cases in Singapore yesterday, taking the total count to 23,787.

Technology to help foreign workers in dorms monitor health amid COVID-19 pandemic: Josephine Teo
Access to telemedicine, devices to check blood oxygen levels among measures
By Goh Yan Han, The Straits Times, 11 May 2020

With the management of foreign workers in dormitories entering the recovery phase, the workers are being given help to monitor their health through telemedicine and a gadget that checks blood oxygen levels.

About 8,000 pulse oximeters have been distributed so far and a further 12,000 will be given out, said Manpower Minister Josephine Teo yesterday.

The devices monitor a person's blood oxygen level and can help detect early signs of a deterioration in health.

Monitoring is seen as the next step in containing the virus, which has predominantly affected foreign workers.

"Now, having stabilised the situation as well as strengthened the medical support, we now need to plan for the next phase," said Mrs Teo.

The idea is to help workers make a full recovery and resume work safely to get the economy back on track. It is the third phase of the strategy that Singapore has rolled out to deal with migrant workers who have accounted for most of the COVID-19 cases here.

The first phase involved safe distancing measures in dorms and relocating essential services workers, while the second phase involved putting a medical support plan in place. About 40,000 medical consultations involving foreign workers took place last month through this plan.

Migrant workers continued to account for a majority of the 876 new cases reported yesterday, which brought the total count in Singapore to 23,336. The focus is now on the third phase.

"A very important aspect of this recovery phase will be how to strengthen the health monitoring and the health surveillance in our dormitories in particular," said Mrs Teo, who was speaking during a visit to JTC Space @ Tuas, where a carpark that has been converted into a medical post for foreign workers will be operational from today.

A medical post has doctors and other staff on duty to address the healthcare needs of foreign workers who have acute respiratory infection symptoms such as fever and cough.

"We are introducing new measures that will help us... do the health surveillance... in a more comprehensive way," said Mrs Teo.

"We hope that by doing so, we will be able to help the individual worker prevent a recurrence if he has already been infected, or for those who have not been infected, to prevent them from falling sick in the first place."

The monitoring process includes teleconsultation services available to workers in dormitories through their mobile phones. They can fill in an online form and a doctor will video call them back in two hours. Around 400 such consultations have been conducted since April 25.

The doctors are from the nine private healthcare providers under the Ministry of Health's regulatory sandbox.

Teleconsultation services will be available even when on-site medical facilities or external Public Health Preparedness Clinics are closed for the day.

Singapore has also been focusing on beefing up medical facilities for migrant workers so that the healthcare system does not get overwhelmed.

The JTC Space @ Tuas medical post is the fifth of its kind, and between them they can cater to around 75,000 foreign workers in factory-converted dorms and temporary on-site quarters.

All 43 purpose-built dorms have their own medical facilities to cater to 200,000 workers.

There are also eight telekiosks in dorms, with more to come to ensure round-the-clock access to a doctor. "We don't want the workers to wait until they are so unwell to seek medical attention," said Mrs Teo.

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