Friday, 29 May 2020

Singapore could move to Phase 2 of COVID-19 reopening before end-June 2020

Task force fleshes out plans for next steps in reopening Singapore economy
It will decide in mid-June whether to move to phase two of process by end of the month
By Lim Min Zhang, The Straits Times, 29 May 2020

Even as Singapore prepares for the lifting of the circuit breaker measures on Tuesday, 2 June, a ministerial task force yesterday fleshed out plans for how the country might move on to phase two of opening up the economy by the end of next month.

National Development Minister Lawrence Wong said that a decision will be made in mid-June on whether conditions are right for Singapore to allow a broader range of activities by the end of the month.



This move into phase two of Singapore's calibrated reopening will hinge on keeping the community spread of COVID-19 low and stable over the next two weeks, he said, adding the caveat that the time-line could change, given how fluid the situation is.

If this timeline is given the go-ahead, then, subject to restrictions, people will be able to dine in at food outlets, exercise at stadiums, visit swimming pools and have small gatherings before the end of next month.

"We will decide by the middle of June on whether we want to take the next step to move to phase two," said Mr Wong, who is co-chair of the multi-ministry task force tackling the coronavirus pandemic.



But for this to happen, fellow co-chair and Health Minister Gan Kim Yong stressed the importance of exercising caution even after Tuesday, when Singapore exits the circuit breaker and enters the first phase of its reopening: "I think if we start with a big bang party, we are going to get into trouble."

About 75 per cent of the economy can resume operations in phase one, which the authorities had earlier said would last four to six weeks but may now give way to phase two earlier. In the first phase, schools will gradually restart, and more Singaporeans will return to workplaces, though dining in will still not be allowed.



Almost the entire economy is expected to reopen in phase two. Retail shops and consumer services can open for business, but masks will still be compulsory for anyone stepping outside his home.

Eateries will reopen but no more than five diners will be allowed per table at food and beverage outlets, including hawker centres. Tables will have to be placed at least 1m apart.



Mr Wong said people will be able to catch up with their friends and relatives, but social gatherings will be capped at five per group. He said the number struck a "reasonable balance" between the risks involved and allowing families to meet.

Meanwhile, some activities - which involve close contact in enclosed spaces - are deemed to carry higher risk of transmission and may be allowed to resume only later in phase two, when sufficient safety measures are in place. These include going to cinemas, religious services, bars and clubs.

"All of these venues, based on our experience and overseas experience, have been instances where there have been cases of transmissions in such settings, and so we want to take a more cautious approach for activities in these areas to resume," said Mr Wong.

Stressing that things can change if the situation worsens, he added that the task force was sharing its plans so that businesses can start planning ahead. "But importantly, those that are looking ahead to reopen should make use of this time now to start preparing and putting in place all the necessary safeguards and precautions."



Asked if the timeline had been moved forward on account of pressure from businesses, Mr Wong said the timeline "is premised on what we think is safe to do from a public health point of view".

Meanwhile, Singapore announced a change in discharge criteria for its COVID-19 patients. Mr Gan said all those who are assessed to be clinically well by the 21st day of their illness can be discharged. Previously, they needed two negative swab tests, 24 hours apart.

As a further precaution, these patients must stay at home or in their dormitories for a further seven days.




















Almost entire economy to reopen under phase two
But certain high-risk locations, activities may not resume immediately: Lawrence Wong
By Timothy Goh, The Straits Times, 29 May 2020

Phase two of Singapore's exit from the circuit breaker will entail the resumption of a wider range of activities and the reopening of almost the entire economy, said National Development Minister Lawrence Wong yesterday.

But certain high-risk locations may not reopen immediately, he added at a virtual press conference.

Around 75 per cent of the economy will resume operations in phase one next Tuesday, after the circuit breaker ends.

Mr Wong, who co-chairs the multi-ministry task force tackling COVID-19, said the authorities will monitor the situation in the first two weeks of next month before deciding whether to proceed to phase two. "If the community transmission (and) infection rates over these two weeks remain low and stable, then we will decide by the middle of June whether we want to take the next step... And that means that phase two could happen before the end of June," he said.



Phase two will see the reopening of retail shops and consumer services, as well as sports facilities such as stadiums and swimming pools.

Wearing masks will remain compulsory when leaving the home, but social gatherings and dining in at food and beverage outlets will be allowed in groups of five or fewer.

Households may receive up to five visitors per day as well.

However, higher-risk activities and locations such as religious services, art galleries, libraries and museums may not reopen as quickly.

The same goes for large-scale events and venues such as conferences, exhibitions, concerts and trade fairs, as well as entertainment venues such as bars, nightclubs, karaoke outlets, cinemas and theatres, along with other indoor and outdoor attractions.

Said Mr Wong: "All of these venues and settings, based on our experience and overseas experience, have been (settings) where there have been cases of transmission... so we want to take a more cautious approach."



The authorities will discuss the various safeguards that need to be put in place with the relevant businesses and organisations, and work out the precise timing when they can resume activities within phase two, he added.

"They may not all resume at the start of phase two, but if they have the safeguards and precautions in place, they could resume later, but still within phase two," he said.

Asked if the move to phase two was being accelerated due to calls from businesses which want to reopen early, Mr Wong said the timeline was, in fact, consistent with what was previously announced.

"It's still within the timeframe that we have been talking about. It's just a little bit more clarity now on what people can expect in terms of the coming weeks," he said.



Health Minister Gan Kim Yong, who also co-chairs the task force, said restrictions may be tightened again, depending on the situation.

This might take the form of targeted, specific controls, rather than a broad circuit breaker approach.

Mr Wong also cautioned that the start date of phase two is contingent on infection numbers remaining low and stable.

Thus far, Singapore seems on track for a move to phase two before the end of next month, he said.



However, he warned: "But anything can happen. You know how the virus is. You know how the situation is... I think all of us are fully aware that things can be fluid and completely unpredictable."

He said: "It is even more important for everyone to take responsibility for their actions." He added that the likelihood of transmission will rise with more activities.

"So it's all the more important for us to stay vigilant... Do not just rely on government measures or government rules. All of us have to do our part as individuals."

























MOH revises discharge criteria for COVID-19 patients, those who are well by day 21 can be discharged
They must remain in their home or dorm for next 7 days; changes take immediate effect
By Linette Lai, Political Correspondent, The Straits Times, 29 May 2020

Coronavirus patients who are clinically well by the 21st day of their illness will be discharged, as more scientific evidence shows they are no longer infectious.

But as a precaution, these people will have to stay at home or in their dormitories for another seven days, Health Minister Gan Kim Yong said yesterday.

They will be allowed to return to work after day 28.

"This revised approach will allow recovered patients who are well and no longer infectious to return to the community in a timely manner," Mr Gan said at a press conference, adding the change will take immediate effect.

However, this will not apply to patients with weakened immune systems, who may continue to shed viable virus for a prolonged period.

The Ministry of Health (MOH) had previously required patients to test negative twice over 24 hours before they could be discharged, even if they had not been ill for some time.

But local and international scientific evidence has since shown that the virus is no longer viable after the second week of illness, even though tests may pick up traces of the virus' genetic material and therefore yield a positive result.

Patients are not likely to be infectious after day 14, and are not infectious by day 21, MOH said.



Professor Leo Yee Sin, who is executive director of the National Centre for Infectious Diseases, also highlighted three local studies on the subject.

The first study, involving 18 people, showed that virus shedding is highest during the early onset of clinical illness.

Another study showed that seven in 10 patients test negative for the virus by day 21, with more than nine in 10 testing negative by day 33.

This shows that a very small number of patients continue to test positive for a long time, Prof Leo said.

The final study found that once the viral quantity in a patient's respiratory sample dropped to a certain level, the virus could no longer be cultured. This happens around the 10-or 11-day mark.

"So if we were to take all this scientific information together, we are confident to say that by the time (patients) reach day 11, and by the time they reach two weeks of their clinical illness, we no longer have any viable virus that we can culture from the respiratory sample," Prof Leo said.

The World Health Organisation recommended on Wednesday that it is safe to discharge coronavirus patients 10 days after their symptoms first appear, if they remain symptom-free for at least another three days after that.



Singapore is requiring that patients stay isolated even longer than that, said Associate Professor Kenneth Mak, MOH's director of medical services.

"So it's a really with an abundance of caution that we have put together a protocol that allows us now to safely move away from needing to test every individual before we discharge them," he said.

Other countries have also begun using or recommending similar criteria to discharge COVID-19 patients. They include Estonia, Ireland, the United States and Britain.

These countries have typically discharged patients between seven and 14 days from the onset of their symptoms, MOH said.

South Korea discharges asymptomatic patients from isolation three weeks after they have been diagnosed with the disease.










New criteria for discharge will free up testing capacity
By Linette Lai, Political Correspondent, The Straits Times, 29 May 2020

The decision to discharge clinically healthy COVID-19 patients without the need for further tests will free up testing capacity, said Associate Professor Kenneth Mak.

This means that more tests can be diverted to the diagnosis of migrant workers in dormitories, for example, or to screen staff looking after vulnerable seniors.

"There will be some realignment of our strategies to accommodate the increase in capacity we now have," said Prof Mak, the Ministry of Health's director of medical services.

Yesterday, the ministry announced that it will discharge all coronavirus patients considered to be clinically well by day 21 of their illness.

Previously, patients had to test negative twice over 24 hours before they could be discharged, even if they had not been ill for some time.



Apart from diagnosis, some of the freed-up testing capacity will be used to ascertain the prevalence of COVID-19 in dormitories, Prof Mak said.

It will also be used to ensure that workers are clear of the virus so that they can return to work as Singapore prepares to ease circuit breaker restrictions and restart its economy.

Prof Mak stressed that Singapore is continuing to test at a "high rate".

More than 330,000 tests have been carried out for more than 210,000 individuals so far. This works out to more than 58,000 tests per one million population.

"So, we have never stopped aggressively testing," he said. "It is just that the strategy, where we prioritise, might change now that we have some free capacity that we can divert for other priorities."

Health Minister Gan Kim Yong said that Singapore's testing strategy will change over time, depending on its objectives.

"So, as we begin to open up more in our economy and our community, I think regular testing of workers will become increasingly important," he said.

"This will allow us to identify, to pick up cases in the community early, so that we can prevent a surge of cases in the community and also prevent the emergence of clusters."

In response to a question on how many patients will be allowed to go home under the new discharge criteria, Prof Mak said the total number had not yet been worked out.

"But I would imagine that there would be a few very happy patients... who would be looking forward to being able to go home, after having spent weeks in one of our community care facilities," he said.















Coronavirus: 13 pre-school staff have tested positive but at least 11 are old infections
By Toh Wen Li, The Straits Times, 29 May 2020

Thirteen pre-school staff have tested positive for COVID-19 since active screening for that group began this month, said the Health Ministry yesterday.

However, subsequent testing showed that 11 of these were old infections and the staff had recovered - meaning they were no longer infectious, said the ministry's director of medical services Kenneth Mak during a virtual press conference.



Results of the serology test, which detects antibodies to tell if a person has been infected, are pending for two staff.

Patients have antibodies around two weeks after they recover from the infection and will not have them at the point of infection.

More than 39,000 pre-school staff have been tested for the coronavirus so far. Of these, 13 staff - about 0.033 per cent - have tested positive.

All pre-school staff have to undergo a one-time swab test for COVID-19 as a precautionary measure before the centres reopen next month.

"The results of the serology tests, together with the polymerase chain reaction tests that we performed, were then critically evaluated. The evidence suggests that these are not active, fresh infections, but old infections," Associate Professor Mak said.

"The test results suggest that these staff members have all recovered from the infection. As a result, it is our evaluation... that none of these staff members is currently a risk to either other colleagues within the pre-school setting, or to the children who are supported and cared for by pre-school staff. And this, of course, means that they are not infectious."

He said the authorities are unable to say for sure when these people had been infected. The majority of the staff were asymptomatic.

"It reaffirms our assessment that previously, prior to the circuit breaker, there was some level of community spread. But with the circuit breaker in place, we've seen the number of community active cases coming down very significantly, consistent with our assessment that the circuit breaker has been effective."

The country's circuit breaker measures will be eased in three phases from next Tuesday.














Dining in, meeting friends allowed in phase two, but capped at groups of 5
By Timothy Goh, The Straits Times, 29 May 2020

When phase two of the post-circuit breaker measures kicks in, people will once again be allowed to dine in at food and beverage outlets, meet friends and visit family members.

But they will be allowed to do so in groups of only five or fewer, said National Development Minister Lawrence Wong at a virtual press conference yesterday.

Dining in at eateries and meeting people outside one's household have generally been prohibited since April 7, the first day of circuit breaker measures aimed at stemming the spread of COVID-19 here.



In the lead-up to the circuit breaker, people were allowed to gather in groups of only 10 or fewer, as part of social distancing measures.

But Mr Wong, who co-chairs the multi-ministry task force dealing with the pandemic, said: "We are not going back to pre-circuit breaker (regulations) precisely, in fact, we are going to be a little bit tighter."

The new regulations will mean that if a household of more than five people wants to dine in at an eatery, they will have to sit at separate tables, said Mr Wong.

Tables at these establishments will also have to be placed 1m apart from one another.

Those who wish to visit their relatives can do so in a group of only five or fewer but, in a loosening of measures from phase one, visitors can be from different households.

When asked how the task force had decided on a group size of five, Mr Wong said: "There is really no magic number. You can set two, you can set five, you can set eight, 10, and if you look around the world, you will find different countries setting different numbers.

"We think that five is a reasonable balance, looking at the assessment of risks and the assessment of the situation that we are in today."

He added that if the authorities were to permit groups of up to 10, as was the case pre-circuit breaker, it could potentially lead to the formation of larger clusters.

"Because there are 10 people, each person may have another 10 contacts, then all that multiplies."



On the other hand, limiting social gatherings or dining in to just two people might be "a little bit too tight" as it may prevent many families from gathering.

"So the balance we struck was about five," said Mr Wong.

He added that the number was not static.

"Of course, as we progress along phase two... as we gain confidence that the virus is under control, the infection rate remains stable, then over time, that number can increase to a larger number. But we will start with five as the rule."










Job security of migrant workers depends on employers, economy
By Toh Wen Li, The Straits Times, 29 May 2020

The job security of migrant workers who return to work after quarantine will depend on their employers and the state of the economy, National Development Minister Lawrence Wong said yesterday.

He was responding to a question from a reporter who noted that migrant workers, such as those in quarantine dormitories, are worried about their future.

"We will take care of the migrant workers during this period when they are in quarantine. That is our commitment," Mr Wong said at a virtual media conference.

"But once workers are recovered and are released to the workforce to work, then whether or not they will continue to work depends on the employers."



Mr Wong said the same holds true for Singaporean workers.

"Because if the state of the economy remains dampened, and demand is weak, it may very well be possible that employers might decide to slow down... businesses may fold," he noted.

Singapore is heading for its worst recession since independence. The economy, which has been hit hard by COVID-19, is projected to shrink by 4 per cent to 7 per cent this year.

The $33 billion supplementary Budget announced on Tuesday - the fourth Budget this year - aims to cushion the economic fallout by creating 100,000 jobs and training opportunities for local workers, among other support measures.

Mr Wong said: "For expatriates, for pass holders, for migrant workers who are here, if indeed (retrenchments) were to happen... they can certainly try and find other opportunities if there are employers who are looking to hire. But if the state of the economy is weak... (if they are) unable to find jobs, they may decide to go back."

More than 33,000 people in Singapore have been infected with the coronavirus, the majority of whom are foreign workers living in dormitories. Many live in crowded spaces, and rights groups have called on the authorities to improve their living conditions.

Plans to improve the living conditions of foreign workers remain a work in progress, Mr Wong said.

"We are certainly in the process of looking at building new dormitories for migrant workers, and these new dormitories will be built quite soon," he said, adding that these new spaces could have a lower density of occupants.

Dormitories in Singapore have been designed for communal living, with shared facilities, but "in this new environment, we will have to design (them) in a very different manner", he added.

"We are getting designers, architects (to think) about how the new dormitories can be designed for the well-being of migrant workers, but also to ensure that the infection controls are raised to a much higher level."

New facilities will be built to house migrant workers who are mildly ill or no longer infectious, the Manpower Ministry said earlier this month, adding that many of these spaces will be in dormitories most severely affected by the outbreak.

New dormitories will also be constructed to house some of the healthy and recovered workers.




















Singapore in talks to set up 'travel bubbles' with countries where COVID-19 is under control to allow essential travel, no leisure travel yet
Testing, contact tracing measures for business travellers as curbs are eased
By Cheow Sue-Ann, The Straits Times, 29 May 2020

New measures and procedures such as compulsory testing will be put in place as Singapore looks to progressively ease restrictions on essential business travel. The plan is to establish "green lanes" and "travel bubbles" with countries where COVID-19 is under control, said National Development Minister Lawrence Wong.

He stressed, though, that mass travel will still be out.

Mr Wong, who co-chairs the multi-ministry task force on COVID-19, said protocols for essential travel would include testing travellers leaving and entering Singapore.



"With these testing protocols in place, we can have assurance that the traveller is free from infection, and then essential travel can resume, step by step, depending on the countries that we have established these green lanes or travel bubbles with," he said.

A traveller entering Singapore will first have to undergo a pre-departure COVID-19 test to determine if he is infected, or a serology test if he had been infected before. On arrival here, another test might have to be done, Mr Wong said.

Visitors will also have to download the TraceTogether app or carry a wearable dongle to ensure that contact tracing can be done quickly if needed.

These measures will ensure that Singaporeans can continue to work, not just here but in places where they need to travel for business, Mr Wong said.

He noted that while these protocols will allow essential travel to resume, mass travel "will take a lot longer to resume, not just in Singapore, but also internationally".

The discussions with other countries to establish "travel bubbles" and "green lanes" are currently at varying stages, with some at more advanced levels while others have just commenced, he added.

Details will be announced when agreements have been reached.

Essential work travel agreements are given priority because these are important for the economy, for businesses and to protect jobs for Singaporeans, Mr Wong said.

"Because if a business says, 'Look, my people cannot move around, then I might as well relocate to another country', then jobs will be lost."



Still, Mr Wong stressed that even with such arrangements, the number of travellers will be limited and quotas set. "We will have to prioritise who can travel for such reasons."

For those who have family members or spouses who are living overseas, allowances are already in place to allow people to come back, Mr Wong said.

This is subject to a quota as returnees must serve a 14-day isolation at dedicated facilities, which have limited capacity.

He added: "So, as we look at the situation, if our facilities expand... if our testing capacity expands, then potentially the daily quota for returnees coming back can increase as well over time."














Singapore, KL in talks to ease border curbs, but with safeguards in place
By Cheow Sue-Ann, The Straits Times, 29 May 2020

Singapore and Malaysia are in talks to ease travel restrictions, with the necessary protocols and measures in place, said National Development Minister Lawrence Wong.

He said: "For Malaysia, it's also more than just about business travel by air; there's also the issue of workers moving up and down through our land crossing."

Mr Wong noted that while Malaysia still has its movement control order and Singapore has the circuit breaker in place, eventually both countries will have to see how best to accommodate workers who want to travel between both sides in a safe manner.

He said: "We'll look at putting in place the necessary protocols, whether it's testing of workers, or for that matter, having them subject to some quarantine arrangements when they come in and out.

"The bottom line is that there will need to be new safeguards and precautions."

Mr Wong noted that even after travel restrictions between Malaysia and Singapore are eased, the situation will not return to how it was before when large volumes of people moved through the land crossings.

"I don't think either side would want to see that happen without any safeguards or precautions," he said.

"If we will have all that in place, we should be prepared that the volume of people sort of commuting daily will likely come down."





























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