Tuesday, 9 June 2020

New screening centres set up to support expanded COVID-19 testing; wearable contact tracing device to be rolled out by end June

By Yuen Sin, The Straits Times, 9 Jun 2020

As more activities resume and people start interacting more freely, there could be an "inevitable" rise in the number of new COVID-19 cases in the coming weeks.

Singapore's strategy to keep the outbreak under control will hinge on testing more widely and stepping up its contact tracing efforts.

Regional screening centres will be set up progressively across the island to help test targeted groups, particularly vulnerable groups and those at higher risk of contracting COVID-19.

A contact tracing device will also be rolled out by the end of this month, the multi-ministry task force handling the outbreak said at a virtual press conference yesterday.

"We expect that there will be a rise in the number of COVID-19 cases in the coming days and weeks," said Health Minister Gan Kim Yong, who co-chairs the multi-ministry task force. "This is inevitable. We have seen this happening in many other countries as they open their economy and community."

But such risks can be mitigated, particularly with basic hygiene practices as well as active surveillance testing which, he said, is a key enabler of Singapore's overall efforts to reopen safely.

Testing had previously focused on groups such as pre-school staff, residents and staff of senior homes, and construction workers.

It has recently been expanded to include individuals with acute respiratory infection when they first see a doctor, starting with seniors aged 65 and above, among others.

Front-line workers supporting COVID-19 operations will also be tested.

Mr Gan said testing is critical, not just to treat the person who is infected, but also "to identify close contacts so that we can ring-fence (them) quickly to prevent the spread of the disease".

He added: "We also do screening for specific target groups, for example, those who are more vulnerable, such as the elderly in nursing homes, to prevent a cluster from forming."

To support this effort, four regional screening centres have been set up.

Two of these centres - at the Old Police Academy and The Float @ Marina Bay - started operating on June 2.

Two more centres were set up yesterday, at Bukit Gombak Sport Hall and Bishan Sport Hall, while another centre at 2 Bedok North Street 2 - the former Sepak Takraw Sport Hall - is in the pipeline.

The centres will support screening requirements for workers in industries such as construction as well as the marine and process sector.

Mr Gan said that while the number of new cases in the community has remained low, it has "increased somewhat" over the past week - the first week after Singapore ended the circuit breaker. But many of these community cases over the past week were the result of active case finding, he added.

Meanwhile, Minister-in-charge of the Smart Nation Initiative Vivian Balakrishnan said the contact tracing device that will be released would complement efforts to curb the spread of COVID-19. As the Government is focusing on digital inclusion, those who do not have a smartphone will be prioritised, he said.

Explaining that the disease spreads more easily at the start of the illness, Dr Balakrishnan said digital contact tracing can speed up the identification of COVID-19 patients and those with whom they had been in close contact.

The use of such digital tools has helped to speed up the process of contact tracing from two or three days to less than a day, said Dr Balakrishnan.

He added: "Now that we are opening up, we're no longer in a circuit breaker... this ability to move and identify (contacts) quickly has become even more crucial."




Contact tracing device to be rolled out this month
It will not track people's whereabouts, says minister as he addresses privacy concerns
By Hariz Baharudin, The Straits Times, 9 Jun 2020

A new contact tracing device will be rolled out from the second half of this month, as the authorities step up efforts to curb the spread of COVID-19.

Minister-in-charge of the Smart Nation Initiative Vivian Balakrishnan, in explaining the need for such a wearable device yesterday, assured Singaporeans that it is not an electronic tag and will not track people's whereabouts.

Data collected will stay encrypted in the device, dubbed the TraceTogether Token, until the user is confirmed to be a COVID-19 patient. The device will then be handed over to the authorities.

"Then and only then is the data uploaded to the Ministry of Health (MOH)," said Dr Balakrishnan.

The token's introduction comes at a time when contact tracing becomes all the more vital in Singapore's efforts to battle COVID-19 as more activities resume post-circuit breaker.

Explaining that the disease spreads more easily at the start of the illness, Dr Balakrishnan said digital contact tracing can speed up the identification of COVID-19 patients and those with whom they had been in close contact.

For instance, what used to take two to three days - to trace the close contacts of an infected person - now takes less than a day with the use of digital tools such as the TraceTogether app, which uses Bluetooth technology to identify nearby mobile handsets, and the Government's visitor check-in system SafeEntry.

Speaking at a multi-ministry task force news conference yesterday, Dr Balakrishnan said those who do not have mobile phones will be prioritised. The device will be distributed in a similar way to how the Government has given out masks.

The token will work in the same way as TraceTogether, exchanging and logging Bluetooth signals between nearby devices.

Dr Balakrishnan, who is also Foreign Minister, said travellers here could also be asked to participate in TraceTogether. He did not specify if they would be given the token or asked to download the app.

Addressing privacy concerns which have surfaced since the token was announced last Friday, Dr Balakrishnan said: "It is not an electronic tag. "There is no GPS (global positioning system) chip on the device. There isn't even any Internet or mobile telephony connectivity."

Only a small number of authorised personnel will have access to the data for contact tracing purposes, he said.

All public sector data protection rules will apply to the data held by MOH, including abiding by the recommendations of the Public Sector Data Security Review Committee. The recommendations include applying digital watermarking to files to identify the source of any leaked files, and replacing data that may identify individuals with random values in a process known as tokenisation.

The Bluetooth exchange logs will be stored for 25 days on a rolling basis on the token, with much older information deleted automatically.

The token will ensure that people who may not have smartphones, including the elderly and young children, can take part in contact tracing. Also, technical difficulties have prevented the TraceTogether app from working well on iPhones. The token is said to be able to plug this gap.

About 1.8 million users have downloaded the TraceTogether app since it was launched in March, which works out to about 25 per cent of Singapore's population. This falls short of the optimum number of users that is needed for TraceTogether to work well, which is about three-quarters of the population.

Dr Balakrishnan said that for now, the Government will still be adopting the voluntary participation approach, and will not make both the token and app mandatory.


Jump in community cases partly due to stepped-up testing: Lawrence Wong
New daily cases within expectations and situation remains under control
Social gatherings pose 'a different magnitude of risk' of COVID-19 compared to contact on public transport
By Lim Min Zhang, The Straits Times, 9 Jun 2020

Community cases have increased a week after the end of Singapore's circuit breaker period but the situation remains under control, Minister for National Development Lawrence Wong said yesterday.

The jump in cases is partly due to a stepped-up testing regime, and the new daily cases are within expectations, said Mr Wong, who co-chairs the multi-ministry task force tackling COVID-19 along with Health Minister Gan Kim Yong.

During a virtual news conference yesterday, Mr Gan added that with more cases expected in the coming days and weeks, it was important to mitigate the risks, with basic hygiene practices and precautions, and ring-fencing cases quickly with timely contact tracing so that large clusters do not form.

"Some worry that the cases in the community have risen quickly after the reopening. In fact, many of the community cases we have seen in the past week were due to active case finding as we proactively conduct surveillance to test on our target groups," he said, adding that these included residents of homes for seniors and pre-school staff.

Singapore ended its two-month circuit breaker period on June 1, and more activities and businesses started to resume the next day under phase one of the easing of circuit breaker measures.

On Sunday, the Ministry of Health said that the number of new cases in the community increased to an average of eight per day in the past week, compared with four the week before.

Community transmission remains a concern, the Ministry of Health's director of medical services Kenneth Mak said yesterday.

"Just as we let more people come out of their homes, going to work, going about their business, it is still important to remember that we should limit travel outside our home and continue doing that only for necessary purposes."

Mr Wong also responded to suggestions on a possible inconsistency on safe distancing rules, where contact with commuters on public transport is deemed acceptable during phase one, yet more meetings between family members are not allowed.

He said he understood why such comparisons are being made, but that the settings and risks in the two cases are very different.

In phase one of Singapore's reopening, people are allowed to visit their parents or grandparents, who can receive only up to two visitors from the same household once a day. Other non-essential activities and social gatherings continue to be prohibited.

When more people use public transport as they go back to workplaces and schools, it will be difficult, and potentially impossible, to maintain safe distances, said Mr Wong. That is why other precautions have to be taken, such as the wearing of masks, requiring people not to talk on buses and trains, and stepping up cleaning regimes.

"In any case, the public transport journeys are not long. These are transient risks, but with these additional precautions, we are able to minimise the risk further."

Mr Wong added: "But social interactions are of a different magnitude of risk altogether. When we gather together, whether to talk, to interact, to have a meal together, the risks are much higher."

He noted that evidence in Singapore and overseas shows that the vast majority of infected cases are typically spread by a few events that involve social interactions and gatherings. This explains the stricter limits on such social gatherings in phase one, he said.

He urged Singaporeans not to "exploit each and every rule to the fullest possible degree".

"We want to appeal to everyone... really to understand the spirit of the regulation and continue to uphold precautions, stay home wherever possible, minimise contacts to the largest extent possible," he said.

The authorities will continue to monitor the situation over the coming week and decide by the middle of the month whether to move to phase two, where more activities will be allowed to resume.

"If we all do our part to comply with the measures in phase one, we will be able to keep community transmission low and stable through this period, and it gives us a much better chance of getting into phase two early," he said.

Distancing, mask wearing crucial despite mass testing, says task force
By Timothy Goh, The Straits Times, 9 Jun 2020

Even as Singapore rolls out mass testing of its population for COVID-19, safe measures like distancing and mask wearing remain critical to preventing the spread of the coronavirus, said the multi-ministry task force tackling the virus yesterday.

Speaking at a virtual press conference, Health Minister Gan Kim Yong said testing has its limitations due to the disease's incubation period. "So, even if you test the whole population today, it doesn't mean that they are not infected. In fact, some of them would have been infected but the viral load may not have risen to a level that is detectable," said Mr Gan, who is co-chairman of the task force.

This could lead to people who test negative despite having the virus believing that they are "safe" and going about their activities disregarding safe distancing measures, thereby spreading the infection.

While it is not possible to pick up every case in the community, "it is important for us to deploy our testing strategy in a very targeted way, focusing on a risk management approach", said Mr Gan.

His co-chairman, National Development Minister Lawrence Wong, noted that limited testing capacity is an issue as well. "Ideally, we would like to test everyone," he said, but pointed out that even with targeted testing, there are still a lot of people who need to be tested.

For now, mass testing will be done "in a strategic and deliberate manner, based on risk".

Active testing will be extended to those who have been diagnosed with acute respiratory infection and are aged 65 and older, healthcare workers, staff of educational institutions, or students aged 13 and above. Such patients will now be tested immediately instead of having their condition observed for a few days.

Mr Wong said the number of patients with respiratory illness fell from 25,000 to fewer than 5,000 a day during the circuit breaker period, as measures helped suppress not just the spread of COVID-19, but other infectious diseases as well.

However, he said he expects this figure to rise in the coming days.

All patients displaying respiratory symptoms will be tested - "so that's a lot already", Mr Wong said.

"And then, we are going to go and look at different high-risk groups, including workers who are in the front line of COVID operations, construction, marine and process - we are going to test them regularly. We are also going to regularly test vulnerable groups, including nursing home residents," he said.

"And, again, if our test capacity increases, certainly we will bring in more people to be tested."

Mr Wong also noted that recently, at least one asymptomatic case has been detected for every symptomatic case.

Asked if this suggested the need for nationwide testing, the Health Ministry's director of medical services Kenneth Mak said the key to fighting asymptomatic cases is observing safe distancing measures, rather than community testing on a wide scale. "The most important strategy remains the discipline for safe distancing, mask wearing, which aims therefore to protect each and every one of us from people who are asymptomatic... That, in fact, is the most important set of measures that we can take to prevent spread from asymptomatic cases."

Expanded active testing for COVID-19
By Timothy Goh, The Straits Times, 9 Jun 2020

The group of people who will actively be tested for COVID-19 infection has recently been expanded.

It now includes those who have acute respiratory infections and fit any of the following criteria:

• Seniors aged 65 and above

• Healthcare workers

• Staff of educational institutions

• Students aged 13 and older

Younger pupils will be assessed to see if they need a test, as they may require different clinical considerations from those for their older schoolmates.

Patients who have prolonged acute respiratory infections, regardless of their age, are already being actively tested.

Other groups that have already been tested include:

• Staff and residents in residential homes for seniors

• Staff of pre-schools and early intervention centres

Migrant workers returning to work in the construction, marine and process sectors will also be tested.

No need to avoid places visited by COVID-19 patients, says Health Minister Gan Kim Yong
By Hariz Baharudin, The Straits Times, 9 Jun 2020

There is no need to worry about going to venues that COVID-19 patients have visited as these places are safe, Health Minister Gan Kim Yong said yesterday.

He added that the Government releases information about these venues to encourage people who went to these places to watch out for symptoms.

Those who wish to visit these places - which have included supermarket outlets, offices, malls and Mustafa Centre - can do so as the venues would have been thoroughly disinfected, Mr Gan said at a news conference by the multi-ministry task force that he co-chairs.

"Once we identify the patient, and when there is a risk at the venue... we will do a thorough deep cleaning at the affected places to render them safe so that workers and family members can go back and continue where they are," said Mr Gan.

"So, for places like Mustafa Centre or shopping centres that he has been to, there is generally no risk... because (the patient is) no longer there."

The purpose of disclosing information about these venues is not to warn people against visiting them but, rather, to encourage people who have visited them before to monitor their health and get tested if they suspect that they have become infected.

This is especially so because contact tracing efforts here might not be fully exhaustive, given how the majority of people here do not use the national contact tracing app TraceTogether.

The app identifies people in close contact with a COVID-19 patient, via wireless Bluetooth technology. Nearby handsets exchange Bluetooth signals and log the interaction in the app.

"This (information) will help us to encourage people who have been there during that period of time to come forward if you are unwell so that we can administer the appropriate tests to determine whether you have been infected," Mr Gan said.

Minister-in-charge of the Smart Nation Initiative Vivian Balakrishnan, who was also at the news conference yesterday, said that TraceTogether would come in useful in instances where people cannot remember if they had visited a venue that would have put them in close contact with an infected patient.

He had earlier given details about a new device called TraceTogether Token, which will allow those without mobile phones or who are not able to use the app to participate in contact tracing efforts here.

Number of tests fluctuates daily based on group to be tested
By Timothy Goh, The Straits Times, 9 Jun 2020

The number of COVID-19 tests carried out may fluctuate from day to day, depending on which group of people is scheduled to be tested, the Ministry of Health's (MOH) director of medical services Kenneth Mak said yesterday.

He was explaining why MOH has said, on several occasions in its daily case updates, that fewer tests had been conducted, leading to a lower number of reported cases.

Associate Professor Mak said the reason fewer tests were done on certain days is not that Singapore has changed its tempo of testing, but that tests for COVID-19 are done across different settings.

For instance, in dormitories, tests are carried out to ensure blocks of foreign workers are infection-free so that they can return to work.

Sometimes, the number of workers tested may vary each day, depending on the group of people scheduled to be tested and the way in which their tests are scheduled, he said.

"And depending on which dormitory is allocated for that particular day, you may end up with more in a particular day, fewer on other days," he added.

Prof Mak also said the laboratory which had calibration issues with its apparatus last month, which led to 33 false positives, has since resolved them and is continuing to help test cases.

Additionally, all laboratories in Singapore participate in a quality improvement programme on a weekly basis.

This helps to ensure that their processes are up to speed, and their tests are of an appropriate quality.

The multi-ministry task force tackling the spread of the coronavirus had said previously that it aimed to ramp up its testing rate to 40,000 tests a day.

However, the task force's co-chair, Minister for National Development Lawrence Wong, noted yesterday that testing will continue to be done in a targeted manner, with high-risk groups being prioritised.

As of June 1, over 408,000 tests, or 71,700 tests per million population, had been carried out.

In a statement yesterday, MOH said: "COVID-19 testing is a key enabler of the Government's overall efforts to safely reopen after the circuit breaker... over the past months, our national capacity to conduct tests for COVID-19 has been ramped up steadily."

Coronavirus: Cross-border travel talks with Malaysia under way but safety still a priority
By Yuen Sin, The Straits Times, 9 Jun 2020

Even as Singapore and Malaysia discuss how travel can be safely resumed, it is "quite clear" that they will not return to the pre-pandemic situation of large numbers of commuters "freely" crossing the border each day, National Development Minister Lawrence Wong said at a virtual news conference yesterday.

But while Singapore hopes to see a resumption of travel and welcomes travellers, safety remains a key priority, Mr Wong said in response to a question on when and how Malaysians will be allowed to come into Singapore to work.

This comes after Malaysia's Senior Minister Ismail Sabri Yaakob announced yesterday that Malaysians working in Singapore can travel and resume work here once both governments reach a resolution on the matter. Malaysians can undergo COVID-19 screenings before resuming work in Singapore, if that is among the conditions, he added.

Mr Wong said the resumption of travel in a safe way "would mean looking at testing protocols in place on both sides before the travellers can come back and forth".

If not everyone can be tested, then a combination of strategies may need to be deployed, including requiring some groups to serve out a quarantine period upon arrival, he added.

He said the Singapore authorities are still in the midst of working out details with their Malaysian counterparts, including the number of people who will be allowed to travel between the countries and the industries that will be allowed to travel for work.

What is clear is that travel between Singapore and Malaysia will not return to the state it was in before the circuit breaker, or before COVID-19 hit, the minister stressed.

"We are not talking about large volumes, daily commuters coming in and out freely... We are talking about resumption of travel but in a controlled manner and in a safe manner for both sides, and that is in our mutual interest."

Singapore residents returning from China to serve 14-day stay-home notice
By Tee Zhuo, The Straits Times, 9 Jun 2020

Singapore residents returning from China under the new "fast lane" agreement between the two countries will have to stay at home for 14 days.

If they keep to this and other terms of the agreement, they will not need to pay coronavirus-related medical bills at public hospitals. The bills are being borne by the Singapore Government for now.

The fast-lane agreement, which exempts visiting essential-business travellers from both sides from quarantine requirements of up to 14 days, started yesterday.

Quarantine orders isolate those suspected of carrying, or known to carry, an infectious disease either at home or at hospitals and dedicated facilities, and are legal orders with severe penalties if they are breached.

Those on a stay-home notice are not allowed to leave their homes.

The fast-lane agreement with China is part of Singapore's plans to gradually reopen its borders by slowly easing restrictions on flights and resuming trade.

The new scheme applies only to business and official travel, for flights between Singapore and six regions in China: Shanghai, Tianjin, Chongqing, Guangdong, Jiangsu and Zhejiang.

Among other requirements, travellers also have to seek approval from the authorities and adhere to a submitted itinerary.

Answers to frequently asked questions on the SafeTravel Pass website launched yesterday said the fast lane is not for long-term work or study.

Singapore residents - citizens, permanent residents and long-term pass holders - who wish to enter China for purposes other than essential business or official travel should contact the Chinese Embassy here for more details.

Fast-lane travellers departing for China must take a swab test within 48 hours of their departure, and get a health certificate that states they have tested negative for COVID-19.

For now, such tests can be conducted only at select clinics from Raffles Medical Group at Changi Airport Terminal 3, HarbourFront Centre, Holland Village, Raffles City and Shaw Centre.

The website added that travellers should expect to pay $180 to $200 for the pre-departure test, and the amount is not payable by Medisave, MediShield Life or Integrated Shield Plans.

Upon arrival in China, fast-lane travellers will have to go through a swab test and a serology test, and will then be quarantined in a designated area for one to two days until the test results are ready.

If found to be COVID-19 positive, the traveller will be given medical treatment. The costs of the tests, stay at the designated location and medical treatment will all be borne by the traveller.

Both tests have to be negative before the traveller can proceed with travel plans in China.

Travellers do not need to take another swab test in China before they return to Singapore.

• Those who need more information can visit safetravel.ica.gov.sg or e-mail covid_safetravelpass@mti.gov.sg

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