Friday, 3 July 2020

Phase 2 of Singapore's COVID-19 reopening will likely stay in place for months

By Calvin Yang, The Straits Times, 3 Jul 2020

Restrictions such as limiting gatherings to groups of five people or fewer will likely remain for some time despite more activities resuming under phase two of Singapore's reopening, National Development Minister Lawrence Wong said yesterday.

Mr Wong told a virtual press conference that phase two, which started two weeks ago, will run for months before the next level kicks in.

"And what do 'months' mean? It's really hard to pinpoint at this stage, because we are just two weeks into phase two. It's still early days," he added.



Although the multi-ministry task force tackling COVID-19 had earlier pointed to some rules that may be relaxed during this phase, Singapore is "not moving to any such relaxation any time soon".

"These sorts of things are unlikely to happen any time soon," said Mr Wong, who co-chairs the task force with Health Minister Gan Kim Yong. "That was the assessment earlier. It remains the same assessment today."

Large-scale events, such as concerts and conferences, will not be allowed to take place, and venues like bars and pubs have to remain closed.

Infection numbers are expected to increase as more activities resume, said the task force, which is casting a wider net around virus cases and testing more aggressively.

It does not rule out tightening some measures if case numbers rise much faster than expected or when large clusters pop up.



Mr Gan said that current numbers have "not fully reflected the effect of the opening" in this phase and cases may continue to go up in the coming weeks.

"We will continue to look at how we can confidently and safely continue our opening process and, eventually, we will reach phase three," he added.

"So we are still in the monitoring stage, and that time will come when we may announce additional relaxation, but I think it's too early for us to discuss at this point."

Attractions like Universal Studios Singapore have started reopening, with some restrictions, after nearly three months of being closed because of the circuit breaker.

Others, including the Jurong Bird Park, River Safari and Singapore Zoo, will reopen to the public next week.



The war against COVID-19 "is not yet over", said Mr Gan, urging residents to stay vigilant and not try to get around the rules.

"We want to move very carefully, very cautiously, and therefore very gradually. So please bear with us as we progressively open up bit by bit, step by step, to ensure safety for all."




 




 










Authorities to cast wider net to identify close contacts of COVID-19 patients to stem spread of infection
More people should expect to be notified of a case or to go for testing as numbers increase with easing of lockdown
By Yip Wai Yee, The Straits Times, 3 Jul 2020

Singapore will cast the net wider around every COVID-19 case to identify close contacts to stem the spread of the disease, following a rise in the number of cases in just two weeks into the reopening of the economy.

At a virtual press conference yesterday, Health Minister Gan Kim Yong and National Development Minister Lawrence Wong presented this new normal, saying it is necessary as more people venture out and mingle with others.

Singapore entered phase two of its reopening on June 19, with more shops reopening and people allowed to dine in and visit one another, as long as they follow guidelines such as a cap of five in a group.

This has led to more cases in the community, though not unexpected, said the two ministers who co-chair a multi-ministry task force tackling the pandemic.

The same thing is happening in other countries that have similarly exited lockdowns, said Mr Gan.

In Singapore, from an average of four new community cases per day in the week before phase two, the number has gone up to about eight new daily cases in the past week, he said.

The majority were picked up via active surveillance and screenings.



The Government is closely monitoring the numbers to prevent a resurgence similar to what is happening in China, South Korea and Japan after lockdown measures were lifted, forcing the authorities in those countries to reintroduce curbs.

Beijing, for instance, mass tested wholesale market workers, restaurant staff, residents and delivery couriers after a fresh wave of cases was linked to a wholesale food market there.

Mr Gan said: "We want to detect cases early so that we can ring-fence them to prevent large clusters from forming."



Mr Wong said Singaporeans should expect that more people will potentially be notified whenever there is a case, and that more people may be notified to go for testing. More people may also be put under quarantine.

"We are casting a wider net around every single infected case," he said, adding that the authorities will move in a lot more aggressively and a lot quicker to identify every possible close contact.

More specific restrictions may also be put in place at work sites or residences if necessary, such as what has been done for people living in Block 111 Tampines Street 11, where nine confirmed cases have emerged from two separate households.

Testing has been offered to residents of 58 households living in the same section as the cases, and everyone living in these units has been put on active phone surveillance.

Mr Wong said: "Our mode of operations has changed... And we likely will operate in this manner for quite awhile before we get to phase three."



The number of cases may also continue to rise in the coming days as the country is only two weeks into phase two, said Mr Gan.

The virus has an incubation period of two weeks, while some cases may see delayed reporting or diagnosis, he said. "Therefore, (the current numbers) have not fully reflected the effect of the opening in phase two," he added.

"We may see the number of cases continue to climb somewhat. What is important is to keep an eye on the total number and spikes in the number, as well as clusters that are being formed."

In Germany, the authorities had to reimpose lockdown restrictions in two districts last week after a spike in cases. This comes after the country began easing measures back in May.

The United States also saw case numbers hitting new records in various states after lockdown restrictions were eased.









See a doctor even if it is just a sniffle, advises Lawrence Wong
By Yip Wai Yee, The Straits Times, 3 Jul 2020

Despite having enhanced testing and tracing capabilities, the authorities have urged the public not to let their guard down and called on everyone to stay vigilant and take all necessary precautions.

These include going to see a doctor as soon as one presents any symptom, even if it is just a sniffle, said National Development Minister Lawrence Wong, who co-chairs the multi-ministry task force tackling COVID-19.

This is more crucial than ever as the risk of transmission is much higher now than during the circuit breaker period when contact with other people had been minimal, he added at a press conference yesterday. "During the circuit breaker... the risk of spreading to many people was very low (as) you're just at home," he said.

But if people were to avoid seeing a doctor even when they feel feverish or have a flu-like symptom, or worse still, go about their daily activities and meet other people, then the risk of spreading COVID-19 increases, he added.

Since the beginning of this month, all patients aged 13 and older who show up at clinics with signs of acute respiratory infection have been required to be tested for the coronavirus.

To verify that one is free of the virus is much safer than not knowing one could have it and then potentially infecting others, said Mr Wong.



"If you have elderly people in the same household, I think the consequences of infecting someone senior in the home can be lethal and dangerous," he added.

He said this after detailing the new normal that involves more aggressive testing and casting a wider net around each confirmed case to identify every close contact.

Still, people should not take these enhanced testing and contact-tracing capabilities for granted and assume that the system can catch every case. "We shouldn't push the system to its limits or take unnecessary risks. So, while we have indeed enhanced our system... it requires everyone to do his part, take all the necessary precautions to stay vigilant and uphold the social distancing measures," said Mr Wong.

Health Minister Gan Kim Yong, who co-chairs the task force, said at the same press conference that even though the recent increase in confirmed cases is not unexpected, the country is only in the early stage of phase two of the economy reopening, which means the risk of community spread remains.

He said: "So, let us remain vigilant, don't let our guard down, be careful and practise safe distancing and obey the spirit of the rules, but not just the words, the letter of the rule. I think this will help us to keep ourselves safe and to keep our loved ones safe as well."















Coronavirus: 58 households placed under surveillance in Tampines HDB block
Swab tests offered to 160 people as precaution after nine COVID-19 cases emerge at Tampines block
By Tan Tam Mei and Timothy Goh, The Straits Times, 3 Jul 2020

On Tuesday, Madam Chan Qwee Lin received a call telling her that nine COVID-19 cases had been confirmed at the Housing Board block where she lives, and offering her the option of getting tested for the coronavirus.

"I wasn't scared... because I have been healthy these past few weeks," the 64-year-old, who works at a nearby pre-school, told The Straits Times last night.

Fifty-eight households were placed under phone surveillance at Block 111 Tampines Street 11 after the cases were discovered last month.



Health Minister Gan Kim Yong said yesterday that swab tests had been offered to 160 people who are residents and visitors of the 58 households as a precautionary measure.

Block 111 has three lifts which serve 11 storeys of units.

All 58 households are in the same section of the block as the nine cases, and share a common lift and stairwell.

Residents whom The Straits Times spoke to said they did not know who the confirmed cases are, and that only those in units which use the lift in the centre of the block were offered the swab test.

Madam Chan said residents were told to go to the nearby Street 11 Clinic for the free test. She went for the swab test on Wednesday, along with two of her adult children, and received her test results on the same day. All of them tested negative for the virus.

Another resident, a 50-year-old man who works in IT and who declined to be named, said he and his wife went to get tested for peace of mind. "We had no symptoms. We did the testing so we could know for certain that we were virus-free. If not, we might keep on worrying about it."



Among other residents of the block who were concerned over the news of the cases was Miss Lee Beiyi, 18, an intern involved in operations at a warehouse.

She was frazzled when she saw the news last evening as she had been nursing a fever last week and was on five days of medical leave. While she does not live in the affected section of the block, she is still worried she may have the virus.

"I come into contact with a lot of people at work, so I can't imagine what would happen if I did catch COVID-19," said Miss Lee, adding that she was trying to arrange for a swab test at nearby hospital.

"It is the responsible thing to do," she said.



Speaking at a virtual press conference yesterday, Mr Gan said swab testing is not mandatory for the residents and visitors of the 58 households as they are not considered close contacts of the confirmed cases. The residents are also not under any quarantine orders, although they are encouraged to minimise their movements.

"We have interviewed them, and they generally do not have interaction with the infected families. But we want to take extra precautions, and that is why we offered them COVID-19 testing," he said.

He added that a significant number - 58 - had already been tested and their results turned out negative as of Wednesday. Another 29 residents are expected to be tested by the end of today.

Mr Gan added that if additional cases are detected, further measures might be taken, but what this entails depends on the nature of the cases detected.

He said: "The task force will continue to press on with our efforts... But the role of the individual is arguably even more critical. I urge everyone to continue to remain vigilant and be socially responsible so as to protect ourselves and our loved ones."

Mr Desmond Choo, a member of the PAP team in Tampines GRC, told The Straits Times that his team is working closely with the Health Ministry to monitor the situation, and has sanitised common areas in the affected block.

He added that the town council had already implemented enhanced cleaning and sanitisation of all blocks in Tampines GRC since the start of the coronavirus pandemic.

"I have been in touch with some residents in the block, and they were assured by the cleaning and sanitisation protocols... The affected families are under quarantine now and we stand by to assist them in any way possible," he said.













Hospitals coping well in the face of both dengue, COVID-19 outbreaks
By Salma Khalik, Senior Health Correspondent, The Straits Times, 3 Jul 2020

Hospitals here are coping well despite having two major infectious disease outbreaks, COVID-19 and dengue, going on at the same time.

Associate Professor Kenneth Mak, director of medical services at the Ministry of Health, said: "The dengue outbreak at this point in time has not taxed us in terms of our ability to provide hospital care for patients, whether (they have) COVID-19 conditions or other medical conditions."

Singapore is facing one of its worst dengue outbreaks, with 1,468 people infected last week, the highest weekly number ever.

Yesterday, the multi-ministry task force tackling the COVID-19 outbreak was asked if people were being tested for both diseases as they share some common symptoms such as fever.

Health Minister Gan Kim Yong replied that when patients have symptoms common to both diseases, "we do test both dengue as well as COVID-19, depending on the presentation of the cases".

Prof Mak said that having a dengue outbreak amid the COVID-19 outbreak "complicates matters for our doctors because they have to distinguish between a fever that presents in a patient with COVID-19 infection versus a fever from dengue".



But he agreed with Mr Gan that where it is not possible to make that distinction based on clinical symptoms and signs, the patients will be tested for both dengue and COVID-19 to make sure one or the other infection is not missed.

He said many patients with dengue do not need to be hospitalised. Most are treated at general practitioner clinics or polyclinics.

Generally, one in five people diagnosed with dengue ends up in hospital. So, of the 14,500 people infected with dengue this year, fewer than 3,000 needed to be hospitalised.

In contrast, more than 44,000 people have been infected with COVID-19. About four in five have only a mild illness.

There have been 16 deaths from dengue this year and 26 from COVID-19.

Mr Gan said it was important to eliminate all possible breeding sites for mosquitoes because the rising number of dengue cases will "eventually stretch our medical system" and also raise the number of cases that clinics have to see.

With more people working from home, he said it is important to eliminate breeding sites of the dengue-spreading Aedes mosquito, which bites in the day.

Cutting down on dengue infections helps in the fight against COVID-19 as having two outbreaks "creates more noise in terms of detection", he said.









Worst dengue outbreak in Singapore's history expected in 2020 with more than 14,000 cases reported so far: NEA
Over 14,000 cases reported since Jan 1; total number this year expected to surpass high of 22,170 in 2013
By Vanessa Liu, The Straits Times, 3 Jul 2020

Singapore is on track to record its worst dengue outbreak in its history this year.

More than 14,000 cases have been reported since Jan 1, with the total number this year expected to surpass the high of 22,170 in 2013, said the National Environment Agency (NEA) yesterday. Eight people died of dengue fever in 2013, and there have been 16 deaths so far this year.

Experts have noted that case numbers are expected to rise further as Singapore is right in the middle of the traditional peak dengue season between May and September.

NEA said there were 334 active dengue clusters islandwide as at Wednesday, well up on the 205 clusters three weeks ago. It noted "intensive" vector control operations are taking place at large clusters in Woodleigh Close, Aljunied and Geylang roads, Bukit Panjang Ring Road, Leicester Road/Potong Pasir Avenue 1 and Bournemouth Road.

There has also been a higher rate of transmission in some clusters, including the Aljunied Road cluster with 191 cases, Bukit Panjang Ring Road with 185, and Bournemouth Road with 175 infections.

Other clusters with a quick rate of dengue spread include those in Geylang Road, Geylang East Avenue 1, Brighton Crescent and Arnasalam Chetty Road/Kim Yam Road. These clusters each recorded an average of about two to five new cases a day over the past two weeks.

Most mosquito-breeding grounds detected during NEA inspections are inside homes and premises, as well as in common areas within residential estates, said the agency.

It noted that while 75 per cent of the 1,328 clusters identified since the start of this year have been closed, "egregious mosquito breeding" continues to be detected.

One was a construction site within a dengue cluster in Potong Pasir Avenue 1. A stop-work order was issued to the site on June 24 after it was found guilty of mosquito breeding on multiple occasions. The order will be lifted when preventive measures have been correctly carried out, said NEA.

Other places found with multiple mosquito-breeding habitats include residential premises within dengue clusters, and common areas of Housing Board estates managed by town councils or residents' committees.

NEA said: "(This shows) that some owners of premises and occupiers are still not carrying out the necessary basic vector control checks, despite the extensive outreach on prevention over the past few months and the current serious situation."



Households will face heavier penalties for mosquito-breeding offences from July 15. Those with mosquitoes breeding in more than one place, or where breeding is found after they have been served a legal notice that they are in a dengue cluster, will be fined $300. Repeat offenders will be given heftier penalties or charged.

NEA said 6,900 premises islandwide have undergone inspection and vector control over the past three weekends. It urged owners and occupants to remove stagnant water in their immediate surroundings to help prevent mosquito breeding and curb transmission.








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