Wednesday 5 May 2021

COVID-19: Singapore cannot afford to close borders for long duration, says Lawrence Wong

By Salma Khalik, Senior Health Correspondent, The Straits Times, 5 May 2021

As a small country that is not resource-rich, Singapore cannot afford to shut its borders for a long time, said Education Minister Lawrence Wong yesterday.

Mr Wong, who co-chairs the multi-ministry task force on Covid-19, was explaining why Singapore did not close its borders to India earlier, given the raging outbreak there.

Singapore stopped entry to all long-term pass holders and short-term visitors with recent travel history to India within the past fortnight from April 24.

"We are small… We need migrant workers to build our homes," he said. Foreign workers are also needed for other essential services, including caring for the elderly.

"It's really very hard for us to close our borders permanently," he said. "Instead, we've always taken a risk-based approach in managing our borders from the start."

This involves controlling the number of arrivals. He said the overall number coming in has been going down, even before curbs on arrivals from India kicked in.

"We've already become very tight, to the point that the backlog of applications has been growing… Many projects have been suffering from delays, as all of us know."

He added: "Some of our housing projects may now be delayed by up to a year or more.

"So it does come at a considerable cost to Singaporeans."

Migrant workers who come in are isolated and "we've been progressively tightening that regime over the past few months". They are also tested more regularly.

In spite of all measures, Mr Wong said there will be leaks into the community from time to time.

This can happen even in a country like China with its very tight border measures, he added.

So there cannot be sole reliance on border measures, he said.

"We have to make use of other tools at our disposal," he said.

"If we do all of these well, then we can control the spread of the infection in our community."

As for visitors who tested negative, but later test positive when they want to leave the country, Mr Wong said there are two possibilities. One is they could have been infected in the community while in Singapore.

The other is that the cases involve an older infection and they are "intermittent shedders" of virus particles. If so, they are less likely to be infectious.

Return to Phase 2: Stricter rules on social gatherings to curb virus from 8 May through 30 May 2021
Measures kick in from May 8, but Minister Lawrence Wong urges all to scale back activities from now
By Linette Lai, Political Correspondent, The Straits Times, 5 May 2021

Singapore will impose stricter rules on social gatherings and require more people to work from home starting Saturday, 8 May, in what Education Minister Lawrence Wong yesterday described as a return to phase two of the country's reopening.

These tighter measures mean people will be allowed to gather in only groups of up to five, down from eight currently. In addition, they will be able to receive only five distinct guests at home each day.

And no more than 50 per cent of employees who are able to work from home should be in the office at any one time, down from 75 per cent at present.

Employers should also continue to stagger the start times of returning staff, and implement flexible working hours. Social gatherings at work should be avoided.

Large events - such as worship services, weddings, funerals and live performances - will see more restrictions in place, including pre-event testing and reduced sizes. Higher-risk settings such as indoor gyms and fitness studios will be closed, as people are often unmasked and in close proximity for extended periods in a small enclosed space.

The measures, aimed at stopping the spread of Covid-19 in the wider community, will kick in on May 8 and be in place until May 30.

Addressing reporters at a press conference yesterday, Mr Wong, who co-chairs the task force tackling the pandemic, said the measures harked back to phase two of Singapore's gradual reopening after the circuit breaker.

"We certainly hope not to have to invoke another circuit breaker," he said. "But we have proposed quite a stringent and very tight set of measures, so that we can respond robustly and pre-emptively to the latest outbreak of clusters and do our best to snuff them out early, and reduce the likelihood of having to impose more drastic measures down the road."

He acknowledged that the move will cause "considerable inconvenience" given several upcoming celebrations - Mother's Day, Hari Raya Puasa and Vesak Day - but urged Singaporeans to understand the need for tighter measures.

Although Singapore has tried its best to ring-fence the clusters of recent community cases, it must still assume that there are hidden cases in the community, he said.

In addition, the country is dealing with new variants that are more infectious and likely to cause larger clusters.

If Singaporeans cooperate with the new rules, the country stands a good chance of bringing Covid-19 case numbers down and getting the situation under control, Mr Wong added.

Stricter border measures will also be put in place for travellers from most areas. Those arriving in Singapore from 11.59pm on Friday will have to serve a 21-day stay-home notice (SHN) at dedicated facilities, while those who have not completed their 14-day SHN by that time will have to serve an additional seven days.

In addition, Singapore will now look at the past 21 days of an individual's travel history, rather than the current 14 days, in applying border measures. This move also takes effect from 11.59pm on Friday, and does not apply to bilaterally negotiated travel lanes such as the reciprocal green lane or air travel bubble arrangements.

Although the stricter measures kick in only on Saturday to give businesses time to adjust, Mr Wong urged everyone to start doing their part with immediate effect. "Starting tonight, try to scale back your activities as much as possible," he said. "Scale back your social interactions and stay home to the extent you can."

He also urged those who are medically eligible to get vaccinated as soon as possible.

"We have been able to keep the infection under control before," he added. "We can certainly do it again, working together, and get back on track with our reopening plans."

Tan Tock Seng Hospital COVID-19 cluster: 9 fully vaccinated cases had mild to no symptoms
They also didn't need oxygen support, while seven among the unvaccinated did
Vaccination helps protect against new COVID-19 variants
By Joyce Teo and Cheryl Tan, The Straits Times, 5 May 2021

More cases of worrisome variants that are circulating around the world have been detected here, and while vaccination may not prevent a person from getting Covid-19, it can protect people from becoming severely ill with the disease, the authorities said yesterday at a multi-ministry task force press conference.

Ministry of Health director of medical services Kenneth Mak said that of the 40 Covid-19 cases in the Tan Tock Seng Hospital (TTSH) cluster, the nine who had received full doses of the Covid-19 vaccines were either asymptomatic or exhibited mild symptoms, and none required oxygen support.

Seven were staff while the other two were patients, he said.

The remaining 31 people were either partially or not vaccinated.

Among the unvaccinated individuals, seven required oxygen therapy, said Associate Professor Mak.

One of them, an 88-year-old woman who was being treated in Ward 9D, died of Covid-19 complications last Saturday.

Prof Mak said that the TTSH cluster had arisen from a viral variant, but the vaccine appears to have done relatively well against it.

"In those who had received full vaccination, they had demonstrated evidence of antibodies to the spike protein of the virus, which is a good response to vaccination," he said.

Five of the cases from the TTSH cluster have the B16172 variant that originated in India, including the 46-year-old nurse who was the first detected case in the cluster.

She had received two doses of the Covid-19 vaccine and suffered mild symptoms of a cough, sore throat and body aches.

"Had we not done so, the TTSH cluster would have been significantly larger at this time, and the likelihood of that cluster getting out of control (will be) that much greater.

"It is therefore a reminder to all of us that we should get ourselves vaccinated and protected when our time comes and we cannot afford to be complacent," he added.

Other variants that have been identified in locally transmitted cases here include the B117 that originated in Britain, the B1351 that was first detected in South Africa and the P1 variant that originated in Brazil.

At the press conference, Health Minister Gan Kim Yong made a call for people, particularly the elderly, to get vaccinated.

"The Covid-19 vaccine is effective in preventing symptomatic disease for the vast majority of those vaccinated, but it does not eliminate the risk of infection completely," said Mr Gan.

"Locally, we have seen some cases who have been infected despite completing the full doses of vaccination.

"But because of vaccination, these cases are either asymptomatic or had mild symptoms, and none has required oxygen so far."

Therefore, vaccination remains an important tool to help lower the risk of infection and severe disease, he said.

TTSH cluster sparked by new variant that originated in India
By Joyce Teo, The Straits Times, 5 May 2021

New viral variants that have originated in India - and are fuelling the devastating second wave there - are believed to have sparked Singapore's largest active cluster at Tan Tock Seng Hospital (TTSH).

Seven cases in three local clusters were found with B16172, a sublineage of a variant from India, said the Ministry of Health's (MOH) director of medical services Kenneth Mak yesterday.

Of these, five are part of the TTSH cluster, which has grown to include 40 TTSH staff, patients and their relatives. One of the five is the first case in the cluster - the 46-year-old nurse who tested positive for Covid-19 on April 27.

The sixth case with the variant originating in India is an Immigration and Checkpoints Authority (ICA) officer deployed at Changi Airport Terminal 1, while the remaining case is a cleaner deployed at a Tuas South community care facility.

"The new variant strains have higher attack rates. They are more infectious and they are causing larger clusters than before," said Education Minister Lawrence Wong, who co-chairs the ministerial task force combating the virus.

"We have tried our best to ring-fence the cases through contact tracing, but we must assume that there are still hidden cases out there in the community."

Viruses mutate all the time, and the B1617 variant was first detected in India in October last year. It has been dubbed the double mutant because it has two major mutations on the spike protein of the coronavirus.

As the cases in India surged, many countries have placed restrictions on travellers from the country.

Yesterday, Prof Mak also said that more cases of worrisome variants that are circulating around the world have been identified among the 60 new community cases that have emerged in the past week.

He noted that the seven cases in the three clusters have the B16172 variant but the viruses in each cluster are "phylogenetically distinct", suggesting the clusters are not linked to one another.

There were also three local cases with the B16171 variant, another sublineage of the double mutant variant first detected in India.

Furthermore, MOH has detected eight local cases with the B1351 variant that originated in South Africa, seven local cases with the B117 variant that originated in Britain, three local cases with the P1 variant that originated in Brazil and one local case with the B1525 variant that also originated in Britain.

In addition, there were four reinfection cases with the B1351 (South African) variant, said Prof Mak.

On how the TTSH cluster spread, Prof Mak said one possibility being studied is that there may be issues with the airflow and ventilation in the ward. Other hypotheses are also being examined.

He said that they have started to study travellers coming into Singapore who have recovered from Covid-19.

"We've not discounted the possibility that some of these recovered travellers might in fact have reinfections and, therefore, bring that in and pose a threat to us," he said.

The TTSH cluster remains a concern, as more cases may emerge among patients who remain in the hospital, the hospital staff and in those who are presently under quarantine.

Earlier in the press conference, Health Minister Gan Kim Yong had called for Singaporeans to get vaccinated as well as to rally around front-line healthcare workers, especially those from TTSH and the National Centre for Infectious Diseases.

"A kind word of encouragement or a thoughtful deed goes a long way to boost their morale during these difficult times."

Mr Gan said the healthcare system is being prepared for more Covid-19 cases and the next few weeks will be critical for Singapore.

"The silver lining is that we have successfully brought our cases down before and we can do it again."

Don't shun TTSH healthcare workers as hospital COVID-19 cluster grows, urges MOH's Kenneth Mak
Show support for TTSH workers
By Cheryl Tan, The Straits Times, 5 May 2021

Healthcare workers and staff from Tan Tock Seng Hospital (TTSH) should not be shunned during this difficult time, Ministry of Health (MOH) director of medical services Kenneth Mak said yesterday.

The hospital currently has a cluster of 40 Covid-19 cases, of whom 10 are healthcare workers.

Speaking at the press conference by the multi-ministry task force tackling Covid-19, Associate Professor Mak said there were reports of healthcare workers being told they were not welcome at their place of accommodation by landlords who heard they worked at TTSH.

"This is a concern for us because these workers are well and they have committed a lot of time and energy towards looking after patients in TTSH," he said. "So we (also) endeavour to support them, (by) making sure that they have... accommodation through this difficult time, when they are being called to do much more than what they would normally be expected to."

Singaporeans can come together to show their support and appreciation for these healthcare workers, he said, like how they did last year.

On March 30 last year, Singaporeans clapped and cheered from their windows and balconies for the front-liners in Singapore's fight against Covid-19.

There were also reports of health workers being shunned by commuters on public transport early on in the pandemic, in February last year.

Noting that healthcare workers have been working long hours looking after both Covid-19 and non-Covid-19 patients, Prof Mak urged the public to show support for TTSH workers and their welfare, as this would be "very important" at this stage.

* Parliament: Singapore is a 'little red dot'; cannot afford to shut borders for prolonged duration, says Lawrence Wong
Border measures have cascading effect on Singapore economy
One concern is firms forced to close amid manpower crunch, leading to job losses
By Lim Min Zhang, The Straits Times, 12 May 2021

Manpower shortages caused by tighter border controls will not be confined to the construction, marine and process (CMP) sectors, but will have a "cascading effect" on the Singapore economy, Education Minister Lawrence Wong told Parliament yesterday.

Any company seeking to bring in workers from higher-risk countries could wait more than six months for entry approval, he said in an update on the Government's response to Covid-19.

Stresses will also be felt in society, he said. Singaporeans will find it harder to reunite with their families abroad, and families applying for new foreign domestic workers to care for their children or the elderly will have to wait at least two months, he added.

Mr Wong, who co-chairs the multi-ministry task force tackling Covid-19, cited these consequences of keeping the country's borders tight as he addressed questions from several MPs about Singapore's border measures.

For instance, Mr Yip Hon Weng (Yio Chu Kang) had asked how the Health Ministry would strengthen its measures to prevent a Covid-19 spread from imported cases.

The authorities have implemented more stringent border measures this month. The stay-home notice (SHN) period for those from higher-risk countries or regions has been lengthened to 21 days, up from 14 days, among other steps.

While there is no medical evidence that new Covid-19 variants have a longer incubation period, there is always a "very small tail risk" of such cases, said Mr Wong.

This was why Singapore moved to the tighter, 21-day SHN regime for travellers from all higher-risk countries during this period of heightened alert, he added.

While one option is to shut borders - an approach that has been taken by larger or resource-rich countries - Singapore is in a "completely different position", he said.

"They are how, as a country, we earn a living and remain relevant to the world," he added, noting that travel restrictions have been slowly lifted in a controlled and safe manner after the country exited the circuit breaker in June last year.

Before the pandemic, Singapore had 200,000 travellers going through Changi Airport every day, either on transit or entering Singapore, he said. This number plummeted during the two-month circuit breaker when borders were closed temporarily.

Some travel restrictions were later eased. By November last year, there were about 820 arrivals a day.

Between December last year and March, there were about 1,200 travellers who arrived at Changi Airport a day, he added.

One reason for this increase is the arrival of more migrant workers in the CMP sectors, as well as foreign domestic workers.

This group was also the largest contributor to Singapore's imported cases, at about 40 per cent over the past six months, although a tighter screening and quarantine process was implemented even as the numbers went up, he said.

But this inflow of workers for the CMP sector is still unable to meet the country's needs to date.

"Because every day, every week, every month, many migrant workers have left to go back to their home countries. Whatever numbers we are bringing in barely replace those who have left," he said.

The Government will do more to help this sector, Mr Wong said, citing the recently announced higher foreign worker levy rebates.

He also said that while there has been a recent spike in community cases, this is not the first time that Singapore has had to deal with the issue.

Compared with a year ago, the nation's capabilities have strengthened significantly, and testing capacity is now much higher. About 35,000 swabs were tested daily in the past week, and there is the capacity to test up to 73,000 people per day, and even more with pooled testing.

"TraceTogether and SafeEntry are more pervasive, which means we can contact-trace and ring-fence cases more quickly," he said. "We are also regularly testing persons in higher-risk settings and undertaking surveillance testing for symptomatic individuals, which is how we uncovered many of the cases reported over recent days."

Vaccination is a major game changer, he added, with most of the older population as well as healthcare and front-line workers having had their jabs.

"This puts us in a much safer position," he said.

**  Shortfall of 130,000 migrant workers if Singapore had shut borders: Ministry of Manpower
Businesses, families would have been severely hit if they had been denied entry after circuit breaker
By Kok Yufeng, The Straits Times, 19 May 2021

Singapore would have been hit hard by a shortfall of at least 100,000 workers and 30,000 domestic workers if migrant workers had not been allowed to enter after the circuit breaker period last year, the Ministry of Manpower (MOM) said yesterday.

This is about one-tenth of the total foreign workforce in Singapore. There were 984,100 migrant workers and 247,400 domestic workers employed here as at last December.

MOM said the Republic would have had a labour shortage of 70,000 service sector workers, including those in essential services such as healthcare and cleaning, 30,000 construction workers and 30,000 domestic workers if it had closed its borders last year.

"The impact on businesses and families would have been severe," the ministry said, echoing its previous statements on the issue.

It noted that it has, since May 2, "completely stopped entry of all from South Asia".

"At the same time, businesses have been appealing for more workers to be allowed to enter Singapore to address manpower shortages," it said.

On Monday, key representatives from the construction industry and built environment sector issued a plea to the Government to allow foreign workers to enter Singapore in a safe and controlled manner.

The Construction Industry Joint Committee said the industry supports the Government's efforts to curb a resurgence of Covid-19 as new virus variants emerge here, but warned of an increasing risk of workplace incidents as the current reduced workforce is already working at maximum capacity.

MOM said yesterday that the outflow of migrant workers has exceeded the inflow over the past year, with many workers returning home at the end of their contracts.

As a result of border restrictions to mitigate the risk of imported Covid-19 cases, Singapore has not been able to adequately replace those who have left.

MOM did not say how many migrant workers have arrived here since the circuit breaker last year.

However, Manpower Minister Tan See Leng told Parliament last week that there was a net outflow of about 5,600 work permit and S Pass holders from the construction, marine, process and service sectors each month from March last year to last month.

This adds up to a net outflow in this period of more than 72,000 workers from these sectors.

From November, entry approval was granted to an average of 5,100 workers per month to alleviate the manpower shortage, but Dr Tan said this inflow could not be sustained due to the dynamic and fluid Covid-19 situation in the workers' home countries.

MOM said that while it makes sense to try to retain existing workers, which businesses are already doing by offering higher retention bonuses and facilitating transfers, many workers are understandably worried about their families at home.


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