Saturday 11 February 2023

Singapore to lift all remaining COVID-19 measures from 13 February 2023

Masks no longer required on public transport from 13 February as Singapore moves to DORSCON green
By Goh Yan Han, Political Correspondent, The Straits Times, 10 Feb 2023

Singapore will lift its remaining Covid-19 restrictions like requiring masks on public transport from next Monday, when the country adjusts its disease outbreak response to the lowest level.

The lowering of the Disease Outbreak Response System Condition (Dorscon) from yellow to green comes as the global and local pandemic situation is stable and the disease is mild, especially among vaccinated individuals, the Ministry of Health (MOH) said on Thursday, noting that Covid-19 currently poses minimal disruption to healthcare capacity and people.

However, MOH will still require mask-wearing for visitors, staff and patients in healthcare and residential care settings such as hospital wards, clinics and nursing homes, where there is interaction with patients, the multi-ministry task force handling Covid-19 said at a media conference.

Vaccination will continue to be offered free to all Singapore citizens, permanent residents, long-term pass holders and certain short-term pass holders.

Everyone aged five and above should still get minimum protection – three doses of mRNA vaccines or the Novavax vaccine, or four doses of the Sinovac vaccine – while the Government will recommend that certain groups take booster jabs annually, said task force co-chair Ong Ye Kung, who is Health Minister.

However, pandemic subsidies will be further scaled back as Covid-19 is treated as an endemic disease. Treatment will no longer be fully subsidised, and patients will have to pay for any Covid-19 testing.

Mr Ong said Singapore’s high vaccination coverage was a key reason why it could progressively restore normal living while keeping deaths caused by Covid-19 at one of the lowest levels in the world, and arrive at Dorscon green.

About 80 per cent of the population have achieved minimum protection, and around half are up to date with Covid-19 vaccination, said MOH.

Mr Ong noted that Singapore had been worried about three areas of potential risk: the year-end travel season, the Northern Hemisphere winter and China’s shift away from its zero-Covid policy.

“But today, those risks are substantially past. We cannot rule out the future possibility of dangerous variants of concern emerging, but the uncertainties and risks we face now are significantly lower compared with one or two months ago,” he said.

Border measures will also be lifted from next Monday. All non-fully vaccinated travellers entering Singapore will no longer have to show proof of a negative pre-departure test, while non-fully vaccinated short-term visitors will also no longer be required to purchase Covid-19 travel insurance.

Meanwhile, migrant workers will no longer face community restrictions from Monday, as the Government discontinues the Popular Places Pass system meant to manage crowding in four designated popular locations on Sundays and public holidays.

From March 1, workers will also be able to recover from Covid-19 within their dormitories instead of being taken to recovery facilities.

Given the stable pandemic situation, MOH said it will step down its contact tracing systems, which comprise SafeEntry and the TraceTogether contact tracing app rolled out in 2020.

MOH has also deleted all identifiable TraceTogether and SafeEntry data from its servers and databases, it said.

A TraceTogether token return exercise will be held from next Monday to March 12 at all 108 community clubs.

The multi-ministry task force, which was convened in January 2020, will also be stood down from next Monday with the lifting of restrictions. MOH will assume management of the Covid-19 situation.

If the situation worsens significantly, an appropriate multi-agency crisis management structure will be reactivated, the ministry said.

Deputy Prime Minister Lawrence Wong, who co-chairs the task force, said the Government’s pandemic management framework and processes continue to be in place.

“We are standing down, but as many of my colleagues have said in this panel, we are continuing to maintain a high level of alertness and preparedness. So we are operationally ready, to use the words of the SAF (Singapore Armed Forces). Any time the button is pressed, we will stand up again,” he added.

These moves come more than three years after Singapore detected its first case of the coronavirus.

The Republic raised its Dorscon level from green to yellow on Jan 21, 2020, and to orange on Feb 7 that same year. The Dorscon level was lowered from orange to yellow on April 26, 2022, as the local Covid-19 situation improved.

Trade and Industry Minister Gan Kim Yong, also a co-chair of the task force, said Covid-19 will not be Singapore’s last pandemic or crisis. “We must always remain vigilant and draw on the lessons we have learnt during the Covid-19 pandemic, so that we can be better prepared for future crises.”

In a Facebook post, Prime Minister Lee Hsien Loong said battling the pandemic has been a long hard slog, with many unexpected twists and turns.

“This crisis of a generation has profoundly shaken our lives and changed the world. But standing united, we weathered the pandemic safely,” he added.

“We supported and trusted one another throughout this journey, and have emerged stronger and more resilient as a nation. This is a hard-earned achievement.”

Covid-19 vaccines will stay free as first line of defence in virus fight
By Ng Wei Kai, The Straits Times, 10 Feb 2023

Covid-19 vaccination under the National Vaccination Programme will continue to be free, but treatment and testing for the virus will no longer be fully subsidised.

All Singapore citizens, permanent residents (PR), long-term pass holders and some short-term pass holders will continue to be offered Covid-19 vaccination at no cost, the Ministry of Health (MOH) said on Thursday, noting in a statement: “Vaccination remains our first line of defence against Covid-19.”

MOH said: “Our high vaccination rates have been pivotal to enable us to weather successive waves of Covid-19 infections, build up our societal resilience, protect our healthcare system and arrive at the endemic Covid-19 norm today.”

While vaccination is free, those who require treatment for the viral illness and its complications will no longer receive a 100 per cent subsidy at hospitals or Covid-19 treatment facilities from April. This is regardless of their vaccination status, MOH added.

“Instead, our regular healthcare safety nets, namely, government subsidies, MediShield Life and MediSave will apply.

“We wish to assure lower-income Singaporeans that financial assistance will be available to ensure that healthcare cost remains affordable,” MOH said.

Health Minister Ong Ye Kung said at a media conference on Thursday: “Testing and treatment throughout have been provided generally free of charge or at a very low fee for practically all residents, given that Covid-19 was an unfamiliar disease.

“It was important that we removed the uncertainties and concerns on the cost of testing and treatments. We have maintained that policy for almost three years.”

He added that as Singapore moves towards living with the disease, the Government will also need to move to a new set of financing arrangements and cannot continue with 100 per cent subsidies.

MOH’s statement also said people with Covid-19 will no longer need to be housed in community isolation facilities, just like for other endemic diseases such as influenza or chicken pox.

“Nevertheless, we will maintain some facilities for Covid-19 patients who want to self-isolate for valid reasons,” it said.

All occupants will be charged for their stay, and as such facilities are not classed as medical facilities, citizens and PRs will not be able to tap government subsidies, MediShield Life or MediSave to pay their bills, MOH said.

All patients will be required to pay for any Covid-19 testing, subject to prevailing subsidies, the ministry added.

But these patients could get other support at no cost, besides Covid-19 vaccinations.

MOH said: “Additionally, patients with a higher risk of severe Covid-19, such as the immunocompromised and individuals with some comorbidities, may be referred by their doctors for free telemedicine support.”

Mr Ong added that MOH is exploring making all nationally recommended vaccines free under the Healthier SG initiative.

While Covid-19 vaccines are not currently nationally recommended shots, if they are added to the programme, they could become permanently free, he said.

Singapore reverts to DORSCON Green: How alert levels guided the response to Covid-19
By Salma Khalik, Senior Health Correspondent, The Straits Times, 9 Feb 2023

Singapore is going green again, after more than three years of living with heightened health alerts about Covid-19 through the national disease response system.

Under the Disease Outbreak Response System Condition (Dorscon) set up in 2005, green indicates that a disease is mild and poses minimal disruption to daily life.

Any colour above green sets in motion actions to be taken by the Government and the healthcare system – as well as the public – and indicates increasing severity and spread of a disease outbreak.

From next Monday, Singapore reverts to the lowest status of green from yellow, which is the next level of severity.

The higher levels are orange, and then red, which is activated only if the country is facing an out-of-control pandemic.

Dorscon was established following the severe acute respiratory syndrome epidemic in 2003 and avian flu situation in 2004.

With the Covid-19 pandemic, Singapore raised the alert level to Dorscon yellow on Jan 21, 2020, two days before the first case was even detected here.

Yellow indicates there is mild infection spreading locally, or severe infection elsewhere that the country needs to guard against. Precautions under yellow include measures at borders and healthcare institutes.

Singapore did not remain at yellow for long. In just over two weeks, on Feb 7, the level was raised to orange – where it remained for more than two years – before it was lowered back to yellow on April 26, 2022.

Dorscon orange officially signifies moderate disruptions to daily life.

Unofficially, it created some panic, with people rushing out to stock up on staples such as rice, noodles and toilet paper.

Images of empty supermarket shelves on social media further fuelled the buying and prompted ministers to plead with people not to overreact.

In the end, Singapore never ran low on such necessities.

While the country has never raised the Dorscon level to red since its inception, some of the measures taken over the past three years seemed closer to that status than to orange.

This included the closure of businesses and the move to home-based learning for schoolchildren during the circuit breaker between April and June in 2020.

Early on in the pandemic, then Health Minister Gan Kim Yong said at a press conference by the Covid-19 multi-ministry task force that the Dorscon colours and associated measures were not cast in stone, but provided general guidelines for the authorities.

“The measures... are not necessarily so closely tied to the Dorscon level. Some of the measures that we were taking when we were in ‘yellow’ were already (like those) in ‘orange’,” he noted.

“And if the situation evolves such that some of the measures (can be) rolled back, we may roll back before we downgrade the Dorscon.”

Deciding the Dorscon level was not a matter of ticking off a checklist, but rather, a judgment call based on experts’ advice and an assessment of the general situation, he said.

Explaining why Singapore never raised the Dorscon level to red, Mr Gan, who is now Trade and Industry Minister, said: “It may not be apparent to members of the public, but Dorscon levels are very important from the point of view of the preparedness of the government agencies, including the healthcare institutions.

“When we raise the alert status, some of the actions have to be taken, including putting aside beds to be ready for Covid-19 cases and raising the alert level of the agencies... These actions are not sustainable for a long period of time.”

By not raising the level to red, hospitals, for instance, could reduce the number of beds ring-fenced for Covid-19, giving the healthcare system greater flexibility in managing patient loads.

Experts agreed it was timely to lower the Dorscon status to green, even though more than 9,000 people have been infected over the past 28 days, with the week-on-week infection ratio at 1.4, meaning the infection is still spreading. In hospitals, there are still Covid-19 patients who need oxygen or intensive care.

“A return to Dorscon green thus does not mean that we no longer care about Covid-19,” said Professor Ooi Eng Eong, an expert in emerging infectious diseases at Duke-NUS Medical School.

“The Covid-19 situation is now, fortunately, a far cry from the days in 2020 and early 2021. We can live with Covid-19.”

He noted that the majority of people here have been vaccinated, and many have also been infected, giving them hybrid protection. Doctors also now have drugs to treat those who are vulnerable and suffer from severe illness if infected with Covid-19.

But this does not mean that the country can let its guard down, said Prof Ooi. “Appropriate Covid-19 surveillance must remain in place to detect waning in hybrid immunity and for the unlikely emergence of variants that escape hybrid immunity,” he added.

People should still have their booster shots when recommended, and wear a face mask in public if they are ill with flu-like symptoms. Healthcare institutions must remain prepared for any surge in capacity.

“With these in place, there is nothing that should stop Singapore from returning to Dorscon green,” said Prof Ooi.

Multi-Ministry Taskforce to stand down, MOH to take over Covid-19 management
Any time the button is pressed, we will stand up again: DPM Lawrence Wong
By Goh Yan Han, Political Correspondent, The Straits Times, 9 Feb 2023

The multi-ministry task force (MTF) handling the Covid-19 pandemic in Singapore will stand down next Monday, with the Ministry of Health taking over to manage the coronavirus like any other endemic disease.

This comes as the task force announced on Thursday that all Covid-19 restrictions would be lifted from next Monday, in line with Singapore lowering its disease outbreak response level from yellow to green more than three years after the first coronavirus case was detected here.

The Covid-19 task force – co-chaired by Deputy Prime Minister Lawrence Wong, Health Minister Ong Ye Kung and Trade and Industry Minister Gan Kim Yong – was set up in January 2020 to coordinate and helm the Government’s crisis response.

The shift to Dorscon (Disease Outbreak Response System Condition) green and disbanding of the task force comes as the local Covid-19 situation remains stable.

Singapore’s director of medical services Kenneth Mak said the daily number of patients hospitalised due to Covid-19 has stayed below 100 in January, while those who require intensive care or oxygen supplementation remain in single digits.

There were 820 deaths related to Covid-19 in 2022, compared with 5,400 deaths from pneumonia or other causes, he added. In 2023, there have been few deaths due to Covid-19 and none reported since February.

“The overwhelming majority of Covid-19 cases have mild infection and recovered at home uneventfully,” said Professor Mak.

Mr Wong said that while the task force is standing down, the Government will continue to maintain a high level of alertness and preparedness.

“So we are operationally ready, to use the words of the SAF (Singapore Armed Forces). Any time the button is pressed, we will stand up again because our framework, our structure, continues to be in place across all the measures, and even for our crisis management processes.”

The task force will be reactivated, along with the necessary community and border measures and responses, if there is a need for it, he added.

Mr Wong noted that the current new normal is not static, as the virus will continue to evolve and new infection waves will come from time to time.

But unless it is a very dangerous and virulent variant, the Government will manage these waves with an appropriate level of measures that will allow everyone to continue to live their lives normally, he said.

If a new and dangerous variant emerges, or healthcare capacity becomes strained, Singapore may then have to revise its Dorscon, Mr Wong said.

“We hope this will not happen. But we have to be mentally prepared for such an eventuality. And if so, we seek everyone’s support to rally together as we have done over the last three years,” he said.

Minister Ong said that while Thursday’s announcement is significant, that “does not mean that our state of alert and preparedness is over”.

“Especially for the healthcare sector, we are still in line. We have to be ready. Covid-19 has taught us valuable lessons and helped us build significant capabilities, and certainly for the healthcare sector, we will use them to the fullest to do our best to improve the health of our people.”

An ongoing review of the Government’s Covid-19 response is expected to conclude soon. Mr Wong said a report will be released, and Parliament will debate it “to make sure we collectively draw the right lessons and act on them”.

“The report is not meant to congratulate ourselves. It’s really meant to take an objective look at what has transpired over the last three years,” he said.

“Areas that we have done well in, we should acknowledge, areas where we should have done better, we should also highlight, and draw out lessons primarily with a view to see what we can do better when the next pandemic strikes.”

But Mr Wong cautioned against falling into the trap of “hard-coding these lessons into rigid doctrines, thinking that the next pandemic will be the same as Covid-19”.

“It may very well be different and that means we have to learn, improve, but at the same time, always have that ability to be adaptable and nimble, and improvise in new situations,” he said.


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