SINGAPORE: While members of the public will naturally be concerned about the recent rise in the number of COVID-19 community infections, the situation “is not unexpected” given the easing of earlier strict restrictions imposed under Phase 2 (Heightened Alert), said the Health Ministry’s director of medical services Kenneth Mak on Friday (Sep 3).
Associate Professor Mak, who was speaking at the COVID-19 multi-ministerial task force press conference, also said there has not been a significant surge in cases requiring intensive care.
Singapore reported 216 new locally transmitted COVID-19 infections as of noon on Friday, including 109 with no links to previous cases.
“The increase in the number of cases will naturally raise concerns among members of the public who are concerned that the COVID-19 situation may be deteriorating. The rise in the number of COVID-19 cases in the community is not unexpected,” Assoc Prof Mak said.
With the easing of restrictions imposed under Phase 2 (Heightened Alert), more people are leaving their homes now on a daily basis for work or for social activities. As groups of up to five people are now allowed to gather for meals and social gatherings, the opportunity for close mask-off physical interactions has increased, he added.
Assoc Prof Mak also noted that earlier strict measures were “not imposed with the intention to simply suppress COVID-19 infections to the extent that (Singapore) will eradicate all such infection in the community”.
Instead, they were introduced to reduce close contact encounters sufficiently so as to ensure that the emergence of new cases can be sufficiently suppressed.
This helps to ensure that demand for hospital isolation beds and intensive care unit (ICU) beds could be met by available healthcare resources, while allowing the national vaccination campaign to proceed.
These measures “have been successful”, said Assoc Prof Mak, noting that the healthcare system is “not overly burdened” with Singapore having fully inoculated 80 per cent of its population.
While being fully-jabbed does not mean that one will not get infected with COVID-19, vaccination reduces the risk of getting a severe infection which may require ICU care or lead to death.
Providing figures on this, Assoc Prof Mak said over the last 28 days, the percentage of those who are unvaccinated and became severely ill or died was 9.2 per cent. In comparison, only 1.3 per cent of those who are fully vaccinated became severely ill.
“This is a seven-fold reduction in severely infected or death rates - a stark difference which demonstrates the protective benefits that vaccination provides,” he told reporters.
“So even though the number of community cases has increased, there has not been a significant surge in the number of cases which requires intensive care.”
ICU admissions have also “held relatively steady”, said Assoc Prof Mak.
There were six to seven ICU cases last week, while this week has seen five such cases so far. There have been no new admissions in the ICU since Aug 21.
“So even though the total number of local cases has increased – from an average of 58 cases a day the week before to 132 cases per day in the past week – ICU numbers have not increased correspondingly,” he said.
Assoc Prof Mak added that the recent clusters involving the Bugis Junction shopping mall and bus interchanges involved “individuals who are relatively young, or did not have risk factors for worse outcome”.
Many of these individuals were also vaccinated hence they “derived the protective benefit of being vaccinated”, he added.
“Over 98 per cent of individuals who were infected were either well without any symptoms, or mildly symptomatic with at most minor respiratory symptoms. We expect them to recover without much need for further medical care,” said Assoc Prof Mak.
“Nonetheless, we monitor them very closely to make sure we provide them with the appropriate treatment for the clinical needs.”
That said, Singapore must still “be prepared for any possible surge in the number of cases” as the country resumes more community activities.
Of specific concern, noted Assoc Prof Mak, is the cluster of cases that have emerged at several bus interchanges.
“The epidemiological investigation so far have not identified specific modes of transmission, but it's highly likely that spread has occurred within the work environment, possibly due to mask-off interactions during rest periods at the bus interchanges,” he said, adding that preliminary phylogenetic test results do support the case of a likely workplace transmission event.
How infection was first introduced into the bus interchanges remains unclear but given the higher number of community cases currently, it “is not unreasonable to expect that … some bus captains had got infected in the community and they in turn infected other bus captains in interchange”.
“We've also seen some infected bus captains bring infection back into their households, infecting their own household members.”
Assoc Prof Mak said there is no evidence as yet that any passengers or users of public transport have been exposed and infected. Hence, the clusters "still appear to be confined to the workplace at the bus interchanges" and new measures announced by the Land Transport Authority will prevent potential further spread.
"We remain optimistic about being able to bring the cases down," he added. "We're not talking about cases coming down to zero but if the numbers continue to come down to a level which does not present many more people becoming severely ill and requiring ICU care, the healthcare system will remain resilient."
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Associate Professor Mak, who was speaking at the COVID-19 multi-ministerial task force press conference, also said there has not been a significant surge in cases requiring intensive care.
Singapore reported 216 new locally transmitted COVID-19 infections as of noon on Friday, including 109 with no links to previous cases.
“The increase in the number of cases will naturally raise concerns among members of the public who are concerned that the COVID-19 situation may be deteriorating. The rise in the number of COVID-19 cases in the community is not unexpected,” Assoc Prof Mak said.
With the easing of restrictions imposed under Phase 2 (Heightened Alert), more people are leaving their homes now on a daily basis for work or for social activities. As groups of up to five people are now allowed to gather for meals and social gatherings, the opportunity for close mask-off physical interactions has increased, he added.
Assoc Prof Mak also noted that earlier strict measures were “not imposed with the intention to simply suppress COVID-19 infections to the extent that (Singapore) will eradicate all such infection in the community”.
Instead, they were introduced to reduce close contact encounters sufficiently so as to ensure that the emergence of new cases can be sufficiently suppressed.
This helps to ensure that demand for hospital isolation beds and intensive care unit (ICU) beds could be met by available healthcare resources, while allowing the national vaccination campaign to proceed.
These measures “have been successful”, said Assoc Prof Mak, noting that the healthcare system is “not overly burdened” with Singapore having fully inoculated 80 per cent of its population.
NO SIGNIFICANT SURGE IN ICU CASES
While being fully-jabbed does not mean that one will not get infected with COVID-19, vaccination reduces the risk of getting a severe infection which may require ICU care or lead to death.
Providing figures on this, Assoc Prof Mak said over the last 28 days, the percentage of those who are unvaccinated and became severely ill or died was 9.2 per cent. In comparison, only 1.3 per cent of those who are fully vaccinated became severely ill.
“This is a seven-fold reduction in severely infected or death rates - a stark difference which demonstrates the protective benefits that vaccination provides,” he told reporters.
“So even though the number of community cases has increased, there has not been a significant surge in the number of cases which requires intensive care.”
ICU admissions have also “held relatively steady”, said Assoc Prof Mak.
There were six to seven ICU cases last week, while this week has seen five such cases so far. There have been no new admissions in the ICU since Aug 21.
“So even though the total number of local cases has increased – from an average of 58 cases a day the week before to 132 cases per day in the past week – ICU numbers have not increased correspondingly,” he said.
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Assoc Prof Mak added that the recent clusters involving the Bugis Junction shopping mall and bus interchanges involved “individuals who are relatively young, or did not have risk factors for worse outcome”.
Many of these individuals were also vaccinated hence they “derived the protective benefit of being vaccinated”, he added.
“Over 98 per cent of individuals who were infected were either well without any symptoms, or mildly symptomatic with at most minor respiratory symptoms. We expect them to recover without much need for further medical care,” said Assoc Prof Mak.
“Nonetheless, we monitor them very closely to make sure we provide them with the appropriate treatment for the clinical needs.”
BE PREPARED FOR POSSIBLE SURGE
That said, Singapore must still “be prepared for any possible surge in the number of cases” as the country resumes more community activities.
Of specific concern, noted Assoc Prof Mak, is the cluster of cases that have emerged at several bus interchanges.
“The epidemiological investigation so far have not identified specific modes of transmission, but it's highly likely that spread has occurred within the work environment, possibly due to mask-off interactions during rest periods at the bus interchanges,” he said, adding that preliminary phylogenetic test results do support the case of a likely workplace transmission event.
How infection was first introduced into the bus interchanges remains unclear but given the higher number of community cases currently, it “is not unreasonable to expect that … some bus captains had got infected in the community and they in turn infected other bus captains in interchange”.
“We've also seen some infected bus captains bring infection back into their households, infecting their own household members.”
Assoc Prof Mak said there is no evidence as yet that any passengers or users of public transport have been exposed and infected. Hence, the clusters "still appear to be confined to the workplace at the bus interchanges" and new measures announced by the Land Transport Authority will prevent potential further spread.
"We remain optimistic about being able to bring the cases down," he added. "We're not talking about cases coming down to zero but if the numbers continue to come down to a level which does not present many more people becoming severely ill and requiring ICU care, the healthcare system will remain resilient."
Related:
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