SINGAPORE: Singapore has managed to keep the number of COVID-19 fatalities "very low", with a death rate of 0.2 per cent compared to 3 per cent or more in countries that experienced a surge in cases before vaccination, said Senior Minister of State for Health Janil Puthucheary on Monday (Nov 1).
The COVID-19 death rate of 0.2 per cent is “comparable to catching pneumonia”, he said in a ministerial statement in Parliament on the country's ICU and hospital capacity.
"But it does mean that over time, the absolute number of deaths from COVID-19 will rise despite the best possible medical care, and we could have 2,000 deaths per year. Most of these will be the elderly and already unwell," he added.
In comparison, about 4,000 patients die as a result of influenza, viral pneumonia and other respiratory diseases annually, Dr Puthucheary noted.
He said this is why the Government keeps emphasising the importance of vaccination and booster jabs.
“We must make sure that everyone who is infected with COVID-19 will receive proper medical care by our healthcare workers and hospital system, and be given the best chance to fight the disease,” he said.
Singapore has had 407 COVID-19 fatalities as of noon on Sunday - 395 died in a hospital, eight at home and four at care facilities.
Dr Puthucheary noted that the number of deaths has increased in the past two months as the overall case count rose.
But Singapore has managed to keep fatalities "very low", he said, adding that that about 99 per cent of the country's COVID-19 cases have had mild or no symptoms because of the high vaccination coverage.
Seniors who are unvaccinated and have underlying medical conditions are at “much greater risk” of severe illness and death, he said.
"Close to 95 per cent of those who died in the last six months were seniors aged 60 and above. Seventy-two per cent of all deceased cases had not been fully vaccinated,” he added.
“Almost all of the remaining 26 per cent who were fully vaccinated suffered from underlying medical conditions such as high blood pressure, diabetes, cancer, and heart, lung or kidney diseases. Underlying conditions add risks, even if the conditions are well controlled before the patient encounters COVID-19, especially if the patient is elderly.”
Singapore's healthcare system is currently "stressed, but it has not been overwhelmed", said Dr Puthucheary. This is unlike the situation last year in many countries which experienced "excess mortality" and patients had to be turned away, he said.
"Excess mortality is when a lot more people than you expect die in a year, he said. "We are trying hard to avoid that, by keeping restrictions tight last year when our population was vulnerable to the disease, and then cautiously opening up after we vaccinated the vast majority of our population."
Although Singapore is trying to live with COVID-19, it "cannot just open up" and risk having cases shoot up, said Dr Puthucheary.
“We are trying to get to the point where the combination of high vaccination rates, booster jabs and even more boosting from mild infections means that COVID-19 will no longer spread as an epidemic in Singapore. And we are trying to get there without excess mortality,” he added.
“In other words, though we will have fatalities as a result of COVID-19, we will not see more overall deaths than we would in a normal non-COVID year. Nearly every other country that has arrived at that destination has paid a high price in lives.”
More cases will result in more ICU beds being used. Beyond a certain point, that will “force us to accept a lower standard of care” and result in more deaths that could have been prevented, said Dr Puthucheary.
“If despite our caution, ICU cases rise sharply, we will still do our very best to look after every patient. But at what level of care? I would strongly prefer if we can avoid that dreadful scenario,” he added.
“We need to continue to manage the overall number of cases in our population, even as we continue to increase our hospital capacity.”
Nonetheless, Dr Puthucheary acknowledged that "there is hope", calling on everyone to do their part.
“MOH and the healthcare teams will continue to train staff, increase beds and expand ICU capacity, he said.
“All of us can continue to play our part. Vaccination remains critical, every single extra person who gets vaccinated makes a difference, to themselves and for all of us. Getting your booster shot as soon as you are eligible makes a difference,” he added.
“Following the safe management measures makes a difference. Regular testing makes a difference. Using the right health care resources appropriately makes a difference.”
The current situation will “not last forever”, added Dr Puthucheary.
“Eventually enough of us will be vaccinated or will have been infected, that we will see the case numbers come down and the situation stabilise. But in getting there, we should try to keep the number of deaths as low as possible.”
He stressed that having one of the lowest fatality rates in the world is “a small miracle”, which didn’t happen by chance.
“It happened because Singaporeans stood together, looked out for each other, did their duty, and put the interests of others ahead of their own," he said. "And the healthcare workers of Singapore have done all this and much much more, caring for us all.”
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The COVID-19 death rate of 0.2 per cent is “comparable to catching pneumonia”, he said in a ministerial statement in Parliament on the country's ICU and hospital capacity.
"But it does mean that over time, the absolute number of deaths from COVID-19 will rise despite the best possible medical care, and we could have 2,000 deaths per year. Most of these will be the elderly and already unwell," he added.
In comparison, about 4,000 patients die as a result of influenza, viral pneumonia and other respiratory diseases annually, Dr Puthucheary noted.
He said this is why the Government keeps emphasising the importance of vaccination and booster jabs.
“We must make sure that everyone who is infected with COVID-19 will receive proper medical care by our healthcare workers and hospital system, and be given the best chance to fight the disease,” he said.
DEATHS “VERY LOW”, HIGH VACCINATION COVERAGE
Singapore has had 407 COVID-19 fatalities as of noon on Sunday - 395 died in a hospital, eight at home and four at care facilities.
Dr Puthucheary noted that the number of deaths has increased in the past two months as the overall case count rose.
But Singapore has managed to keep fatalities "very low", he said, adding that that about 99 per cent of the country's COVID-19 cases have had mild or no symptoms because of the high vaccination coverage.
Seniors who are unvaccinated and have underlying medical conditions are at “much greater risk” of severe illness and death, he said.
"Close to 95 per cent of those who died in the last six months were seniors aged 60 and above. Seventy-two per cent of all deceased cases had not been fully vaccinated,” he added.
“Almost all of the remaining 26 per cent who were fully vaccinated suffered from underlying medical conditions such as high blood pressure, diabetes, cancer, and heart, lung or kidney diseases. Underlying conditions add risks, even if the conditions are well controlled before the patient encounters COVID-19, especially if the patient is elderly.”
Related:
“WE CANNOT JUST OPEN UP”
Singapore's healthcare system is currently "stressed, but it has not been overwhelmed", said Dr Puthucheary. This is unlike the situation last year in many countries which experienced "excess mortality" and patients had to be turned away, he said.
"Excess mortality is when a lot more people than you expect die in a year, he said. "We are trying hard to avoid that, by keeping restrictions tight last year when our population was vulnerable to the disease, and then cautiously opening up after we vaccinated the vast majority of our population."
Although Singapore is trying to live with COVID-19, it "cannot just open up" and risk having cases shoot up, said Dr Puthucheary.
“We are trying to get to the point where the combination of high vaccination rates, booster jabs and even more boosting from mild infections means that COVID-19 will no longer spread as an epidemic in Singapore. And we are trying to get there without excess mortality,” he added.
“In other words, though we will have fatalities as a result of COVID-19, we will not see more overall deaths than we would in a normal non-COVID year. Nearly every other country that has arrived at that destination has paid a high price in lives.”
More cases will result in more ICU beds being used. Beyond a certain point, that will “force us to accept a lower standard of care” and result in more deaths that could have been prevented, said Dr Puthucheary.
“If despite our caution, ICU cases rise sharply, we will still do our very best to look after every patient. But at what level of care? I would strongly prefer if we can avoid that dreadful scenario,” he added.
“We need to continue to manage the overall number of cases in our population, even as we continue to increase our hospital capacity.”
“THERE IS HOPE”
Nonetheless, Dr Puthucheary acknowledged that "there is hope", calling on everyone to do their part.
“MOH and the healthcare teams will continue to train staff, increase beds and expand ICU capacity, he said.
“All of us can continue to play our part. Vaccination remains critical, every single extra person who gets vaccinated makes a difference, to themselves and for all of us. Getting your booster shot as soon as you are eligible makes a difference,” he added.
“Following the safe management measures makes a difference. Regular testing makes a difference. Using the right health care resources appropriately makes a difference.”
The current situation will “not last forever”, added Dr Puthucheary.
“Eventually enough of us will be vaccinated or will have been infected, that we will see the case numbers come down and the situation stabilise. But in getting there, we should try to keep the number of deaths as low as possible.”
He stressed that having one of the lowest fatality rates in the world is “a small miracle”, which didn’t happen by chance.
“It happened because Singaporeans stood together, looked out for each other, did their duty, and put the interests of others ahead of their own," he said. "And the healthcare workers of Singapore have done all this and much much more, caring for us all.”
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Continue reading...