Rapidly rising COVID-19 cases putting 'serious strain' on hospitals, action needed: Task force
SINGAPORE: The rapid rise in COVID-19 cases is “of concern” and putting "serious strain" on hospital resources despite the shift to community and home care, said co-chair of the multi-ministry task force Gan Kim Yong on Friday (Sep 24).
To ensure that the healthcare system can continue to cope with these cases, Singapore has to take action to slow the rise in cases to protect the hospital system, he added.
Dining-in at F&B outlets and social gatherings will be reduced to groups of two from next Monday. Home-based learning for those in primary school and special education schools will be extended to Oct 7.
Work from home will also now be the default. Fully vaccinated people aged 50 to 59 who finished their vaccination regimen at least six months ago will be invited to take their booster shots from Oct 4, the task force announced.
Speaking at a press conference, Mr Gan noted that Singapore has seen a sharp increase in the number of local cases since two weeks ago, almost reaching 1,600 cases a day.
“If the trend continues, the number of cases is likely to double to 3,200 a day by next week, and may even increase beyond that,” he added.
Singapore is also keeping a close watch on the number of serious COVID-19 cases, said Mr Gan.
While the number of serious cases is “still manageable” now, it takes about a week to 10 days or more for positive cases to show complications, he added.
“If positive cases continue to rise rapidly, we will expect to see the number of serious cases rise also. In fact, we are already starting to see a rise in the number of persons requiring oxygen, admission into ICU and deaths, mostly from cases infected some weeks ago,” said Mr Gan, who is also the Trade and Industry Minister.
“While we watch ICU cases, the rapidly increasing number of new cases is also of concern, as it is creating a serious strain on our hospital resources, despite the shift to community and home care. To ensure our healthcare system can continue to cope with these cases, we will need to take action to slow the rise in cases to protect our hospital system.”
The large majority, or 98 per cent of cases, are asymptomatic or have mild symptoms, said the Ministry of Health (MOH) in a separate press release.
This is due to Singapore’s high vaccination coverage, with 82 per cent of the population fully vaccinated, it said.
Of the 254 cases with severe illness in the past two weeks, a “disproportionate” 48 per cent were unvaccinated, and the remainder were vaccinated individuals with co-morbidities.
"This ratio needs to be understood in the context of more than 80 per cent of our population being fully vaccinated," said the Health Ministry.
The numbers indicate a vaccine efficacy against severe illnesses that is still around 80 to 90 per cent. The elderly and those with co-morbidities among the vaccinated make up the 10 to 20 per cent who remain susceptible despite vaccination, it added.
As of Thursday evening, 23 beds in the ICU were occupied, and Singapore can set up almost 300 beds “at short notice”, said Health Minister and task force co-chair Ong Ye Kung.
“As of now the situation remains stable, but we need to watch it very closely. ICU numbers lag infection numbers by 10 days, 14 days, so we will expect ICU numbers to rise in the coming days,” he added.
“And some of them, especially if they are unvaccinated, elderly or with underlying illness, will unfortunately succumb.”
Responding to a reporter's question about how many cases Singapore's healthcare system can take before it fails, the Health Minister said that currently, it can handle 2,500 to 3,000 cases if the home recovery programme is implemented smoothly.
"At the same time, we need to dig very deep to prepare ourselves for 5,000 cases. These are the parameters that we are working on now. On one hand is the capacity, on the other hand, (the) last resort is always tapping on the brakes like we have to do now."
"TEETHING ISSUES" IN HOME RECOVERY SCHEME
Singapore entered the preparatory stage of its transition to living with COVID-19 as endemic on Aug 19. Home recovery for COVID-19 patients who are younger or vaccinated and are asymptomatic or have mild symptoms has also been introduced.
“While we have been advising individuals with mild COVID-19 symptoms that it is appropriate to recover at home, we understand the anxiety of some individuals to want to seek medical attention at hospitals,” said the Health Ministry in its press release.
MOH also acknowledged that the protocols and processes for home recovery are new and there have been "service lapses" as numbers increased.
“We are ironing out the teething issues with the home recovery programme, and in the coming few weeks, will further ramp up our care facilities to handle more cases.”
Without the home recovery programme, the system would already have been overwhelmed, said Mr Ong.
Home recovery is still the “most appropriate” care protocol for most cases that show mild symptoms or are asymptomatic, said the Health Ministry.
"But if the overall number of cases continues to rise rapidly, we are also likely to see a growing number of infected persons, especially among the elderly, who do need hospital care. Hence, there is a need to slow down community transmission."
Mr Ong stressed that those on home recovery were "not left on (their) own to recover", adding that the health ministry's hotline operator team will be expanded and telemedicine services were available for support.
Private sector primary care providers have also been roped in to help with such services.
"The high number of cases these past couple of weeks struck us before we can fully put them in place. So I fully acknowledge that the past few days have been frustrating for you if you are undergoing home recovery," he added.
The Singapore Armed Forces will also be supporting with operations, which Mr Ong said had significantly "augmented" resources and capabilities. He also urged the public to allow the ministry to "progressively clear the backlog that has accumulated over the past few days".
MOH has joined Telegram groups where people on home recovery are providing support to each other, said Mr Ong.
"We are joining so that we are able to answer your queries, and also at the same time pick out many of these common queries and confusion."
In a Facebook post on Friday night after the press conference, Prime Minister Lee Hsien Loong said that the new measures would "give us more time to deliver booster shots to people, and vaccinate those still not vaccinated".
Singapore is also expanding its hospital capacity, said Mr Lee.
"This will ensure that our healthcare system is not overwhelmed and can continue to take good care of all those who need medical care, whether for COVID-19 or other conditions," he said.
"We have to adapt our response to COVID-19 as the pandemic develops. I know the changes can be confusing and unsettling, but please bear with us. We will work closely with you to protect all our families."
"DIFFICULT DECISION TO APPLY SOME BRAKES"
Acknowledging that Singaporeans may be disappointed by the new restrictions, co-chair of the task force Lawrence Wong said: “We had all hoped that we could put these restrictions behind us, especially with our high vaccination rates and with our plans to move forward to a COVID-resilient nation.
“But the reality is that with the current infection trajectory, our healthcare system and our healthcare workers are facing many pressures. And that’s why we had to make this very difficult decision to apply some brakes and to slow down the rate of transmission.”
Singapore is still committed to its reopening plans, said Mr Wong, noting that the task force has left “many other parameters untouched”.
For example, mask-on vaccinated events can continue. The vaccinated travel lanes with Germany and Brunei have been rolled out, as well as plans for dormitory workers to re-enter the community, he added.
“After this wave crests, and it certainly will at some point in time, the daily numbers will come down. But they will stabilise at a new level which is likely to be much higher than what we have been used to before,” said Mr Wong.
“In other words, we are not going back to a scenario of low daily cases anymore. It’s not going to be possible, because we are moving forward to learn to live with the virus and we are continuing with our reopening plans.
“That’s part of the adjustment we all have to make to prepare ourselves for the time when COVID becomes an endemic disease and learn to live with more daily cases.”