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reporter2
11-09-21, 16:55
Singapore's new Covid-19 wave 'happening faster than expected': Lawrence Wong

But no need to return to 'heightened alert' or 'circuit breaker' for now despite escalating case numbers, he says

Sep 11, 2021

https://www.businesstimes.com.sg/government-economy/singapores-new-covid-19-wave-happening-faster-than-expected-lawrence-wong

Singapore

SINGAPORE'S new wave of Covid-19 cases has yet to peak, and all countries that have opened up have also had to deal with such fresh waves, the government's Covid-19 multi-ministry taskforce (MTF) said on Friday.

"For us, it is happening faster than we had expected, and it's also the first time since our (reopening) that we are facing such a new exponential wave of infection in our community," said Finance Minister and taskforce co-chair Lawrence Wong.

"Very soon, we will reach 1,000 new cases a day, and in a few weeks' time, we will probably get to 2,000 new cases a day."

Health Minister and fellow co-chair Ong Ye Kung said based on the experience of countries in Europe, a transmission wave may take four to eight weeks to peak, with daily cases doubling every 10 days, making for about four to five doubling cycles.

Singapore is now 18 days into the wave which began on Aug 23, with daily cases having already doubled twice and on the way to a third doubling - from 400 to 800, he noted.

"This rapid and exponential rise in daily infections that we are experiencing now is what every country that seeks to live with Covid-19 has had to go through at some point," Mr Ong said.

He added that Singapore has always wanted to "go through it differently" in two major ways - with as few deaths as possible and without a hard lockdown.

"A key imperative is to get our healthcare protocols readjusted, in fact, reconfigured, and we need to shift decisively to cope with a much larger number of infections based on the characteristics of the Delta variant," he said.

This points to four major changes, with more resources focused on vulnerable settings and large clusters and automatic quarantine orders for household members of infected patients. Quarantine periods will be shortened while infected individuals could be discharged earlier if they test negative. Home recovery will now be default for young and healthy fully-vaccinated individuals who do not live with vulnerable persons.

Meanwhile, Singapore's booster programme for seniors aged 60 and above as well as immunocompromised persons will begin on Sept 15.

Given the rapidly changing infection situation, Mr Wong said a more cautious approach is needed.

Despite the escalating case numbers, there is no need to return to a "heightened alert" or "circuit breaker" at this juncture, he said.

"Our actions have been guided by data and evidence, and based on the advice of our medical and scientific experts, and the collective view of the MTF and our experts is this," said Mr Wong.

At the same time, the taskforce does not think it is prudent to press ahead with any opening measures, as it would be "reckless" under current circumstances, he added.

"Our position is we believe it is more prudent to take a pause now, do our best to slow down the spread where we can, and then monitor closely what happens to our ICU situation over the next two to four weeks," said Mr Wong.

Mr Ong said the government is also ramping up healthcare facilities to handle about 1,000 infections, with drawer plans to make further changes to handle beyond that number.

He said while there is sufficient capacity to accommodate 1,000 ICU cases, "really, we don't want to go anywhere near because to reach there, you seriously degrade hospital services".

Mr Wong added that one should not underestimate exponential growth: "Don't be lulled by 'seven cases in ICU and therefore we've got so much head room'. Exponential growth can change the situation in a few weeks' time."

The difference between now and a few months ago is, he said, a much higher vaccination rate today at about 81 per cent.

Still, there are also countries with high vaccination rates that have experienced fresh waves of infection despite their best preparations.

"That's why we are asking everyone to exercise restraint during this period, scale back on non-essential social activities, get tested regularly and let's all do our part to try and slow down the spread of the virus," said Mr Wong.

reporter2
11-09-21, 16:57
Revealing more of the math behind Covid-19 action plans can help allay public fear, uncertainty

Authorities face two opposing tides of opinion: those alarmed by rising numbers and those wanting more decisive reopening

Sep 11, 2021

https://www.businesstimes.com.sg/opinion/revealing-more-of-the-math-behind-covid-19-action-plans-can-help-allay-public-fear

Singapore

FRIDAY brought a literal insight into the calculations of the multi-ministry taskforce on Covid-19, as taskforce co-chair and Health Minister Ong Ye Kung laid out what this exponential phase of cases may mean.

The figures serve not just to prepare the public for high case numbers, but also - importantly - to signal the taskforce's own expectations.

Based on the experiences of countries in Europe, Singapore may see four or five 10-day "doubling cycles" of cases before the wave peaks, said Mr Ong. Daily cases are in the middle of a third doubling from 400 to 800. With two more cycles, cases could rise to 1,600, and then to 3,200.

This is "what is possible", though how it actually unfolds depends on Singapore's actions, he added. With extensive testing and public responsibility, this wave might be restricted to three or four doubling cycles.

Finance Minister Lawrence Wong put it starkly: "Very soon, we will reach 1,000 new cases a day, and in a few weeks' time we will probably get to 2,000 new cases a day."

The taskforce has to navigate between two opposing tides of public sentiment: those who are alarmed by rising numbers, and those who want more decisive reopening. Providing such figures may help on both fronts.

First, advance figures could forestall public anxiety. Without such foreshadowing, breaching the psychologically weighty threshold of 1,000 daily cases might spark a stronger reaction from the worried.

Second, knowing the taskforce's calculations makes its actions more predictable - addressing the complaints of those who see it as erratic.

The recent rise in cases "is happening faster than we had expected", said Mr Wong. Now that the taskforce has revealed the pace that it expects from here, it will be clear if the situation is deviating from this. This should reduce the usual public speculation that occurs as cases climb.

Indeed, the taskforce reiterated on Friday that the focus is on intensive care unit (ICU) cases. While the number is still low, "we must not be complacent and assume this will automatically remain so over the coming weeks", said Mr Wong.

He explained why they cannot simply give a figure that some have called for: the threshold of ICU cases that would prompt tighter measures.

"We have to not only watch the numbers... but also the trajectory," he said. "Because the number may be 50, or whatever it is, in a few weeks time - but if the trajectory is going up sharply, then it is a warning sign that in the coming weeks, we may see many more ICU cases."

In other words, it is not that the taskforce refuses to reveal this magic number, but that there is no such number; they are not watching one indicator, but the broader situation.

As for the perception of inconsistency, Mr Wong laid out the taskforce's position again: while there is no need to take last-resort measures at this juncture, it would be reckless to press ahead with opening now.

"Our position is we believe it is more prudent to take a pause now, do our best to slow down the spread where we can, and then monitor closely what happens to our ICU situation over the next two to four weeks," he said.

One could draw a parallel with central bank policy amid a crisis: while the aim is eventual normalisation, a premature move might jeopardise the recovery. Better, then, to hold steady and monitor the data - though the goal has not changed.

This does raise a question: With the reopening midway, there is still scope to pause. What happens if cases flare up after fuller reopening, in the endemic steady-state? What can be done besides taking the "last resort" of tightening measures?

Other longer-term questions remain, too, such as what full-year mortality rates might look like in a steady-state - as Mr Wong noted on Friday, adding: "That's a separate conversation which we can have later on."

One hopes for similar transparency on future calculations. As Mr Wong also said: "We will continue to provide timely updates to everyone so that people get a sense of our latest thinking."

The recognition that the public wants clarity not just on the health situation, but also the taskforce's own thinking, is welcome.