Singapore has successfully transitioned to living with Covid-19: Experts

Singapore has managed to return to normality without excessive deaths or hospitals being overwhelmed, said one expert. ST PHOTO: DESMOND WEE

SINGAPORE - Pandemic restrictions are unlikely to be reimposed here as Singapore has managed to successfully transition to living with Covid-19, experts said.

This is even as new coronavirus variants continue to emerge, and the virus is unlikely to ever be eliminated, they noted.

A slew of pandemic-related restrictions aimed at stemming the spread of Covid-19 such as mandatory masking in most public spaces, contact tracing and vaccination proof for accessing facilities were lifted over the past year.

Since Nov 7, the Health Ministry has stopped reporting new daily cases of Covid-19 infection, opting instead for a seven-day moving average of local cases as a more accurate indicator of infection trends – one that is less prone to day-to-day fluctuations.

Health Minister Ong Ye Kung announced on Nov 8 that hospitals would no longer have to set aside entire wards for Covid-19 patients.

Instead, these patients will be managed according to the severity of their condition, with those assessed to be at risk of spreading infectious diseases placed in isolation beds, as is the current practice.

This aligns Covid-19 hospitalisation protocols with other conditions such as influenza, for which there are no cohort wards except during brief occasions, said infectious diseases expert, Associate Professor Hsu Li Yang, noting that this helps to ease the crunch on hospitals.

The vice-dean of global health at the National University of Singapore’s Saw Swee Hock School of Public Health believes the moves the Republic has made have been appropriate.

“I believe there will always be those who think the steps were taken too fast or had occurred at too slow a pace,” he said.

However, the outcome of the measures taken is that the country has managed to return to normality without excessive deaths or hospitals being overwhelmed, said Prof Hsu.

Restrictions were likely not lifted earlier due to Singapore’s status as one of the most connected cities in the world, said Professor Paul Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection.

He added that hundreds of thousands of people crossed the country’s borders every day before the pandemic.

The lifting of pandemic measures will allow Singapore to concentrate on the “very real problems that did not go away just because we had the pandemic”, he said, pointing to issues such as diabetes and a global rise in tuberculosis cases.

While hospitals no longer have to set aside entire wards for Covid-19 patients, restrictions on visiting hospitals and residential care facilities – including limiting visits to 30 minutes and allowing patients only two pre-designated visitors a day – have been extended to Nov 23.

Prof Tambyah suggested this could be to prevent patients from becoming super-spreaders and infecting a large number of visitors, though he noted this could delay discharge planning for patients as well as affect their mood.

“This is especially the case for the elderly, as I have seen so many seniors’ faces light up when they see and hold their grandchildren. Screen images are not quite the same in the recovery process,” he said.

Experts said that while the country may yet experience another wave of coronavirus infections, these are unlikely to result in more severe cases.

The infection waves caused by the BA.4, BA.5 and XBB sub-variants have not resulted in more serious illness, despite the minimal measures aimed at containing their spread, Prof Hsu said.

“So I am cautiously optimistic that we are much less likely to experience anything like what happened during the Delta and initial Omicron waves in the future,” he added.

There is a “near-zero chance” of a surge in serious infections, Prof Tambyah said, noting pandemic viruses typically evolve to become more transmissible but less virulent.

He pointed to how the Spanish flu – estimated to have killed up to 50 million people worldwide – evolved to become the dominant strain of seasonal influenza between 1920 and 1957.

“There are indications that this is happening already with Sars-CoV-2 and thus no measures should be implemented, even if the case numbers go up, as the severe case numbers are unlikely to change,” he said.

It is unlikely that Covid-19 will ever be eliminated, the experts said. It became evident early on that that wiping out Covid-19 would be impossible without widespread lockdowns, which would have had a “huge human cost”, Prof Tambyah said.

“I do not believe we can eliminate Covid-19 from Singapore, much as we are unable to eliminate influenza,” said Prof Hsu, noting however that the disease had reached endemicity.

Vaccines and natural immunity have blunted the impact of infection, and the mindset of most has changed such that the there is no longer an “epidemic of fear” around Covid-19, he added.

“I believe a significant proportion of our people already considers Covid-19 as not being a ‘big deal’, and this proportion will naturally grow over the next several months until we consider Covid-19 no differently from the other viral respiratory illnesses such as influenza.”

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