Singapore's response to Covid-19 variant Omicron: Too much, too little or just right?

Entry requirements into Singapore have been tightened, with all air travellers required to take a PCR test on arrival. ST PHOTO: JASON QUAH

SINGAPORE - When the stakes are very high, it is always better to take possibly unnecessary precautions than to be caught off guard and end up with needless suffering and deaths.

This is what Singapore and the rest of the world are doing with the emergence of Omicron, the latest Covid-19 variant of concern (VOC).

The World Health Organisation (WHO) has very quickly declared it a VOC - less than a month after it was first detected and even before there is enough information to know if it really will be of concern.

The decision was based on the potential for more rapid transmission given the number and location of the spike protein mutations in Omicron that might make it easier for the virus to enter human cells and reproduce.

This is unlike how the WHO dragged its feet in declaring the Covid-19 a pandemic in 2020. That resulted in slower reactions by many countries in dealing with the spread of the virus - and is partially responsible for the more than 5.2 million Covid-19 deaths over the past two years.

One could say the world has learnt from its mistakes and is reacting much faster, just in case, instead of waiting for more information to emerge.

This time, more than a dozen countries, including Singapore, have started closing their borders to visitors from countries where the new variant might be spreading, primarily those in southern Africa.

Entry requirements into Singapore have also been tightened, with all air travellers required to take a polymerase chain reaction (PCR) test on arrival.

If there is a positive test result, a ringfence will be thrown around the person and any close contacts, to prevent Omicron from entering the community.

But the multi-ministry task force tackling Covid-19 has stopped short of dialling back the recent relaxation of measures in the community, which now allows people to dine in groups of five, among other things.

It has, however, paused further relaxation while signalling its readiness to act if the situation demands it.

This approach seems well-calibrated as the community measures have only recently been eased. Until Omicron spreads in the community, there is no need to tighten measures, as it can be done quickly if needed.

The obvious questions that arise are: Is Singapore doing too little? Too much? Or is this the best approach?

There are bound to be different opinions, but there will not be a clear answer until some time into the future.

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While the border measures will buy us more time, should Omicron turn out to be as transmissible as the Delta variant or more so, it will still likely find its way into Singapore eventually. And its entry might not be through the airport. Experts believe the huge Jurong Fishery Port cluster was caused by the virus arriving on a foreign fishing vessel.

As scientists around the world work hard to learn more about this new variant, there are a few important questions that need to be answered.

The first is to confirm whether fears that Omicron is more transmissible, given the mutations in the spike protein, are true. If it is, we can expect a lot of people to get infected.

Next is whether it is more virulent or causes a milder version of the disease. As viruses mutate, they generally become less virulent to ensure the host survives to continue the spread.

If that happens, it might actually be a good thing, as an infection can boost a person's immune response for added protection against more virulent variants.

But just because mutation often weakens the virulence of a virus, it does not mean that it will always be so, hence caution at this time is a good thing.

Associate Professor Hsu Li Yang, an infectious diseases expert at the NUS Saw Swee Hock School of Public Health, said the new measures will increase the chances of picking up people infected by Omicron entering Singapore, and delay its spread here.

This might "suffice to buy enough time until we understand more about the characteristics of the variant via laboratory studies as well as through monitoring its impact on South Africa and other countries", he said.

World leaders are also asking how much protection current vaccines give, and if modified vaccines are needed. If they are, then buying time while they are developed, manufactured and distributed would be important.

Current vaccines should provide some protection, especially against severe illness, since the core of the virus remains unchanged.

Professor Ooi Eng Eong, an expert in emerging infectious diseases at the Duke-NUS Medical School, said vaccines do more than produce antibodies that prevent infection.

He said the mRNA vaccine, the most widely used form of vaccine here, "produce spike-reactive killer T cells" that can detect and kill infected cells.

"These T cells detect multiple portions of the spike protein in ways that are different to how antibodies bind the virus," he added.

So anyone who is worried about Omicron should make sure they get vaccinated, and go for their booster shot, if it is due.

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