Unvaccinated seniors at highest risk of needing ICU care, dying from Covid-19

Unvaccinated individuals account disproportionately for the rates in ICU care and death.
Unvaccinated individuals account disproportionately for the rates in ICU care and death.PHOTO: ST FILE

SINGAPORE - Unvaccinated seniors are at the highest risk of needing treatment in the intensive care unit (ICU) and dying when they get infected with Covid-19, said Health Minister Ong Ye Kung on Saturday (Oct 2) during an update by the multi-ministry task force tackling the coronavirus pandemic.

Mr Ong, together with director of medical services Kenneth Mak, urged those who remain unvaccinated, especially seniors, to get the Covid-19 vaccine.

Mr Ong, who co-chairs the task force, said that out of all Covid-19 cases in Singapore, 0.2 per cent of the patients needed care in the ICU and 0.1 per cent have succumbed to the virus.

But delving deeper into these figures, Mr Ong pointed out that unvaccinated individuals are disproportionately represented in the ICU care and death figures.

Specifically, unvaccinated people are 14 times more likely to need ICU care or die, compared with those who are vaccinated.

Within this group, it is the unvaccinated seniors who are at the highest risk of needing ICU or dying.

"Therefore, it is very critical for unvaccinated seniors to take your vaccines," he said. "And this is also why we're going all out through our mobile vaccination team, as well as our home vaccination team, to vaccinate as many seniors as we can."

He noted that there are now fewer than 80,000 unvaccinated seniors, a drop from the 200,000 some months ago.

Home vaccination teams have vaccinated over 8,000 seniors who are immobile and home-bound, he said. They will be administering the second dose to these seniors this month and beyond that, the booster shots.

"Over the last two weeks, we have seen some decline in unvaccinated seniors who have become infected as a percentage of total cases," Mr Ong said, adding that the percentage now ranges from 0.7 per cent to 1.2 per cent.

"It is very important for unvaccinated seniors to continue to reduce your social activities and your movement, and for the families to take care of them so that you do not bring the virus to them inadvertently," he said.

Meanwhile, seniors who are vaccinated are at much lower risk of severe illness if they do get a breakthrough Covid-19 infection, he added.

Associate Professor Mak noted that of the patients who are currently diagnosed to have Covid-19, the majority, at 98 per cent, either have no symptoms or very mild symptoms.

These patients are able to self-isolate and recover at home safely, he said, due to the high vaccination rates in the population. About 56 per cent of all patients are recovering at home.

"We see a good potential to offer the home recovery programme to more patients over the next few weeks," he added. But another 6 per cent of patients are unable to self-isolate in their place of residence, so they have to recover at a community care facility.

An additional 13 per cent of cases comprise people in other settings, such as migrant workers, who can safely isolate themselves within dedicated facilities like the dormitories.

"This means we already have about 75 per cent of all persons with Covid-19 recovering from the illness without needing to be admitted into hospital for treatment," Prof Mak said.

But about 2 per cent need hospital care, including 1.5 per cent of cases who require oxygen supplementation in general and isolation wards. This will be typically for two to five days before they recover sufficiently and no longer need oxygen support, he added.

But about 0.2 per cent of cases are critically ill and need ICU care. They may be placed on a mechanical ventilator or receive other treatments for organ failure and sepsis, he said. About 0.1 per cent of all people with Covid-19 infection die.

However, Prof Mak also noted that the chances of going to ICU or dying rise for older patients.

From May 1 to last Friday (Oct 1), there were no patients below 20 years old in the ICU or dying. The majority of Covid-19 patients in the ICU were above 60 years old, but there were some between 20 and 60 years old who were mostly not fully vaccinated and had other medical conditions.

"The group most at risk of needing ICU care was seniors above 60 years old who were not vaccinated," Prof Mak said. "This represented 14.2 per cent of unvaccinated seniors above 80 years old, 7.6 per cent of those between 70 and 80 years old, and 5.6 per cent of those between 60 and 69 years of age."

But for those who are fully vaccinated, this figure stood at only 1.9 per cent for those above 80 years old, 0.7 per cent between 70 and 80 years old, and 0.1 per cent between 60 and 69 years old.

"There's clearly a significant protective effect from vaccination. And no one who was below the age of 50 years old and fully vaccinated needed admission into the ICU," he said.

Overall, 1.67 per cent of unvaccinated people needed ICU care or died, compared with 0.12 per cent of fully vaccinated persons.

"So please, for those of you who still remain unvaccinated, please realise that you are endangering yourself, and you do risk death if you do get infected with Covid-19 if you fall into these high-risk groups. Please go to a vaccination centre and get yourself vaccinated," Prof Mak said.

He added that vaccinated people also should not be complacent and assume their protection is permanent.

"If you're eligible for booster vaccination dose, or you're in that sub-group of patients whom we know may not mount a sufficient immune response to the usual two-dose vaccination regime to protect yourself, please do not delay and get your third vaccination dose as soon as possible."