News analysis

VTL likely to see some import of Covid-19, but that will have little impact on Singapore

Visitors have as much risk of getting Covid-19 while in Singapore as locals have when overseas. PHOTO: ST FILE

SINGAPORE - More travellers will be entering Singapore without the need to quarantine as the Vaccinated Travel Lane (VTL) scheme is extended to nine more countries.

This also applies to Singaporeans who want to go on an overseas trip.

Airlines faced a flood of inquiries and saw tickets getting snapped up right after last week's announcement of the easing of travel curbs, indicating a lot of pent-up demand.

Most people welcomed the opening of Singapore's borders - even though it was only to a select few countries and limited to 3,000 travellers a day - as an indication that the nation has started its move towards normality.

Eyebrows have been raised, however, about some of the 11 countries selected for the scheme.

Many found the inclusion of the United States and the United Kingdom, in particular, questionable, as both these countries continue to top the charts in terms of the daily new infections - and in the case of the US, also for the number of daily deaths.

The US had 99,000 new infections and 1,831 deaths, while the UK had 43,000 new cases and 136 deaths on Wednesday (Oct 13), local time.

At least the vaccination rate in the UK is high - though not as high as in Singapore - with close to 80 per cent of eligible people fully vaccinated. In the US, less than 60 per cent of the population has been fully vaccinated.

And yet, Singapore is allowing people flying in from these two countries to enter without the need for quarantine.

In explaining how these 11 countries were picked, Transport Minister S. Iswaran explained that they accounted for 10 per cent of travellers in pre-Covid-19 days.

He also told The Straits Times' digital broadcast, The Big Story: "They are among our top 20 trading partners, and they have sizeable business communities and families here in Singapore. So it is important that we reconnect with them."

But there are other, larger foreign communities here - and from countries with lower Covid-19 infection rates. Malaysia, Indonesia and India are good examples. Would they be equally safe countries to have under the VTL scheme?

Of course, the VTL is an agreement between two countries, so the other country needs to agree to similar travel conditions.

For some very safe countries such as China, Singapore has already unilaterally opened up, but China has not reciprocated - not surprising, given the relatively high rate of infection and deaths here in recent weeks.

So while there is minimum fuss for travellers coming from China, the same doesn't apply when these travellers return home.

But vaccination and infection rates, as well as willingness on the part of the other country, are not the only criteria for the VTL scheme.

While these are important, there are other factors at play, said Mr Iswaran.

These include "operational risk assessments in terms of whether we can implement the processes that we have in mind well, and whether the airlines and the airports, et cetera, can work seamlessly to make it happen".

So, aside from vaccination and infection rates, the efficiency and reliability of the other country's administrative and technological systems also play an important part.

This makes sense.

There must be a reliable source to ensure that people who say they have been fully vaccinated really have been. This also means the need for compatible technology since both countries must be able to digitally verify vaccination status.

Similarly, Singapore should be able to rely upon the authorities in the other country to ensure that all passengers are cleared with a polymerase chain reaction (PCR) test before flight departure.

Said Mr Iswaran: "We want them to have a negative PCR test within 48 hours of departure. But we need to be sure that the facilities are there, the test results are readily available, and these can be reliably accessed by the airline and also our own agencies."

Professor Teo Yik Ying, dean of the NUS Saw Swee Hock School of Public Health, said the choice of countries for VTL entry is determined by a combination of public health and economic considerations.

He said: "These are countries where there are strong economic ties with Singapore, as well as a sizeable population of expatriates working in Singapore, and host a number of Singaporeans working or studying there. These are also strategic for Singapore to remain as an air hub in Asia-Pacific."

As for the US, he said the vaccination rate is uneven across states, but places where travellers from Singapore are likely to visit, such as New York, California and Hawaii, have more than 70 per cent vaccination rates.

Places in the US where travellers from Singapore are likely to visit, such as New York, have more than 70 per cent vaccination rates. PHOTO: AFP

Other countries suitable for early VTLs, he said, include Australia, Japan and New Zealand. But this is provided they, too, agree to such hassle-free travel.

Professor Dale Fisher, a senior infectious diseases consultant at the National University Hospital (NUH), expects expansion of the VTL scheme fairly soon.

His rationale: "Many of the countries in the VTL seem fairly random. Why Spain and not Portugal? Why Germany, France and Italy, but not Switzerland, which they surround? In Europe, people travel between countries freely."

He added that the infection rate in the other country is not as important as having all incoming travellers fully vaccinated.

Vaccinated travellers who are infected will likely be mildly ill or have no symptoms, and carry low viral loads that reduce the risk of onward transmission.

This raises the question of the testing regimen required.

Travellers need to test negative in the 48 hours before departure, and again on arrival.

Taking the extreme limits, that's 48 hours, plus flight time of, say, 30 hours. That's 78 hours in all by the time they do their second test.

Most travellers would have a much shorter period between the two tests.

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The incubation of the Delta variant, which is now globally dominant, is much shorter than earlier variants and takes four days or less. Four days is 96 hours.

That means travellers who have been infected can test negative for both tests as it is during the incubation period.

Their viral load goes up only after a day or two at their destination.

Yes, such leaks are not just possible, but are also likely to happen, said all the experts The Straits Times spoke to.

But as Associate Professor Alex Cook, vice-dean for research at the NUS Saw Swee Hock School of Public Health, said: "At the number of community cases we're seeing, even adding 100 infected travellers a day would have very little impact on the amount of community transmission.

"The key is that the travellers must be vaccinated (or young). We do not want additional unvaccinated people coming into the country and potentially adding more strain to the healthcare system."

Singapore has been recording about 3,000 new infections daily, indicating that the virus is spreading rather freely in the community. About 22,000 people are currently recovering from Covid-19.

This is why Prof Fisher said Singapore can afford to relax the need for quarantine and repeat tests for travellers from other countries.

He explained: "Imported cases used to matter when we were in the containment phase. But now, border closures add nothing to the strategy where we are transiting into endemicity."

Visitors have as much risk of getting Covid-19 while in Singapore as locals have when they are overseas. So, such restrictions may no longer be meaningful.

What is important is that all who face such risks are fully vaccinated, so they have good protection against severe illness and deaths - no matter whether they get infected overseas, or in Singapore.

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