Why it makes sense to sharpen differentiated Covid-19 rules based on vaccination status

Unvaccinated people will no longer be able to dine in, even at hawker centres, in Singapore from Oct 13, 2021. ST PHOTO: KEVIN LIM

SINGAPORE - Border requirements have been eased further with the Vaccinated Travel Lane (VTL) scheme now extended to nine more countries.

In the coming weeks, fully vaccinated visitors from 11 countries only need to take the polymerase chain reaction test pre-departure and on arrival. Once they test negative, they do not need to isolate themselves.

This is great news for travellers - both people here eager to go abroad and foreigners wanting to come here.

But within Singapore, measures have been somewhat tightened for unvaccinated people.

From Wednesday (Oct 13), those who are unvaccinated will no longer be able to dine in, even at hawker centres, though they may still buy food to take away.

They will also not be allowed into shopping malls where they may be exposed to crowds, although they may enter supermarkets that are standalone stores.

Is Singapore being unfair to people here while it opens up its borders to visitors? The short answer is "no". The numbers bear this out.

Measures are not being tightened because the borders are opening.

The number of imported cases has remained low, even as community infections have risen, so there is no need to tighten or ease both in tandem.

The risk of imported cases spreading the virus here is extremely low.

There is also little fear of a new variant being introduced, as Gisaid, the international body that tracks changes in the coronavirus, shows that aside from South America, the Delta variant circulating here accounts for 95 per cent or more of all infections.

On the other hand, the benefits of opening up are huge. Aside from the freedom to travel - and airlines are already being inundated with queries and bookings reflecting the pent-up demand - opening up will also give the economy a boost.

Nevertheless, Singapore remains cautious in opening its borders, capping the number allowed to enter through VTL to 3,000 a day.

People queueing at the Singapore Airlines Service Centre at Ion Orchard mall on Oct 9, 2021. ST PHOTO: GAVIN FOO

Transport Minister S. Iswaran said on Saturday when the new measures were announced: "We will monitor the incidence rate, observe the demand before deciding on any further increases in capacity."

Meanwhile, the number of unvaccinated people in Singapore who have become seriously ill with Covid-19 is worrying.

More than half the people who had become seriously ill or died over the past fortnight were unvaccinated. The vast majority who needed intensive care were older people. The only two below the age of 50 years were both unvaccinated.

While half might not sound like a lot, it is when you consider that at the time they were infected, fewer than 100,000 seniors remained unvaccinated.

Against this, the 46 per cent of seriously ill patients who were fully vaccinated come from a pool of more than 4.5 million people - and all had underlying medical conditions.

Or as Director of Medical Services Kenneth Mak put it, the unvaccinated are 14 times more likely to become seriously ill, if infected.

While we may say it is the individual's choice not to get vaccinated - and with non-messenger ribonucleic acid vaccines available they can no longer say they refuse because of the novelty of the vaccine - can we, in good conscience, see them dying when that can be prevented?

As Associate Professor Mak also said: "We must do all we can to reduce the risk of persons getting a severe infection."

The new measures aim to protect the unvaccinated from serious illness and death, while reducing the load on hospital beds.

And it is not just the availability of intensive care unit (ICU) beds that is the issue.

It is the trained and experienced staff that makes the biggest impact on the survival of patients in ICUs, since rapid decision-making is sometimes crucial and necessary. This is where experience counts.

It is important to keep the number of patients needing intensive care at a number that can be safely managed, says Senior Health Correspondent Salma Khalik. PHOTO: ST FILE

So it is important to keep the number of patients needing intensive care at a number that can be safely managed.

To cater to Covid-19 patients, hospitals have delayed non-urgent surgical cases. This too is unfair to a segment of the population.

But as Trade and Industry Minister Gan Kim Yong, a co-chair of the Multi-Ministry Taskforce on Covid-19, said: "As soon as we relax measures, the number of cases will surge again, as we have seen over the last few months."

Does this mean that Singaporeans have to live with these measures for a long time to come? Not if two things happen.

One is for more seniors to get their two jabs of the vaccine. Of the 51 patients admitted to ICU in the past fortnight, only one in three was fully vaccinated.

If more people get vaccinated, that should shave a significant number off the total who need intensive care.

The other game changer is the booster jabs now being rolled out. Many of the vaccinated seniors who have become seriously ill have underlying medical conditions that put them at higher risk.

The booster should ramp up their antibody levels tenfold within a fortnight. High antibody levels reduce the risk of getting infected in the first place.

As more people get vaccinated or get booster shots, they will act as firebreaks in the spread of the virus in the community, and this in turn will bring down the number of people getting hospitalised and even dying of Covid-19.

Covid-19 would then become a manageable disease.

Meanwhile, Singapore might want to consider extending the differentiated treatment between those who are vaccinated and those who are not.

Prime Minister Lee Hsien Loong said on Saturday when he addressed the nation that the threat of Covid-19 is now mainly to seniors: 60 years and older if not vaccinated, and 80 years and older even if vaccinated.

He said: "With vaccinations, Covid-19 has become a treatable, mild disease for most of us. This is especially so if you are young."

Perhaps it is time to give these younger people greater freedom. Let classes at institutes of higher learning return to a form where vaccinated students can mingle freely on campus. Such interaction is an important part of their education.

There is also no reason to restrict outdoor activities for fully vaccinated younger people. It is time to return their lives to them.

But if such freedom is given, these younger people also need to be aware that they may catch the infection and pass it on to their seniors, and take sufficient precaution against that.

That is, until these seniors have received their booster shots. In fact, there is no reason not to extend more normal lives to people who have taken their third jab.

Doing so will also encourage more people to get their boosters, and speed up the nation's road to normalcy.

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