SINGAPORE - More people have been reported to have died from Covid-19 complications in October than in the 18 months prior, an indication of the virulent nature of the Delta strain and its impact on the unvaccinated here.
The country's first death was recorded on March 21 last year. The 75-year-old woman was linked to the cluster at The Life Church and Missions Singapore.
As at Wednesday (Oct 20), Singapore has recorded 264 deaths in total, with 169 patients reported to have succumbed to Covid-19 complications in October.
"When the Delta variant first reached Singapore, our case numbers were still quite low as we had more aggressive contact tracing and quarantining measures and were actively trying to slow down spread to buy time to get people vaccinated," said Associate Professor Alex Cook, vice-dean of research at the National University of Singapore's Saw Swee Hock School of Public Health.
"However, we've now reduced the effort to prevent transmission, such as by making quarantine and isolation less onerous. This is due to our high vaccination rates, which have made Covid-19 become a much milder disease for most of us. But this would mean a deadlier pandemic for the unvaccinated," he added.
A closer look at the numbers makes this point clear - the unvaccinated are around 8½ times more likely to die from the virus compared with a vaccinated person - based on calculations by The Straits Times using figures from October.
This ratio was arrived at by using the death rate of those who did not receive a single dose and comparing it against the death rate of those who had received two doses.
The Ministry of Health only started to release data on the vaccination status of those who died in late September.
Prof Cook noted that if there were no restrictions, the death rate will be higher.
"For anyone middle-aged or older, it's a huge gamble to be unvaccinated, with everything to lose and very little to gain," he added.
In a press conference on Oct 2, Health Minister Ong Ye Kung also said that unvaccinated people are 14 times more likely to need intensive care or die, compared with those who are vaccinated.
Around three in four who were reported to have died in October were individuals who received a single dose of a vaccine or were unvaccinated.
The unvaccinated accounted for 84 out of 169 of the reported deaths here this month as at Wednesday, and 30 more of the reported deaths had only a single dose of the vaccine.
Global push to vaccinate
Prof Cook noted that Singapore's experience is not unique.
The Guardian in September reported that while 80 per cent of the adult population in Britain are fully vaccinated, there has been an uptick in unvaccinated people ending up in hospital.
Dr David Windsor, a critical care consultant in south-west England told The Guardian: "What we are seeing right now is a large number of unvaccinated people coming into hospital - far more than we would expect."
In the United States, the estimate is that between 98 per cent and 99 per cent of Americans dying of Covid-19 complications are unvaccinated.
The situation was so grave that US President Joe Biden and the director of the Centres for Disease Control and Prevention (CDC), Dr Rochelle Walensky, coined the term "pandemic of the unvaccinated".
Singapore's death rate remained fairly flat initially, in part due to tighter measures, such as the revision to phase two (heightened alert) in July to stem the spike in community cases.
By the end of August, Singapore's vaccination rate had hit the 80 per cent mark.
But some people remained hesitant, and others reluctant, to get vaccinated against Covid-19.
Currently, around 84 per cent of the population have been fully vaccinated, and 85 per cent have received at least one dose.
This leaves around 15 per cent unvaccinated, with a significant proportion being children below the age of 12.
Expectations are that approval will be given early next year for children aged between five and 12 to receive the shots as well.
Northeast Medical Group chief executive Tan Teck Jack said: "People are usually worried about the side effects of mRNA vaccines. Some of these concerns include pre-existing drug allergies, adverse reactions to previous mRNA vaccines and genuine concern for children or elderly with chronic illnesses."
Dr Tan added: "Most of these concerns can be easily addressed and most of them simply need reassurances."
More getting vaccinated now
The numbers clearly show that vaccination prevents death and serious illness.
On Wednesday, Mr Ong noted that in the last 28 days, about 98.6 per cent of infected individuals have mild or no symptoms. The remaining 1.1 per cent of cases need oxygen supplementation, 0.1 per cent require time in the intensive care unit, and 0.2 per cent have died.
At Northeast Medical Group's clinics, all of its vaccination slots over the last weekend were filled up, a 30 per cent increase compared with the previous weekend.
"It was a mix of booster shots and primary doses. There seems to be a sudden surge in health awareness because many Singaporeans now know of someone close to them who has already caught Covid-19," Dr Tan said.
Dr Mark Yap, who runs Cashew Medical and Surgery in Fajar Road, noted that those who had wanted to get vaccinated would have already received their shots, given that the non-mRNA jabs have been recognised here and mobile vaccination teams are already catering to those who are unable to travel.
Dr Yap, who mostly sees patients coming in for booster shots, had just five elderly patients wanting to get their first doses since his clinic started offering the vaccine three weeks ago.
Dr Yap said that if he sees an unvaccinated patient, he will spend time to understand the patient's concerns and "strongly encourage" the person to get vaccinated.
But as Singapore opens up, the urgency for the unvaccinated to get their jabs is now critical, say experts.
The Delta strain is more than two times as contagious as previous variants, with some data suggesting that it might cause more severe illness than previous variants in unvaccinated people, the CDC said on its website.
The push here to get vaccinated turned into a near shove when the Government announced new vaccination-differentiated measures on Oct 9.
The unvaccinated would not be allowed to dine in at eateries, go to shopping malls or visit attractions from Oct 13. They can go to hawker centres and coffee shops only to buy takeaway food.
It had the desired effect - from Oct 9 to 15, about 17,000 people received their first dose of a Covid-19 vaccine under the national vaccination programme, while another 162,000 took their booster shot.
In comparison, from Oct 2 to 8, about 11,000 people got their first dose of a vaccine under the national vaccination programme, while about 135,000 received their booster dose.
Though the increase in vaccination rates have plateaued, there are still people going in to get their shots.
Family physician Dale Lim from The Tenteram Clinic in Whampoa told ST that while the majority of patients are in for booster shots, a woman below 40 years old did walk in on Tuesday for her first dose.
"She cited the high number of cases as a reason to vaccinate. She thought she could avoid needing the vaccine as cases were low last time, but now, it is different," Dr Lim said.