1,535 excess deaths in Singapore in 2021, of which 804 were due to Covid-19

In a pandemic, excess deaths will be higher than officially reported deaths directly caused by the disease. ST PHOTO: LIM YAOHUI

SINGAPORE - Singapore saw 1,535 excess deaths last year, after accounting for the country's ageing population, said Health Minister Ong Ye Kung on Monday (May 9).

The 804 deaths due to Covid-19 accounted for 52 per cent of this figure, said Mr Ong, who was responding to Workers' Party MP Leon Perera (Aljunied GRC) on the number of excess deaths due to Covid-19 and how the authorities derived this figure.

In his response, Mr Ong explained the Health Ministry (MOH) compares death rates across the years to calculate the excess death rate.

There are excess deaths if the death rate in a pandemic goes above that expected in the absence of a pandemic, and over what is expected from the population ageing.

Singapore's age-standardised death rate decreased from 563 to 519 per 100,000 residents between 2017 and 2020. But last year, this rate went up to 557 per 100,000 residents.

In a pandemic, excess deaths will be higher than officially reported deaths directly caused by the disease, Mr Ong said.

He cited a World Health Organisation report that found global Covid-19 deaths amounted to just over six million, but excess deaths stood at 15 million.

This discrepancy can be explained by several reasons, he said.

First, deaths may be under-reported in certain regions where testing is insufficient or data is hard to collate. Next, people with Covid-19 may have died of other illnesses, with the coronavirus a contributing factor rather than the main cause.

With the pandemic raging around the world, people with chronic ailments may also have put off medical check-ups or treatment, to their own detriment.

Lastly, places where healthcare systems were overwhelmed meant that proper care was denied to many patients, not just those infected with Covid-19.

In Singapore, excess deaths can be attributed to some of these reasons, Mr Ong said.

Under-reporting is not a problem in an urban environment like Singapore, he noted, and the country prioritised its healthcare system to prevent it from being overwhelmed, going into a circuit breaker when needed.

"So although our hospitals came under significant pressure at the height of the infection waves, they were not overwhelmed and hospitals could continue to give priority to serious and urgent cases," he said.

He reiterated that MOH is continuing to collect and analyse data to assess the impact of Covid-19 in a more comprehensive way. A special report on excess deaths and the key factors leading to these deaths will be released soon, he said.

"I should emphasise that whether it is official Covid-19 death toll or excess deaths, Singapore will have one of the lowest rates in the world, amongst countries that have chosen to live with Covid-19 and resumed normal lives."

Mr Lim Biow Chuan (Mountbatten) and Workers' Party MP Louis Chua (Sengkang GRC) also asked about Singapore's Disease Outbreak Response System Condition (Dorscon) framework and its continued relevance.

Mr Ong said the Dorscon framework was developed in 2003 as a tool for government agencies to coordinate their response to infectious disease outbreaks.

It was made public during the Covid-19 pandemic to underline the need for personal vigilance and social responsibility, but resulted in supermarket runs among other issues, he observed.

"This is one key issue for review, as Dorscon is meant to bolster preparedness, not to induce public anxiety."

Mr Ong noted that Singapore society has learnt much more about pandemic response over the past two years, and that the public pay much less attention to the Dorscon level now. Instead, people now take care to understand public health measures in detail and respond accordingly.

"So the Dorscon framework is most likely still relevant, but it needs to be part of a larger emergency preparation and public communications framework that we have developed and which people understand."

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