1. Let me give a brief update of the epidemic situation. As everyone knows, we are going through an Omicron wave.
a. Ours is largely driven by the BA.2 variant, which accounts for about 90% of daily cases today.
b. There are good indications that the wave has peaked, and is subsiding, albeit slowly.
c. Based on the 7-Day Moving Average of local cases, on 26 February, the number peaked at about 18,300 cases. Since that day, case numbers have come down steadily and gradually, and it stands at about 16,300 or so, as of yesterday.
d. The week-on-week ratio is now 0.93. What it means is that if it stays at 0.93, in four to five weeks, the number will be halved. But we expect the week-on-week ratio to reduce further in the coming days. Reproduction rate is about 1.0 now.
e. We hope this reduction in daily caseload will accelerate in the coming days.
2. The Multi-Ministry Taskforce (MTF) has explained, and I am glad today there is widespread acceptance by our population that what is important is not so much the daily caseload but how that daily caseload translates into hospitalisation and illness severity, and then impact our healthcare system.
a. As of now, our public hospitals, polyclinics, General Practitioner (GP) clinics have been and are still very busy, and healthcare workers have been coming under significant stress.
b. Fortunately, the Intensive Care Unit (ICU) utilisation rate is well within capacity, and so too are infected patients who need oxygen supplementation.
c. However, normal wards, especially the Emergency Departments (ED), are overloaded. In tandem with the drop in cases over the past couple of weeks, the number of ED attendance has come down somewhat over the same time period. It used to be 3,000 cases a day, attended to by our public hospitals, and that has dropped to 2,800 cases a day, but it is still a very high number.
d. To support the hospitals, the Ministry of Health (MOH) has stepped up various efforts.
i. One is to beef up manpower for public health institutions. We have tremendous help from the Singapore Armed Forces (SAF) and we thank them very much. They have supplied us with very skilled medics as well as their supervisors. We have also recalled about 300 nursing students who are doing their Advanced Diplomas. I thank them for returning to work and staying in their posts and contributing to the public hospitals.
ii. We are transferring more patients from public hospitals to other care settings.
iii. One major care setting is the private hospitals. We got the private hospitals to raise the risk profile of the kind of patients they can take in and as a result they have been increasing the number of patients they can take in from the public hospitals. We can now transfer more patients from public hospitals to private hospitals, which is a big help.
iv. We have also been increasing the number of transfers from public hospitals to our COVID-19 Treatment Facilities (CTFs). Let me explain this a bit. We used to have many CTF beds (more than 4,000 of them) but they were not well utilised – only 10% to 20% were occupied. So we worked with the CTFs, who are operated by private healthcare providers, to repurpose the facilities, and consolidated their manpower to improve the nurse-to-patient ratio, so that they are also able to handle higher risk patients now. This has allowed more patients in public hospitals to be transferred to the CTFs. So now the CTFs are on average 50% to 60% occupied.
v. Where possible, hospitals will also provide home care instead of hospital care and give the family support so that the patient can recover at home.
vi. We also partnered various stakeholders to reduce ED admissions, such as Singapore Civil Defence Force who may now bring clinically stable patients directly to CTFs rather than to public hospitals and then decant to CTFs.
vii. We are starting to divert some non-COVID cases from public hospitals to facilities outside of the public hospitals., such as private hospitals and the CTFs. These are non-COVID, but stable, patients who require monitoring and management of their chronic conditions. We set up specific facilities, such as an entire hall at Connect@Changi, where these patients can be re-sited. That will free up capacity and reduce the load in public hospitals as well.
viii. Because of all these efforts, we have managed to transfer on average 470 patients per day out of public hospital wards and their EDs every day.
ix. COVID-19 cases in hospitals have fallen from the peak of about 1,700 to 1,450 now, but it is still a high number.
x. We will continue these efforts to relieve the public hospitals, especially their EDs.
3. We can all do our part to help ease the workload on hospitals, and the pressure on healthcare workers.
a. So how do we do our part? It means if we are infected and experiencing mild symptoms, do not visit the hospital EDs. Instead, go to a GP clinic, or if you really need some kind of documentation proof, go to a test centre where you can be tested and given such a document, and then recover at home. The great majority of Singaporeans have done our part to get ourselves vaccinated and it made such a huge difference to our pandemic management and relieved the workload on our public hospitals. Now we can continue to do our part by avoid going to the EDs of our hospitals, when it is not necessary
b. I thank healthcare workers for your continued dedication and hard work, remaining at your posts despite the very heavy workload.
c. I also want to thank our partners, private hospitals and those who run our CTFs, and also our GPs and primary care partners for all your support and taking on all these workload.
4. Given the above and the situation in our healthcare sector, it is not time to ease our Safe Management Measures (SMM). However, we can proceed with SMM1-5, which we announced three weeks ago, and which we had been deferring, because these are largely streamlining in nature. I thank the public for your understanding for these three weeks as we deferred these measures, but it is important for us to stand in solidarity with our healthcare workers.
a. As the MTF has explained three weeks ago, SMM1-5 are largely streamlining measures. There will be no change to the key parameters and factors that will drive infections such as group sizes, wearing of masks. These are important to continue to keep check on the transmissions.
b. But even if there are some rules which are streamlined away, and have some marginal impact on infections or transmission, these will typically be felt two weeks later, when cases would have fallen even further and more than offset any impact.
c. On the other hand, by moving to SMM1-5, the rules will be simpler to understand and remember, and people are more likely to be able to do their part and exercise personal responsibility to help us manage the pandemic.
d. Part of the streamlining of measures include some easing and the most critical is that we will allow sports activities to resume. This is a significant move, because on the risk side, as contact during sports activities are transient, there has been no clear evidence that sporting activities drive infections. On the benefits side, sporting activities bring tremendous benefits especially to our young, physically and emotionally. After two years of suspending sporting activities, the suspension is taking its toll, especially among our young. In the coming weeks, the Ministry of Culture, Community and Youth will bring back sporting activities progressively, starting with selected operator supervised facilities.
e. SMM1-5, resumption of sports, are all essential steps to prepare us to live with COVID-19 and enable us to progressively ease our SMMs when the conditions further improve in time to come.
f. SMM1-5 will be effective from next Tuesday, 15 March 2022.
5. As we manage the pandemic, another important consideration is the condition of patients coming to our hospitals, seeking inpatient care.
a. Increasingly, our hospitals are observing that they are reporting sick, not so much because of COVID-19, but because of their chronic illnesses.
b. So they are admitted with COVID-19, and not necessarily because of COVID-19.
c. These patients typically have quite significant chronic underlying conditions, and COVID-19 infections tipped them over to become very sick.
d. For these patients, the primary aggravating factor is their chronic illness, and not so much the transmission wave.
e. Let me now invite the Director of Medical Services to explain this further.
Source: Ministry of Health, Singapore