IN FOCUS: Tackling COVID-19 with targeted measures - the new normal for Singapore?
SINGAPORE: It had been a tough year for Singapore.
And so, as 2022 came to its shut, information technology looked similar the land could see a flicker of calorie-free at the end of the long COVID-19 tunnel with its transition on Dec 28 to Stage iii of its reopening.
And in the months that followed, the path to a post-pandemic normality looked to exist adequately polish, with community cases generally running to no more than than a few a solar day.
Plans for events which hadn't been possible for months started to gather pace. This was in spite of the pandemic standing to rage worldwide, with a number of countries forced to innovate and then reintroduce measures to curb the spread of the raging virus.
Singapore hadn't needed to.
And then, very rapidly, things changed. Clusters began to bound up, with one emerging at Tan Tock Seng Infirmary - the offset in a local infirmary since the pandemic began. Customs cases began to steadily increase.
To tackle the spike, Singapore announced some tighter, targeted measures on May iv.
Places that were considered high-risk, such as indoor gyms and fitness studios, were instructed to close unless they offered low-intensity activities, while fewer people would exist immune at attractions, public libraries, funerals and MICE events.
Limits for gatherings reverted to five people.
But as community cases showed no signs of letting upward, measures were farther tightened on Friday (May 14) under what the Wellness Ministry called "Phase 2 (Heightened Alert)".
READ: Group sizes down from 5 to 2, dining-in suspended as Singapore tightens COVID-19 measures
Among other initiatives, sizes of group gatherings were further reduced from five to two people, with dining-in at F&B establishments banned. Working from home is likewise to be the default at workplaces.
The new measures will have issue from May 16 through June thirteen.
Speaking at a multi-ministry building task force press conference on Friday, Teaching Minister Lawrence Wong noted in particular that "take chances settings" for the spread of the virus were indoor environments where people do not put a mask on.
This is why the Government had focused on tightening restrictions in such areas, he noted.
"We have already done then earlier for activities in the gyms and fitness centers where you lot are unable to keep your mask on," Mr Wong explained.
"And now the next step ... is to restrict such activities in F&B establishments, and therefore no more dining in. In other settings - outdoors or when you are in a space simply you are able to keep your mask on - nosotros believe with safe distancing, with proper precautions, and safeguards, these activities tin still go on."
Health Minister Gan Kim Yong likewise added that such moves would be role of Singapore'south "journey to recovery".
"This is office of a journey to recovery, because every now and and so, when there's (an) outbreak, we have to review our measures, and we need to tighten as we become along. And when infections come up under control, then we'll have (the) opportunity to roll back some of these measures, open upwardly the economy, open the community, so that people tin begin to also socialise and interact with 1 another."
BREAKING THE CHAINS OF TRANSMISSION
As the COVID-19 situation continues to evolve globally, infectious illness experts say that targeted sectoral measures, such as the ones introduced by Singapore, are set to be the fashion forrad.
"Sectoral lockdowns in a targeted fashion (are) likely the style to become, only the affair is that the decision to do that must be quick and fast," said Dr Ling Li Min, who is an infectious disease specialist at Rophi Clinic.
Dr Ling noted that such an approach requires that community cases are non widespread.
"When countries commence on these targeted measures, it is probably at a point in time whereby they feel that they can still control it, meaning that community cases are not widespread, it's only pocket-size clusters here and there," she explained.
"Early, you tin can't go on waiting for the cases to increment, and that can only happen when the community cases overall are still low. If there are a lot of community cases, then your sectoral lockdown isn't going to work."
For such measures to deport fruit, the rest of the community must be "clued in", said Dr Ling.
"The testing, the tracing, (the) isolation must be superb and robust. Some of these countries don't quite have that - they're not as swift with that," she noted.
Dr Paul Tambyah, infectious diseases proficient and president of the Asia Pacific Gild of Clinical Microbiology and Infection, noted that these sectoral measures are probable to remain in place until vaccination rates reach higher levels.
READ: 1.eight million people in Singapore have received at least one dose of COVID-19 vaccine
"I think that these measures are temporary until the vaccination rates reach levels that accept been achieved in countries such as State of israel where the measures are existence lifted gradually," he said.
"Like opening up is occurring in other highly vaccinated places such as the Uk and The states and UAE. If the WTO (World Merchandise Organisation) waiver on vaccine patents is granted, then this is likely to happen sooner rather than subsequently all over the world."
As Singapore is one of the world'due south most globally connected cities, information technology is likely to need "far higher" levels of vaccination to protect the population than other more "airtight or isolated" societies such equally State of israel or New Zealand, added Dr Tambyah.
Equally of May nine, near 1.8 million people had received at least i dose of a COVID-19 vaccine, with 1.2 meg of them receiving their 2nd dose, Mr Gan had said in Parliament on Tuesday (May 11).
Data compiled past the Our World in Data projection at the University of Oxford, shows that close to threescore percent of Israel's population has received at to the lowest degree one dose of the vaccine. The number currently stands at about 30 per cent for Singapore.
FINDING 'Eye Basis'
One of the reasons why total lockdowns accept been implemented in some countries is due to the fact that hospitals are facing the possibility of being inundated, said Dr Teo Yik Ying, who is dean of the Saw Swee Hock School of Public Health.
"A total lockdown is necessary when the health system is at risk of existence overwhelmed. That is when y'all realize that the state of affairs is getting rapidly out of control. And the definition of out of control hither is that the infection is spreading so fast in the customs, and resulting in a large number of people entering the hospitals," said Dr Teo.
A total lockdown would serve two main purposes, he noted. The commencement of which would exist to stop interaction so as to cut bondage of transmission in the community.
And when such chains are cut, this minimises the infections only to households, he added.
"What that means is that with time, you actually allow the number of patients in the hospitals to slowly go down ... Your hospitals at present take a run a risk to breathe," he said.
"That is really very important considering once your hospital is overwhelmed, you realise that anyone seeking care at the infirmary, whether it is COVID, or non COVID related, they will be compromised considering nurses are overwhelmed, doctors are overwhelmed."
And while Singapore had been forced into a excursion-breaker menstruation - like to a lockdown - final yr, there has not been a need to re-impose that because the healthcare system is non at the risk of being overwhelmed, said Dr Teo.
READ: Stretched just coping: How Singapore's healthcare arrangement has cranked upwardly efforts to deal with COVID-19
For one, in addition to current bed capacity, at that place was also the setting upwardly of customs facilities around the isle last twelvemonth to eternalize chapters, he pointed out.
"After our initial fright that we saw in April (and) May last twelvemonth, at that place is now built in place some additional surge capacity. It is not massive, it is never massive, but at least hospitals now have a better manner of coordinating their resources to cope with rising numbers," he added.
Speaking to CNA, Dr Dale Fisher, who is senior consultant at the National University Infirmary's sectionalization of infectious disease, noted that many countries have tried to find a compromise as part of their strategy to tackle COVID-19.
"Many countries have tried to observe this heart ground - particularly Singapore plainly - of targeting specific things for specific reasons. So I don't think it's new," he said.
"At present if y'all've got skilful contact tracing, good case isolation, adept quarantining, expert social distancing, good community buy in, chapters to scale up testing - if all these are in place, then really countries should exist less inclined to do the blunt lockdowns."
He noted that bated from countries with a strategy of complete elimination of the virus such every bit Australia, such a lockdown should not be the offset option.
"It should have been a place of terminal resort, when you lot actually had lost control of the situation. Your contact tracing couldn't keep up, your quarantining wasn't effective, or your case isolation was not in place - many countries didn't isolate their cases," he added.
Dr Tambyah noted that such a total lockdown would be "very desperate" and have "numerous agin consequences". These include risks of death from falls in older people living alone, mental health problems in individuals who are isolated, as well every bit increases in domestic violence, among other things, he said.
READ: Possibility of excursion breaker 'not ruled out' equally COVID-nineteen task forcefulness announces tighter measures
Going back to such lockdowns would be a very "retrograde step", added Dr Fisher.
"I recollect that would be a very retrograde step because we want to be pushing forward in opening up to reach this balance of living with the virus and nosotros don't want to have to be locking down regularly," said Dr Fisher.
"I think what Singapore is doing is the correct style, which is try and nuance your fashion through it, bring that number dorsum down."
WIDENING 'INEQUITIES'
Dr Teo that "personal safe management measures" such as mask wearing and social distancing remain important.
"One time we started imposing face mask wearing, we never inverse our opinion on that, we never inverse our stance on social distance, and neither our opinion on grouping size restrictions. We have always maintained that at that place is a need to restrict group sizes, considering whether it is for dining, coming together for things, those are the activities that have the highest risk of spreading (the virus)," he added.
And Dr Teo noted that acceptance of these measures remain loftier despite the fact that Singapore has been in this pandemic for over a year.
However, there remain disadvantages associated with such a targeted approach, he said.
"Sectoral lockdowns actually widen inequities. Effectively, you are saying that sure sectors of the economy take to be close downward in gild to allow other sectors of the economy to progress," Dr Teo added.
Every bit such, policies need to exist put into place to ensure that these sectors are being looked afterwards, amongst the closures, he added.
On Fri, it was announced that F&B businesses, which are going to have to bargain with the suspension of dine-in business, will get boosted financial support.
Regardless of whether a total lockdown or targeted sectoral measures are put into identify, Dr Ling noted that there is a risk of fatigue among the public.
"At this point in fourth dimension, everyone knows that if nosotros don't practice something about it, it's just only going to get worse. And then information technology ends up existence (a) total lockdown for anybody, which is even a lot worse. (Information technology is alike to) choosing between the devil and deep blue sea, information technology'due south like there's no good choice," she said.
Given that safe management measures are non compulsory in some other countries, this could potentially exacerbate fatigue, she noted.
"In certain countries, it is very difficult to implement safe management measures and implement masking, to make information technology compulsory. And so when there are a lot of interactions, and when at that place is slight breakdown in whatsoever of these measures, the cases will balloon," she said.
While other countries aim for a strategy which involves a total emptying of the virus, Singapore is trying to find a compromise between assuasive economic activity, and some social activities to resume while trying to keep the public wellness state of affairs under command, noted Dr Teo.
"It means that we will get-go to wait at some of this dialing upward and dialing down of our measures between phase 3, phase two, phase 3, phase two, even maybe going dorsum to phase 1 from fourth dimension to time. This volition exist something nosotros accept to be mentally prepared for," he said.
READ: Be 'obsessed' with wearing masks properly: Experts urge compliance as COVID-nineteen cases grow
At the same time, Dr Ling emphasised the need for Singaporeans to be constantly on their toes.
"The community has to exist mentally prepared that COVID is going to exist here to stay for an indefinite period of fourth dimension," she said.
"Nosotros being office of this community and being part of a global order, nosotros just take to brand sure that we attempt to keep it at bay for as long as we can. And we're going to have to do whatever we can to do that."
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Source: https://cnalifestyle.channelnewsasia.com/singapore/focus-tackling-covid-19-targeted-measures-new-normal-singapore-276631
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