Home » Omicron has become mainstream, how should Singapore respond? – FT Chinese Network

Omicron has become mainstream, how should Singapore respond? – FT Chinese Network

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At present, in Singapore, the Omicron coronavirus strain has replaced the delta strain as the main strain circulating in Singapore, and Singapore no longer distinguishes between Omicron cases when it publishes case data. Singapore reported 3,496 new confirmed cases of Covid-19 on January 23. The Ministry of Health of Singapore also announced the first death of Omicron on the 22nd. Singapore’s Ministry of Health expects that the number of confirmed cases of the new crown may surge in the next few weeks, doubling every two or three days, and may even reach at least 10,000 to 15,000 new cases per day. Although it has survived the impact of Delta, can the medical system still be safe in the face of Omicron, which has a stronger spread? How has Singapore prepared for this?

Based on science, the number of days in which patients are quarantined will be reduced, and positive entry will also be easier

Health Minister Wang Yikang, who co-leads the government’s inter-departmental working group on the fight against the virus, announced at a press conference on January 21 that the authorities will publish two daily case figures each day, one for those diagnosed by polymerase chain reaction (PCR) testing. The number of patients; the other is the number of patients detected by rapid antigen testing (ART) in family clinics. It is conceivable that this new data can better reflect the real situation of the infection. According to the website of the Ministry of Health of Singapore, as of January 22, in the past 28 days, there were 22,712 cases of new coronavirus infections, of which 99.6% were asymptomatic or mildly symptomatic, 0.3% needed oxygen, 0.04% were admitted to the ICU, and 0.03% died. Some research reports show that the incubation period of Omicron is very short, only about 3 days. People who have been infected or vaccinated before, even if they are unfortunate enough to be infected, tend to have mild symptoms.

Wang Yikang also announced at a press conference on January 21 that research from the National Center for Infectious Diseases in Singapore showed that although Omicron is more likely to spread, the virus load carried by patients is generally low, and they recover quickly. The authorities decided to shorten the upper limit of the quarantine period for some patients. According to Lianhe Zaobao, “Associate Professor Mai Xiwei, director of medical services of the Ministry of Health, also said that the viral load of patients infected with Omicron will drop to an extremely low level on the seventh day of infection, and it will no longer be possible to collect any more from them. The virus was cultured in the sample, showing that the patient was no longer infectious. This was much faster than getting the delta strain.”

In the future, the quarantine period for general patients will be shortened from 10 days to 7 days. The condition is that the vaccination has been completed, the physical condition is good, and the symptoms are mild. Those who have recovered well, can end their isolation even 72 hours after diagnosis, and can resume normal activities as long as the rapid antigen test (ART) result is negative. Only those who have not completed the vaccination still need to quarantine for 14 days.

“In this way, we can deal with this wave of large-scale infections without putting too much burden on the medical system, and only those who need it most can get medical care resources,” said Wang Yikang.

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In addition, Singapore will further open its borders to recovered patients who have tested positive for PCR but are no longer contagious. The Ministry of Health said in a recent statement that as the number of cases globally increases, so will the number of people who have recovered recently. “After a patient recovers, they may continue to shed virus fragments, which can lead to a positive COVID-19 test, but in fact they are no longer at risk of spreading the virus.” People who have just recovered after being vaccinated have a higher risk of COVID-19. Immunity to the disease and the possibility of re-infection are also lower. Therefore, from January 24, incoming travellers, recent Covid-19 recoveries and those who have completed vaccinations will be exempt from all entry testing and stay-at-home notice requirements in Singapore as long as they can present relevant certificates. That is to say, according to the situation, as long as you have been vaccinated and there is no risk of transmission, positive people can also be exempted from isolation and testing.

A bomb that could collapse the medical system

The inter-departmental working group of the government jointly led by Singapore announced at a press conference on January 21 that there are still about 120,000 people over the age of 20 in Singapore who have not been vaccinated against the coronavirus. Most of them choose not to be vaccinated, and only a few People cannot be vaccinated for health reasons. According to data from the Ministry of Health, as of January 21, 91% of Singapore’s vaccinated population has completed the vaccination, while 88% of the general population have completed the vaccination, and 55% have been vaccinated with the booster (the third dose). Earlier, the government also called on the public to choose the Moderna vaccine as a booster as much as possible, because studies have shown that the effect of the Moderna vaccine has a slight advantage over Pfizer.

Vaccines can alleviate symptoms, and various researches say that “Omicron is weakly pathogenic”, which is under the premise of inoculating mRNA vaccines throughout the process and producing effective antibodies. Otherwise, as Zhang Wenhong, a Shanghai infectious disease expert, said, if the immunity is insufficient, Omicron will “bite people”. The World Health Organization also warned earlier that Omicron should not be considered mild, and that it can also eventually lead to hospitalization and death in cases of insufficient immunity.

Wang Yikang said that many unvaccinated people believe that their number is small, and even if they become severely ill or die after being diagnosed, they will not cause a burden on the medical system. However, according to Singapore’s Ministry of Health, the proportion of unvaccinated or incompletely vaccinated patients in the ICU has remained at two-thirds since the outbreak began. When the number of confirmed cases is in the tens of millions, severe cases only account for a tiny proportion, which will also bring down the medical system. Unvaccinated people also have a much higher risk of severe illness or death than vaccinated people, and this risk increases with age.

Some of the people who insist on not vaccinating are worried about the safety of this vaccine approved by the WHO for emergency use. According to relevant news reports, on January 18 this year, at the Global Young Scientist Summit organized by the National Research Foundation of Singapore, American biochemist Thomas Che, who won the 1989 Nobel Prize in Chemistry for his discovery of the catalytic properties of ribonucleic acid (RNA), received the Nobel Prize in Chemistry in 1989. Thomas Cech stated that the technology and materials used to develop and produce messenger ribonucleic acid (mRNA) vaccines are safe and mature, and scientists have now been able to develop a vaccine against the new virus in a very short time. Pfizer and Moderna vaccines have demonstrated the safety of mRNA technology.

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Although the mRNA vaccine was only recognized by the public after the outbreak of the new crown, it has actually been studied in academia for decades. The 2008 Millennium Technology Award winner and one of Modena’s co-founders, Robert Langer, also attended the seminar. “We started making nanoparticles to deliver larger molecules as early as the mid-1970s, when people thought it was impossible, but many different fields are starting to do it,” Langer said at the meeting, according to Lianhe Zaobao. It was the opportunity to discover mRNA vaccines later, and the results of quantum biology and chemistry allowed us to change mRNA and design a vaccine very quickly.” Cech also said that mRNA technology is very mature, and many students in the laboratory can be within a week. Sorting viruses and manufacturing corresponding vaccines based on this, the biggest problem currently facing is not the lack of vaccine research and development technology, but the communication.

What Cech means is that the lack of popular science in this regard has caused communication problems between scientists and the public, and people’s understanding of the development of related science and technology should be improved to encourage people to be vaccinated. And because vaccines are used in healthy people, countries have adopted higher standards and requirements than other drugs when approving vaccines, and the probability of adverse reactions must be kept at a very low level to pass the review.

Since the large-scale promotion of vaccines, the Singapore Health Sciences Authority has continued to issue vaccine safety reports. On January 19, the ninth COVID-19 vaccine safety report was released. The report said that as of the end of last month, a total of 2,217,161 people had received booster doses, and the authorities had received 401 reports of adverse reactions to the Pfizer/Forbidi vaccine, accounting for 0.03% of the number of injections; There were 172 reports of reactions, which also accounted for 0.03% of the number of injections. People aged 5 to 11 have received more than 20,000 doses of COVID-19 vaccines last month, of which 6 had adverse reactions, accounting for 0.03%. The six adverse reactions included three cases of hives and allergic reactions such as swelling of the eyelids, face and lips, and one each of dizziness, fever and shortness of breath. No children had serious adverse reactions.

Under the global pandemic of the new coronavirus, governments around the world are struggling between efforts to contain the spread of the virus and ensure people’s livelihoods. So far, the best way is to promote vaccines, and many countries have implemented differentiated vaccine management measures to encourage and force people to get vaccinated as soon as possible.

The bottom line of epidemic prevention is to ensure that the medical system does not collapse. After Singapore’s Omicron replaces Delta as the mainstream strain, the unvaccinated group is likely to constitute a bomb that will explode at any time and impact the medical system. Individuals predict that between the freedom of personal choice and public health security, the issue of how to choose will gradually rise to the height of ethics and morality.

Vaccines have an expiration date, and wearing masks will last until the end

Singapore is one of the first countries to order mRNA vaccines. Since last year, the epidemic prevention policy has relied on vaccines. In the second half of the year, differentiated vaccine management measures have been gradually implemented. At the beginning of this year, the differentiated management measures were implemented more strongly. This means that People who are not vaccinated will face enormous inconvenience and risk losing their jobs because they cannot return to the workplace. Vaccine differential management measures are exempted only for reasonable reasons for those who have not been vaccinated.

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From January 15 this year, all people who have not been vaccinated will not be able to return to the workplace even if they test negative. Authorities are advising employers to arrange for them to work from home, or give them unpaid leave to give them time to get vaccinated, but terminating a contract because an employee is unable to perform at the workplace will not be considered “wrongful dismissal”. Under such a policy, it is believed that many unvaccinated people will face the fate of being fired. In addition, the Singaporean authorities have also set an expiry date for those who have been vaccinated. Starting from February 14 this year, those who have not received a supplementary dose after 9 months of receiving the Covid-19 vaccine will have their vaccination status changed to “unfinished vaccination”. Since October 13 last year, people in Singapore who have not completed their vaccinations have been banned from entering shopping malls and large independent malls, dine-in and attractions. In addition, the Ministry of Health announced that from December 8 last year, those who can be vaccinated but insist on not getting vaccinated will have to pay for their own medical expenses if they contract the coronavirus.

While Singapore continues to loosen other epidemic control measures, conditionally shortening and exempting measures such as isolation, masks have gradually become Singapore’s last insistence. At the beginning of the epidemic in Singapore, there was a shortage of masks on the market. At that time, the authorities did not encourage ordinary people to wear masks, and called on everyone to “use masks responsibly” and leave masks to the sick and the frontline of medical care. risk groups. Subsequently, with the change of the situation and the change of understanding, the Singapore government began to impose legal mandatory on the behavior of “wearing a mask”. So far, Singaporeans are required to wear masks when going out, in any place, be it a workplace or a school, otherwise it is illegal. Most public health experts predict that despite Singapore’s continuous push to open up, the idea of ​​”coexisting with the virus” is scientific and practical, and masks may be the last measure to be lifted. In an interview with the media, Professor Zhang Yiying, Dean of the National University of Singapore’s Great Sau Ruifu School of Public Health, predicted that people must wear masks for at least the next two or three years.

Although Singapore adheres to the line of “coexisting with the virus”, it does not take it lightly. The government is still committed to expanding medical facilities, strengthening the response capacity of the medical system, pre-purchasing coronavirus drugs, and building a vaccine factory. Conduct, for example, regular monitoring of the number of viruses in the civil sewage discharge of each building. However, all decisions related to epidemic prevention are based on scientific evidence, not on imagination and fear, with individual exceptions.

As Kenneth Paul Tan wrote in his book The Singapore Model: A Brief History of the Construction of the City-State, the official account of the “Singapore Story” emphasizes that the country is small, resource-poor, and constantly confronted with various threats. For the survival of the country, the Singaporean government acts on the principles of pragmatism and meritocracy. This philosophy of governance emphasizes two points: first, the existence of the state should not be constrained by a particular ideology and moral values; second, the state must recruit a wide range of talents. This governance philosophy is also reflected in all public policy formulations related to epidemic prevention.

(This article only represents the author’s point of view. Responsible editor email: [email protected])

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