From the outset, Singapore's most important goal has been to protect lives, minimize avoidable deaths and resolutely prevent Singapore from being left in a dire situation where someone cannot be treated.
Written by | Yan Xiaoliu
Source | "Medical Community" public account
From 29 March, Singapore entered the final stage of "coexistence with COVID-19". The goal is to become a "resilient country" to fight the epidemic.
At that time, the epidemic prevention measures will be further relaxed. The number of people in the gathering will increase from the current 5 to 10. 75% of those who work from home will return to work. Large-scale events such as concerts will resume, with a capacity of up to 75% of the thousands of people. Masks are not mandatory outdoors.
In addition, entry and exit requirements will be greatly simplified. From 1 April, air and sea travellers who have been vaccinated only need to be tested within 48 hours of departure, and no longer need to be tested and quarantined after entry.
In June 2021, the Singapore government for the first time vowed to "coexist with the virus". After 9 months, the country is gradually returning to pre-pandemic life. "Singaporean nationals travel abroad almost as much as they did before the pandemic." Sin Chew Daily and other media reports.
"After taking this big step, we will wait for a while until the situation stabilizes. If all goes well, it will be further relaxed. On March 24, Singaporean Prime Minister Lee Hsien Loong delivered a national televised speech titled "Entering a New Phase."
Image courtesy of Prime Minister's Office Singapore
He said Singapore's confrontation with the new crown epidemic has entered an important turning point, "Next, we will resolutely move towards coexistence with the new crown disease." ”
Open confidence
Singapore, with a total population of nearly 5.69 million, was one of the first countries to move from seclusion to "coexistence with COVID-19".
The "Surging News" report pointed out that Singapore can change the preconditions for epidemic prevention thinking, including 3 aspects. For example, the government can adjust control measures at any time according to the severity of the epidemic.
Second, Singapore has the world's leading vaccination rate. According to Singapore's health department, as of March 23, 93% of the country's total population had received at least one dose, 92% of the total population had completed two doses, and the intensification rate had reached 71%.
Super high vaccination rates, and "many people have contracted the disease and have recovered, so our herd immunity is higher." Lee Hsien Loong said.
Third, as the epidemic changes, Singapore has flexibly adjusted its testing methods and continued to reshape medical procedures.
In May 2021, Delta, a highly transmissible and pathogenic variant, invaded Singapore, causing a surge in infections and straining nucleic acid testing capabilities. Due to the large increase in the number of infected patients, the absolute number of severely ill patients is expanding, even if the proportion is small. Healthcare workers are starving, and the use of the intensive care system once reached 90%.
The following month, Singapore launched a rapid test kit that people can buy and test at home. The National University of Singapore and others also distributed kits to teachers and students of the school, and gave self-testing and reporting cycles for different situations such as residential and day schools.
Due to the self-test screening of a large number of asymptomatic and mildly ill people, all of them can not be hospitalized or centralized isolation, Singapore launched a home isolation rehabilitation program.
By the summer of that year, those under the age of 59 who had been vaccinated but were asymptomatic or mildly symptomatic were no longer taken directly to the hospital. Initially, they were sent to a community care facility for isolation and then transitioned to home isolation for rehabilitation. In July, Health Minister Wang Yikang said as many as 40 percent of infected people were expected to be isolated at home. "As more people get vaccinated, this rate can increase to more than 50 percent in the coming weeks."
"In the beginning, some people didn't understand home isolation." Ms. Hu, who has been living in Singapore for a long time, told the "medical community" that the situation changed after the widespread spread of Omi kerong.
Miss Hu introduced that many friends and colleagues around her have been infected with Omicron, because 3 doses of vaccines are mild. I am not infected for the time being, and I may have been infected but do not know.
Xu Zhenyi, director of Singapore Eye, a media personality who has long been concerned about Singapore's epidemic prevention work, told The Paper that when Omi Kerong first appeared, the Singapore government first required all patients to be quarantined centrally. Three or four weeks later, the government observed that Omikerong was less toxic, much more contagious, and had few severe deaths, and resumed home isolation. "By now, it's the equivalent of flu treatment."
We will preserve medical strength at all times
"Take one step forward, take three steps backwards at once." Red Ant, a Singapore-based commentary website, once commented on the country's epidemic prevention measures.
The network's editorial team also pointed out that Singapore has better preserved its medical system due to continuous relaxation and tightening.
"From the very beginning, Singapore's most important goal has been to protect lives, minimize avoidable deaths and resolutely prevent Singapore from being left in a critical situation where people cannot be treated." Lee Hsien Loong mentioned in his speech on the 24th that when deciding how quickly to relax restrictions and how much to relax, the government knows that the pressure on medical staff and the medical system cannot be allowed to reach the limit, which will lead to excessive burdens on medical staff and put patients with coronary and non-coronavirus diseases in urgent need of treatment at risk.
Since the pandemic, Lee Hsien Loong has made at least nine public speeches on the epidemic situation. There are several references to the "responsiveness of the healthcare system".
In the first year of the outbreak, Singapore adopted strict "zero clearance" measures. From April 7 to June 1, 2020, the country imposed a similar lockdown and actively tested, tracked, quarantined, etc. Lee Hsien Loong explained that it was "because he didn't know much about the new crown virus" and "seeing that the situation in some countries was grim, medical staff were forced to decide who to save and who not to save."
The change in the thinking of epidemic prevention occurred in the late spring and early summer of 2021. On May 31, Lee Hsien Loong released a speech on "How to Better Coexist with COVID-19", mentioning how to achieve a balance that is both open and not a large-scale outbreak in the community. Both medical response and vaccination were mentioned in that statement.
By August, the Singapore government had formally proposed a phase 4 roadmap for "coexistence with the virus". At that time, Singapore's health minister Wang Yikang and a number of experts said in an interview that one of the criteria for judging whether it can enter the next stage is whether the epidemic can continue to be controlled, and the most important measure is the medical pressure. Even if the number of confirmed cases increases again, the number of cases requiring oxygen assistance or intensive care can remain stable.
"Soon after the Delta outbreak subsided, we had another problem. This came back with the more contagious Aomi Kerong. We are waiting for a new number of confirmed cases around the world. Cases in Singapore have also surged, with more than 25,000 new cases in a single day at their peak. However, due to the high vaccination rate on the mainland and the sound health care system, we are still confident that we can cope with the epidemic. Lee Hsien Loong said on the 24th that the burden on the medical system is still heavy, but the pressure to see a doctor has slowed down. Singapore has ensured that hospitals have sufficient intensive care beds and oxygen supplies to treat every patient in need and gain time to improve the response capacity of the healthcare system.
Since the outbreak, Singapore has been one of the lowest mortality rates in the world.
As of 12:00 on 24 March 2022, singapore has confirmed more than 1 million cases of COVID-19, and the mortality rate of unvaccinated people is 0.67%. In the past 28 days, Singapore has had more than 387,000 new infections, with an intensive care rate of 0.04% and a mortality rate of 0.05%.
In November 2021, Professor Cheung Yi Ying, Dean of the Suri-Fu School of Public Health at the National University of Singapore, wrote that even in the 22 months of the COVID-19 pandemic, Singapore has not been overwhelmed by the epidemic and the death rate has soared due to the epidemic. Compared to 2016-2018, when there was no outbreak, Singapore's overall mortality rate was lower in 2021.
Be prepared, there are twists and turns in the future
Singapore's announcement comes as more and more countries loosen their grip.
Japan lifted business hours restrictions on restaurants and shops in Tokyo and 17 other prefectures. South Korea has abolished curfews after 23:00 in restaurants and, like New Zealand, abolished the use of vaccine passes in public places. Malaysia announced that it will end quarantine requirements for vaccinated people from April 1 in order to revitalize tourism. The Hong Kong SAR, which has 10,000 cases of infection every day, is also scheduled to relax in April, including lifting the ban on some international flights.
Unlike some countries that have been fully opened up, Singapore still retains some basic requirements for epidemic prevention. For example, indoors and outdoors, as long as masks are not worn, people must maintain a distance of 1 meter. All restaurants are allowed to eat at the same table for up to 10 completed vaccinators, but vaccination checks must be carried out at the entrance. Unwell, self-testing, positive results need to be isolated at home.
Lee Hsien Loong called on the public to be mentally prepared for the possibility of encountering more twists and turns in the future. "It's possible that more contagious and dangerous mutant strains will emerge, just like the Delta strains." If this happens, we may need to go backwards and tighten the epidemic prevention measures again. We cannot rule out this possibility, even if we hope it does not happen. ”
"We have made great progress on this long road against the epidemic. We haven't reached the finish line yet, but we're closer to the finish line. The key factor in our ability to respond calmly is the trust that our people have in the government and health authorities, and in each other. We have always trusted and supported each other, and this spirit of solidarity and solidarity will remain crucial as we meet new challenges in the future. ”
Source: Medical community
Editor-in-charge: Zheng Huaju
Proofreader: Zang Hengjia
Plate making: Xue Jiao