Why Singapore is still in a transition stage towards endemic living: Infectious disease experts explain
SINGAPORE: On Monday (Sep 6), multi-ministry task forcefulness co-chair Lawrence Wong announced new measures to stem the spread of infections, including more testing and a ban on workplace social interactions.
The news raised questions over Singapore's plans to live normally with an owned COVID-xix and how far the state is from that.
In June, Wellness Government minister Ong Ye Kung said Singapore'southward build-up of contact tracing, testing and quarantine capabilities will enable the country to "put circuit breaker behind us ".
Yet Mr Wong mentioned on Monday that a circuit breaker could non exist ruled out at this betoken.
Daily infections take ticked up since belatedly-August – the Ministry of Wellness reported 450 locally transmitted cases on Thursday (Sep 9). Unlinked cases have besides crept upwards, with several clusters involving a key essential service – jitney interchanges.
Infectious disease experts interviewed on CNA's Eye of the Matter say Singapore is still in a "transition stage" and this is where we may be for some fourth dimension however.
Dr Lim Poh Lian, member of the skillful committee for COVID-19 vaccination, said the science is still evolving, and this means figuring out how and when to move forward isn't straightforward.
Dr Lim added that if one looks at the arroyo taken by other countries that have opened upwardly quickly and and then been hitting by infection waves that led to deaths and overwhelmed hospitals, Singapore'due south slow, careful approach has been validated.
"Every expiry is i expiry as well many ... we are still trying to minimise that every bit much as possible."
Singapore's testing and reducing infections as much as information technology can has made the difference in keeping a lot of people prophylactic and alive, she said.
The other difficulty is if Singapore opens upwardly as well quickly and more people are infected, there could be wider implications. "Other countries would potentially non want to have u.s.a. visit,'' she said.
As well CAUTIOUS?
Dr Ooi Eng Eong, Professor at the Plan in Emerging Infectious Diseases at Duke-NUS Medical School, who was besides on the podcast, offered a different view, maxim it all boils down to risk appetite and what gild is willing to have.
"Either nosotros bite the bullet and say, okay, this is normal from at present on. That nosotros volition never be able to gather as a family if the family is larger than five, we volition never exist able to … celebrate weddings with our families and friends. Are we going to have that? I am not certain that society is quite prepared for that,'' he said.
Against the backdrop of high vaccination rates and the ability to carry out rapid testing and contact-tracing, Dr Ooi said: "At some point we have to accept nosotros are chasing our ain tail. We (can) go back to our normal lives and expect there will be some severe cases. Just that'south a conclusion for social club to make.''
Dr Lim, however, pointed out that Singapore's cautious approach has kept information technology rubber so far and while this is a "ii steps forrad, one step back" dance, going deadening is the all-time thing to practice.
Merely is the cost to people and businesses too high?
The pandemic has been very hard on most people who demand a clearer thought of what will happen in a few weeks or months, said Dr Lim. For instance, people want to know if they can plan a holiday in December.
Unfortunately for everyone, the changing nature of the pandemic ways "it is non always possible to try and force certainty when at that place is no certainty to be had. This is one of those times … it's like playing five or x-dimensional chess, the virus is changing, the vaccines are changing.''
"We're in the transition phase … We are not yet at endemic living …everyone wants to reopen and go back to normal but we take to get at that place safely,'' she said.
DELTA VARIANT
Referring to Mr Wong'due south announced measures and explaining why there was a need to "tap on the brakes", Dr Lim said the Delta variant has been a "game-changer".
"Delta changed everything … so the goalposts shift, partly considering the virus itself is changing," said Dr Lim.
It'due south a tighter race between the virus and allowed organization, which takes four days for cells to mount a defence, Dr Ooi, pointed out.
But the Delta variant takes only three days to cause fever and illness, a much faster rate compared to the original strain'due south five days.
Lab results showed this variant is "very fit", he said. "Everything that has come out so far has been suppressed by Delta. Even if there is a new variant, information technology'south hard to come across it being fitter," he said
The World Health Organization (WHO) reported that the Delta strain has been recorded in 124 territories . In Singapore, it accounted for 99.half-dozen per cent of infections sequenced between April and August according to the National Centre for Infectious Diseases (NCID).
The Delta variant's loftier transmissibility is a cause for concern. "Asymptomatic people can even so be infectious and that makes a difference. Y'all could exist sitting adjacent to your colleague at work who could exist two months pregnant. Or attend a dinner with 10 people who are exposed.''
Listen to CNA's conversation with Dr Lim Poh Lian and Dr Ooi Eng Eong on CNA's Heart of the Matter podcast:
VACCINES NOT A Argent BULLET
But with cases rising despite the vast majority of Singapore vaccinated against COVID-xix, does this mean that vaccines cannot offer the protective shield they were touted to?
Vaccines were never meant to be a silver bullet, said Dr Lim. "Just it is silly to throw away a good intervention like vaccinations just because it is not 100 per cent,'' she said, adding that infectious diseases cannot be eradicated without vaccines.
Most importantly, vaccinations as well clearly forbid severe affliction – well within the 90 per cent, Dr Ooi pointed out.
While the main objective of vaccination is to foreclose severity and death, Dr Lim said the number of infections even so matter as early warning indicators that tougher measures might be needed.
"We have always said that we control COVID-19 with a combination of measures, including masks, contact tracing for exposed persons, isolation of infectious cases and border control measures. So, when nosotros see a rise of cases, we have to sort of tap on the brakes lightly.''
Dr Ooi withal offered a different view on whether one should "get nervous" virtually the high infection numbers, when proactive polymerase chain reaction (PCR) tests tin can selection upwardly balmy and asymptomatic cases compared to at the starting time of the pandemic.
"At present, because we have the tools to be able to become and screen and notice the virus very sensitively, nosotros are picking up a lot. Part of this 200, 300 cases we are seeing now, unfortunately mixes in asymptomatic infection … so by counting this into the grouping, the numbers are a lot bigger," he said.
His view is that there isn't a need to "worry likewise much" peculiarly when Singapore has antiviral and antibiotic treatments similar remdesivir, dexamethasone and molnupiravir, that could eventually be given in a primary care setting without the demand to get to the hospital.
Only Dr Lim countered that these drugs remained expensive and if people reached a stage where such treatments were needed, information technology was best to administer them in a hospital setting where they can be observed.
"At that place are fires burning around us. If we open up, we take to do information technology very carefully. We can brainstorm to try to approximate endemic living but it's going to be a lot of stepping frontwards and stepping dorsum because we are not at that place even so,'' concluded Dr Lim.
Source: https://cnalifestyle.channelnewsasia.com/singapore/singapore-endemic-living-transition-covid-coronavirus-283911
0 Response to "Why Singapore is still in a transition stage towards endemic living: Infectious disease experts explain"
Post a Comment