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COVID-19: Can Singapore “coexists with virus” find a way for the world?
COVID-19: Can Singapore “coexists with virus” find a way for the world? The most difficult thing is the “change” of collective thinking: accepting that someone will die from the disease, accepting that “not being vaccinated will be treated differently”
On August 10, Singapore officially entered the “preparatory period” for “coexisting with the virus.” This is eight days ahead of the country’s earlier plan to “step into the new normal.” At this time, Singapore has completed 72% of the total population of the COVID-19 vaccination.
According to Singapore’s joint leadership of the anti-epidemic inter-departmental working group (hereinafter referred to as the “anti-epidemic team”), the achievement of the “new normal of coexistence with the virus” is divided into 4 stages, including preparation period, transition period A, transition period B, and becoming a A country that is resilient to the epidemic”.
Among them, the “preliminary period” lasts about 1 month. Relevant departments will take a set of measures during this period, including gradually relaxing epidemic prevention measures such as social activities and travel, shortening the number of days in hospital for confirmed cases, and allowing more people to be isolated at home.
Choosing to “coexist with the virus” means that Singapore no longer pursues blocking and “clearing.” On August 10, there were 53 newly confirmed local cases in the country, of which nearly 28.3% (15 cases) “cannot find the source of infection.”
Currently, Singapore still has 118 active infection groups. Among them, the “Jurong Fishing Port Infected Group” that first appeared in mid-July has a total of 1,149 confirmed infections, which is described as a “major setback in the process of unblocking (major setback).”
The epidemic prevention situation did not improve due to this group of infections. On July 22, Singapore tightened its epidemic prevention measures and returned to the “second stage of high-alert unblocking”, banning dine-in, only two people going out, and suspending all people who need to take off their masks. Activity.
The Singapore government explained that temporarily tightening the epidemic prevention measures and returning to the second stage of unblocking is mainly to buy time for more people to be vaccinated, and then gradually relax.
“We are gingerly loosening, walking step by step, crossing the river by feeling the stones to balance our livelihood and safety.” Health Minister Wang Yikang of the “Anti-epidemic Team” believes that the most difficult thing is the change in collective thinking. “The public is requested not to focus on the number of new cases per day, because a high number of confirmed cases does not necessarily mean that more people are seriously ill or die.”
Photo caption: Due to the outbreak of the “Jurong Fishing Port Infected Group”, Singapore returned to the second stage of high-alert unblocking from July 22 to August 18 and tightened its epidemic prevention measures. / Lianhe Zaobao
Singapore’s epidemic prevention is loose and tight, and the death rate of COVID-19 is lower than that of the flu
Since the pandemic, Singapore’s epidemic prevention and control model has been tightened and liberalized, and it has been repeated in general, showing a “dance on the tip of a knife”: insisting on rapid detection, tracking, and blocking the spread of the virus to prevent infection, serious illness, and death The number of people has risen disorderly, but basic economic activities, social life, and opening to the outside world are maintained to the greatest extent, and educational institutions at all levels are kept open.
In October 2020, Singapore took the lead in launching the “Travel Bubble” (also known as “Travel Bridge” or “Travel Corridor”) globally. “Travel Bubble” targets travelers from countries and regions where the epidemic has been controlled, claiming that the waiting period for entry can be exempted, and they can travel between the two places freely, without compulsory testing or quarantine.
“Lianhe Zaobao” reported that Singapore’s epidemic prevention strategy has its economic considerations.
As early as June this year, Singapore’s official anti-epidemic trio (Minister of Trade and Industry Yan Jinyong, Minister of Finance Huang Xuncai, and Minister of Health Wang Yikang) wrote in a joint article in The Straits Times: “The COVID-19 virus is likely to become an endemic epidemic. This means that The new coronavirus will continue to mutate and survive in the community.”
So, if we follow the “zero tolerance” and “zero clearance policy” of the epidemic, it will severely hit an open economy like Singapore that is highly dependent on international trade, commerce, and tourism.
From a global perspective, Singapore’s time-to-time intensive epidemic prevention has achieved remarkable results. According to information from the Ministry of Health of Singapore at 14:00 on August 11, 2021, a total of 65,836 cases of COVID-19 infection have been confirmed in the country, 42 cases have died, and the crude death rate is 0.064%.
According to the World Health Organization, in the United States, the influenza-related mortality rate for people over 65 is 0.03%-0.15% (30-150/100,000). In the UK, which has also chosen to “coexist with COVID-19” and has fully opened up, the crude death rate is about 0.3%.
On the same day, a total of 11 patients were admitted to the intensive care unit in Singapore, an increase of 3 cases from the previous day. 32 people need oxygen support. These 43 people were called severely or critically ill, and the unvaccinated rate reached 86% (37 cases). Among them, 34 were over 60 years old.
As of August 11, Singapore was admitted to intensive care (orange column) and conditions requiring oxygen support (blue column). / Ministry of Health Singapore
Based on the above data, the “Lianhe Zaobao” pointed out that Singapore has basically achieved the reduction of the impact of COVID-19 to the same level as influenza, and has the ability to greatly reduce the threat of the epidemic.
“After the promotion of large-scale vaccination, although people will still be infected, most of the confirmed cases can be isolated and recovered at home due to the significant decline in severe illness and mortality. The government will focus on how many people are seriously ill and how many people are affected. In the intensive care unit, how many people receive intubation treatment, etc. This is the same way we monitor the flu now. More epidemic prevention measures can be loosened.” The Finance Minister Huang Xuncai of the “Anti-epidemic Team” and others said in an article in June, This is the meaning of “coexisting with the virus”.
At the end of June, the Singapore government has stated that it will gradually change the epidemic surveillance model, and will no longer try to track the trajectory of each infected person in order to stop the spread, and will no longer detail the age, occupation, and date of diagnosis of the infected person.
How to “coexist with the virus”?
During the “preparatory stage” of the four stages of “coexistence with the virus”, Singapore will open dine-in meals for some people (5 people per table), allow them to participate in large-scale events for 500 people, and allow gyms and beauty institutions to open .
According to The Straits Times, those who “enjoy special treatment” are divided into three categories: people who are fully vaccinated with vaccines on the World Health Organization’s emergency use list, and the time of vaccination is more than two weeks; people who have recovered from COVID-19 for no more than 270 days; unfinished Those who are vaccinated but are negative in real-time testing.
At the same time, the procedures related to the diagnosis and treatment of COVID-19 pneumonia will undergo major changes. First, if a breakthrough infection occurs after being vaccinated at the age of 45-59, if they are asymptomatic or have only mild symptoms, they will be treated, quarantined, or recovered at home in a community care facility instead of being sent to a hospital. Previously, Singapore had done this among 17-45 year-olds with breakthrough infections. Singapore hopes to increase the proportion of “community rehabilitation” to 80% of the total number of confirmed cases.
The length of hospital stay for confirmed patients will also be shortened. Studies have shown that the viral load in a person with breakthrough infection drops very quickly, falling to an undetectable level 9 days after diagnosis. The Singapore government stated that if a person who has completed the vaccination is infected and recovers on the 10th day of isolation, he can be discharged early without adding 3 days of asymptomatic.
If medical measures are adjusted, but the number of severely ill patients does not increase significantly, Singapore will expand the scale of various social activities on August 19, and 50% of corporate employees will be able to return to the workplace, and people will no longer have to take their temperature in public places.
The Minister of International Trade and Industry Yan Jinyong added that once it is assessed that the local medical system may be difficult to cope with, it will slow down the opening speed and even take additional measures to gain time and space to ensure that the medical system can continue to operate effectively. “Make judgments in the process, not a big move to immediately lift all restrictions.”
When 80% of the local population has completed the full dose vaccination, Singapore will enter the second phase of “transition stage A” (transition stage A), further relaxing travel restrictions, economic and social activities.
By then, those who have completed the full dose of vaccination can travel abroad, at least to those countries where the COVID-19 pandemic has become a local norm. Singapore will mutually recognize each other’s vaccination certificates. If the risk of COVID-19 at the travel destination is very low, after the vaccinated people return, they can go home only after completing a strict COVID-19 screening, or perform a 7-day “home notification” at home (similar to China’s “fixed-point quarantine”).
Those who have not been vaccinated will also be expected to leave the country, but they must strictly abide by and fulfill the “home notice” locally and after returning to Singapore.
The medical system remains stable during the transition period A, and the government will consider further deepening into the “transition period B” until it finally enters the fourth phase of “the new normal of coexistence with the new coronavirus.”
Different from the preparatory period and the transition period A, the start-up standards and epidemic prevention details of the transition period B and the new normal are waiting to be determined.
In addition, in Singapore’s existing instructions, there is no mention of whether people who are vaccinated by foot doses should wear masks when going out, whether they should maintain social distancing indoors and outdoors, etc. “This should not be our option.” “Lianhe Zaobao” commented .
The prelude to “coexisting with the virus”: vaccination and strong testing
CNN analyzed that the main reason for Singapore’s ability to conceive and implement a “coexistence with the virus” strategy is the high coverage rate of the COVID-19 vaccine.
The Ministry of Health of Singapore reported that as of August 8, 81% of the population received at least one dose of the vaccine, and 72% of the population completed a full dose of vaccination. With the increase in vaccination rates, 97.5% of the local confirmed patients have asymptomatic infections or mild symptoms.
In order to make vaccination more convenient, starting from August 10, Singaporeans, permanent residents and foreigners with long-term documents who are 12 years of age and older can go to the country’s 26 vaccination centers for mRNA vaccination without appointment.
According to age group, Singaporeans have received at least one dose of vaccine. /Ministry of Health Singapore
Second, Singapore continues to strengthen its rapid testing strategy.
At present, the country adopts multiple parallel testing methods, including PCR nucleic acid testing, rapid antigen testing, respiratory testing, and sewage testing, and strives to complete sampling as quickly as possible and detect community transmission as soon as possible. According to its plan, by 2022, Singapore’s sewage monitoring and virus monitoring sites will increase from more than 200 to more than 400, and the scope of wastewater monitoring for labor dormitories and residential areas will be expanded.
In the future, rapid detection points for the COVID-19 virus will be everywhere, and routine tests will be set up in airports, shopping malls, and educational institutions. Among them, the National University of Singapore may become a “learning sample for educational institutions.”
Starting from August 10th, the school started “Fast and Easy Testing” (Fast and Easy Testing, referred to as FET). School staff and students have received self-service antigen rapid testers distributed by the school. The frequency of testing depends on the vaccination status and whether they live on campus.
The school will use an APP to record the number of times everyone has entered and exited the campus, combined with data analysis, and issued test reminders. Students and employees can also check and register the receiving status of the rapid tester through this APP. In order to avoid crowd gathering, you can also make an appointment for collection time.
Chen Xinyi, a freshman who has completed vaccination and lives on campus, told Lianhe Zaobao that after entering the “new normal”, testing has become a social responsibility. “Everyone should do their part to conduct regular testing, especially in high-density environments.”
“We must also be mentally prepared that new mutant strains will definitely appear. They may be more infectious, have a higher lethality, and can successfully break the current vaccine protection shield. These mutant strains are likely to cause more serious disease. The emergence of the infected group of infections has caused us to tighten epidemic prevention measures from time to time. We are looking for new solutions for mutant strains, which may be chasing enhanced injections, or introducing newer vaccines.” Wang Yikang and others said that they are discussing Continuous vaccination plan for the COVID-19 vaccine.
After unblocking, taking into account the flow of people, the maximum number of diners in each group of some catering establishments in Singapore is still two. / Lianhe Zaobao
Problem: 125,000 high-risk groups have not been vaccinated
According to the analysis of FT Chinese website, from various information, there are loopholes in the current situation of vaccination in Singapore.
As of August 2, 26% of the country’s 70-year-old and above still had not completed the vaccination, and the number was nearly 125,000. This age group is the first population in Singapore to open vaccination.
In addition to the elderly, people of other age groups also generally “do not beat the clan.” The reasons for “not hitting” include excessive fear of vaccine side effects; lack of confidence in the effectiveness of the vaccine; and “free-riding” mentality, thinking that as long as people around are vaccinated, an “immune barrier” can be established to protect yourself in the crowd. Even some “do not fight” simply because of “trouble.”
Take the “KTV infection group” as an example, the infected person is 19-60 years old. As of July 15, of the 88 confirmed cases, only 6 had completed two doses of vaccination.
The Singapore government has racked its brains to make the vaccination rate reach the standard. For the elderly, the health department dispatched mobile vaccination teams to go deep into the neighborhood and set up points downstairs in the community. The elderly only need to go downstairs to complete the vaccination.
In addition, the government has clearly stated that it will distinguish between vaccinated and non-vaccinated groups during the gradual opening of borders and security management measures. For example, people who have been vaccinated can participate in a social gathering of 5 people, and those who have not been vaccinated can only participate in a gathering of 2 people.
For those who have completed the vaccination, a group of 5 people can carry out higher-risk activities without wearing a mask. The maximum number of people for large gatherings is 500. Those who have not been vaccinated can only participate in social activities with a maximum of 50 people, provided that the COVID-19 test meets the standards.
The Ministry of Manpower of the country will begin accepting entry applications from holders of work permits and their families from “higher-risk countries and regions”, and the requirement is that vaccination must be completed before entry.
“(Differentiating the vaccination situation) is to protect the unvaccinated and the vulnerable groups from contracting the virus. It is best for (such people) to minimize the frequency of participating in large-scale events and avoid going to restaurants and gyms and other high-risk environments that are easily exposed to the virus. “The Singaporean government statement.
(source:internet, reference only)