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Covid-19: Revised MOH nightly update focusing on big picture trends 'the way to go', say experts

SINGAPORE — The revised approach by the Ministry of Health (MOH) to its nightly Covid-19 update, with a focus on big picture trends rather than details of every infection, is more suited to the current situation as Singapore moves to treating the coronavirus as endemic, infectious disease experts have told TODAY.

Various infectious disease experts said a move by the Ministry of Health to focus on big picture trends in its nightly Covid-19 update could help boost vaccine uptake.

Various infectious disease experts said a move by the Ministry of Health to focus on big picture trends in its nightly Covid-19 update could help boost vaccine uptake.

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  • MOH revised its nightly Covid-19 update to report more on key trends, vaccaination progress and people in critical condition 
  • It will no longer release the list of public places visited by Covid-19 cases while they were infectious
  • Infectious disease experts said the update now serves to encourage people to get vaccinated and shows that vaccinations work

 

SINGAPORE — The revised approach by the Ministry of Health (MOH) in its nightly Covid-19 update, with a focus on big picture trends rather than details of every infection, is more suited to the current situation as Singapore moves to treating the coronavirus as endemic, infectious disease experts have told TODAY.

MOH’s emphasis on information such as Covid-19 patients who need oxygen or are in a critical condition, along with whether these people had been vaccinated, could help encourage more Singaporeans to get their shots, they added.

The ministry changed its nightly update on the Covid-19 situation here from Tuesday (June 29) to give more information on infected people’s vaccination status and those who are in a critical condition and need special treatment.

Besides the daily numbers, MOH will include information on the key trends of the situation here, the clusters it is monitoring, the progress of the voluntary national vaccination programme as well as the number of people who suffer a severe form of the disease.

MOH will no longer release the list of public places that have been visited by Covid-19 cases while they were infectious. It will also not provide details of each case detected in the community, such as the person's age, occupation and when the person tested positive.

WHAT EXPERTS SAY

TODAY interviewed a range of infectious disease experts, including Dr Leong Hoe Nam from Rophi Clinic, who said that the new format is “correct”.

“I expect 50 to 100 new cases daily going forward so these details are not needed. This is endemic living,” he said.

“They are expecting many more cases now. It is very tedious to generate this data and it offers very little benefit if we are not trying to eliminate it. (It's) just (feeding information to) curious news readers,” Dr Leong added.

Dr Ling Li Min, an infectious diseases physician also from Rophi Clinic, agreed that the information that will no longer be included is “not needed” and “this is the way to go”.

“It was just too many cases and too much information. Nobody is going to remember 20 people who got Covid-19 and where they went. People will only remember trends, if it's worsening or getting better,” she said.

“The purpose of reporting is you want people to read it and have certain take-home messages. And currently, what's happening over the past two months, we just want people to know how we are going, if cases are down or up, more about the vaccination status and about clusters, whether people are living near one,” Dr Ling said.

Professor Dale Fisher, an infectious disease expert from the National University of Singapore (NUS) Yong Loo Lin School of Medicine, said that the new format will give information that is “much more relevant now”.

“I expect that the overall numbers will still be updated on the MOH website periodically but the emphasis is appropriately being removed as we transit out of the pandemic,” he said.

“We don’t count all colds or all flus or even test for most upper respiratory infections normally and that is where we are headed back to,” Prof Fisher added.

“After the pandemic, we won’t be tracking all circulating diseases and numbers of asymptomatic cases. So we are transitioning to this. What matters is rates of vaccination and rates of severe disease.

“Asymptomatic disease is much less important now than it was a year ago. We also need to know about the numbers in hospitals as this impacts our health system.”

Associate Professor Alex Cook, vice-dean of research at the NUS Saw Swee Hock School of Public Health, said that there are both advantages and disadvantages to this format of the update.

“The advantages of not releasing case details is the protection of their privacy and the saving of resources to collate and present the information. The (previous) format encourages in-depth reporting of clusters and places where cases have gone, which elevates the public’s threat perception but may not be needed as vaccination rates increase,” he said.

The disadvantage, however, is that some people may wish to avoid places where cases have been and now, they will no longer have that information.

Assoc Prof Cook added that it is worth noting that not many countries report their cases to “anywhere near the detail that MOH does”.

MOH has previously said that there is no need to avoid places where confirmed cases of Covid-19 have been, explaining that the National Environment Agency “will engage the management of affected premises to provide guidance on cleaning and disinfection".

"Individuals may access the SafeEntry Location Matching Self-Check service via the TraceTogether app or at https://wereyouthere.safeentry.gov.sg to check whether they were at these locations during the specified timings, based on their own SafeEntry records,” MOH said before.

President of the Asia Pacific Society of Clinical Microbiology and Infection Dr Paul Ananth Tambyah agreed that there are “pros and cons” to the changed approach.

He said that by omitting some case details, there are “lots of speculations right now about what happened at VivoCity and Harbourfront given the announcement of the mandatory testing for all staff working at the two places”.

He added that the old format would disclose if there were one or two people at each place and if they were staff or customers.

On the other hand, too much detail may also be harmful as it would raise privacy concerns, Dr Tambyah said, especially where Housing and Development Board blocks are concerned as individuals may be identified and there may be stigma and discrimination.

Assoc Prof Cook said that he welcomes the extra details on vaccination progress, “which has sometimes lagged by a week or more”.

“The new format should highlight the risk of remaining unvaccinated, as it will be obvious that the severe cases are substantially more likely not to have been vaccinated yet. This should counter some of the misinformation that is circulating on social media and, hopefully, boost vaccine uptake.” 

Assoc Prof Cook highlighted that in Tuesday’s update, MOH reported that since the start of June, only 4 per cent of the people who needed supplemental oxygen had been vaccinated, and none of the patients who were under intensive care or died had been vaccinated.

“This highlights quite starkly how much the vaccines protect against the worst effects of Covid,” he said.

Dr Leong shared his sentiments, saying that the revised nightly update now serves to encourage people to get vaccinated and shows that vaccinations is effective.

“By providing vaccination status in cases of severe illness, it gives a glimpse of hope and encouragement that vaccination works,” he said.

SUGGESTIONS FROM EXPERTS

When asked if there is more information that should be included in the nightly updates as the country moves to treating Covid-19 as endemic and living with the disease normally, Dr Leong said that “we should go forward and discern how many had Sinovac and mRNA vaccines”.

“Singapore is unique in that it has both these vaccines available. We can do a comparison as to how these two vaccines are effective when placed side by side.” 

TODAY has asked MOH for its response on this suggestion.

Dr Ling said that it would be good if the current table listing the clusters could be in the form of a map instead.

“It’s nice to have visualisation. So people in surrounding suburbs can see that they might be living near a cluster, maybe within their 5km or 10km range. It's hard to visualise with a table.” 

Dr Tambyah suggested that it would be useful to know the results of surveillance such as the sampling in polyclinics of acute respiratory infection, and the genotyping data on the different variants in the imported and local cases.

“These are routinely provided in periodic reports by Public Health England and are very useful to understand the pandemic.”

Related topics

MOH Covid-19 coronavirus vaccination

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