Next Covid-19 wave likely to be driven by reinfections, vaccination for younger children, infants ready by Q4: Ong Ye Kung

SINGAPORE — To prepare for the next wave of Covid-19 cases, which is likely to be driven by reinfections, Singapore is setting up transition care facilities, preparing general practitioners and expanding vaccination coverage, Health Minister Ong Ye Kung said on Wednesday (Aug 24).

An example of this is the Government's plan to vaccinate young children aged five to 11, with the health authorities sending out early notices via phone text messages to parents to recommend first booster jabs for their children.

The vaccine for infants and children aged six months to five years will also be ready in the fourth quarter of this year "if all goes well", Mr Ong added.

Speaking at a press conference by the governmental Covid-19 task force, Mr Ong said that when the next infection wave comes, Singapore will "need to be more prepared, more resilient than now”.

"(We also have) to be prepared that the next variant may be of a different nature," the minister who co-chairs the task force said.

Deputy Prime Minister Lawrence Wong, another co-chair, said that the task force is not disbanding because there is a possibility that the next wave could be more "aggressive and dangerous", and urged people to be mentally prepared for sudden changes.

"We are continuing to monitor closely and we have drawer plans in place for various contingencies, including scaling up our healthcare capacity, as well as stacking up vaccination operations if and when the need arises," he said.

"We also have multiple lines of defence, as all of you are aware, which we can activate if needed."

WAVE OF REINFECTIONS

Based on the latest serological (blood and antibodies) studies by the Ministry of Health (MOH), around 70 per cent of Singapore's population has been infected with Covid-19, which means that the country now has "far fewer Covid-naive individuals", referring to people who have not been infected yet, Mr Ong said.

"This means that when the next wave comes in, it is a big wave, comprising many reinfections. It will be a reinfection wave.” 

Giving an analysis of reinfection rates, he said that these numbers are being monitored more closely because it gives the authorities an idea of when the next wave can happen.

The probability of reinfection eight months after the first infection, when compared with a previously uninfected individual, is 5 per cent, he said.

Mr Ong describes this as a "good sign", but he noted that reinfection cases are increasing as a proportion to total daily cases.

Reinfections comprise 5.5 per cent of total infections in August, compared with 3 per cent in July this year. As immunity gained from infections wanes over time, Mr Ong noted that reinfection rates are expected to increase further.

In the northern hemisphere, countries such as Europe, the United Kingdom and the United States are all prepared for a "winter wave" at the end of the year, as well as the possibility of dealing with a new variant of concern, he noted.

Therefore, Singapore's preparation efforts have to come on three fronts: Safe management measures, healthcare capacity, and vaccinations.

“If we manage the last two well, then we can avoid restrictive safe management measures,” he said.

HEALTHCARE CAPACITY

In order to ease the heavy workload in hospitals, Mr Ong said that the authorities are setting up Covid-19 treatment facilities for lower-risk patients, and moving long-stay seniors from acute hospitals to nursing homes so that wards can be freed up for more patients. 

There are also transitional care facilities, which function as a dual-use facility that can be used as a treatment facility for lower-risk Covid-19 patients during an ongoing wave, Mr Ong added.

When there are no ongoing infection waves, however, such a facility would be used as a step-down care facility should there be no space in hospitals for patients who suffer from chronic illnesses but also have Covid-19. 

He pointed to a 164-bed transitional care facility near Sengkang General Hospital, which has worked well to help reduce the heavy workload in the hospital.

By the end of September, Singapore will have 364 beds at such facilities when Hall 10 of Connect@Changi — located at Singapore Expo — is converted from a Covid-19 treatment facility to a transitional care facility.

Mr Ong added that general practitioners continue to play a vital role in looking after Covid-19 patients without severe symptoms — by prescribing therapeutics such as oral antivirals, which will help reduce the number of infected persons with severe illnesses and lessen hospital workload.

There are also around 1,500 telemedicine consultations daily, which also help to ease the load on healthcare capacity.

"We are ramping it up to about 9,600 consultations a day to prepare ourselves for any possibility of future surges," he said.

VACCINATION FOR CHILDREN

Announcing the Government’s plan to vaccinate children, Mr Ong said that they will be handled in two groups: Children aged five to 11, and those aged six months to five years. 

MOH is giving out an early notice to vaccinate young children because Mr Ong said that he has heard concerns from parents.

Notifications will be sent to parents via phone text messages to recommend Covid-19 vaccine boosters for children aged five to 11.

The expert committee on Covid-19 vaccination had concluded that the benefits "clearly" outweigh the risks for this group to receive booster shots, he added. 

As for the second group of children aged six months to five years, Mr Ong said that the expert committee is still in the process of reviewing the safety and efficacy of Moderna's Spikevax Covid-19 vaccine.

He added that "if all goes well", the Moderna vaccine will be approved for use by children Singapore in the fourth quarter of this year as a two-dose regime that is administered 28 days apart.

This would mean that the vaccine could come after the school examinations period and before a potential year-end wave, which will also make it convenient for parents.

"We are also considering the Pfizer-BioNTech vaccine for infants and young children,” he added.

CLARIFICATION: An earlier version of this article said that Hall 10 of the Changi Exhibition Centre was being converted from a Covid-19 treatment facility to a transitional care facility. The Ministry of Health has clarified that it is Hall 10 of Connect@Changi that is being converted into such a facility.