Hence I have decided to speak directly to you, to explain: Our current situation and what has changed, our strategy for this phase of the pandemic, and our path forward to a new normal.
I want to share my thoughts and concerns with you, because unity of purpose and hearts is crucial to get us through the next few months.
Our Original Approach – “Zero COVID”
Last year, at the start of the outbreak, we were dealing with an unknown disease. Globally, there was little scientific knowledge about COVID-19. Our own experience from SARS gave us some idea where to start. As we learnt more about the virus, we adjusted our strategy to the evolving situation.
Our original approach was to do our utmost to prevent Singaporeans from being exposed to COVID-19. We tightened Safe Management Measures (SMM) as much as necessary, to bring cases down to a very low level. We judged this the best way to minimise serious illness and deaths.
“Zero COVID” was the right strategy at that time. Our population was not yet vaccinated. People had little or no immunity against COVID-19. The consequences of catching the virus were serious. But because the virus was not so infectious then, our measures could work to break the chain of transmission. The strategy succeeded. We avoided the huge loss of lives that many countries saw. We have one of the lowest COVID-19 death rates in the world.
At the same time, we planned ahead and secured vaccine supplies. Vaccines were a game changer. A safety vest for each of us in this pandemic. Our national programme to vaccinate everybody has been very successful. Thanks to your trust and cooperation, we now have one of the highest vaccination rates in the world – almost 85%. This has greatly enhanced our protection against the virus. Our data, as well as data from around the world, clearly show that vaccination sharply reduces the risk of serious illness. The vast majority of local cases (more than 98%) have mild or no symptoms. Only 2% or less developed more serious illness. Of these, 0.2% died or needed ICU treatment – just two out of every one thousand cases. The rest have needed oxygen supplementation for a few days. In other words, with vaccination, COVID-19 is no longer a dangerous disease for most of us.
A Changed Situation
But the emergence of the Delta variant has put us in a changed situation.
The Delta variant is highly infectious, and has spread all over the world. Even with the whole population vaccinated, we still will not be able to stamp it out through lockdowns and SMMs. Almost every country has accepted this reality.
Furthermore, even if we manage to keep COVID-19 cases down through stringent SMMs, the virus will spread swiftly again as soon as we ease up. This is especially true in Singapore, precisely because of our “Zero COVID” strategy. The majority of us have never experienced an infection. Or as doctors say, we are COVID-naïve. As a result, our natural (population) immunity is low. Even if we have been vaccinated, we are still at some risk of getting infected. This is why we must be prepared to see quite many COVID-19 cases for some time to come.
Yet Singapore cannot stay locked down and closed off indefinitely. It would not work, and it would be very costly. We would be unable to resume our lives, participate in social activities, open our borders, and revive our economy. Each time we tighten up. Businesses are further disrupted. Workers lose jobs. Children are deprived of a proper childhood and school life. Families are separated for even longer. Especially families with loved ones overseas and extended families who have not been able to come together. All these cause psychological and emotional strain, and mental fatigue. For Singaporeans and for everyone else here with us, including our migrant workers.
Therefore, we concluded a few months ago that a “Zero COVID” strategy was no longer feasible. So we changed strategy, to “Living with COVID-19”.
Living with COVID-19
“Living with COVID-19” has not been a smooth and easy journey. In August, after we reached 80% vaccinations, we eased up the Heightened Alert. We expected cases to go up, as more people resumed activities and interacted with one another, but the numbers went up more sharply than we had anticipated, because the Delta variant was so infectious.
Initially, our healthcare system was still able to cope. But we worried that it would come under significant strain, and it has. So have our medical personnel. As cases grow exponentially, the number of serious cases will also grow in step. And when the number of cases grows very large, even 2% of a very large number will translate to many patients needing hospital and ICU beds. Our healthcare system would rapidly be overwhelmed.
That is why last month we tightened up our restrictions. It was to slow down the growth in cases, so that we can ease the burden on our healthcare workers and stabilise our healthcare system. We are using this time to further expand healthcare capacity and strengthen our case management. So that we can better identify COVID-19 patients with mild symptoms to recover at home. And make sure we can care properly for those who fall seriously ill. As well as continue to attend to the many non-COVID-19 patients who also have urgent medical needs.
The Next Steps
We must press on with our strategy of “Living with COVID-19”. What next steps must we now take?
To start with, and most fundamentally, we¬ need to update our mindsets. We should respect COVID-19, but we must not be paralysed by fear. Let us go about our daily activities as normally as possible, taking necessary precautions and complying with SMMs. With vaccinations, COVID-19 has become a treatable, mild disease for most of us. This is especially so if you are young. Or even if you are not so young but fully vaccinated. The threat of COVID-19 is now mainly to seniors: 60 and above if you are not vaccinated, or 80 and above even if you are vaccinated. So for 98% of us, if we catch COVID-19, we can recover by ourselves at home, just as we would if we had the flu.
That is why we are shifting to relying heavily on Home Recovery. It will be the norm for COVID-19 cases. You can get well in a familiar home setting, without the stress and bother of admitting yourself into a care facility. If most of us can recover at home, it will greatly ease the strain on our hospitals, doctors and nurses. It will free up badly needed beds for COVID-19 patients who are at high risk of becoming seriously ill, especially the elderly. Of course, if you have vulnerable family members at home, you can go to an isolation facility to recover. I know many people still have concerns and anxieties about Home Recovery. They are fearful of the disease itself. They fret about the risk to the rest of their household. They also worry whether they will receive adequate care and support at home, should they get worse. I understand your anxieties. Let me assure everyone on Home Recovery that you will get the care and support you need throughout your recovery journey. Earlier, our service delivery fell short. But we have worked hard to fix this, and put things right. If at any point you need to be admitted to hospital or a COVID-19 treatment facility, we will get you there.
