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Living with COVID-19 endemic: roadmap to a new normal

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COVID-19 is likely to be endemic. This means it is here to stay – like influenza – and we will have to live with it, co-chairs of the Multi-ministry Taskforce said in an op-ed published by the Straits Times.

Each year, many people fall sick from influenza. Most recover with little or no medications. But a small number of people do fall seriously sick and succumb to it, especially the elderly and those with co-morbidities.

But because the chances of falling very ill from influenza is very low, people just live with it and get on with their daily activities, taking simple precautions or getting an annual flu jab.

Like influenza, the COVID-19 virus will continue to mutate and survive in the community.

The new normal is life with COVID-19 endemic. The government is drawing up a road map to transit to this new normal. This will be the government’s priority in the coming months and there is already a broad plan.

“We can’t eradicate COVID-19, but we can turn the pandemic into something much less threatening, like influenza, hand, foot and mouth disease, or chickenpox, and get on with our lives,” the ministers said.

Vaccination is key

Early evidence suggests that COVID-19  can be tamed with vaccination as the Israel’s experience shows. Vaccines are highly effective not just in reducing the risk of infection, but also the risk of transmission. Even if a vaccinated person is infected, the vaccine will help prevent severe COVID-19 symptoms.

In Israel, the infection rate among vaccinated persons in Israel is 30 times less than that of the unvaccinated. The hospitalisation rate for the vaccinated is also lower by 10 times.

Booster shots may be needed in the future to sustain a high level of protection and to defend against new mutant strains resistant to current vaccines, the ministers said.

Testing

Testing and surveillance will take on a different focus. Rigorous testing will still be needed at our borders to identify any person carrying the virus, especially variants of concern.

“Domestically, testing will be less of a tool for ring-fencing and quarantining people exposed to infected persons. Instead, it would be to ensure that events, social activities and overseas trips can take place safely; as well as to reduce transmission risks, especially to those who are vulnerable to infections,” said the ministers.

Testing will be made easier and more comfortable with antigen rapid tests including self-tests which have already been rolled out to polyclinics, private clinics, employers, premise owners and pharmacies.

Even faster test kits are in the pipeline such as breathalysers which take about one to two minutes to produce the results and do not involve swabbing. In time, the airport, seaport, office buildings, malls, hospitals and educational institutions can use these kits to screen staff and visitors.

In addition, there is also wastewater testing which is useful in finding out if there are hidden infections in dormitories, hostels or housing estate.

COVID-19 treatment

One reason why Singapore’s COVID-19 mortality rate is among the lowest in the world is because we already have a range of effective treatments. We now have many therapeutic agents that are effective in treating the critically ill, quickening recovery, and reducing disease progression, severity and mortality, the ministers said in the op-ed. Our medical researchers actively participate in the development of new treatments.

Social responsibility remains critical

“If all of us practise good personal hygiene, we are less likely to be infected. If all of us are considerate to one another, staying away from crowds when we feel unwell, we will reduce transmission. If all of us shoulder the burden together – workers keeping their colleagues safe by staying at home when ill, and employers not faulting them – our society will be so much safer.”

How the new normal will likely look like this

1. An infected person can recover at home because with vaccination, symptoms will be mostly mild and risk of transmission also low. We will worry less about the healthcare system being overwhelmed.

2. There may not be a need to conduct massive contact tracing and quarantining of people each time we discover an infection. People can get themselves tested regularly using a variety of fast and easy tests. If positive, they can confirm with a PCR test and then isolate themselves.

3. The focus will shift from monitoring the number of daily Covid-19 infection to outcomes: how many fall very sick, how many in the intensive care unit, how many need to be intubated for oxygen, and so on. This is how influenza is monitored.

4. We can progressively ease our safe management rules and resume large gatherings as well at major events, like the National Day Parade or New Year Countdown. Businesses will have certainty that their operations will not be disrupted.

5. We will be able to travel again, at least to countries that have also controlled the virus and turned it into an endemic norm. We will recognise each other’s vaccination certificates. Travellers, especially those vaccinated, can get themselves tested before departure and be exempted from quarantine with a negative test upon arrival.

“History has shown that every pandemic will run its course. We must harness all our energy, resources and creativity to transit as quickly as we can to the desired end-state. Science and human ingenuity will eventually prevail over Covid-19. Cohesion and social consciousness will get us there faster. We must all do our part.”

– Gan Kim Yong, Ong Ye Kung, Lawrence Wong

Read also  Hope for humanity: has Israel found the COVID-19 treatment?
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