COVID-19: Use of community care facilities to be stepped up – Ong Ye Kung

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A room for COVID-19 patients seen at a community isolation facility within the Changi Exhibition Centre on 24 April 2020. (PHOTO: Dhany Osman / Yahoo News Singapore)
A room for COVID-19 patients seen at a community isolation facility within the Changi Exhibition Centre on 24 April 2020. (PHOTO: Dhany Osman / Yahoo News Singapore)

SINGAPORE — There will be greater use of community care facilities instead of hospitals in the fight against the COVID-19 pandemic, Health Minister Ong Ye Kung said in Parliament on Monday (26 July).

Delivering his Ministerial Statement, Ong spoke about the shifts in healthcare protocols and collective psychology in the pandemic.

“We cannot carry on with the current healthcare protocols (for COVID-19). They need to shift closer to how we treat influenza today, without extensive contact tracing and quarantine in dedicated facilities, and hospitalising only those who are very ill,” said Ong, who is also co-chair of the multi-ministry taskforce on COVID-19.

But this can only happen when the likelihood of developing very serious or life- threatening disease as a result of COVID-19 has been significantly reduced by effective vaccination of the population, he added.

As such, given the current rate of vaccinations, the authorities have started to take the first transition step to remodel the healthcare protocols.

Vaccinated individuals aged between 45 and 59 who test positive for Covid-19 and show no or mild symptoms can be directly admitted to community care facilities instead of going first to hospitals.

This was already the practice for all cases aged between 17 and 45 years, but the protocol has been expanded to include those up to age 59, Ong said.

With this change, up to 60 per cent of infected cases are expected to recover in community care facilities, instead of in acute care. In the next phase, perhaps 80 per cent can be admitted to community care facilities, and some can even recover at home, Ong added.

In addition, the authorities have shortened the length of stay in hospitals and community care facilities. Tests have shown that the viral load in infected persons who are fully vaccinated falls very rapidly, to a very low level after nine days.

Previously, most people generally were discharged only after 21 days, Ong said.

The authorities are now discharging fully vaccinated persons after 14 days from onset of illness with a seven-day leave of absence, so long as their tests show that they are COVID-19 negative or have very low viral loads.

“We are further reviewing our policy to allow fully vaccinated patients to be discharged even earlier, and to complete the rest of the isolation period at home, if their home environment is suitable.”

There will also be greater use of home quarantine, Ong said. For fully vaccinated persons under quarantine, they can now serve their quarantine at home instead of at a government quarantine facility, provided that their home is suitable for isolation.

“We expect up to 40 per cent of persons under quarantine can serve their quarantine at home, and this will go beyond 50 per cent in the coming few weeks as more people are vaccinated.”

Collective psychology

Ong also spoke about a “palpable shift” in Singapore’s collective psychology during the pandemic.

There has been a shift away from always focusing on infection numbers and many people are “rightfully focusing” on the number of people with severe illnesses, Ong said.

A second shift is a greater acceptance of differentiated safe management measures, between those who are vaccinated and those who are not, according to Ong.

That was why the MTF decided on the 2/5 rule for restaurants recently, before it was scuttled with the reversion to Phase 2 (Heightened Alert), Ong said. He was referring to a previous rule whereby two individuals regardless of vaccination status could dine in at restaurants while up to five individuals under specific conditions could do so including those who were fully vaccinated.

When Singapore’s population is very highly vaccinated and society has transitioned to living with COVID-19, there should be very little differentiation between the vaccinated and the unvaccinated, Ong said.

“But during the period of transition, when we are still building up our resilience, differentiation by vaccination status is a practical way to open up some activities first, while protecting those who are still vulnerable.”

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