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As the country moves into DORSCON code green, this implies an updated advisory for infected persons, discontinuation of the the Popular Places Pass for migrant workers, and removal of the negative pre-departure test for non-fully vaccinated travellers.
With a stable situation in recent months, despite increased travel over the year-end holiday period, the Northern Hemisphere winter season, and China’s shift away from a Zero-COVID policy, Singapore has removed its remaining few COVID-19 measures, as it looks to establish an endemic COVID-19 new norm.
This announcement by the Ministry of Health (MOH) implies an updated advisory for infected persons, discontinuation of the Popular Places Pass for migrant workers, and removal of the negative pre-departure test for non-fully vaccinated travellers. Details on all measures are listed below.
DORSCON code moves to Green
The Disease Outbreak Response System Condition (DORSCON) framework, which gives an indication of the current disease situation, moves from Yellow to the lowest-threat level Green from 13 February 2023. Here's what the different DORSCON levels mean.
Mask-wearing guidelines in different settings
From 13 February 2023, mask-wearing on public transport and indoor healthcare and residential care settings will no longer be required under the temporary COVID-19 regulations.
However, the practice of mask-wearing for visitors, staff, and patients in healthcare and residential care settings, will remain in place. This includes hospitals and polyclinics, private primary care and dental facilities, specialist facilities, TCM clinics, renal dialysis centres, clinical and radiological laboratories, residential care homes (such as nursing homes), COVID-19 care facilities, testing centres and vaccination centres, as well as ambulances and medical transport vehicles.
Within these areas, masking is required within these settings:
- Indoor patient-facing areas
- When there is face-to-face interaction with patients
- When care is being delivered to patients
As such inpatient wards, emergency departments, consultation rooms and waiting areas, and pharmacies are included in mandatory mask-wearing policies. Excluded from this mandate are retail and F&B outlets (including retail pharmacies), clinical labs (where there is no patient interaction), admin and backroom facilities, staff rest areas, car parks, and other non-patient-facing areas.
This will become an MOH requirement rather than mandated under the COVID-19 regulations. Further, the Ministry of Social and Family Development (MSF) will also apply this requirement to Homes for the elderly.
Besides healthcare, other authorities may also require mask-wearing, just as the Singapore Food Agency has required food handlers to wear a mask or spit guard for food safety reasons. Employers may also opt to maintain mask-wearing requirements as company policy for workplace health and safety or business continuity reasons.
Further, MOH advises individuals who are unwell with symptoms of COVID-19 or other respiratory infections to wear a mask when they need to leave their homes.
Curbs for in-bound travellers scaled back completely
Having first launched the Vaccinated Travel Framework (VTF) in April 2022, it has now been decided to stand down the remaining COVID-19 border measures.
This implies from 13 February 2023, all non-fully vaccinated travellers entering Singapore will no longer be required to show proof of a negative pre-departure test. Non-fully vaccinated short-term visitors will no longer be required to purchase COVID-19 travel insurance.
However, the VTF will remain in place for reactivation if there are international developments of concern, such as new severe variants or signs that Singapore's healthcare capacity is strained by imported cases.
Inbound travellers to Singapore must note that they will continue to be screened for other infectious diseases of concern, such as Yellow Fever, Middle East Respiratory Syndrome and Ebola.
Further, all travellers entering Singapore via air or sea (including Singapore residents), and short-term visitors entering via land, must continue to submit a health declaration via the SG Arrival Card e-service, as well as check the ICA website for the latest border measures before entering Singapore.
Protocols for unwell or infected persons
Protocols 1-2-3, which the public maybe have become familiar with, will be removed from 13 February 2023. The following are the protocols for unwell or infected persons, termed as "updated general advisory":
Medically vulnerable persons (i.e. seniors and those with chronic medical conditions) that have Acute Respiratory Infection (ARI) symptoms, as well as persons with severe, prolonged or worsening ARI symptoms, should see a doctor. Here is the updated advisory for persons who are at increased risk of severe COVID-19. In short, such persons should:
- Be encouraged to be vaccinated against COVID-19 if they have no medical contraindications,
- Pay special attention to MOH’s health advisories, to observe a high level of personal hygiene with frequent hand washing with soap and water
- Follow infection prevention and control recommendations, e.g., use of masks, avoiding crowds and close contact with others who are unwell,
- Continue to take medications for any underlying health conditions exactly as prescribed,
- Go for regular vaccinations based on clinical indication, and
- Seek medical attention promptly if feeling unwell.
Persons with mild ARI symptoms should stay at home until symptoms resolve. If there is a need to go out while symptomatic, or if asymptomatic but tested positive for COVID-19, they should exercise social responsibility – minimise social interactions, wear a mask, avoid crowded places, not visit vulnerable settings such as hospitals and nursing homes, and not have contact with vulnerable persons, such as the elderly.
Measures for migrant workers living in dormitories
From 1 March 2023, the Ministry of Manpower (MOM) will align measures for migrant workers (MWs) living in dormitories with the new general advisory for the community.
This means, MWs with mild ARI symptoms may recover in their dormitory or see a doctor if they wish at any primary care provider clinic. COVID-19 tests will only be administered for symptomatic vulnerable MWs or those with severe ARI symptoms.
In addition, MWs who test positive for COVID-19 will not need to be conveyed to COVID-19 recovery facilities but may recover within their dormitories. MWs with more serious symptoms (e.g. shortness of breath, chest pain) will be conveyed to the emergency department of public healthcare institutions.
As for the intra-city mobility of MWs, they have been able to exit dormitories and visit community areas since the beginning of 2022, supported by the Popular Places Pass, a contingency measure to manage crowding in four designated popular locations on Sundays and public holidays. During this period, passes have been ample and no migrant worker has been prevented from visiting the community. As such, the Popular Places Pass will be discontinued from 13 February 2023.
Stepping down of TraceTogether (TT) and SafeEntry (SE) apps
Apps TT and SE helped Singapore in accelerating contact tracing efforts and enabling the implementation of community safe management measures, but over the past few months, the Government has progressively stepped down TT and SE. As such, infected persons are no longer required to submit TT data, SE data is no longer being collected, and MOH has deleted all identifiable TT and SE data from its servers and databases.
The only exception is the TT data pertaining to a murder case in May 2020, which will be retained indefinitely. MOH explained: "This is especially necessary for serious cases such as murder, where legal applications may be made to challenge the conviction or sentence many years after the case has concluded, and the Singapore Police Force (SPF) may be obliged to disclose the data."
Nevertheless, the nation will keep both the TT and SE systems ready for reactivation for the contingency if a new, more dangerous Variant of Concern breaks out. For this purpose, registration details such as name, business UEN, and mobile number will be retained in the system, to minimise the steps taken by individuals and companies to set up and re-register for TT and SE, should it be needed. Both the TT and SE (Business) Apps will also remain available on the App Store, Google Play Store and Huawei AppGallery for quick reactivation if needed.
Notably, members of the public can uninstall their TT App, and enterprises may do the same for the SE (Business) App.
For those using TT Tokens, a return exercise will take place from 13 February to 12 March 2023, whereby TT Tokens can be returned at counters that will be open at all 108 Community Clubs/Centres (CCs). These tokens will be refurbished and recycled for distribution to those who need it, should digital contact tracing operations have to be reactivated.
Scaling back of pandemic-related subsidies
From 1 April 2023, Singapore will need to further scale back pandemic subsidies and re-align the provision of financing support for COVID-19 testing and treatment to that of other acute illnesses. This will mean the following changes, applicable to new admissions to the following three facilities from 1 April 2023:
a) Hospitals and COVID-19 Treatment Facilities (CTFs). All patients, including Singapore Citizens, Permanent Residents and Long-Term Pass Holders (SCs/PRs/LTPHs) regardless of vaccination status, will no longer be accorded 100% subsidy. Instead, Government subsidies, MediShield Life and MediSave will apply to SCs and PRs and defray their healthcare expenses. Financial assistance will be available to lower income Singaporeans when needed.
b) Community Isolation Facilities (CIFs). CIFs will no longer be required for COVID-19, just as they are not required for other endemic diseases like influenza or chicken pox. Nevertheless, some CIFs will be maintained for COVID-19 patients who want to self-isolate for valid reasons. However, all occupants, including SCs/PRs/LTPHs, will be charged for their stay. As CIFs are not medical facilities, SCs and PRs will not be able to tap on Government subsidies, MediShield Life or MediSave to pay for their bills.
c) Primary care settings (Polyclinics and GP clinics). All patients will be required to pay for any COVID-19 testing, subject to prevailing subsidies.
As for COVID-19 vaccines and therapeutics, they will remain fully subsidised for clinically eligible patients in outpatient (including primary care), ambulatory settings of public hospitals and nursing homes, until further notice. This, MOH noted, is because these are important preventive steps to avoid severe disease and hospitalisations. Additionally, patients with a higher risk of severe COVID-19, such as the immunocompromised and individuals with some comorbidities, may be referred by their doctors for free telemedicine support.
Vaccination remains Singapore's first line of defence
MOH has shared the following updated recommendations on COVID-19 vaccines, after a review by the Expert Committee on COVID-19 Vaccination (EC19V):
- Everyone aged 5 years and above should achieve at least Minimum Protection – that is, three doses of mRNA or Novavax vaccine, or four doses of Sinovac vaccine.
- Persons at higher risk of severe disease from COVID-19, that is, persons aged 60 years and above, medically vulnerable persons, and residents of aged care facilities, are recommended to take the booster around one year after the last booster dose.
- Persons aged 12 to 59 years who are healthy have a lower risk of severe disease. Nevertheless, a booster around one year after their last booster dose will be offered to enhance their protection.
- Persons aged 5 to 11 years continue to be recommended to achieve Minimum Protection. They are neither recommended nor eligible for additional doses at this time.
- Children aged 6 months to 4 years continue to be recommended to complete two doses of Moderna/SpikeVax or three doses of Pfizer-BioNTech/Comirnaty. They are not recommended nor eligible for additional doses at this time.
To affirm, COVID-19 vaccinations under the National Vaccination Programme will continue to be offered free to all Singapore Citizens, Permanent Residents, Long Term Pass Holders and certain Short Term Pass Holders. Vaccines will be available at the Joint Testing and Vaccination Centres, participating Public Health Preparedness Clinics, polyclinics and Vaccination Centres.
For seniors, mobile vaccination teams (MVTs) will continue to be deployed to heartland locations. Between 15 February and 2 April 2023, MVTs will be deployed to multiple heartland locations for three days each. The full list of MVT sites and schedules will be continually updated here.
MOH, with the advice of EC19V, will update vaccination recommendations in future and when needed.
Vaccination requirements for those living and working in Singapore remain in place
The COVID-19 vaccination requirements for new Permanent Residence, Long-Term Pass and Work Pass applications, as well as the renewal of selected Work Permit Holders and S Pass Holders in the construction, marine shipyard and process sectors or residing in dormitories, will remain in place.
From 1 April 2023, persons who recently recovered from COVID-19 will no longer be given temporary exemption from COVID-19 vaccination requirements.
All of these updates come as the local population has developed a high level of hybrid immunity and is well protected from severe COVID-19. Around 80% of the population has achieved minimum protection, and around half is up to date with their vaccinations. Many have also recovered from infection during previous COVID-19 waves. MOH stated: "With this, the risk of COVID-19 infections leading to severe illness or death has become very low, comparable to other endemic respiratory diseases, such as influenza or pneumococcal infections."
In spite of the new announcements, the MOH has cautioned the virus will continue to evolve, and new infection waves should be expected from time to time, as such measures will be adjusted when necessary. But unless it is a very dangerous and virulent variant, it is expected that these subsequent waves can be managed with strategies that do not deviate significantly from the new norm.
Lead image / Shutterstock
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