Singapore to step up vaccinations and boosters, and give GPs a more proactive role in Omicron fight

A new vaccination policy could be announced at the end of 2021 or in early 2022, but Health Minister Ong Ye Kung has assured that there will be no lapse in full vaccination status for those who have not received their booster shots by then.

Ahead of the Multi-Ministry Taskforce's updates on Tuesday (14 December 2021), regarding the Singapore-Malaysia VTL Land and upcoming safe management measures, Minister for Health Ong Ye Kung spoke on Singapore's next course of action in tackling COVID-19.

In his speech, the minister mainly touched on areas such as the Omicron variant; stepping up vaccination & booster shots, and adjustments to health protocols.

As it stands, Singapore is "in a good position now". Minister Ong described the situation with the following figures:

• Daily cases are in three digits, and often below 500;
• The total number of COVID-19 patients in Singapore's system is now under 4,000, while it was over 26,000 at its peak in end-October;
• ICU bed occupancies are slightly above 30, while this number stood at more than 160 at its peak; and
• Hospital beds/COVID-19 Treatment Facilities (CTFs) bed occupancies are at a "healthy level."

That said, Minister Ong remained cautious of the Omicron variant, and detailed two out of a five-part action plan to tackle it, as follows:

1. Step up vaccination and boosting, and
2. Adjust Singapore's health protocols.

Vaccination & boosters

According to the Minister for Health, vaccination will continue to be central to the country's response, and it is important "to get the unvaccinated vaccinated".

"There are about 160,000 of them in Singapore today, with 40,000 who are seniors aged 60 and above. They are all at very high risk of falling very sick, needing ICU care or dying, if they are infected with COVID-19," Minister Ong shared.

"We will also need to administer as many boosters as possible to those who are due to take them, to get them well-protected against Omicron early."

On that note, the Minister added the MTF "will therefore have to set a validity period for full vaccination status", which the Ministry of Health (MOH) is consulting the Expert Committee on COVID-19 Vaccination (EC19V) to determine the duration. This would mean that after two doses of mRNA vaccines, and three doses of Sinovac/Sinopharm vaccines, an individual's 'fully vaccinated' status will only last for a limited period.

"We expect to announce the new policy at the end of this year or early next year. But please be assured: We will design the policy such that if you have not been given a chance to get your booster, your full vaccination status will not lapse. Similarly, if you belong to a group not eligible for boosters, such as those aged below 18 years, your full vaccination status will also not lapse," he said.

Regarding boosters, Minister Ong shared that the two mRNA vaccines can be used interchangeably as boosters.

"For the month of December, we have more Moderna supplies. So if you are eligible to receive your booster shot and if you choose to take a Moderna booster, you can just walk into a Moderna vaccination centre for your jab. There is no need to pre-book a slot", he added.

Monitoring time for post-boosters will also be reduced from 30 minutes to 15 minutes, as "data shows a very low incidence rate of significant acute adverse reactions after taking boosters". With more time available at hand, Minister Ong said it "will expand our booster delivering capacity", which includes plans to set up more vaccination centres, to support the vaccination of children, and to administer boosters.

With these in place, there will be "a few operational adjustments", which see the exemption of VDS for recovered patients adjusted from 270 days to 180 days.

Health protocols

According to Minister Ong, there is also a proposal to allow general practitioners (GPs) to play a more proactive role in Singapore's Healthcare Protocols 1-2-3 — by allowing them to trigger Protocols 1 and 2 with an MC, and to provide follow-up care for their patients, instead of relying on centralised coordinated care administered only by the MOH.

"GPs can also judge the disposition and risk profile of the patient, and order either a PCR or an ART test. For very mild or asymptomatic cases, the GP may want to just order an ART test, and if positive, the patient may be asked to go on a few days of MC, rest at home, and come out when tested ART negative," Minister Ong added.

This is because GPs "have expressed a strong interest to continue to care for their COVID-19 patients, instead of having them onboarded into a national HRP (home recovery programme)", which is something the Ministry of Health supports. Minister Ong maintained that the "long-term doctor-patient relationship is actually the essence of primary care".

Prior to this proposal, GPs could only prescribe a PCR test to an individual who feels unwell, who if tested positive will most likely be put under the HRP for 10 days.

"We are therefore thinking through how to have our GPs play an even bigger role, especially if we ever have a big Omicron wave," Minister Ong said.

Read the Minister's full speech here. 

Image / 123RF

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