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Gahmen needs to come clean on those cases classified as "work permit holders not residing in domintories"

jw5

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from MOH report 20 December 2021:

SUSPECT OMICRON CLUSTER AT ANYTIME FITNESS (BUKIT TIMAH SHOPPING CENTRE)​


The Ministry of Health (MOH) has detected a cluster of three COVID-19 cases linked to Anytime Fitness (Bukit Timah Shopping Centre), of whom two have tested preliminarily positive for the Omicron variant and the result for the remaining case is pending. All three cases are fully vaccinated and have mild symptoms. MOH is ringfencing the cases through contact tracing.

Case 280856

2. Case 280856 is a 24 year-old male who is unemployed. He developed a sore throat and fever on 18 December 2021 and sought medical attention at a General Practitioner (GP) clinic where he underwent a polymerase chain reaction (PCR) test. His test result came back positive for COVID-19 infection on the same day.

Case 280951



3. Case 280951is an 18 year-old female who is a student at Ngee Ann Polytechnic, and was last in school on 15 December. She developed a sore throat and fever on 18 December and sought medical attention at a GP clinic where she was tested for COVID-19. Her PCR test result came back positive for COVID-19 infection on 19 December.

Case 280990

4. Case 280990 is a 21 year old male who is a student at At-Sunrice Global Chef Academy but had not been to school recently. He developed a sore throat on 18 December and sought medical attention at a GP clinic where he was tested for COVID-19. His PCR test result came back positive for COVID-19 infection on 19 December.

5. All three cases had no recent travel history. Our epidemiological investigations found that they recently visited Anytime Fitness (Bukit Timah Shopping Centre) between 15 December and 17 December 2021.

6. Staff and visitors of Anytime Fitness (Bukit Timah Shopping Centre)who are identified to be close contacts of the cases will be placed on quarantine. As a precautionary measure, other visitors to the gym between 15 December and 17 December will be issued Health Risk Warnings (HRW). They will also be contacted by MOH for a one-time targeted PCR test.

7. All visitors to the affected premises are advised to monitor their health closely, and minimise social interactions as far as possible, for 14 days from their date of visit. They are encouraged to see a doctor immediately if they feel unwell.

8. To date, there are 71 confirmed Omicron cases detected in Singapore, with 65 imported cases and 6local cases. Given its high transmissibility and spread to many parts of the world, we should expect to find more Omicron cases at our borders and also within our community. It is important for everyone to continue to play their part and remain vigilant to mitigate the spread of COVID-19, and to come forward to receive your vaccination or booster dose when offered.

MINISTRY OF HEALTH
20 DECEMBER 2021
 

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from MOH report 21 December 2021:

FIRST SHIPMENT OF PAEDIATRIC DOSES OF PFIZER-BIONTECH/COMIRNATY COVID-19 VACCINE TO ARRIVE IN SINGAPORE​


The first shipment of paediatric doses of the Pfizer-BioNTech/Comirnaty COVID-19 vaccine is en route from Europe and is expected to arrive in Singapore on 22 December 2021. This will enable us to start vaccinations for children aged 5 to 11 years in end-December as planned.



2. The Pfizer-BioNTech/Comirnaty COVID-19 paediatric vaccine has met quality, safety and efficacy standards and has been approved by the Health Sciences Authority for use in children aged 5 to 11 years. The Expert Committee on COVID-19 Vaccination has also recommended its use for this age group.



3. The Ministry of Health is working with the Ministry of Education (MOE) and the Early Childhood Development Agency (ECDA) on details on the rollout of vaccination for this age group. Further operational details will be announced shortly by MOE and ECDA.



4. Vaccinations and boosters are the best protection against COVID-19. The extension of vaccination to include children aged 5 to 11 years will strengthen our collective resilience against the evolving COVID-19 situation, and we encourage everyone who is eligible to be vaccinated when it is offered to them.


MINISTRY OF HEALTH
21 DECEMBER 2021
 

jw5

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from MOH report 21 December 2021:

Protecting Our Children from COVID-19 with Vaccination for 5 to 11-Year-Olds​


The Ministry of Education (MOE) and the Early Childhood Development Agency (ECDA) will be working with the Ministry of Health (MOH) to extend the national vaccination programme to cover over 300,000 children aged 5 to 11, starting with the older children from 27 December 2021. The programme will be open to all children who are Singapore Citizens (SC), Permanent Residents (PR) and long-term pass holders (LTPH). Booking for vaccination appointments will start on 22 December 2021.

2. The Health Sciences Authority (HSA) has approved the use of the Pfizer-BioNTech/Comirnaty COVID-19 vaccine for use in children aged 5 to 11. The Phase 3 clinical trial of the vaccine has shown that the Pfizer BioNTech/Comirnaty COVID-19 vaccine is safe and effective for children in this age group. The Expert Committee on COVID-19 Vaccination has assessed that the benefits of vaccination far outweigh the risks. Currently, the Pfizer-BioNTech/Comirnaty COVID-19 vaccine is the only vaccine approved for children aged 5 to 11 in Singapore.

3. As of 19 December 2021, about 94% of those in the 12 to 19 age group have completed the full vaccination regimen. The extension of the vaccination programme to children aged 5 to 11 is part of the larger national efforts to keep our children, their families and the wider community safe.

Designated Paediatric Vaccination Centres​

4. To facilitate the vaccination of younger children, 15 designated paediatric vaccination centres (VCs) located island-wide will progressively begin operations1. These VCs will be manned by medical personnel trained in paediatric care, as well as staff trained in administering vaccination for children. Please refer to Annex A for a map of the VCs. Seven paediatric VCs will start operations from 27 December 2021, followed by seven more centres from 3 January 2022. MOE has also worked with MOH to set up an additional paediatric VC within Yusof Ishak Secondary School (YISS)2 to provide better coverage of the Punggol/Seng Kang area, commencing operations on 11 January 2022.

Roll-Out of Vaccination and Registration Process​

5. The registration process for the vaccination exercise will open progressively to all eligible children broadly by age bands, starting with children born between 2009 to 2012, followed by those born between 2013 to 2017. Children must have crossed their 5th birthday before they are eligible to book an appointment and receive the vaccination.

6. In addition, to facilitate vaccination for those who are enrolled in MOE primary schools3, MOE has arranged to send an SMS invitation to their parents/guardians to expedite the vaccination booking process by primary level cohorts.

7. Please refer to Annex B for a summary of the registration process.

All students in P4-P6 (in 2022) as well as children born between 2009 to 2012

8. From 22 December 2021 (Wednesday), parents/guardians of Primary 4 to 6 students (all references to primary level cohorts is for the year 2022) studying in MOE primary schools can expect to progressively receive an SMS invitation with a unique link to book a vaccination appointment.

9. From 27 December 2021 (Monday), the MOH National Appointment System (NAS) at child.vaccine.gov.sg4 will open up for parents/guardians of all children aged 9 - 11 (defined to be those born between 20095 to 20126) to register their interest to vaccinate their child/ward. After registration, parents/guardians can expect to receive a unique link via SMS within 3 to 5 working days to book a vaccination appointment.

All students in P1-P3 (in 2022)

10. From the week of 3 January 2022, parents/guardians of Primary 1 to 3 students (in 2022) in MOE primary schools can expect to progressively receive a unique link via SMS to book a vaccination appointment.

Children born between 2013 to 2017

11. From the week of 10 January 20227, parents/guardians of all children aged 5 and above may proceed to register their interest on the NAS. After registration, parents/guardians can expect to receive a unique link via SMS within 3 to 5 working days to book a vaccination appointment.

Special arrangements for MOE Special Education (SPED) schools and ECDA-funded Early Intervention Programme for Infants and Children (EIPIC) centres

12. To facilitate access for children in SPED schools and ECDA-funded EIPIC centres, MOH will deploy mobile vaccination teams to schools for all eligible SPED and EIPIC students from 12 January 2022. Parents/guardians may either opt for their child to receive the vaccination via these mobile vaccination teams, or register their interest on the NAS for their child to receive the vaccination at a paediatric VC. The SPED schools and EIPIC centres will share registration instructions and guidelines with the parents/guardians of these children.

13. Parents/guardians of children with special and developmental needs who do not attend SPED schools or EIPIC centres, such as those from Private Early Intervention centres or who are home-schooled, may register their interest on the NAS when their children's respective age bands are eligible for registration.

Parental/guardian Consent​

14. Parental/guardian consent is required to book a vaccination appointment for both doses of the Pfizer-BioNTech/Comirnaty COVID-19 vaccine. All children aged 5 to 11 must also be accompanied by one parent/guardian at the VC for their appointment. Parents/guardians should bring along their child/ward's Student Identification, or if not available, other forms of identification (e.g. Birth Certificate/Passport/SingPass) during the vaccination appointment for verification purposes. Those who registered their interest on the NAS will also be required to sign a consent form and bring along a hardcopy or softcopy to the VC for verification. The consent form can be found on NAS.

15. To ensure compliance with Safe Management Measures at the VCs, only one parent/guardian is allowed to accompany their child/ward into the VC.

16. We strongly encourage parents/guardians to get their child/ward vaccinated if they are medically eligible, to keep our families and our wider community safe. For more information on this "5-to-11" vaccination exercise, please visit https://www.moe.gov.sg/faqs-covid-19-infection.

Frequently Asked Questions


Footnotes​

  1. Designated paediatric VCs, apart from Yusof Ishak Secondary School, are co-located with existing vaccination centres for adults and older children. There will be separate queues and spaces to ensure adherence to safe management measures and correct administration of the vaccine.
  2. The MOE paediatric VC at the newly-completed YISS campus in Punggol will be located at the school’s Indoor Sports Hall (ISH). It will be supported by mobile vaccination teams from the Health Promotion Board (HPB) who are experienced in administering paediatric vaccination. The vaccination operations at YISS’ ISH will be segregated from the rest of YISS and will not affect lessons and programmes for YISS e.g. direct entry to the ISH from pedestrian gate of school).
  3. Students in primary level Madrasahs will largely follow similar arrangements as those for MOE primary schools. An SMS invitation will also be sent to their parents/guardians.
  4. The link will go ‘live’ from 27 December 2021.
  5. Those born in 2009 who have reached 12 years old as of the date of the first vaccination appointment will be required to take the Pfizer-BioNTech/Comirnaty COVID-19 vaccine for ages 12 and above and not the paediatric dose.
  6. For this phase, we will open up registration based strictly on calendar year of birth and not go by when the child turns 9, to keep the registration process simple. The issue of turning 9 will no longer be relevant once we fully open the registration process to all who are 5-11, by around mid-January 2022.
  7. MOE and ECDA will provide an update in early January on the confirmed date for this phase of paediatric vaccination registration and booking.
 

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from MOH report 22 December 2021:

REMAINING VIGILANT AGAINST THE OMICRON VARIANT​


In response to the emergence of the Omicron variant globally, the Multi-Ministry Taskforce (MTF) had introduced travel restrictions for affected countries/regions and enhanced our testing regime for travellers, including those arriving via the Vaccinated Travel Lanes (VTLs).

2. We are picking up more Omicron cases because of the rapid spread of the variant across many countries/regions. Thus far, our enhanced testing regime for travellers has helped us to detect 65 confirmed Omicron cases. With aggressive contact tracing and ringfencing measures, we have, for now, been able to limit onward community transmission. But it is a matter of time before the Omicron variant spreads in our community.

3. Our border measures will help to buy us time to study and understand the Omicron variant, and to strengthen our defences, including enhancing our healthcare capacity, and getting more people vaccinated and boosted.

4. Meanwhile, we need everyone to remain vigilant to reduce the risks of widespread community transmission, and to keep yourself, your loved ones and the community safe. In particular, travellers must adhere closely to the travel health control measures.

Stricter enforcement for Travellers on Vaccinated Travel Lanes

5. We remind all VTL travellers1 that they must strictly adhere to the enhanced testing regime upon arrival in Singapore. VTL travellers are required to undergo an on-arrival test2 and test themselves daily using self-administered antigen rapid tests (ARTs). On Days 2, 4, 5 and 6, travellers are required to submit the results of their self-administered ART online using a link which will be sent to them via their declared contact details after arrival in Singapore. On Days 3 and 7, the tests must be done under supervision at a Combined Test Centre (CTC) or Quick Test Centre (QTC).3 Please refer to the Annex for an illustration of the testing regime.

6. Travellers must test negative on their self-administered ART before going out for activities on that day, except on Days 3 and 7 whereby travellers are to undergo their supervised test at a CTC or QTC before going about any other activities on that day. Travellers must take their ARTs and submit their self-administered ART results as necessary in a timely manner. Travellers who do not undergo the required tests and/or submit their results will be issued a Stay-Order/Stay-Home Notice (SHN), and will also face enforcement actions under the Infectious Diseases Act.

7. In view of the rise in Omicron cases globally, travellers should exercise personal responsibility, minimise their social interactions, and refrain from high-risk mask off activities (such as dining at F&B establishments, exercising in gyms or attending fitness classes), as well as avoid large gatherings and crowded places for 7 days from arrival, even if they have a negative daily ART result. Travellers who are unwell, including those showing early/mild symptoms should be socially responsible and seek medical attention immediately.

Freezing of new VTL bookings

8. To limit our exposure to imported Omicron cases, we will impose limits on the number of VTL arrivals for the time being. We will freeze all new ticket sales for VTL flights and buses for travel into Singapore from 23 December 2021 to 20 January 2022, both dates inclusive. All travellers who already hold a ticket on a VTL flight or bus and meet all the other VTL requirements can continue to travel under the VTL. We will also temporarily reduce the VTL quotas and ticket sales for travel after 20 January 2022. We will continue to monitor developments closely and update this policy as the situation changes.

9. The Civil Aviation Authority of Singapore (CAAS) will provide further details for the VTL-Air, and the Ministry of Trade & Industry (MTI) for the VTL-Land.

Remaining vigilant against the Omicron variant

10. We seek everyone’s continued effort and cooperation to exercise social responsibility and comply with all the measures that have been put in place. Test yourself regularly and follow the health protocols. Only by doing so can we strengthen our collective resilience against the evolving COVID-19 situation.


MINISTRY OF HEALTH
22 DECEMBER 2021

1 As announced on 4 December 2021, all Construction, Marine Shipyard and Process (CMP) S Pass and work permit holders, as well as other dormitory-bound work pass holders, will not be allowed to enter Singapore via VTLs.
2 VTL air travellers will undergo a Polymerase Chain Reaction (PCR) test and VTL Land travellers will undergo an ART.
3 VTL travellers will be provided with a link via their contact details submitted in the Singapore Arrival Card and electronic Health Declaration Card (SGAC/eHDC) to book their supervised tests on Days 3 and 7. Bookings will be on a first-come-first-served basis.


ANNEX

The table below summarises the testing regime for all VTL travellers

Testing regime for VTL travellers last updated 6 December 2021, 2359 hours
(Dates are illustrative based on arrival on 21 December 2021)


DayDateTest
Within 2 days before departureOn or after 19 December 2021Pre-Departure PCR test or ART
1 (arrival)21 December 2021On-Arrival PCR test (for VTL-Air) or ART (for VTL-Land)
222 December 2021Unsupervised self-administered ART*
323 December 2021Supervised self-administered ART at QTC/CTC^
424 December 2021Unsupervised self-administered ART*
525 December 2021Unsupervised self-administered ART*
626 December 2021Unsupervised self-administered ART*
727 December 2021Supervised self-administered ART at QTC/CTC^
*Results to be submitted online.
 

jw5

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from MOH report 24 December 2021:

NO APPOINTMENT NEEDED FOR PERSONS DUE FOR THIRD DOSE OF SINOVAC-CORONAVAC VACCINE​


1. Individuals who have taken their first two doses of the Sinovac-CoronaVac vaccine can now walk into selected vaccination centres for their third dose of COVID-19 vaccine to complete their primary series, without prior appointment.



2. This follows our announcement on 2 December 2021 that those who have taken two doses of Sinovac-CoronaVac are strongly encouraged to take their third dose of a COVID-19 vaccine before 31 December 2021, as long as three months have passed from their second dose. There are currently about 29,000 individuals who are due for their third dose, after having received two doses of the Sinovac-CoronaVac. They are strongly recommended to receive a PSAR-authorised mRNA vaccine for their third dose unless medically ineligible to do so.



3. This will help maintain the protection from the vaccine, as antibody levels from the Sinovac-CoronaVac vaccine declines rapidly within three to six months after completion of the second dose. Emerging international data indicates that while the mRNA vaccines, especially with booster vaccination, are protective against the Omicron variant, the Sinovac-CoronaVac and Sinopharm vaccines result in weaker neutralising activity and may not be protective.



4. Taking the remaining dose of the three-dose primary regime will maintain the individual’s fully vaccinated status. Beyond this time interval, the individual’s vaccination status will revert to ‘additional dose needed’ and will be subject to the current Vaccination-Differentiated Safe Management Measures (VDS) if they do not do so.



Walk-ins for Eligible Individuals to Complete Third Dose of COVID-19 Vaccine



5. Individuals who have taken the Sinovac-CoronaVac vaccine as their first two doses can now walk into the following vaccination centres for their third dose to complete their primary series:



a. Vaccination centres offering the Moderna vaccine;



b. Vaccination centres offering the Pfizer-BioNTech/Comirnaty vaccine, if they are aged 60 years and older; and



c. Raffles City Convention Centre (RCCC), which offers the Sinovac-CoronaVac vaccine, and takes walk-ins until 31 December 2021.



Three Vaccination Centres to Offer both Pfizer-BioNTech/Comirnaty and Moderna Vaccines



6. From 27 December 2021, three Vaccination Centres – Bishan Community Club, Canberra Community Club, and Tanjong Pagar Community Club – will begin administering the Moderna vaccine, in addition to the currently available Pfizer-BioNTech/Comirnaty vaccine. Individuals who have booked a slot for either vaccine brands at any of these Vaccination Centres via the National Appointment System are required to keep to their bookings and chosen vaccine type.



7. In view of the rise in Omicron cases globally and locally, there is a need to be boosted for better protection. Those who have had their second dose of Pfizer-BioNTech/Comirnaty or Moderna vaccine at least five months ago, but have not yet received their SMS notification can walk into any Vaccination Centre for a booster vaccination without the need for a prior appointment.



MINISTRY OF HEALTH
24 DECEMBER 2021
 

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From ICA website:

2) Obtaining a Pre-Departure COVID-19 Test in Singapore for Overseas Travel​

Travellers who are required by their destination country/region to take a pre-departure COVID-19 test must book an appointment with any clinic found on this list. As a general guide, travellers who present themselves at a clinic less than 38 hours before their flight will not receive their pre-departure test result on time. Travellers are therefore strongly encouraged to allocate sufficient lead time when scheduling a test appointment.

On the day of the test, travellers should bring the following documents to the clinic:

  1. Identity card (for Singapore Citizens, Permanent Residents, and Long-Term Pass Holders)
  2. Passport
  3. Flight booking details showing the departure timing
For details related to the cost and administration of the test, travellers should enquire directly with the clinic. Travellers should note that government subsidies cannot be used to offset the cost of the test, and a test memo will not be issued for any government-paid-for tests.
 

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from ICA website:​


3) Digitally Authenticated Outbound Pre-departure COVID-19 Test Result​

Travellers who have taken a COVID-19 Polymerase Chain Reaction Test (“PCR test”) in Singapore for overseas travel will receive a digital test result certificate. Those who are unable to receive a digital certificate or have taken a COVID-19 test that is not a PCR test can request a hardcopy certificate from the clinic instead.

Travellers should digitally authenticate their test results with the help of the clinic (if the service is available), and/or via Notαrise. All successfully authenticated digital result certificates will be converted into a QR code which can be used during boarding and immigration clearance overseas. Travellers who are authenticating their certificates with the help of the clinic must provide their NRIC. Upon successful authentication, they can retrieve the QR code of their authenticated certificate from their Singpass account. Travellers who have successfully authenticated their certificates with Notαrise can expect to receive their QR code via email within 15 minutes of submission.

Travellers who do not receive their QR code or encounter any technical difficulties while authenticating their digital result certificate may write to [email protected] for assistance, or refer to this FAQ
 

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from ICA website:

4) Digitally Authenticated Vaccination Certificate​

All hardcopy vaccination cards/ slips issued in Singapore, as well as vaccination records found on mobile applications such as TraceTogether and HealthHub may not be accepted for use overseas where digital verification might be required i.e. scanning the QR codes on your digital vaccination certificate.

Travellers who are vaccinated in Singapore and are required by foreign authorities to show digitally verifiable proof of vaccination should obtain a digitally verifiable vaccination certificate (‘Vaccination HealthCert’) at Notαrise. Upon successful application, the Vaccination HealthCert will be sent by Notαrise to the traveller’s email and/or Singpass app (for users who logged in using Singpass app/ credentials). Foreign authorities will be able to scan the QR codes on the certificate to digitally verify that the certificate is authentic.

Travellers who generated offline QR codes before 10 Dec and are experiencing vaccination expiry date issues during verification should regenerate their QR codes on Notαrise. Please note that while Singapore's Pre-Departure Test (PDT) and Vaccination HealthCerts are considered equivalent to the EU DCC, your destination may be using reader applications that are unable to validate offline QR codes. You can ask the authorities/businesses if verification can also be done by scanning the online QR code with a mobile device connected to the internet.
 

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jw5

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from MOH website:

Both mRNA vaccines work well as boosters, P-P-M has a slight edge


 

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from MOH report 31 December 2021:

UPDATES ON BORDER MEASURES FOR TRAVELLERS​


1. When the Omicron variant of concern surfaced globally, the Multi-Ministry Taskforce (MTF) announced enhanced testing regime for travellers arriving via the Vaccinated Travel Lanes (VTLs) to reduce the risk of spread of Omicron into Singapore. As of 30 December 2021, we have detected 912 Omicron imported cases; of whom 685 were detected through our enhanced testing regime for VTL travellers.



2. We previously announced that all VTL travellers [1] must undergo COVID-19 tests up till Day 7 of their arrival and strictly adhere to this enhanced testing regime (please see Annex for testing regime) for four weeks in the first instance (until 2 January 2022). The enhancement has proven effective in detecting imported Omicron cases amongst VTL travellers and reducing onward transmission. As such, we will be extending the enhanced testing regime for an additional four weeks and will review it as the situation evolves.



3. We had earlier also required all non-VTL travellers entering Singapore to undergo on-arrival tests (OAT). This was to pick up the Omicron cases early, as the variant was new, and we wanted to learn more about it. As we have gathered more information on the Omicron variant, we have further assessed that OATs for non-VTL travellers, who are all required to serve a 7 or 10 day Stay Home Notice (SHN) either at their place of residence or at a dedicated facility, are no longer required. In addition, these travellers will also be required to undergo a Polymerase Chain Reaction (PCR) test at the end of their SHN, and have to test negative before they are allowed to exit SHN, further reducing the risk of onward transmission. Hence, from 7 January 2022, 2359 hours (Singapore time), all non-VTL travellers entering Singapore from Category II (non-VTL), III and IV countries will no longer be required to undergo a COVID-19 PCR test on-arrival.



Regular Review of Border Measures



4. As the global situation evolves, we will continue to adjust our border measures in tandem with our roadmap to becoming a COVID resilient nation. The full list of Safe Travel Lanes for travel to Singapore and prevailing border measures under each lane for different categories and changes to border measures will be updated on the SafeTravel website. Not all lanes may utilise the Category I/II/III/IV health measure framework. Travellers are advised to visit the website to check the latest border measures for their country/region which will apply upon entry into Singapore and be prepared to be subjected to the prevailing border measures upon entry.



MINISTRY OF HEALTH

31 DECEMBER 2021




[1] As announced on 4 December 2021, all Construction, Marine Shipyard and Process (CMP) S Pass and work permit holders, as well as other dormitory-bound work pass holders, will not be allowed to enter Singapore via VTLs.
 

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from MOE website:

Sibling Walk-In Arrangement and Opening of More Vaccination Centres – Greater Convenience for Parents​


Updates on Vaccination Progress and Roll-Out​

1. As of 2 January 2022, 6pm, more than 6 in 10 of Primary 4 to 6 students in MOE primary schools have registered for vaccination. Another 9,000 children aged 9 to 11 who are not in our primary schools have registered their interest on the Ministry of Health (MOH) National Appointment System (NAS) at child.vaccine.gov.sg.

2. From 3 January 2022, seven more paediatric VCs have started offering vaccinations for children aged 5 to 11. We are now ready to support the next phase of the paediatric vaccination roll-out, with increased capacity and greater convenience to parents so that all medically eligible children can be vaccinated as soon as possible.

3. From 5 January 2022, about 110,000 parents/guardians of Primary 1 to 3 students in MOE primary schools can expect to progressively receive a unique link via SMS to book a vaccination appointment. From 6 January 2022, parents/guardians of all remaining children aged 5 to 8 may proceed to register their interest on the NAS1.

"Sibling Walk-In" Arrangement from Mondays to Thursdays​

4. To provide greater convenience for parents/guardians with more than one child/ward aged 5 to 11 years and to optimise our available vaccination capacity on Mondays to Thursdays, from 10 January 2022, all accompanying siblings of a child with an appointment on Mondays to Thursdays can walk in for their vaccination without prior appointment2. Parents/guardians who intend to vaccinate their children/wards under the "sibling walk-in" arrangements should arrive at the vaccination centre by 7pm on Mondays to Thursdays3. We encourage parents/ guardians who have booked separate appointments for different children/wards to keep only one desired slot and cancel the remaining bookings on NAS. As the children must be accompanied by one parent/guardian, it would suffice for one parent/guardian to be present for children going for the same vaccination appointment. However, we will exercise flexibility and allow one parent/guardian per child, should there be requests from the parent/guardian.

5. We are currently unable to accommodate the sibling walk-in arrangement on Fridays to Sundays due to high demand in appointment bookings for the next few weekends. We seek the understanding and cooperation of parents to ensure we can provide a smooth and orderly vaccination process for all our children, and will continue to work with MOH to consider further operational enhancements to the paediatric vaccination arrangements.

Webinar on Paediatric Vaccination​

6. MOE, in collaboration with MOH and ECDA, will be holding a webinar for parents/guardians on 5 January 2022 (Wednesday), 7.30pm to 8.30pm to address concerns or queries that they may have on COVID-19 vaccination for children. The webinar is open to 3,000 participants on first-come, first-served basis. Parents/guardians can attend the webinar via https://go.gov.sg/5janvaccinewebinar4 and submit their questions before the session5.

7. We strongly encourage parents/guardians to get their child/ward vaccinated as soon as they receive the invitation. This is our key measure to keep our children, families and wider community safe and resilient against COVID-19. Students will be deemed to be on medical leave if they receive their vaccination during school hours, or feel unwell from the vaccination. Schools will make the necessary arrangements to help them with schoolwork if needed, and ensure that students do not engage in physically strenuous activities for two weeks after vaccination.


Footnotes​

  1. After registration, parents/guardians can expect to receive a unique link via SMS within 3 to 5 working days to book a vaccination appointment.
  2. Parents/guardians should bring along the Student Identification, or if not available, other forms of identification (e.g. Birth Certificate/Passport/SingPass) of all children/wards receiving the vaccination for verification.
  3. Parents/guardians who intend to vaccinate their children/wards under the "siblings walk-in" arrangement at the paediatric vaccination centre at Yusof Ishak Secondary School (YISS) should arrive at the VC by 5pm on Mondays to Thursdays. The VC at YISS will begin operations on 11 January 2021.
  4. To enter the webinar, please enter the meeting passcode: 5janvac.
  5. Parents may submit their questions at https://go.gov.sg/questions5janwebinar.
 

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from MOH report 5 January 2022:

EXPERT COMMITTEE ON COVID-19 VACCINATION RECOMMENDS BOOSTER VACCINATION AT NO LATER THAN NINE MONTHS​

The Expert Committee on COVID-19 Vaccination (EC19V) recommends that all vaccinated persons aged 18 years and above should receive a booster vaccine dose at about five months after the last dose of their primary vaccine course, or as soon as possible thereafter, in order to maintain good protection against COVID-19. This booster dose should not be delayed beyond nine months after the primary vaccine course.



2. Local and international data show reduced vaccine protection against COVID-19 infection from around six months after completion of the last vaccine dose in the primary vaccination series or earlier. The level of protection drops even further over time. There is also some reduction in protection against severe disease, particularly in older persons. In addition, international studies have shown that the protection against Omicron variant infection by a primary vaccination series is weaker compared to previous variants, and that boosters increase the protection against infection and severe illnesses caused by Omicron. As such, booster vaccination is crucial to ensure continued protection against COVID-19.



Booster Recommendation for Persons Vaccinated with the mRNA Vaccines



3. EC19V therefore recommends that those aged 18 years and above who have completed a primary course comprising two doses of either the Pfizer-BioNTech/Comirnaty or the Moderna COVID-19 vaccine should receive a booster dose of either mRNA vaccine around five months after the second dose, or as soon as possible thereafter. This booster dose should not be delayed beyond nine months after the primary vaccine course.



Booster Recommendation for Persons Vaccinated with the Sinovac-CoronaVac and Sinopharm Vaccines



4. Persons who had received two or more doses of the Sinovac-CoronaVac or Sinopharm vaccines as part of a three-dose primary vaccination series are strongly recommended to receive one dose of an mRNA vaccine as a booster dose. Such persons who received an mRNA vaccine as their third dose should do so around five months thereafter. However, those who received the Sinovac-CoronaVac or Sinopharm vaccine as their third vaccine dose should do so at three months thereafter, due to lower antibody levels generated by the third vaccine dose.



Booster Recommendation for Non-mRNA Vaccines



5. Individuals who have received recognised primary vaccination regimens other than the vaccines mentioned above are also recommended to receive a booster dose around five months, or as soon as possible thereafter. This includes persons who had completed the primary series vaccination with other WHO EUL vaccines.

Booster Recommendations for Recovered Persons and Persons with Medical Conditions Requiring an Enhanced Primary Series of Three mRNA Vaccine Doses



6. Persons with medical conditions such as moderate or severe immunocompromise, and who have received an enhanced primary series of three doses of an mRNA vaccine, are recommended to receive a booster dose (i.e. fourth dose) of an mRNA vaccine around five months after the third dose.



7. Persons who have recovered from COVID-19, and who were unvaccinated or partially vaccinated before their infection should receive one dose of the mRNA vaccine at least three months after infection to reduce their risk of reinfection. There is no change from previous recommendations for this group. No subsequent doses of vaccination are recommended at this time, but recommendations may be updated, as more data become available.



8. Persons who were fully vaccinated with two doses of mRNA vaccine and are not immunocompromised, who subsequently were infected with COVID-19 and recovered, also do not require an additional booster dose at this time. There is no change from previous recommendations for this group.



9. The Sinovac-CoronaVac vaccine should only be considered as a booster vaccine in persons who are medically ineligible to receive mRNA vaccines. All other persons should be boosted with the mRNA vaccines.



10. Timely booster vaccination will ensure optimal protection against COVID-19, including the Omicron variant. EC19V urges all persons aged 18 years and above to receive their booster vaccination as soon as they are eligible to do so.





EXPERT COMMITTEE ON COVID-19 VACCINATION

5 JANUARY 2022
 

jw5

Moderator
Moderator
Loyal
from MOH report 5 January 2022:

STRENGTHENING OUR READINESS TO LIVE WITH THE OMICRON VARIANT​


Over the past week, we have seen a rise in the total number of confirmed Omicron cases. Given the higher transmissibility of the Omicron variant, we are likely to experience an infection wave that is greater than that of Delta. Although there may be proportionately fewer severe cases or deaths due to Omicron’s lower severity and continued protection from our vaccination and booster efforts, when multiplied over a much larger number of cases, it could still result in a significant number of individuals requiring intensive care unit (ICU) care, and put significant pressure on our healthcare system. Hence it is important that we put in place appropriate response measures to prepare ourselves well for this upcoming wave.



2. We had earlier shifted our approach to manage Omicron cases like other COVID-19 cases, including to transit Omicron cases to prevailing Protocols 1-2-3, and allow for home recovery instead of isolating them at dedicated facilities. Moving ahead, we will further streamline the management of COVID-19 cases by enhancing Protocols 1-2-3. In particular, we will work with our primary care doctors to enable them to trigger Protocol 2, to support low-risk individuals with mild COVID-19 symptoms in recovering safely in the community. To maximise the level of protection that our population has against the Omicron variant, we will also require individuals to get their booster shots in order to maintain their fully vaccinated status.



Updates on Local Situation and Detected Omicron Cases



3. Our local COVID-19 situation remains within control. Over the past week, daily case numbers have been around 200 on average. 16 cases are currently in ICU care. These figures are significantly lower than when we experienced a peak in infection numbers a few months ago, indicating that the recent wave of Delta infections has subsided.



4. However, we are seeing a growing number of confirmed Omicron cases even as the Delta wave subsides. Over the past week, we have detected 1,281 confirmed Omicron cases, comprising 1,048 imported cases and 233 local cases. This makes up around 18% of our local cases in the last week. With higher transmissibility of the Omicron variant, we are likely to experience another wave of community infections soon.



Revised Healthcare Protocols



5. Since 11 October 2021, we have simplified our healthcare protocols as part of the broader shift towards personal responsibility and self-management as appropriate. This has enabled the majority of COVID-19 patients to self-isolate or recover at home safely once tested positive. Patients with mild symptoms who are on home recovery programme generally recover quickly in the comfort of their home without the need for further medical care. Prevailing evidence also indicates that Omicron, while more transmissible, is also less severe. We will therefore further enhance the use of Protocols 1-2-3 to facilitate streamlined management of COVID-19 cases. From 6 January 2022, we will manage individuals based on the severity of symptoms and health status, as laid out in the revised protocols below. Our primary care doctors will be key, as we allow patients to recover at home and avoid hospitalisation.



6. For low-risk individuals with mild symptoms, primary care doctors can make an immediate diagnosis via a healthcare-administered antigen rapid test (ART) and continue to care for them under Protocol 2. To elaborate, after seeing the primary care doctor who has ascertained that their symptoms are mild and that they are at low risk of developing severe symptoms:



a. The individual will be required to self-isolate at home for at least 72 hours. Following which, if they feel well, they may exit self-isolation and resume normal activities upon a negative self-administered ART, similar to Protocol 2. Those who continue to test ART positive should continue to self-isolate and self-test daily until they obtain a negative ART result, or until Day 10 for vaccinated individuals or Day 141 for unvaccinated or partially vaccinated individuals, whichever is earlier.



b. The individual will receive a 5-day Medical Certificate from the primary care doctor (or longer, depending on clinical discretion) to cover the expected period of rest needed for the symptoms to resolve. If symptoms worsen or do not improve with time, the individual is advised to return to the doctor or call 995 in emergency situations.



c. Health Risk Warnings (HRW) will be issued to the individual’s close contacts, including those identified through the TraceTogether app and self-declaration of household members. Persons issued with HRW should follow the prevailing Protocol 3.



7. Individuals who are assessed by their doctors as high risk (e.g. elderly, pregnant, immunocompromised status) or with significant symptoms (e.g. chest pain, shortness of breath, prolonged fever) will continue to be managed under Protocol 1 where they are required to undergo both ART and polymerase chain reaction (PCR) swabs and, if tested positive, will be issued an Isolation Order (IO) for 10 or 14 days, depending on their vaccination status.



8. Low-risk individuals who are well and/or asymptomatic will continue to be managed as per existing Protocol 2 if they test positive on ART.



9. The Ministry of Health (MOH) will monitor the situation in the coming weeks and make further adjustments to gradually allow more individuals to safely recover under Protocol 2 after seeing a primary care doctor, and support their earlier return to normal activities.



Booster Dose Required to Maintain Fully Vaccinated Status



10. Vaccination, especially boosters, retain substantial protection against severe disease for COVID-19 and against the Omicron variant. Nevertheless, the protection from the primary series vaccination wanes with time and is substantially reduced six months after the last dose in the primary vaccination series. International data has also shown that protection against Omicron variant from a primary vaccination series is weaker compared to that against the Delta variant, while boosters increase the protection against infection and severe illness from Omicron.



11. In view of these, the Expert Committee on COVID-19 Vaccination (EC19V) has recommended that persons aged 18 years and above who completed a primary vaccination series should receive a booster dose of an mRNA vaccine2 no later than 270 days after the last dose in the primary vaccination series. This will also apply to individuals who received recognised non-mRNA primary vaccination regimens offered under the National Vaccination Programme, such as three doses of the Sinovac-CoronaVac, or three doses of Sinopharm vaccines, as well as regimens of other WHO EUL vaccines. For this group, most will not be due for booster for some time. We expect the Novavax vaccine, which is a non-mRNA vaccine, to be available to them as an option by then.



12. Taking into account EC19V’s recommendation, from 14 February 2022 onwards, persons aged 18 years and above who have completed the primary vaccination series of COVID-19 vaccines and are eligible for booster vaccination will be considered as fully vaccinated for 270 days after the last dose in their primary vaccination series. They should receive their booster vaccination from around 5 months thereafter as recommended and no later than 270 days thereafter, to ensure an optimal level of protection. Upon receiving their booster, they will continue to be considered as fully vaccinated beyond the 270 days.



13. For example, if an individual completed his primary vaccination series on 1 June 2021, he would be eligible for a booster vaccination 5 months later, i.e. from 1 November 2021 onwards, and would have to receive his booster by 26 February 2022 to continue to be considered as fully vaccinated.3



14. For vaccinated persons who have recovered from COVID-19, no additional booster dose is required at this point in time. However, recovered persons who were unvaccinated or partially vaccinated before their infection should receive one dose of the mRNA vaccine (two doses if they are taking Sinovac-CoronaVac vaccine4) at least three months after infection to be considered as fully vaccinated. The 270-day vaccination validity period does not apply to recovered persons who complete this vaccination requirement.



Learning to Live with the Omicron Variant



15. We remain committed to living normally with COVID-19, while protecting the vulnerable and ensuring that our healthcare system can cope with any future infection wave. This is why it is important that everyone plays their part in getting their vaccinations and booster doses promptly, complying with safe management measures, testing regularly, and following the necessary health protocols if tested positive. We also seek Singaporeans’ continued cooperation and support in complying with the revised protocols and measures, as we roll them out in the coming weeks.





MINISTRY OF HEALTH

5 JANUARY 2022




[1] Day 1 is taken as the date of positive healthcare-administered ART.
[2] Persons who are medically ineligible to receive the mRNA vaccine may consider taking the Sinovac-CoronaVac vaccine, which is the only non-mRNA vaccine offered under the National Vaccination Programme, as a booster vaccine. The Sinovac-CoronaVac vaccine should otherwise not be used as a booster vaccine for other groups.
[3] Eligible individuals can walk in at any Moderna vaccination centre during operating hours, while appointments can be made for Pfizer-BioNTech/Cominarty vaccinations.
[4] For recovered individuals who have received a mixed vaccine combination incorporating Sinovac-CoronaVac or Sinopharm vaccines, please refer to details of the requirements at https://go.gov.sg/sinovac-mixed-vac-combi.
 

jw5

Moderator
Moderator
Loyal
from MOH report 5 January 2022:

OPENING REMARKS BY MINISTER FOR HEALTH MR ONG YE KUNG AT COVID-19 MULTI-MINISTRY TASKFORCE PRESS CONFERENCE ON 5 JANUARY 2022​


1. I have just given an update on the Delta wave earlier this week through a social media post so I will not repeat that information. In summary, the Delta wave has substantially subsided, and this is despite the resumption of many social activities. This means our society has become a lot more resilient to the virus than before, and we are making strides towards living with COVID-19. This is an important milestone.

2. This is also the result of everyone’s efforts and our collective will. While cases rose exponentially in many parts of the world, we maintained our discipline, kept our masks on, stuck to our group sizes, got ourselves vaccinated and boosted, and kept our infection levels low.

The Omicron Situation

3. But an Omicron wave is imminent. Globally, Omicron is already fast displacing other variants as the dominant variant, and there have been record high daily infections in several countries.

4. What is the situation in Singapore now?

5. That brings me to a recent US Centers for Disease Control and Prevention (CDC) ruling. It has updated the travel advisory for Singapore to “Level Unknown’. This is because the US CDC is not aware of our surveillance test numbers. The Ministry of Health (MOH) is engaging the US Embassy as well as the US CDC to provide them with the necessary data.

6. To be clear: we know our situation very well.

7. Every week, we administer over 150,000 polymerase chain reaction (PCR) tests. That works out to over 21,000 PCR tests per day. The positive rates for these tests are under 2 percent.

8. We also have 145 wastewater testing stations across the island, in housing estates, dormitories, nursing homes etc. Only a very small handful are registering the presence of COVID-19 viral fragments.

9. So we are sure that the incidence of COVID-19 in our community is currently low and stable. But Omicron is already in our community. While community cases are not high currently, and Omicron accounts for close to 20 percent of local cases, it is a matter of time before it starts to multiply quickly. We must be prepared for that.

Response Thus Far

10. Let me talk about our response thus far.

11. When Omicron was first detected in November last year, and scientists around the world were grappling to find out more about the variant, we adopted a cautious containment approach at that time. We closed our borders to affected countries in Africa, stepped up the frequency of testing for travellers, isolated infected individuals at National Centre for Infectious Diseases, and conducted very active and stringent contact tracing and quarantine around Omicron cases.

12. Those measures helped to delay the introduction of the variant into our community and slowed the local spread. It bought us valuable time to learn more about the nature and behaviour of Omicron variant, so we can better respond to it.

13. Today, we have reviewed overseas as well as local data, with the time we have bought for ourselves, and we are able to clearly map out the characteristics of Omicron. Let me go through them briefly.

· First, Omicron is more transmissible than Delta, so we must brace ourselves for a much bigger infection wave from Omicron compared to the Delta variant. For example, at the peak in late October and early November last year, we were registering about 3,000 Delta infections a day. Omicron could exceed this by a few times. At its peak, Delta infections were doubling every six to eight days, Omicron infections may double in two to three days.

· Second, the silver lining is that studies coming out from various countries including South Africa, US, UK and Canada, indicate that Omicron infections are less severe than that of Delta - and the data has been very consistent - particularly amongst the vaccinated, and more so amongst those who are boosted. Locally, we have found this to be the case as well. We have so far accumulated 2,252 Omicron cases. Out of the 2,252 cases, three required oxygen supplementation, and all had been taken off oxygen within three days. So all three are now recovering. None has required intensive care unit (ICU) care, as yet. If these same 2,252 infections had been caused by Delta, based on our experience, we would expect about 30 individuals (1.3 percent) to require oxygen supplementation, ICU care or die.

· Third, vaccines, especially boosters, retain substantial protection against severe disease and hospitalisations for Omicron cases. For example, the UK estimated that effectiveness of vaccines and boosters in preventing hospitalisation is 72% and 88% respectively.

Director of Medical Services (DMS) Associate Professor Kenneth Mak will explain these further.

14. Unlike the last time I was speaking to you here, Omicron is now a better known enemy. We know how it attacks and among whom it is most likely to inflict the greatest harm, and so we can take steps to protect ourselves better, and then ride the Omicron wave as safely as we can. As a result, we are making a few policy adjustments.

First, Vaccination Validity

15. First, is vaccination validity. But let me first give you an overview of where we are now in terms of vaccination. International data has shown that protection against Omicron by a primary vaccination series is weaker compared to that against the Delta variant. It also wanes more quickly, typically after five to six months. However, boosters will restore the vaccine protection against infection and severe illness from Omicron.

16. Vaccination and boosters therefore continue to be our primary response. We are now delivering over 50,000 jabs a day – vaccination and boosters. Let me first talk about vaccination.

17. By now, over 87 percent of our population has received two doses of their COVID-19 vaccines. Over the past months, we have managed to vaccinate well over 90 percent of every eligible age group.

18. For example, for seniors aged 60 to 69 years and 70 and above, their vaccination coverage is 96 percent and 95 percent respectively. About 38,000 seniors remain unvaccinated, compared to 200,000 a few months ago. We have also recently started vaccination for children aged 5 to 11 years, and response has been encouraging.

19. Our high vaccination rates have kept the number of severe cases low. As a result, even at the peak of the Delta wave, our hospitals and healthcare system were under stress but not overwhelmed.

20. This reflects the resilience of our population – young and old, men and women, Singaporeans as well as Permanent Residents (PRs) and foreigners. We would have been in far worse shape if we were not a high trust society.

21. For boosters, more than 42 percent of our population have received their booster doses. Amongst those eligible, 78 percent have taken up boosters. Amongst just the seniors aged 60 years and above, 89 percent have taken up boosters. So, this is encouraging.

22. Even as we accelerate the pace of vaccination and boosting, we must not lose our advantage over the virus and we need to keep our wall of resilience strong. Hence our experts have been keeping a close watch on the immunity levels of vaccinated individuals.

23. That is why I explained in a previous press conference that we need to treat COVID-19 vaccination as a three-dose regime for the mRNA vaccines. On that basis, the full vaccination status accorded after two doses of mRNA vaccines and three doses of Sinovac/Sinopharm vaccines, cannot last in perpetuity. The protection will wane after a few months and needs to be restored with a booster.

24. I have therefore earlier indicated that there will need to be an expiry date for full vaccination status, after two doses of mRNA vaccines or three doses of Sinovac/Sinopharm vaccines. We have studied the matter and in line with the recommendation of the Expert Committee on COVID-19 Vaccination (EC19V), MOH will set the expiry to be 270 days or nine months after the last dose of vaccine of the primary series.

25. So there are two durations to remember. 150 days or five months after you have taken your second dose of mRNA or third dose of Sinovac/Sinopharm vaccine – you will be invited to take your boosters. 270 days or nine months after you have taken your second dose of mRNA or third dose of Sinovac/Sinopharm vaccine and you have not taken your booster, your full vaccination status will lapse. This will amongst other things, affect your access to vaccination-differentiated venues such as malls, restaurants, libraries etc.

26. This policy will be effective from Monday, 14 February 2022.

27. Let me explain this new policy with some dates, just to illustrate and make it clear. From now to 13 February 2022, so long as you have taken two doses of mRNA or three doses of Sinovac/Sinopharm vaccines, regardless of how long ago you have received those jabs, you will still be deemed as fully vaccinated.

28. From 14 February 2022, if your last vaccine dose was taken before 20 May 2021 (i.e. 270 days or nine months ago), your full vaccination status will lapse. To maintain your full vaccination status, you would need to take a booster vaccine dose before the deadline of 14 February 2022.

29. We are setting the effective date of the new policy to almost 1.5 months from now, so that everyone whose vaccination status may lapse from 14 February 2022 has a chance to get their booster jabs early and before that deadline. Those who have not reached the nineth month expiry or who are medically ineligible for boosters will not be affected.

30. We have been inviting those who have completed their primary series vaccination regime about five months ago to register for their mRNA booster shots. To facilitate bookings for booster appointments, in the coming weeks, we will send out invitations for booster shots for those aged 60 years and above earlier, around four months. We have consulted the EC19V and they are supportive of this administrative move.

31. I urge all eligible individuals to take their boosters promptly. Let us remain a high trust, resilient nation.

Health Protocols

32. Another important response is to prepare our healthcare system for a potentially high number of Omicron cases.

33. DMS will explain the work that we are doing to ready our healthcare capacity. In particular, if indeed Omicron infections are less severe, and hospital stays are shorter, which is what international data is indicating, we can better leverage our COVID-19 Treatment Facilities (CTFs), instead of straining our hospital resources.

34. The majority of patients though would be able to recover safely at home without the need to be admitted to a hospital or CTF. Here, we will adjust our health protocols. I said at the last Multi-Ministry Taskforce press conference that we want to further empower our primary care doctors, especially our General Practitioners (GPs), to look after their patients who are infected with COVID-19. Let me explain how we are doing this.

35. Most people are familiar with Protocols 1 and 2.

36. Just to recap, under Protocol 1, the individual who is not well will be asked to undergo a PCR test, and if tested positive, will be placed under the Home Recovery Programme, or conveyed to Community Isolation Facilities (CIFs), CTFs or hospitals, depending on their disposition and their risk levels.

37. Under Protocol 2, the patient is usually asymptomatic or has mild symptoms. They will self-administer antigen rapid tests (ART), and if positive, isolate at home for at least 72 hours. Thereafter, if they test negative with an ART, they may exit self-isolation and resume normal activities.

38. We will empower primary care doctors to trigger not just Protocol 1, which they currently do, but also Protocol 2. We have since engaged our primary care partners and I am happy to share that they welcome this and the new protocol will kick in progressively from tomorrow, 6 January 2022.

39. So to explain and illustrate, this means that under the new arrangement, individuals who see a primary care doctor will be clinically assessed based on their symptoms and health status. For low-risk individuals with mild symptoms, the primary care doctors will be able to make an immediate diagnosis and administer an ART on the patient.

40. If positive, a medical certificate will be issued and the patient will be asked to isolate himself for the next 72 hours. After that, if they test negative on a self-administered ART, they may exit self-isolation and resume normal activities.

41. At any point in time if they feel unwell, their primary care doctor will be there to support them. Anyone who feels very unwell will always be able to seek medical attention from our hospitals, and also call 995.

Living with Omicron

42. To be COVID-resilient, we must ride the Omicron wave as another rite of passage, just as we have done so for Delta. At the end of the next wave, we will be even more resilient than now. And we will have achieved another milestone.

43. Then, it is possible that we ride subsequent waves of COVID-19 just like we do so for influenza every year, without major issues. Getting there will require our collective effort and co-operation, and each of us doing our part and taking care of each other.

44. Let me now hand the floor to DMS.
 

jw5

Moderator
Moderator
Loyal
from MOH report 21 January 2022:

FOCUSING OUR RESOURCES AND REFINING OUR HEALTHCARE PROTOCOLS TO DEAL WITH THE OMICRON WAVE​


The number of confirmed Omicron cases has started to rise more sharply over the past week. With our high vaccination rates, steady uptake of booster doses, and Safe Management Measures (SMMs) including Vaccination Differentiated SMMs, the number of severe cases remains low. However, as Omicron is more transmissible than Delta, we should prepare for further surges in infections in the weeks ahead.

2. As seen in other countries, the high case numbers are likely to disrupt manpower resourcing nationally and will exert significant pressure on our healthcare system. Businesses should prepare their business continuity plans, adhere strictly to SMMs and encourage workers to test themselves regularly, so as to dampen transmission and minimise operational disruptions.

3. In the coming weeks, it is extremely important to protect our healthcare capacity and vulnerable seniors, so as ride through the Omicron wave. We will therefore temporarily suspend in-person visits to hospital wards and residential care homes (‘Homes’) for the next 4 weeks.

4. We have made plans to optimise our healthcare resources and adjusted our protocols to better prepare for this upcoming wave. We had earlier worked with primary care doctors to let low-risk individuals with mild COVID-19 symptoms recover safely at home under Protocol 2, while putting individuals needing more medical support under the Home Recovery Programme. We are making preparations to further widen the applications of Protocol 2 in the next couple of weeks, to progressively include more patient groups and settings.

5. Given a shorter infectious period for Omicron, we will also reduce the duration of isolation under Protocol 1 from 10 days to 7 days for fully vaccinated individuals.

6. We will refine the testing regime for Vaccinated Travel Lane (VTL) travellers. The current regime put in place in early December 2021 sought to delay the spread of Omicron while we understand the variant better. This is now less relevant given our understanding of the variant and the wider community transmission of Omicron.

7. To maximise our protection against Omicron as we go about our daily lives, we agreed with the recommendations of the Expert Committee on COVID-19 Vaccination (EC19V) to extend the booster programme to individuals aged 12 to 17. We had earlier announced that from 14 February 2022, persons aged 18 years and above will be considered fully vaccinated only for 270 days after the last dose of their primary series of COVID-19 vaccines. Thereafter, to retain their fully vaccinated status, they need to receive a booster dose. For those aged 12 to 17, the deadline will be set later, from 14 March 2022. This will give them sufficient time to receive their booster dose. We urge our young to go for their booster vaccinations as soon as possible, once they are invited to do so 5 months after their last dose.

8. While our high vaccination coverage and strong booster take-up has helped to protect our population against severe illness and slowed the spread of Omicron, we should nonetheless exercise caution in the upcoming Chinese New Year festivities and limit our interactions with friends and family members. This will reduce the spread of Omicron, particularly to our vulnerable or unvaccinated family members.

Updates on Local Situation

9. Our local COVID-19 situation remains under control. The numbers in ICU care remained low at 14 as of 20 January 2022. This is despite the rising numbers of PCR positive cases from around 800 daily last week, to 1,472 cases on 20 January 2022, with local cases forming a large and growing majority at 1,133 cases versus 339 imported cases. At the same time, with the expanded use of Protocol 2, there has been an increasing number testing positive on Antigen Rapid Tests (ARTs). In the past week, there was a daily average of around 800 patients who tested ART positive at healthcare facilities. As we make more pervasive use of ART in lieu of PCR tests, it is timely for us to publish the number of ART positive cases seen at healthcare facilities daily, alongside the number of PCR positive cases.

10. We expect the number of infected cases to rise sharply as the more transmissible Omicron wave spreads through our community. Cases could double every two to three days, and could reach 10,000 to 15,000, or even more, cases per day. However, international and local data shows that Omicron is less severe compared to Delta. Referencing data from South Africa (Chart 1) and the United Kingdom (UK) (Chart 2), we can expect hospitalisations and deaths to experience a gentler rise compared to the steeper climb in overall case numbers.

MTF21012022_Chart1

Chart 1: Reported Cases, Hospital Admissions and Deaths in South Africa

MTF21012022_Chart2

Chart 2: Reported Cases, Hospital Admissions and Deaths in the UK


11. Given Omicron’s lower severity, we should focus our attention on the numbers in ICU care instead of case numbers. Nevertheless, Omicron’s higher transmissibility means that we cannot let our guard down, as an uncontrolled rise in overall case numbers could still push hospital and ICU admissions to unmanageable levels. Unvaccinated individuals, with no protection from infection and severe illness, will continue to disproportionately contribute to the number of severe cases requiring acute medical care, especially the elderly (see Annex A for details). 12% of our non-fully vaccinated cases aged 60 and above were critically ill in ICU care or died, compared to 1% of fully vaccinated cases of the same age groups.

12. With Omicron’s higher transmissibility, the number of individuals with severe symptoms could be even higher than the earlier Delta wave simply because more individuals will be infected. This will again strain our healthcare capacity. Hence, we urge unvaccinated individuals to get vaccinated at the earliest opportunity. We also strongly encourage those who have completed their primary series vaccination and are eligible to receive their booster dose to do so as soon as possible, to maximise your protection against COVID-19 as cases rise.

Safeguarding Essential Services, Protecting Patients and Healthcare Workers

13. As observed in other countries which have already experienced Omicron waves, high case numbers in our workforce can disrupt business operations. Even if workers who are infected have mild or no symptoms, health protocols will require them to be isolated. As the number of infections could potentially be very large, absenteeism rate can go up very sharply.

14. Businesses, particularly those which provide essential services, should ensure robust business continuity plans, such as split team arrangements, and adhere strictly to workplace SMMs to minimise transmissions. Those returning to the workplace should self-test themselves regularly. If unwell, workers should visit a doctor for medical review and avoid entering their workplace.

15. Keeping our healthcare system functioning well under such circumstances will be a difficult challenge. To better protect our patients and healthcare workers, particularly settings with vulnerable persons, in-person visits to all hospital wards1 and residential care homes (‘Homes’) will be suspended for a period of four weeks, from 24 January to 20 February 2022 (both dates inclusive). During this period, Hospitals and Homes have the discretion to allow visits for exceptional cases, for example if the patient/resident is critically ill. Visitors would be subjected to visitor management measures (refer to Annex B for details).

16. To ensure that patients/residents remain connected with their loved ones, the Hospitals and Homes will continue to support alternative methods of communication such as through telephone or video calls.

Right-siting Patients and Streamlining our Healthcare Protocols

17. NCID’s studies have shown that the viral load for Omicron infections is lower than for Delta infections throughout the course of the infection period. Given that and Omicron’s shorter infectious period, we will shorten the maximum isolation period for fully vaccinated individuals and children below the age of 12 years old for both Protocols 1 and 2 from 10 days to 7 days. The maximum isolation period for unvaccinated individuals aged 12 years old and above will remain at 14 days for both Protocols 1 and 2.

18. Since 6 January 2022, our Healthcare Protocols have focused on managing COVID-19 cases based on the severity of their symptoms and individual risk factors. Lower-risk individuals with mild symptoms can now be immediately diagnosed by their primary care doctors via a healthcare provider-administered Antigen Rapid Test (ART) and recover safely under Protocol 2; whilst those assessed by their doctors as high risk (e.g. elderly, pregnant, paediatrics, immunocompromised status, etc) or with significant symptoms (e.g. chest pain, shortness of breath, prolonged fever, etc) will be managed under Protocol 1. These higher risk patients will also be assessed for placement on the Ministry of Health’s (MOH) Home Recovery Programme, or further management or monitoring in a care facility. Low-risk asymptomatic patients, including those who test positive on self-administered ARTs, will continue to be managed under Protocol 2.

19. These arrangements have worked well in ensuring that medical resources go to those who need them the most, and enabling patients to return to normal activity as soon as possible once it is safe for them to do so. We will therefore expand the application of Protocol 2, to more patient groups and settings.

20. With immediate effect, we will expand the age bracket suitable for Protocol 2 to include children aged 5 to 11 years old, regardless of their vaccination status. We urge those with non-emergency conditions, including children, to avoid seeking treatment at hospitals and to consult their primary care doctor instead. Those who test ART positive at non-clinical settings (e.g. unsupervised or employer supervised self-swab tests) but who identify themselves as potentially at risk (see Annex C) should still visit a doctor for medical advice even if they feel well.

21. We will also allow patients who are on Protocol 1, recovering well and whose symptoms have improved, to transit smoothly to Protocol 2. This means that they can be discharged earlier and return to normal activities if they test negative on a self-administered ART taken 72 hours or more after their first positive COVID-19 test.

22. This will be progressively put in place in the coming couple of weeks, where Protocol 2 can be applied to all low-risk, asymptomatic individuals who are in Protocol 1 settings, such as COVID Treatment Facilities, those who test positive for Pre-departure Tests (PDT), Pre-event Testing (PET), Rostered Routine Testing (RRT) and mandatory traveller tests (e.g. On-arrival Tests (OAT) and tests taken at the end of Stay-Home Notice (SHN) periods), so long as their medical conditions allow it.

23. These changes enable us to deal more nimbly with Omicron and minimise disruption to normal activities for fully vaccinated and boosted persons even as case numbers continue to rise. MOH will continue to monitor the situation closely and adjust our approaches as necessary.

Updates to Border Measures

Calibrating Vaccinated Travel Lane (VTL) Testing Regimes


24. On 31 December 2021, we announced a four-week extension to the enhanced 7- day testing regime for travellers arriving via VTLs in order to facilitate the detection of imported Omicron cases and slow transmission into the community. This has bought time for us to booster vaccinate more residents, learn more about the Omicron variant and make necessary adjustments to our COVID-19 strategy. As imported cases now form a shrinking proportion of our overall cases, we will simplify the VTL testing regime.

25. These measures are less relevant now. Hence, VTL travellers entering Singapore after 23 January 2022, 2359 hours via both air and land checkpoints will only be required to do unsupervised self-administered ARTs from Day 2 to Day 7 of their arrivals if they need to leave their place of residence or accommodation. Travellers need not submit their ART results but must test negative before going out. VTL travellers who arrive before 23 January 2022, 2359 hours are still required to continue with the existing testing regime (i.e. unsupervised self-administered ART on Days 2, 4, 5 and 6 with submission of results online, and supervised ART on Days 3 and 7 from their arrival).

26. Travellers who test positive on ARTs (i.e. the on-arrival test for VTL-Land and unsupervised self-administered ARTs on Days 2 to 7) no longer need to undergo a confirmatory PCR test, but should instead simply recover under Protocol 2.2 That said, those who identify themselves as potentially at risk (as stipulated in Annex C) should visit a doctor for medical advice after testing positive even if they feel well.

27. We will continue to maintain a 50% limit on VTL flight and bus tickets for entry into Singapore for now. We will continue to review the local and global COVID-19 situation and adjust our measures accordingly.

Facilitating Travel for Recently-Recovered Travellers

28. With the growing number of cases worldwide, there is a rise in the number of travellers who have recently recovered from COVID-19. Such travellers can continue to shed non-infectious viral fragments even after they have recovered, and therefore test positive for COVID-19 despite posing no infection risk. As fully vaccinated individuals who recently recovered from infection have a high level of immunity through their recent COVID-19 infection and vaccination, the likelihood of reinfection is low.

29. Hence, travellers arriving after 23 January 2022, 2359 hours who are fully vaccinated and recently recovered (i.e. within 90 days of their last infection) will be exempted from all testing and SHN requirements if they are able to provide appropriate documentary proof. Non-fully vaccinated recently-recovered travellers will be exempted from pre-departure testing requirements, but will still be subjected to all other prevailing border measures. This will facilitate the safe return of recently-recovered residents who travel overseas. See Annex D for the list of documentation to be presented by such travellers at check-in and arrival immigration to qualify for this exemption.

Regular Review of Border Measures

30. A summary of the prevailing border measures can be found in Annex D. The full set of Safe Travel Lanes for travel to Singapore and prevailing border measures under each lane for different categories will be updated on the SafeTravel website. Travellers are advised to visit the website to check the latest border measures for the associated country or region before entering Singapore; and be prepared to be subjected to the prevailing border measures upon entry into Singapore.

31. We will continue to monitor the global COVID-19 situation and adjust our border measures in tandem with our roadmap to becoming a COVID resilient nation.

Increasing our Protection with Vaccinations and Boosters

32. Vaccinations, especially boosters, will ensure we retain substantial protection against Omicron. Boosters have helped dampen the rise in Omicron cases thus far and increases our protection against infection and severe illness.

33. Interim analysis of 50 cases from KK Women and Children’s Hospital from their COVID-19 vaccination study of 150 children aged 5 to 11 years showed that all of them developed high antibody levels in response to two doses of the Pfizer-BioNTech/ Comirnaty vaccine at the paediatric dose. The rates of adverse reactions after vaccination were lower than in adolescents, with none requiring medical review or hospitalisation to date. With these positive findings locally, we encourage all children aged 5 to 11 years to come forward to be vaccinated.

Extension of Booster Vaccination Programme to Persons Aged 12 to 17 Years

34. MOH and EC19V had previously recommended for all persons aged 18 years and above to receive a booster dose of an mRNA vaccine offered under the National Vaccination Programme five months after completing their primary vaccination series. This recommendation is now extended to individuals aged 12 to 17 years. From early February 2022, we will progressively invite individuals, starting with those aged 16 and 17 years, to receive their booster dose, followed by those aged 12 to 15 years.

35. Individuals aged 12 to 17 years will require the consent of their parent/guardian to book an appointment. Parents/guardians of these individuals will receive an SMS with a personalised booking link to the mobile number that they had registered with for the primary series, to provide consent and book their child/ward’s booster vaccination appointment. They can be boosted in any vaccination centre offering the Pfizer-BioNTech/ Comirnaty vaccine and should bring along their Student Identification, or if not available, other forms of identification (e.g. Birth Certificate/Passport/SingPass) for verification purposes.

36. Parents/guardians of children/wards aged 13 and above are not required to accompany them on the day of vaccination. However, children/wards aged 12 and students of Special Education (SPED) schools will need to be accompanied by a parent/ guardian, as per the arrangements for the primary series vaccination. MOH and the Health Promotion Board will work with SPED schools, and more details will be shared by SPED schools with parents/guardians at a later date.

37. Individuals aged 12 to 17 years who are medically ineligible for the Pfizer-BioNTech/ Comirnaty vaccine will be offered a Sinovac-CoronaVac booster dose under a dedicated public health programme. This programme will also be extended to children aged 5 to 11 years who are medically ineligible for the Pfizer-BioNTech/ Comirnaty vaccine for their primary vaccination series. Participants in the public health programme will be closely monitored by trained medical personnel. MOH will contact eligible persons with detailed instructions.

Expansion of Requirement for Booster Dose

38. As announced previously, from 14 February 2022, persons aged 18 years and above who have completed the primary vaccination series and are eligible for booster vaccination will be considered as fully vaccinated for only 270 days after the last dose in their primary vaccination series. Upon receiving their booster, they will continue to maintain their vaccinated status. In tandem with the immediate extension of eligibility for booster doses to them, starting from 14 March 2022, persons aged 12 – 17 years who have completed their primary series and are now eligible for booster vaccination will similarly be considered fully vaccinated for only 270 days after their last primary series dose, and will require a booster dose to maintain their vaccinated status thereafter.

39. Persons who have recovered from COVID-19 and have completed their primary series vaccination3 do not require an additional booster dose at this point in time. They will continue to be considered fully vaccinated after 14 February 2022. However, it is safe for such persons to receive a booster dose from five months after their last dose and our vaccination centres will not turn away such individuals.

Reminder to Receive Booster Dose to Maintain Vaccinated Status After 14 February 2022

40. Persons aged 12 years and above who have been offered the booster dose should not delay receiving the booster dose beyond nine months after the last dose of their primary vaccination series. Also, the Sinovac-CoronaVac vaccine should only be used as a booster by persons medically contraindicated to receive the mRNA vaccines.

41. Persons who had received two or more doses of the Sinovac-CoronaVac or Sinopharm vaccines as part of a three-dose primary vaccination series are strongly recommended to receive one dose of an mRNA vaccine as a booster.

a. Persons who had received an mRNA vaccine as the third dose of their 3-dose primary series should receive their booster around five months thereafter.

b. Persons who received the Sinovac-CoronaVac or Sinopharm vaccine for all three doses should receive their booster at three months thereafter, due to lower antibody levels generated by the third vaccine dose.

42. We strongly encourage all those who are eligible to receive booster doses to take them as soon as possible. This will help to keep you and your loved ones safe.

Updates on Community Safe Management Measures

Exercising Caution During the Chinese New Year (CNY) Festive Period


43. Our high vaccination and booster rates give us confidence that we will be able to mitigate the impact of the Omicron wave on our society and economy. We seek everyone’s cooperation to uphold the prevailing SMMs especially during the CNY period:

a. House visits. The permissible group size for social gatherings remains at 5 persons. Correspondingly, the maximum number of unique visitors per household will remain at 5 persons per day. Individuals may wish to take an ART in advance of such gatherings, particularly if there will be elderly or unvaccinated family members present.

b. Dine in at Food & Beverage (F&B) establishments. Prevailing rules at F&B establishments will continue to apply, including to reunion dinners or other CNY meals at these establishments. Social gatherings remain capped at 5 persons and multiple table bookings exceeding this are not permitted, except for those from the same household.

c. Other religious or customary activities. Large-scale events, including religious processions or dinner banquets (including company-organised meals or tuan bai) will continue to be disallowed to avoid superspreading events.

Riding through the Omicron Wave

44. We have been monitoring data on Omicron cases and optimising our responses to ensure we are able to ride through this wave of Omicron cases. Boosters and vaccinations remain a critical part of our COVID-19 strategy in ensuring our population is well protected against infection and severe illness. We urge all who are eligible for vaccinations and booster doses to receive them as soon as possible. We seek the continued cooperation and support of all in complying with the adjusted protocols and measures as we pave the way to living with COVID-19.


MINISTRY OF HEALTH
21 JANUARY 2022


1 Includes public acute hospitals, community hospitals and private hospitals
2 You may refer to www.covid.gov.sg/well-and-positive-or-condition-assessed-mild-by-doctor for more details on Protocol 2. For more information on what to do if you feel unwell while travelling in Singapore, please refer to www.covid.gov.sg/travellers.
3 Persons who have recovered from COVID-19 and have completed their primary series vaccination include those who were fully vaccinated when they were infected with COVID-19, and those who received a valid dose of an mRNA vaccine (or two valid doses of Sinovac) after they were infected with COVID-19.
 

jw5

Moderator
Moderator
Loyal
from MOH report 21 January 2022:

EXPERT COMMITTEE ON COVID-19 VACCINATION RECOMMENDS BOOSTER VACCINATION FOR ADOLESCENTS AGED 12 TO 17 YEARS​


The Expert Committee on COVID-19 Vaccination (EC19V) recommends to extend booster vaccination to adolescents aged 12 to 17 years. Persons aged 12 to 17 years should receive a booster dose of the Pfizer-BioNTech/ Comirnaty vaccine (30 micrograms), as long as it has been five months or longer after the last dose of their primary vaccine course.

2. Local and international data show that vaccine protection against COVID-19 infection in adolescents aged 12 to 17 years wanes with time, even if protection against severe illness remains robust. As with adults, waning of protection against infection is observed for adolescents by six months (or earlier) after their last dose of vaccine, but more gradually when compared to adults.

3. Data has also shown that booster vaccinations increase the protection against infection by the Omicron variant, which appears more transmissible than previous variants, and has caused COVID surges in many countries. Booster vaccinations may also confer more robust protection against future variants of concern that may emerge from time to time.

4. The safety profile and side effects of a Pfizer-BioNTech/ Comirnaty booster dose are comparable to that of the first two doses. Local and international data also indicate that the risk of myocarditis with a booster dose is comparable or lower than for the first two doses of the Pfizer-BioNTech/ Comirnaty vaccine.

5. Considering the benefits and safety profile of a booster vaccination dose, the Committee recommends that adolescents aged 12 to 17 years receive a booster dose (30 micrograms) of the Pfizer-BioNTech/ Comirnaty vaccine as long as it has been five months or longer after the last dose of their primary vaccine course, and to get the booster dose as soon as it becomes available for them.

EXPERT COMMITTEE ON COVID-19 VACCINATION
21 JANUARY 2022
 

jw5

Moderator
Moderator
Loyal
from MOH report 21 January 2022:

OPENING REMARKS BY MINISTER FOR HEALTH MR ONG YE KUNG AT THE COVID-19 MULTI-MINISTRY TASKFORCE PRESS CONFERENCE ON 21 JANUARY 2022​


Today, I will take stock of 2021, and then talk about what more we will do to help us prepare for this Omicron wave that we are already in.

2. What we are going to present, will hold fast to a few key principles. First, we continue to aim to live with COVID-19, including the Omicron variant. Second, we must understand the variant scientifically, so as to better shape our policies and responses. Third, focus our energy and resources on the risk areas, and on the vulnerable. It is very important once the wave becomes very big. Finally, count on everyone to do our part in the united national response.

Taking Stock of 2021

3. First, let me take stock of 2021. It was a difficult year, but fortunately, we ended the year with a subsiding Delta wave.

4. The Ministry of Health (MOH) has been compiling data on the incidence of infected individuals needing ICU care or died, broken down by age and vaccination status. We have released this data twice last year and now, we have updated the numbers until the end of 2021.

5. This set of data is predominantly related to the Delta variant, and we are now in an Omicron wave. So it is timely and useful to do this year-end stocktake on the incidence rate of severe illnesses and deaths.

6. The conclusion of the updated dataset is consistent with our last two releases:

• Number one, unvaccinated individuals are at far higher risk of falling severely ill or die, and this increases especially with age.

• Number two, the chances of unvaccinated COVID-19 patients needing ICU care or dying is many times that of the fully vaccinated – it ranges from seven times more for those aged 80 and above, and 50 times more for those in their 30s.

• Specifically, the chances of unvaccinated individuals falling severely ill or dying are: for those in their 60s – 7.2%; for those in their 70s – 14%; for those 80 and above – 24%.

• And in contrast, for fully vaccinated individuals in their 80’s, the corresponding percentage is only 3%.

7. I cited this data because I have come across the argument from individuals who do not want to take COVID-19 vaccines, that there should not be Vaccination-Differentiated Safe Management Measures (VDS).

8. Their view is that the number of unvaccinated people in our population is not large to start with, and since only a small percentage, if infected, will fall severely ill or die, the load on our healthcare system caused by the unvaccinated will not be significant. We should therefore remove VDS and allow the unvaccinated free access to various premises.

9. I want to just point out that based on all these numbers – as I have said, our response must be scientifically backed up – this argument is not correct. Throughout the pandemic, two-thirds of our ICU beds were occupied by people who were not fully vaccinated. And very likely for Omicron, it may turn out the same way.

10. If you look at the numbers, today we have about 120,000 adult individuals above the age of 20 who are unvaccinated, so this is the unvaccinated adult population, and very few are due to medical ineligibility. Most are due to choice. Based on the incidence rate of severe illnesses and deaths that I just presented, and the age profile of the current unvaccinated population, if all of them were infected with the Delta variant, we expect about 5,800 of them to require ICU care or to die.

11. 5,800 is not a small number. Remember, at the peak of the Delta wave, our maximum ICU occupancy was 176,. And 176 ICU beds occupied contributed to a severe strain on our healthcare system. Of course, in reality, not all unvaccinated persons will be infected and for those who are, not all will be infected at the same time.

12. However, even if say, a quarter of the 5,800 ICU cases occur over a duration of four to eight weeks, it will be a significant load on our healthcare system.

13. A significant load enough to displace many patients – suffering from acute complications of cancer or severe chronic diseases – who may need urgent medical care. Enough load to consume a lot of costly COVID-19 therapeutics. Enough to degrade the overall quality of care of the healthcare system, which will ultimately affect everyone, especially non-COVID patients who are critically ill.

14. All these can be avoided if unvaccinated individuals had chosen to take their jabs instead.

15. Some may argue that my data and my analysis is based on Delta, and Omicron is less severe. Indeed, from the experiences of other countries, we know that Omicron infections are much less severe for the vaccinated and boosted, and for those who were infected and recovered.

16. But we are not so sure that the same is true for individuals who are unvaccinated and COVID naïve. We have not seen the full impact of the Omicron wave in Singapore. Now is not the right time to take a gamble to remove VDS, on the hunch that Omicron may be less severe for the infected unvaccinated. We cannot gamble on the health of Singaporeans.

17. Even if, hypothetically, someday the number of unvaccinated people falling severely ill because of COVID-19 infections works out to be very a low number, and does not impact or burden the healthcare system excessively, remember the credit goes to the rest of the population. The rest of the population – which is the great majority – chose to vaccinate themselves. A significant number, in fact, were worried about vaccinations too, but nevertheless decided to do their part for their family and for the society.

18. And conversely, if everyone adopts the attitude that they need not get vaccinated because others will, and then we free ride on the rest, then our society would never have achieved the high level of resilience it has today.

19. The vaccination exercise for children is now ongoing. It is a teachable moment for them, and I hope we teach them the right lessons.

20. It is important for children to get the vaccinations. In countries experiencing Omicron waves, hospitals are seeing a sharp spike in paediatric admissions, mostly because children are not vaccinated. While the great majority of these children recover quickly, this is not something we can take lightly. Director of Medical Services (DMS) will explain this further.

Preparing for Omicron

21. Now, let me talk about the Omicron infection wave. It is all over the world and dominating the Delta variant – and this is already happening in Singapore.

22. The good news is that our existing vaccines are working against the Omicron variant, and people are generally having less severe symptoms as compared to the Delta variant. Given that, we will be making a few further changes to our vaccine policies and our health protocols to further prepare ourselves to ride this Omicron wave.

23. First, the Expert Committee on COVID-19 Vaccination, EC19V, has recommended, and MOH has accepted, that young people aged 12 to 17 can now receive boosters. Other countries such as the US, Chile, Qatar and Israel have already extended boosters to this age group. The EC19V has reviewed the data, and is satisfied that boosters are safe and effective for individuals in this age group.

24. We will progressively roll out booster vaccinations for this age group, and SMS invitations will be sent out to the 16- and 17-year-olds from early February onwards. Younger children, or teenagers, will then be invited gradually.

25. With this change, the 270-day validity period for two shots of mRNA vaccines and three shots of Sinovac/Sinopharm vaccines, will be extended to those aged 12 to 17.

26. But it will start later than the rest of the population. As you know, for the rest of the population this will kick in from 14 February 2022. For those aged 12 to 17, we will kick this off one more month later, on 14 March 2022. This will give the young people aged 12 to 17 more time to get their boosters.

27. In the meantime, if you are in this age group, and you have received an SMS invitation to receive your booster shot, go and get the jab promptly.

28. Second, we will further rationalise health protocols at the borders and in the community.

29. Minister Gan explained the changes for travellers, so I will not repeat. Let me instead briefly talk about community health protocols.

30. NCID studies showed that while the Omicron variant is more transmissible, infected individuals carry a lower viral load and generally recover faster. We will therefore reduce the isolation period for the fully vaccinated individuals and children under 12 years old from 10 days to 7 days.

31. We will also allow for the wider application of Protocol 2. As you know, Protocol 2 is where individuals perform ART self-test, self-isolate for 72 hours, and once you are Ag-, you can then go out and resume normal activities.

32. It is important for us to make this move, because that way, we can handle this large wave without overburdening the health response system, and medical care can go to those who need it most. Protocol 2 is based on personal responsibility and civic consciousness, and with the cooperation of Singaporeans, it has actually worked very well.

33. These are quite detailed changes and DMS will elaborate later.

34. Third, we would have to change the case definition for daily reporting.

35. It used to be that when you see a doctor - a General Practitioner (GP) - he can only order a PCR test if you are suspected to be infected with COVID-19. And if you are PCR-positive, you are either sent to a medical facility, such as a hospital or a COVID-19 Treatment Facility (CTF), or you are placed under the Home Recovery Programme for ten days. We are changing this to seven days. This is essentially called Protocol 1. Essentially GP, primary care providers, they could only order Protocol 1.

36. On 6 January this year, we changed this arrangement. We empowered our GPs and other medical providers to also be able to order Protocol 2 if they encounter a patient who might be of low risk and experiencing very mild symptoms or in fact, no symptoms. For simplicity, let’s call these GP Protocol 2 cases. Last time, GP could only do Protocol 1, so now there are GP Protocol 2 cases.

37. This change makes a lot of sense. Because whether an individual undergoes Protocol 1 with a 10-day (and now 7-day) home recovery or Protocol 2 with a 72-hour self-isolation, it should depend on the risk profile and the severity of the symptoms of the patient, not because of whether he decided to go to a GP or do a self-test.

38. Hence, under the new arrangement, GPs and medical providers will look at the patient, do a clinical assessment, refer to MOH’s guidelines, and decide whether to prescribe him Protocol 1 or Protocol 2.

39. Consistent with the ART self-test under Protocol 2, we had not been reporting the GP Protocol 2 cases in our daily updates. The numbers were not large, about 100 to 200 cases a day when we first started the arrangement on 6 January this year.

40. However, as it becomes increasingly evident that Omicron is a less severe disease than Delta, GPs also started to see more and more mild Omicron cases and they prescribed more and more Protocol 2 to these patients. Hence, GP Protocol 2 cases rose quickly, to about 400 to 500 daily cases a day last week, and this week, over 1,000 cases a day.

41. MOH has reviewed the situation and decided that it is better to include the GP Protocol 2 cases in our daily updates on infection numbers. It will give a better picture of the epidemic situation in Singapore, and which part of the epidemic curve we are on. In other words, the number that you will be reporting will be higher.

42. But let me caveat that is still not the full picture, and neither is it possible to get a full picture. This is because many cases with no symptoms and very mild symptoms may remain undetected, and others may choose to self-test and self-administer Protocol 2, which is also not possible to be captured. This was the case during the Delta wave, and is now more apparent with the Omicron variant, because it is generally a milder disease.

43. We will therefore be releasing two numbers every day – one for infections confirmed by PCR tests, which is the number reported currently, and then another for the GP Protocol 2 cases. We will backdate the numbers to 6 January 2022, when GPs started to order Protocol 2, for the purposes of calculating total number of infections in Singapore, as well as the week-on-week increase in infection numbers. To satisfy your curiosity, with this new method, the week-on-week increase in cases will remain largely unchanged compared to now, at around 2.5.

44. As Omicron has clearly dominated the current infection wave, MOH will also stop differentiating between Omicron and non-Omicron infections in our daily updates.

45. This is a change in case definition and how statistics are compiled. In reality, the way we lead our lives, the way we respond to the disease, nothing has changed. Only the statistics and the numbers have changed. It does not change the actual epidemic situation we are experiencing. Over the past weeks, we have been living with COVID-19 and Omicron variant quite carefully and calmly with a less restricted posture where we can meet in groups of five. This attitude should not change because of an adjustment in case definition and reporting methods.

46. The fact is that with vaccinations working well, and the Omicron variant being less severe, the top line infection number is becoming less meaningful in our response to COVID-19. This top line infection number comprises mostly people who are vaccinated, who are experiencing mild symptoms or no symptoms, which from a public health point of view is not something we should be overly concerned about. We watch it, but should not be overly concerned about it.

47. This is an issue I discussed with World Health Organization Director-General Dr Tedros last week when we were on a Zoom call, and it was well acknowledged by him and his experts, that in time, when we start to live normally with the disease, the world needs to move away from focusing on the top line infection numbers.

48. The more important statistics are in the bottomline – how many people are severely ill needing oxygen supplementation, how many in ICU care, and how many died.

49. To date, of the 12,078 individuals confirmed infected with Omicron – and there are many others whom we cannot ascertain – 34 or less than 0.3% of them required oxygen supplementation. Most needed oxygen for one day, with the longest duration of five days for one patient. So, compare Delta and Omicron. For Delta, the numbers were 0.8% needing oxygen, 0.2% in ICU, 0.2% died. Altogether 1.2%. Omicron, so far, what we are seeing, is less than 0.3% needing oxygen.

50. I should point out there is one senior in his 80s infected with Omicron, he was admitted to the ICU as he required high flow oxygen. He was not intubated, and he was given the oxygen and discharged from ICU the next day.

51. So in the 20 days since the start of this year, we have nine days without any COVID-19 related deaths, seven days with one death, and the rest of the days three or fewer deaths.

52. In terms of healthcare capacity, we now have 14 COVID-related patients in our ICU, all due to Delta. We have about 300 patients occupying about a quarter of our 1,100 isolation beds, which we can ramp up to 2,500 at short notice. We have about 200 patients occupying 6% of our 3,200 CTF beds, which we can ramp up to 4,000 by the end of January and 5,000 by the end of February.

53. All in all, we are in a good position now. But when cases start to rise further, we must expect ICU cases to rise, and some deaths to happen, and healthcare capacity will also be filled up. But so far, our experience with Omicron is similar to other countries that encountered it before us – it is a less severe disease.

54. Nevertheless, we need to be psychologically prepared for big infection numbers – 10,000, 15,000, maybe and probably more. We all need to stay vigilant and do our part, to get ourselves vaccinated, and protect the vulnerable amongst us.

55. If the situation in our hospitals is stable, we should ride through the Omicron wave with the current safe management measures, through Chinese New Year.

Conclusion

56. In conclusion, I have earlier said that going through the Omicron wave is like the game of snakes and ladders – it may set us back or it may take us forward. We will find out the answer quite soon. Whatever the outcome may be, we need to once again call on everyone to support our healthcare workers, and do our part to ride through this wave.

57. I will now hand the floor to DMS, to talk about child vaccinations, and elaborate on the changes to health protocols.
 

jw5

Moderator
Moderator
Loyal
from MOH report 25 January 2022:

Updated Safe Management Measures for Religious Activities​


On 14 December 2021, the Multi-Ministry Taskforce (MTF) announced that Vaccination-Differentiated Safe Management Measures (VDS) will be expanded to more settings, as Singapore anticipates a potential surge in local Omicron cases. This document provides the conditions under which religious organisations (ROs) are permitted to carry out activities in places of worship from 1 February 2022.

2. The key changes affecting religious activities from 1 February 2022 are:

a. VDS is required for congregational and other worship services, and solemnizations, irrespective of the number of participants. b. All unmasked performers who are singing and/or playing wind instruments as part of a live performance for congregational or worship services can obtain their required negative COVID-19 test result either through an MOH-approved test provider or a self-administered ART test. Annex A summarises the changes that will take effect from 1 February 2022.

Religious activities​

Worship Services

3. From 1 February 2022, ROs must implement VDS1 for all congregational and other worship services at places of worship, which can involve up to 1000 worshippers at a time, subject to SMMs and the safe capacity of the premises. This cap excludes religious and supporting workers, who must be fully vaccinated.

4. Worshippers have to be segregated into zones holding no more than 100 worshippers each.

a. As there should be no mingling of individuals across zones, each zone must be completely separated from another by either a physical solid partition (at least 1.8m high if not floor-to-ceiling, from wall-to-wall); or at least 2 metres physical spacing demarcated by continuous physical barriers (e.g. rope barrier).

b. Worshippers can be seated in groups of no more than 5 persons, with 1 metre safe distancing between each group.

c. There must either be a separate ingress/egress for each zone or staggered entrance/exit timings so that worshippers from different zones do not mix with one another during entry/exit.

d. ROs must also take reasonable steps to ensure that worshippers do not cross the physical barrier (where applicable) or enter another zone that they are not assigned to.

5. Children who are 12 years old and below, i.e. born in or after the year 20102, who are unvaccinated, may be exempted from VDS and can be included in a group of up to 5 persons for congregational and worship services3 as long as all the children in the group are from the same household.

6. ROs should continue to observe the following SMMs for worship services:

a. Keep worship services to as short a duration as possible. There must be no reception or mingling between worshippers, before, during or after each worship service.

b. All persons present (except children below 6 years of age) must wear a face mask at all times.4 Face shields are not permitted as substitutes for face masks. Young children are still strongly encouraged to use a mask, especially when they are in a group setting (e.g. attending worship service).

c. Singing by worshippers with masks on is not permitted.

d. Live performance elements are permitted during the worship service at places of worship, with the following SMMs (see Annex B for details).

i. A maximum of 50 persons are allowed to be involved in/support the conduct of the worship service. This includes persons on-stage, backstage or off-stage.

ii. Up to 20 persons who are involved in the conduct of the worship service may unmask at any given time, of which up to 20 persons can be unmasked for singing or playing of wind/brass instruments. Persons should only unmask when required to perform their duties.

iii. Persons unmasked for singing or playing of wind/brass instruments must obtain a negative ART result on a Pre-Event Test, taken within 24 hours before the end of the live performance. From 1 February 2022, unmasked performers may obtain a negative result on an ART test, conducted by an MOH-approved test provider or self-administered. A self-administered test must be supervised onsite or virtually by the RO’s live performance organiser. ROs are to keep records of unmasked singers/persons playing wind/brass instruments and their ART test results.

iv. There must be at least a 2 metres setback between persons involved in the conduct of live performance elements and worshippers.

v. Minimise the duration of live performance elements for congregational and other worship services.

vi. Masked singing will be treated in the same way as unmasked singing (i.e. masked singers will count towards the maximum number allowed to unmask for singing and/or playing of wind instruments).

vii. Static performers (i.e. in the same position throughout the live performance) may be in groups of 5 persons

i. At least 1 metre safe distance from other groups if there are no persons singing and/or playing wind/brass instruments

ii. At least 2 metres safe distance from other groups if there are persons singing and/or playing wind/brass instruments

e. There should be no sharing of prayer and other common items (e.g. holy books, passing of offertory baskets, prayer mats) as this increases the risk of COVID-19 transmission. Worshippers are to bring along their personal prayer items instead, where required.

f. Places of worship with reduced air circulation (e.g. enclosed prayer spaces, air-conditioned worship hall) should, where possible, open doors and windows to naturally ventilate the space after each use5.

Private Worship

7. Given the prevailing permissible group size of 5 for social gatherings, ROs can continue to allow one group of up to 5 persons (regardless of vaccination status) at any one time to conduct private worship in the place of worship.

a. Private worshippers must remain masked at all times.

b. Private worshippers may interact with a religious worker who is fully vaccinated, with at least 1 metre safe distancing between the group and the religious worker.

8. There should be no mingling between the private worship group and persons involved in worship services and other religious activities, which are subject to VDS.

Marriage Solemnizations

9. ROs may continue to use places of worship to conduct marriage solemnizations involving up to 1000 attendees (including bride and groom) with VDS.

10. These activities are subject to SMMs and the safe distancing capacity of the solemnization premises6.

Funerals

11. Funerals, funeral wakes or funeral processions held during or before the burial or cremation of the deceased will not be subject to VDS and can involve not more than 30 attendees at any time, and in groups of no more than 5 persons (excluding religious and supporting workers, whose numbers should be kept to a minimum), subject to SMMs and the safe capacity of the premises.

a. There must not be any reception with food and drinks.

b. ROs must also comply with prevailing SMMs listed on MTI’s website7.

12. Funerary-related activities at places of worship may continue to involve live instrumental music (non-wind/brass) with the necessary SMMs in place (see Annex C). Persons involved in/supporting the live instrumental music segment should be kept to the minimum. No other performances (e.g. singing, dance, variety act) are allowed.

13. Visits to columbaria at places of worship for up to 5 persons will be allowed without VDS. Visits should be kept as short as possible.

Other Religious Activities

14. Religious rites that are not part of a worship service and other religious activities (e.g. pastoral services) will be subject to VDS and can involve up to 50 persons (excluding the religious and supporting workers whose number should be kept to a minimum).

15. Religious classes can be held for up to 50 persons, inclusive of teachers and support staff, without VDS. ROs are strongly encouraged to conduct religious classes online.

16. Religious and supporting workers (including volunteers) conducting in-person religious classes for children aged 12 and below more frequently than once a month are required to undergo Fast and Easy Testing (FET).

a. The mandatory FET8 will be conducted once a week (7 days), regardless of vaccination status.

b. ROs are required to notify MCCY through the CPRO website of (i) the names of the persons involved in the conduct of the class; and (ii) appointed supervisor to oversee the FET, before conducting the religious class. More information on the FET guidelines is available on the CPRO website.

Recording and Broadcast of Religious Services and Prayers

17. ROs can continue to support the religious needs of their communities via remote means such as recording and broadcast of religious services and prayers.

a. ROs can have up to 50 persons on-location for these productions, of which up to 20 persons can be unmasked at any one time. All 20 unmasked performers may sing or play instruments which require intentional expulsion of air at any given time, if all performers and crew are fully vaccinated.

b. Masked singing will be treated in the same way as unmasked singing (i.e. masked singers will count towards the maximum number allowed to unmask for singing and/or playing of wind instruments).

c. Static performers (i.e. in the same position throughout the live performance) involved in this production may be in groups of 5 persons with
i. At least 1 metre safe distance from other groups if there are no persons singing and/or playing wind/brass instruments
ii. At least 2 metres safe distance from other groups if there are persons singing and/or playing wind/brass instruments

d. The time spent on-location for this activity should be kept as short as possible. The production team must also put in place safe management measures, including no-cross deployment between locations, and thorough cleaning of technical equipment. There shall be no audience.

Safe capacity in the place of worship​

18. All the permitted religious activities (i.e. excluding congregational and other worship services) can continue to take place concurrently, subject to a total premises cap9 of 1000 persons, SMMs and the safe distancing capacity of the premises – and only if these activities can be conducted safely at separate locations within the place of worship, with no interaction between worshippers while entering, exiting or while in the premises, and where the activities also comply with the activity SMMs.

Deployment of manpower​

19. ROs should primarily engage their religious workers and staff to support the permitted religious activities but can deploy volunteers to support if necessary. The number of personnel involved in conducting each permitted activity should be kept to a minimum.

20. Up to 50% of employees who are able to work from home can be at the workplace at any point in time, provided they are fully vaccinated. Social gatherings at the workplace will continue to be disallowed. Religious workers and administrative staff should comply with prevailing workplace SMMs stipulated by the Ministry of Manpower (MOM)10. Restrictions against cross-deployment11 across worksites remain in place.

TraceTogether and SafeEntry​

21. TraceTogether-only SafeEntry, where the TraceTogether App or Token is required for SafeEntry check-ins, is required at all venues that are required to implement SafeEntry. ROs must make the necessary preparations to accept check-ins by the TraceTogether App or Token. ROs can refer to www.safeentry.gov.sg for more information.

Mandatory submission of safe management plans (SMP)​

22. ROs must acknowledge through the CPRO website the new conditions for religious activities imposed before commencing the activities from 1 February 2022. The detailed requirements and format for submitting the acknowledgement form can be found at www.cpro.gov.sg.

23. MCCY reserves the right to suspend a RO’s activities if there are gaps in the SMP submitted and until the necessary rectifications are made. ROs are responsible for the implementation of SMMs and action could be taken for lapses and breaches. Should there be any confirmed COVID-19 cases linked to a RO’s premises or place of worship, the premises may be closed for a period of time as determined by the authorities.

Working together towards a Covid-19 resilient Singapore​

24. We thank ROs for their continued vigilance and understanding during this Transition Phase. This set of measures serves as important safeguards to prepare ourselves for a potential surge of local Omicron cases. Hence, we seek the continued cooperation of the ROs and their followers to exercise social responsibility and ensuring that religious activities can continue safely. MCCY will continue to work with our ROs to ensure a COVID-19 resilient environment for religious activities.

Ministry of Culture, Community and Youth​

For more information and FAQs on COVID-19 for the religious sector, please visit www.cpro.gov.sg or contact MCCY’s Crisis Preparedness for Religious Organisations Programme Office ([email protected]).


1For more information, refer to MOH’s COVID-19 phase advisory (https://www.moh.gov.sg/covid-19-phase-advisory)
2A grace period has been extended to children born in December 2009 to allow them sufficient time to get fully vaccinated. Children born in 2009 who will turn 13 in 2022 will need to be fully vaccinated to enter venues and participate in activities with VDS from 1 March 2022. Please refer to the MOH Press Release on 2 December 2021 for more details.
3The cap on the number of unvaccinated children aged 12 years and below participating in activities and events with VDS has been removed across all settings from 1 January 2022.
4Children 12 years and below, as well as persons who have health conditions that may result in breathing or other medical difficulties when a mask is worn for a prolonged period of time, may wear a face shield in lieu of a face mask.
5Refer to: https://www.nea.gov.sg/media/news/n...ther-reduce-the-risk-of-covid-19-transmission
6Refer to SMMs for Marriage Solemnizations at: https://www.gobusiness.gov.sg/safemanagement/sector/
7Refer to SMMs for Funeral Events at: https://www.gobusiness.gov.sg/safemanagement/sector/
8The Government will be funding the cost of antigen rapid test (ART) kits for FET till 31 March 2022. Beyond that, employers and businesses should be prepared to factor in testing costs as part of their normal business operations.
9This total cap is the combined number of persons participating in the various permitted activities (excluding congregational and other worship services) on the premises at any one time, excluding religious and supporting workers. Respective caps on the individual activities will continue to apply.
10For more information, please refer to MOM’s advisory at https://www.mom.gov.sg/covid-19.
11If cross-deployment cannot be avoided (e.g. due to the nature of the job), additional safeguards must be taken to minimise the risk of cross-infection (e.g. systems are in place to ensure no direct contact with the cross-deployed personnel). ROs will be required to demonstrate that cross-deployment or interaction between employees is critical for business operations, when requested by MOM or MCCY.
 

jw5

Moderator
Moderator
Loyal
from MOH report 29 January 2022:

BOOSTER RECOMMENDATION FOR PERSONS WITH POSITIVE ANTIGEN RAPID TESTS​


Early this year, the Ministry of Health (MOH) announced that for individuals aged 18 years and above, their full vaccination status after two doses of mRNA vaccines and three doses of Sinovac/Sinopharm vaccines will lapse after 270 days. This policy will be effective from 14 February 2022, to give individuals sufficient time to receive their boosters and extend the validity of their full vaccination status.

2. As the deadline of 14 February 2022 draws near, MOH would like to remind the public to get their booster doses on time, i.e. recommended from about 5 months after the last dose of your primary vaccination series. Upon receiving your booster dose, you will continue to be considered fully vaccinated beyond the initial 270 days. There is no expiry for the period of validity following the booster at this point. Meanwhile, MOH would also like to answer two common queries from members of the public.

3. First, whether individuals who have been infected with COVID-19 after their primary series should still receive their booster dose.

4. The default is yes. With Omicron being a less severe disease, people are getting mild symptoms with lower viral loads. A booster dose will confer longer protection into the future. As recommended by the Expert Committee on COVID-19 Vaccination, it is safe for persons who have recovered from COVID-19 to receive a booster dose. Our vaccination centres have been instructed to administer the booster dose to you and you will not be turned away.

5. However, if you (a) much prefer not to get the booster dose, and (b) have seen a doctor when you were infected or were detected to be COVID positive when travelling into Singapore, and a record of your infection is reflected in our medical records (and you can see it in your HealthHub records), you can choose not to take the booster dose. The infection episode can be considered as your booster dose. The update of your status is automatic, and no action is required on your part.

6. For clarity, the above does not apply to someone who performed an antigen rapid test (ART) self-test, or has undergone Rostered Routine Testing or Pre-Event Testing and was discovered to be COVID-19 positive. These individuals will typically undergo self-isolation under Protocol 2, recover and then resume normal activities. There is therefore no record of their infection in our medical records. If so, you will need to receive your booster dose, recommended from about 5 months after the last dose of your primary series, in order to extend the validity period of your full vaccination status beyond the initial 270 days.

7. Second, there have also been many queries on the need for boosters after various permutations of mRNA vaccine doses, Sinovac/Sinopharm vaccine doses, and infections. As the answers are complicated and depend on the order and timing between these occurrences, MOH is working on a calculator for our official website, to help individuals determine if they need to take boosters to extend their validity period.

8. But a simple rule of thumb is: two doses of an mRNA vaccine or three doses of Sinovac/Sinopharm confer full vaccination status for 270 days. A booster or an infection recorded in our medical records after that will extend the validity.

9. MOH would also like to advise individuals against taking serology tests to try to exempt themselves from a booster dose. A serology test is not a strong indication of resilience against severe illness caused by the COVID-19 virus. Further, positive serology can be generated due to vaccinations or infections, without clear indication of timing, and does not provide a good basis to decide if the individual can be exempted from boosters. When in doubt, please come forward to receive a booster dose and get yourself properly protected.


MINISTRY OF HEALTH
29 JANUARY 2022
 
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