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             We are currently in a XBB wave. Daily cases are rising, and the 7-Day Moving Average (7DMA) is about 7,700 per day now. The week-on-week infection ratio hit a peak of 1.74 a few days ago on 10 October, and has started to trend down subsequently. This means cases are not accelerating. So hopefully the worst of the worst is over.

2.             The Omicron XBB subvariant is essentially a cross between BA.2.75 and BA.10. Within three weeks, it has out-competed every other subvariant. Therefore the current wave is pretty much driven by XBB.

3.             While it is driven by XBB, it is also contributed by reinfections. As I mentioned earlier in Parliament, because 75% of our population has already been infected, any new wave has to be contributed by reinfection. That is what we are seeing now. About one month ago, reinfections were still hovering at about 5% to 6% of daily cases but that has been rising steadily. Then it tapered off for a while, to about 15% to 16% for several days, it has gone up again in the last few days to 17% to 18%. While still increasing, it is no longer at a steep rise.

4.             From 8 to 14 October, the incidence rate of a COVID-19 naïve person getting infected was 162.5 infections per 100,000 person-days. But if you have been infected in the last one to three months, the probability of reinfection is very low – a very small fraction compared to somebody who is COVID-naïve. If you had your infection four to six months ago, or seven to 10 months ago, the probability goes up but it is still significantly lower than a COVID-naïve person. For somebody who got infected pre-Delta or during the Delta wave, his/her risk of being reinfected is almost the same as a COVID-naïve person. That is also what is driving the reinfections.

5.             There is now a divergence and weakening of the correlation between the number of cases and new hospitalisations. In mid-September, the number of hospitalisations compared to the number of infections was about half-half. By now, it is less than half. When we calculate the incidence rate of hospitalisation over the last four weeks, we see a slight reduction in the incidence of hospitalisation.

6.             There could be several reasons. One is of course the time lag, especially for the latest week ending 14 October. Another reason could be that XBB is indeed less severe. It could also be that reinfected cases tend to be more mild.

7.             What can we expect? Based on data that has just been presented, we have been working with experts from the Saw Swee Hock School of Public Health to model the wave, as we do for every wave. This is likely to be a short and sharp wave, driven by XBB, but contributed to a small extent by reinfections.

8.             Our model shows that we might well peak at around 15,000 7DMA daily cases. Within a week there are ups and downs, and for the weekends, people tend to hold back on visiting the doctor until Monday. We report Monday’s numbers on Tuesday, and that is why Tuesday’s numbers are always highest. So on a Tuesday, it is possible to see numbers like 20,000 to 25,000 cases.

9.             By around mid-November, we should see the wave subside. But as we always emphasise, topline figures are much less important. We are only looking at the topline numbers to see where we are in terms of the wave, and how it translates into hospital burden and hospital workload, which are what we should focus on.

10.          At this juncture, I should talk a bit about endemicity. We have never declared that COVID-19 is an endemic disease, like some countries have. We have never declared it is no longer a social or health threat. We much prefer to let actions and our lives speak for themselves.

11.          What we have done is that with every successive wave we have gone through, we relaxed the Safe Management Measures (SMMs) to the extent that now, almost everything has been dismantled, with the latest standing down of the Vaccination-Differentiated SMMs (VDS). So, in reality, having done all that, in effect, we are living with COVID-19 like it is an endemic disease.

12.          Endemicity does not mean you pretend the virus does not exist, or treat the virus as if it does not exist. On the contrary, endemicity means that we accept it exists, and take the necessary steps to live with it. So we must accept that some parts of our lives must change, in order for us to live with this virus. As much as possible, we do not want it to disrupt our normal lives, and therefore we try our very best to never go back to Circuit Breaker or Heightened Alert, or anything that severely disrupts our normal lives.

13.          We will take necessary precautions in order to manage the situation. What are some these precautions? I think there are at least four.

14.          One is personal responsibility. Test and isolate yourself when you are not feeling well. Wear your mask if unwell. If you are living with an elderly person, or want to interact with an elderly person, wear your mask. If you are infected, follow Protocol 1-2-3. Personal responsibility is very important.

15.          Two, from time to time when we have a wave like this, when hospitals come under additional pressure, we will have to restrict visitors.

16.          Three, also extremely important – keep our vaccinations up to date. Yesterday we started administration of the bivalent Moderna vaccine, and we had about 4,200 vaccinations yesterday. Our Joint Testing and Vaccination Centres (JTVC) operate on half-day today, and do not open on Sunday. If there is a lot of demand, we will open JTVCs on both days of the weekend. If we want to do that, we will start from next week, but we are monitoring the demand.

17.          If you are above 50, and your last shot was more than five months ago, consider walking into a JTVC to get the Moderna bivalent vaccine.

18.          These three areas – personal responsibility, cutting back on visitors at hospitals, and keeping vaccinations up to date – are part and parcel of living with COVID-19 as an endemic disease.

19.          There is a fourth set of measures that we cannot rule out – SMMs that we may have to reinstate should the situation worsen, but in a way that does not disrupt our normal lives. For example, maybe we put back our masks indoors, or indoors and outdoors, if the situation requires it. Two, as the Multi-Ministry Taskforce (MTF) earlier announced, we stepped down all VDS, but when the situation requires, we may have to step up VDS to an appropriate level, in order to protect those who are not up to date with their vaccination.

20.          We are monitoring the XBB wave closely, and its impact on the healthcare system to see if some of these measures are necessary. As of now, no decision has been taken, but we are watching the situation closely.



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