Covid-19 infections in Singapore stable from Dec 12 to 17
Covid-19 infections appear to have plateaued over the week of Dec 12 to 17. The seven-day moving average was 7,780 on Dec 12 and went down slightly to 7,730 on Dec 17.
While the numbers remain high, experts say this is not a cause for concern, even though serious illness and deaths tend to lag behind infection figures.
Professor Paul Tambyah of the National University Hospital, speaking in his capacity as president of the International Society for Infectious Diseases, said there is no need for people to worry about the rising Covid-19 infection numbers. Instead, they should “just be sensible about taking precautions about their health, not go to work or school if they are unwell and seek medical attention instead”.
On the other hand, Professor Hsu Li Yang, an infectious diseases specialist at the National University of Singapore’s Saw Swee Hock School of Public Health, said: “We should be concerned because a large number of infections will impact healthcare services and also result in higher numbers of serious illnesses and deaths.
“Everyone – including those at minimal risk of severe Covid-19 – should do their part in slowing down the transmission of the virus.”
The Ministry of Health (MOH) has said that public hospitals here are prepared to delay non-urgent surgery to keep beds free in case of a surge in cases and the demand for hospital beds go up.
Associate Professor Alex Cook, also from the NUS Saw Swee Hock School of Public Health and an expert in biostatistics and modelling, said the real number of people with Covid-19 is “many times more” than the numbers announced by the MOH, as most people with mild illness, even if they test positive, do not see a doctor.
He added: “The current wave is what we should expect of endemic Covid-19, just like we see with endemic influenza and all the other common respiratory infections. There’s no more reason to worry about the Covid-19 wave than about similar influenza waves in the past. But just because we should not be consumed by anxiety, it doesn’t mean we should do nothing at all.”
All the experts said people should be socially responsible and mask up in crowded enclosed places, even if they feel well, since the transmission of the virus occurs a day or two before symptoms appear.
Dr Asok Kurup, an infectious diseases expert in private practice, said there is a need to play the game right with this virus and know what the weakest links are: “We have elderly and vulnerable persons among us. In crowded and less ventilated settings, we should encourage mask-wearing to help mitigate cross transmission.
“It’s too late to start mask-wearing only when symptoms start, as transmission begins earlier.”
Most of the experts said that the most important number is not how many people are infected, but how many need to be hospitalised or require intensive care.
Prof Tambyah said that while intensive care unit (ICU) case numbers may lag behind actual waves of infection for a week or two, they remain “the most objective indication of strain on the healthcare system” because “they reflect cases which objectively need ventilatory or circulatory support”.
His colleague from NUH, Professor Dale Fisher, said infection numbers are useful for the public to gauge their risk of infection in the community. “By placing an emphasis on the current risk individuals may decide to get a vaccine booster, as the risk of severe disease is higher in those who haven’t been vaccinated for a year,” he said.
MOH data indicates that people with minimum protection – three mRNA or four traditional vaccinations – whose last Covid-19 jab was more than a year ago face almost twice the risk of needing hospital care than someone who had a booster within the past 12 months.
He added that the current 20-plus Covid-19 patients in ICUs is a far cry from the 150 or so at the height of the pandemic. He expects the current wave to continue to the end of 2023 before plateauing and going down by early 2024.
Dr Shawn Vasoo, clinical director at the National Centre for Infectious Diseases (NCID), said that while the absolute number of infections has increased, the severity of the infections has not gone up.
Nevertheless, he said those at higher risk of severe infection should get antiviral medicine from their doctor within five days of getting sick. The drugs, such as Paxlovid and Molnupiravir, “can substantially reduce the risk of hospitalisation and severe disease if started early”, he said. These medications are free for Singapore residents.
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