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Singapore's Omicron wave - what you should know

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A month after Singapore reported its first Omicron Covid-19 case in early December, Health Minister Ong Ye Kung warned that a wave of infections driven by the new variant was imminent.

Since then, infection numbers have climbed steadily, raising the question - has the next wave hit us yet?

Here are answers to some questions about the next wave.

Q: Has the Omicron wave started yet?

A: Yes, it has.

Overall Covid-19 infection numbers have been creeping up since the first Omicron case was reported on Dec 2 last year, as has the number of Omicron cases.

"It is clear that Singapore already has community infections that are driven by Omicron, which means Omicron is already circulating in the community," said Professor Teo Yik Ying, dean of the National University of Singapore's (NUS) Saw Swee Hock School of Public Health.

While initially most Omicron cases were imported, the number of community cases has now outstripped imported cases.

On Wednesday (Jan 19), there were 965 local and 220 imported Omicron cases. Singapore reported 1,615 Covid-19 cases in total.

Q: The Ministry of Health (MOH) gives a daily update on the number of Omicron cases in Singapore. Does this mean all other cases belong to other variants?

A: Each day’s Omicron infection numbers include cases that have been reported as part of the overall case count earlier in the week. This is because testing for the variant takes time.

Cases which have not been classified as Omicron infections may simply be pending identification, or may belong to other variants.

Q: Do Singapore's daily case numbers accurately reflect the overall number of Covid-19 cases here?

A: The daily case numbers reflect only reported Covid-19 cases.

This means that the daily case count does not include anyone who tests positive with an antigen rapid test (ART) but does not follow up with a confirmatory polymerase chain reaction test, nor people who are infected but asymptomatic and hence may not even get tested.

At present, those who test ART-positive but feel well are asked to self-isolate for 72 hours. They do not have to report their results nor see a doctor if they test negative after this time period. Such cases would not be reflected in Singapore's daily case count.

Q: How would we know if the Omicron wave has peaked?

A: We would know that the peak is past when Singapore sees a sustained decrease in case numbers over a period of time, Prof Teo said.

But Associate Professor Alex Cook, vice-dean of research at the NUS Saw Swee Hock School of Public Health, noted that should the country see such a large number of cases that its testing capacity struggles to keep up, it may be unclear whether the infection wave has peaked.

This was the case in Australia, where a spike in cases drove up the demand for testing and led to longer wait times for results.

Prof Cook added that it is more important to focus on the peak in severe cases, rather than overall case numbers. This peak will lag behind the overall case count, as it takes time for people to develop severe illness after becoming infected.

A large number of severe cases could overwhelm Singapore's healthcare system.

Q: Are Singapore's healthcare protocols different for people with the Omicron variant?

A: No, they are not.

MOH applies a single approach to all Covid-19 cases. This is because scientific evidence indicates that Omicron infections are likely to be less severe than those caused by the Delta variant.

In other words, people recover in the settings that are most suited to their medical conditions. Those who require extra care and monitoring are admitted to hospitals or community treatment facilities, while those whose conditions are stable can recover at home.

The same goes for imported cases, who recover in hotels or at home.

Q: Do we know which age groups are most likely to be hospitalised after getting infected by this variant?

A: The MOH website displays information on the number of patients hospitalised, on oxygen or in intensive care, broken down by age group. But this is not specific to the Omicron variant.

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