Healthcare capacity to be ramped up amid potential COVID-19 Omicron surge in Singapore

SINGAPORE: Singapore is putting in place contingency plans to ramp up capacity in public hospitals and intensive care units to prepare for a potential surge of local COVID-19 Omicron cases. 

To help manage the load in the public hospitals, the Ministry of Health (MOH) on Tuesday (Dec 14) said it is also prepared to increase capacity at COVID-19 treatment facilities (CTF), where more stable patients from public hospitals can be transferred to for continued monitoring if necessary.

MOH added that it is also stepping up efforts to increase the manpower required in hospitals and CTFs.

"Given the likely higher transmissibility of the Omicron variant, a surge in local Omicron cases could risk straining our healthcare system once again," MOH said.

This comes as Health Minister Ong Ye Kung warned at a COVID-19 multi-ministry task force press conference on Tuesday of a "potentially big Omicron wave coming our way".

As of Tuesday, MOH has detected 16 Omicron cases in Singapore, with 14 imported cases and two local cases who were airport passenger service staff.

"With preliminary data suggesting that it is at least as transmissible as the Delta variant and may carry a higher risk of reinfection, there is a need for us to put in place additional measures to make sure we are prepared to deal with a spread of the Omicron variant in our community," MOH said.

Nevertheless, the Health Ministry said a majority of Singapore's COVID-19 cases have mild symptoms and can safely recover at home. This has been demonstrated for the Delta variant, and likely continues to be so for Omicron, it added.

MOH said it will work with public health preparedness clinics (PHPC) to better support the recovery of individuals who do not require acute care in hospitals and help them return to their normal lives as soon as possible.

"This would entail expanding the current Protocol 2 in January 2022 to cover mildly symptomatic and suitably fit COVID-19 patients who can recover well at home. More details will be released at a later date," it added.

Under an expanded Protocol 2, more COVID-19 patients would only need to self-isolate at home for the next 72 hours.

Protocol 2 refers to the management protocol for those who are well and test positive for COVID-19. Currently, these people need to self-isolate at home for the next 72 hours. Following this, they can exit isolation if they produce a negative antigen rapid test (ART).

Mr Ong explained that general practitioners (GP) could be further empowered to judge the disposition and risk profile of COVID-19 patients and trigger Protocol 2 with a medical certificate.

"So even within the more formal HRP (home recovery programme) system, there is scope for the GPs to be providing follow-up care instead of centralised, coordinated care administered by MOH," he said.

Mr Ong said GPs already play a "very big and vital role" in this regard, as they administer polymerase chain reaction (PCR) tests for patients and help onboard patients to the home recovery programme. 

"Many GPs have been family physicians for their patients for many years. Hence, they have expressed a strong interest to continue to care for their COVID-19 patients, instead of having them onboarded into a national HRP," he said.

"MOH supports this because maintaining that long-term doctor-patient relationship is actually the essence of primary care. We are therefore thinking through how to have our GPs play an even bigger role, especially if we ever have a big Omicron wave."

TESTING "REMAINS KEY"

Still, MOH said testing "remains key" to early detection and rapid tracing and containment of transmission, especially in light of the Omicron variant.

"During this period as we step up our efforts to quickly detect and ringfence Omicron cases, all sectors will remain on their existing mandatory RRT (rostered routine testing) regime, until more information is available on the Omicron variant," the ministry said.

The Government will continue subsidising companies on mandatory rostered routine testing until Mar 31, 2022. Beyond that, employers and businesses should be prepared to factor in testing costs as part of their normal business operations, MOH said.

The mandatory ART-based rostered routine testing regime was introduced for work settings at higher risk of COVID-19 exposure and spread.

With the emergence of the Omicron variant, airport and other border frontline workers who are at heightened risk of exposure to the variant had recently reverted to a weekly PCR testing scheme as a precautionary measure.

On top of mandating regular testing at high-risk work settings, MOH again encouraged everyone, including fully vaccinated individuals, to exercise social responsibility and self-test regularly with ART kits, especially if they are participating in higher risk activities or attending large-scale events.

"Regular testing should become a way of life as we adapt to the evolving COVID-19 situation. This will be supported by a comprehensive network of testing infrastructure that is easily accessible islandwide," MOH said.

In line with this, MOH has partnered GPs, mall operators and hotel groups to set up private quick test centres at locations across the island.

MOH expects to have at least 60 additional private quick test centres set up within the next few weeks, and will continue to work closely with the industry to grow this network.

"This will go a long way in fostering a culture of testing, which is important for early detection of cases and for keeping our communities safe," the ministry said.

In addition to the private centres, the Health Promotion Board has set up or partnered private providers to set up almost 60 quick test centres where members of the public can make an appointment to conduct a self-administered ART while supervised by trained personnel.

Each test is priced at S$15, and can be used to fulfil workplace requirements under the rostered routine testing regime, for pre-event or pre-activity tests, or for those who wish to get tested before attending a large-scale event.