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MOH to change daily reporting of COVID-19 cases to give 'better picture' of epidemic situation in Singapore

MOH to change daily reporting of COVID-19 cases to give 'better picture' of epidemic situation in Singapore
People walking outside Singapore Sports Hub on Jul 22, 2021. (Photo: CNA/Hanidah Amin)

SINGAPORE: The daily COVID-19 infection numbers reported will soon be higher, as the Ministry of Health (MOH) has decided to include the number of Protocol 2 cases in its daily updates, said Health Minister Ong Ye Kung on Friday (Jan 21). 

Protocol 2 cases are individuals who are well and tested positive, or have been assessed by a doctor to have a mild condition. These cases are not included in the current reporting of daily COVID-19 infections by MOH. 

Speaking at a multi-ministry task force press conference, Mr Ong said that reporting the number of Protocol 2 cases would give "a better picture of the epidemic situation in Singapore and which part of the curve we are on". 

He noted that it has become "increasingly evident" that the Omicron variant is "a less severe disease" than the Delta variant; and as such, general practitioners (GPs) have started to see more mild Omicron cases. 

As a result, Protocol 2 cases "rose quickly" to about 400 to 500 cases a day last week, and more than 1,000 cases a day this week. 

However, Mr Ong pointed out that this number still did not represent the full picture of the COVID-19 situation in Singapore, and neither would it be possible to get the full picture. 

"This is because many cases with no symptoms and very mild symptoms remain undetected, and others may choose to self-test and self-administer Protocol 2, which is also not possible to be captured," he said. 

"This was the case during the Delta wave and is now more apparent with the Omicron wave, because it's generally a milder disease." 


By including the number of Protocol 2 cases in the Health Ministry's daily updates, there will then be two sets of numbers reported every day.

One would be for the infections confirmed by PCR tests, which is the number currently reported. The other is for the Protocol 2 cases. 

"We will backdate the numbers to Jan 6 when GPs started to order Protocol 2, for the purposes of calculating the total number of infections in Singapore as well as the week-on-week increase in infection numbers.

"With this new method, the week-on-week increase in cases will remain largely unchanged compared to now at about 2.5," said Mr Ong, referring to the weekly infection growth rate. 

It used to be that GPs could only prescribe an individual as a Protocol 1 case, in which they test positive and are unwell. In a Protocol 1 case, the individual would be placed on the home recovery programme for 10 days or sent to a medical facility, such as a hospital or COVID treatment facility. 

MOH has now amended the duration of home recovery for Protocol 1 cases to seven days, said Mr Ong. 

Mr Ong explained that this method of reporting makes "a lot of sense".

Whether an individual undergoes Protocol 1 with a seven-day home recovery, or Protocol 2 with a 72-hour self-isolation period, should depend on "the risk profile and the severity of the symptoms of the patient" - and not whether the patient decided to see a GP or to do a self-test. 


Mr Ong added that with vaccinations "working well" and the Omicron variant being less severe, the top line infection number has become "less and 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," he said. 

Highlighting a call with the World Health Organization that he had, Mr Ong said it was "well acknowledged" by 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".

The more important statistics are in the bottom line, he said.

"How many people are severely ill, needing oxygen supplementation? How many is in ICU care? How many died?"

To date, less than 0.3 per cent of the 12,078 individuals in Singapore who are confirmed infected with Omicron required oxygen supplementation. In comparison, 0.8 per cent required oxygen for those infected with the Delta variant, said Mr Ong.


MOH will also stop differentiating between Omicron and non-Omicron infections in its daily updates, as Omicron has "clearly dominated" the current infection wave, noted Mr Ong. 

"This is a change in case definition and how statistics are compiled. In reality, the way we live our life and the way we respond to the disease, nothing has changed. ... So it does not change the actual epidemic situation we are experiencing over the past weeks," he said.

"We have been living with COVID-19 and the Omicron variant quite carefully and calmly, with a less restricted posture where we can meet in groups of five. So this attitude should not change because of an adjustment in case definition and reporting methods."

Source: CNA/gy(rw)