SINGAPORE, Aug 5 — Infectious disease experts TODAY spoke to yesterday (August 4) were generally optimistic that Singapore will be able to exit the current Phase Two (heightened alert) as scheduled on August 18, despite the recent spike in cases linked to the Jurong Fishery Port and karaoke lounges.

However, among the four interviewed, only one, Dr Leong Hoe Nam from Rophi Clinic, believes that the current restrictions may be extended by another four to six weeks.

Associate Professor Hsu Li Yang, the vice-dean (global health) at the National University of Singapore’s Saw Swee Hock School of Public Health, said Singapore will likely have 80 per cent of its population fully vaccinated by September.

As it is, 63 per cent of the population have already completed their vaccination regime as of Monday, and the country looks set to meet its target of having two-thirds of the population — or about 66 per cent — fully vaccinated by National Day on August 9.

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And the statistics from the Ministry of Health (MoH) about the local cases in the last 28 days by vaccination status and severity of their condition have shown the efficacy of the vaccines.

According to the data, which was last updated on Tuesday, 5.2 per cent of unvaccinated patients required oxygen support, while 1.1 per cent needed to be warded in an intensive care unit (ICU).

In contrast, the percentage for fully vaccinated patients was 0.4 and 0.2 per cent respectively.

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Dr Dale Fisher, who agreed with Assoc Prof Hsu, said needing oxygen support is a sign that an infection is severe. “Low oxygen levels are critical especially for heart and brain function. Oxygen supplementation works and by then we hope that the treatment or the body’s natural capacities kick in to allow recovery.”

Dr Paul Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection, said that with good vaccination rates, he believes that Singapore is on track to “relax the restrictions, rather than extend them”.

While Dr Leong agreed with the need for vaccinations, which he said helps to “tame the bite of the infection”, he said his concern is about having adequate capacity within the hospitals.

As of Tuesday, there were 592 cases that have been warded in hospital, though the MOH said most are well and under observation. There are currently 37 cases of serious illness requiring oxygen support, and seven in critical condition in the ICU.

“Think of the country as a battleship, bombarded consistently with enemy fire,” said Dr Leong.

“As long as the engine room is not damaged (by having enough ICU beds), the sailors are protected (by being vaccinated), and the ship moves (economy running), we will move on.”

Being vaccinated, he said, will help to ensure there are sufficient hospital beds for those who need it.

That said, he believes Covid-19 cases will fall to acceptable levels — such as having fewer than 20 cases a day — in four weeks, and will require another two weeks for the authorities to sufficiently clear the hospitals of Covid-19 patients.

However, Dr Fisher said that even when the population is fully vaccinated, Singaporeans should still expect to see high case numbers, especially when the restriction measures are eased.

When Singapore finally treats Covid-19 as an endemic disease, he said the focus should be on monitoring severe cases instead.

“The severe (form of the) disease will be limited to the unvaccinated, and rarely someone vaccinated,” he said.

Assoc Prof Hsu, who is also his school’s programme leader for infectious diseases, added that mild cases of Covid-19 can then be treated at home, which will similarly free up crucial space in the hospitals.

Nonchalance will lead to mutant variant

While the surge in Covid-19 cases from the fishery port and the karaoke lounges led to the implementation of the second round of restrictions, Assoc Prof Hsu said the number of new cases is gradually coming down.

Since the restrictions were imposed on July 22, the number of locally transmitted Covid-19 infections has fallen from 162 to 92 yesterday.

“Generally it has taken at least a week, based on previous stricter restrictions, for the numbers to come down,” said Assoc Prof Hsu.

Still, there is some cause for concern because many in the population are not yet fully vaccinated, said Dr Fisher.

Dr Tambyah added that many people feel that their risk of infection is low so they are not willing to try a novel treatment which has only existed anywhere in the world for nine months, such as messenger ribonucleic acid (mRNA) vaccines.

“The rising number of cases, especially the unlinked ones, makes this less tenable an argument,” he said.

Since July 22, the number of unlinked cases has largely trended in the shape of an inverted-U, with numbers rising from 21 and peaking at 51 on July 27. It has since gradually fallen to 31 on Tuesday.

Dr Leong said this is worrying because it reflects Singapore’s inability to track infected people, despite the use of technology such as TraceTogether.

Such technology, he said, is only as good as how well it is used.

“Singapore is relatively safe, and we have become a victim of our own success,” he said. “In other parts of the world where there are plenty of cases, the need for vaccination goes up because the fear is very tangible (due to the number of deaths).”

He said this relative calmness in Singapore over the virus leads to nonchalance.

“Unfortunately, nonchalance… will drive the development of a (Covid-19) mutant. The rest of the world, and Singapore, will be faced with yet another survival threat with yet another variant.” ― TODAY