Gan Kim Yong
Singapore
“Consumer complaints relating to the secondary resale market for tickets to major events and concerts have generally remained low. Nonetheless, to protect the public from scams on secondary ticket resale platforms, the Police have imposed Code of Practice requirements under the Online Criminal Harms Act to require designated online service…”
“Singapore does not condone the use of forced labour. We criminalise forced labour in Singapore under various laws. Relevant Government Ministries and agencies, such as the Ministry of Manpower, Ministry of Home Affairs and Singapore Police Force, play their part in investigating complaints of suspected breaches in domestic laws that relat…”
“The Association of Banks in Singapore (ABS) discontinued the PayNow nickname feature as scammers had been exploiting the use of nicknames to impersonate legitimate entities and trusted individuals.”
“As of end-2025, around 6,900 private residential buildings have registered their solar installations with SP Group for the export of excess solar-generated electricity to the grid. The installed solar capacity of these residential buildings is 115.3 megawatt-peak (MWp), or around 5.5% of all current installed solar capacity in Singapore.”
“The one-year pilot extension of liquor trading hours has seen strong interest from businesses. As of 31 May 2026, the Police have approved 88 applications for the extension of liquor trading hours from public entertainment outlets in these areas.”
“The Government does not make projections of domestic or regional demand for renewable diesel or sustainable aviation fuel. Demand depends on commercial considerations, evolving market conditions and regulatory developments across different jurisdictions.”
The complete record
Every one of 3,841 lines we hold for Gan Kim Yong, in date order, each linked to its source. Free to read, in full, without an account. Page 33 of 77.
“I thank the Member. We do not have an estimated total number of people returning because it depends on the decision of the individuals, whether or not they intend to return. Many of these, who are on Stay-Home Notices, are required to stay at home and we are leveraging technology as well to monitor them. We call them, we have video calls as well and we also track their location, where they are. This will help us to reduce the manpower resources that we need to ensure that they stay at home. This is a step-up from the Leave of Absence (LOA) that we have introduced, where they were allowed to go out occasionally for meals and so on. For the Stay-Home Notice, they are required to stay home all the time and we will do spot checks on them through telephone calls and so on, to make sure that they are at home. I think this is the enforcement regime, which was explained yesterday.”
“The conditions for DORSCON levels are published on our website. These are guidelines. At the end of the day, we would need to make a judgement. In making the judgement, we have to take into account inputs from the professionals, inputs from the community and make an assessment of the situation. So, there are multiple factors that need to be considered. It is not just counting the numbers and ticking the boxes before we decide to switch either way. Currently, we have a Ministerial Taskforce. The Taskforce will assess and recommend, and eventually, the Minister for Health is the one who declares the DORSCON level. Just for avoidance of doubt, let me repeat this. We have no plans to go to DORSCON Red. Whenever I hold a press conference, rumours will fly around that we are going to go to DORSCON Red. Every time, we would have to spend resources and efforts to address the rumours. So, please help us not to spread rumours that are untrue. Well, rumours are by nature untrue! Again, as we continue to monitor the situation, there may be a time when we will have to adjust the DORSCON level downwards to Yellow or to Green. Again, we will take into account multiple factors – the number of infections that we are seeing, the severity of the diseases and whether or not the viral transmission is able to be controlled. So, there are many factors that we will consider, including outside Singapore, what is the situation globally. Therefore, it is not a straightforward answer. It is eventually a judgement, taking into account all the various relevant factors.”
“But if you do not have a temperature, it does not mean that you are perfectly well. We still have to make an assessment, whether you feel well or unwell. For organisations, we also advise them, even after they have taken the temperature, observe the individual. If he does not look well, please advise him to go back and rest, rather than rely solely on temperature-taking.”
“Temperature screening remains one of the very important parts of the measures that we have put in place to prevent people who are ill from joining activities and participate in mass gatherings. That is very important. Individually, it is also important for you to take temperature regularly so that you know whether you are well or unwell. But very often, you also find that individuals know that they are unwell even if they do not have a temperature. It is also evidenced from the studies that show that, for COVID-19, sometimes, the high temperature comes much later, in the later part of your illness. In the beginning part, when you are in the initial phase, your symptoms may be very mild but you do carry viral load and you can still be infectious. Therefore, we encourage Singaporeans who feel unwell, especially with the symptoms that I had mentioned, respiratory symptoms – coughing, running nose and so on – to please consult a doctor, particularly with PHPC, now that we have activated them. Or come to our polyclinics for a proper assessment. Once we have made the assessment, if we find that you are at risk, we will then refer you to the hospitals for assessment and testing. If not, doctors are given guidance to give you a five-day MC so that you can rest at home. If your symptoms recover within those five days, well and good. If not, please go back to the same doctor. If you go to a different doctor, they may not know the history and you have to repeat all over again, and you may have missed out certain indications. We encourage you to go back to the same doctor so that there is a continuity of care. This way, we will help to minimise transmission. To answer the Member's question, temperature-taking is an important part of our precautionary measures.”
“Therefore, we advise organisations that when there is a confirmed case, if they are not sure, to consult us or to consult the National Environment Agency (NEA) which oversees the environmental cleaning processes. This way, we will then be able to react calmly and respond effectively to any confirmed cases. I would advise organisations that are uncertain to please contact us. We will provide the necessary guidance and advice.”
“I thank the Member. This is a very important question. In fact, we have been briefing those who have been affected, including corporations, entities, organisations. As I had mentioned, last week, I met the religious leaders, church leaders to explain to them what are the precautions they can put in place. As the Prime Minister said, life must go on. We have to continue as normally as possible while taking the necessary precautions. For church organisations, for example, we have advised them to continue with their services, minimise unnecessary social interactions so as to minimise contact to prevent transmission within the church and to also continue to take temperature and remind members that if they are unwell, they can stay at home and rest rather than to come to church. These are the types of advice we have given to the churches. Depending on the situation, different organisations may adopt different measures where practical and, if they are in doubt, we have also invited them to contact us. We will provide the necessary advice. We have done the same to the other religious organisations – the Buddhist organisation, the Taoist organisation, the Hindu organisation. We are reaching out to them and any organisations that have questions or are uncertain as to what they should do, they can contact us. When a case is identified as positive, we will also inform the organisation to do the necessary cleaning and disinfection and so on. Sometimes, organisations may overreact and take upon themselves to do things that may not be necessary and may cause misunderstandings.”
“Observing good personal hygiene, such as washing our hands with soap and water regularly, and not touching our face and eyes, remains the key means by which individuals can protect themselves and reduce the risk of transmission. Each person should also monitor his or her health closely, take temperature twice daily, see a doctor when unwell and stay home to rest, and if they must go out, for example, to see a doctor, wear a mask. We expect to see more cases in Singapore, partly as a result of enhanced surveillance we put in place recently. We must be prepared for the possibility of wider community spread. We will continue to monitor the situation and prepare for different scenarios I sketched out during the Ministerial Statement at the last Sitting. We will also finetune and adjust our measures accordingly as the situation evolves. Together, with everyone playing our part and staying united, we are confident that we will overcome this outbreak and emerge stronger as a nation.”
“The Ministry of Health (MOH) has, therefore, given guidance to doctors to provide medical certificates (MCs) of five days for patients with respiratory symptoms so that they can and should stay home to rest and recover quickly. We urge individuals with respiratory symptoms, such as fever, cough, sore throat and runny nose, to seek medical treatment at PHPCs or polyclinics early and stay home throughout their MC period. Let me take this opportunity to once again thank our healthcare workers who courageously rose to the call of duty and, in particular, our PHPC doctors, who had just started up the PHPC clinics today. I am also heartened to see many ground-up initiatives to support our frontline healthcare workers, the needy and vulnerable groups, as well as the affected patients and their families. This whole-of-society spirit is essential in building a resilient nation. When we stand united, we will prevail, and I am glad to see Members wearing this SG United button. Let us stay united as we battle this disease. Knowledge of COVID-19 is still evolving as scientists around the world work to better understand the virus. MOH studies the latest reports, consults international infectious diseases experts and keeps in touch with other health authorities to gain greater knowledge of the virus and how it is transmitted. The current medical assessment still points to COVID-19 spreading mainly through droplets and physical contact from an infected person. Based on evidence available in China, an expert from the Chinese Center for Disease Control and Prevention has said that there is currently no evidence that the virus can be transmitted through aerosol. Individually, we can each play a part to curb the spread of disease through socially responsible practices.”
“Thank you. I think it will be useful for me to give a quick update of the situation. The Coronavirus Disease of 2019 (COVID-19) situation continues to evolve globally and locally. As of 17 February 2020, based on the World Health Organization’s report, globally, there are 70,548 confirmed cases in mainland China with 1,770 deaths, and 881 confirmed cases outside of mainland China with five deaths. Locally, as of 17 February 2020, we have 77 confirmed cases of COVID-19. Twenty-four cases have fully recovered from the infection and have been discharged from hospital. Of the 53 cases still in hospital, most are stable or improving. Four are in critical condition in the intensive care unit. Contact tracing has helped us to identify five clusters and investigations on these clusters are ongoing. Contact tracing is underway for the other seven locally transmitted cases to establish any links to previous cases or travel history to mainland China. Since early January, we have progressively put in place precautionary measures to detect and limit the transmission of the virus. These include travel controls, contact tracing and placing identified close contacts under quarantine. Today, we activated the Public Health Preparedness Clinics (PHPCs) to strengthen our defences at the primary care front to better detect and manage COVID-19 cases. The PHPCs will provide subsidised care for patients with respiratory illnesses in the community. We observed that several of the locally confirmed cases had remained in the community or gone to work even when they were ill.”
“Mr Speaker, Sir, may I have your permission to take the first two questions together?”
“In addition, Student Health Advisors are deployed in schools to support students on health issues, including tailored counselling to quit smoking. HPB also complements anti-tobacco messages in the school curricula with interactive programmes, such as assembly skits and workshops.”
“Smoking prevalence among students in secondary schools, Institutes of Technical Education (ITE) and polytechnics decreased from 8% in the period from 2011-2013 to 4% in the period from 2014-20161. Similarly, smoking prevalence among Singapore residents aged 18-29 has declined from 17.2% in 20072 to 9.9% in 2017.3 The average age of smokers who started smoking daily was 18 in 2017.4 According to research conducted by the Health Promotion Board (HPB), the key reasons behind why the youth started smoking are social influence from friends and the perception that smoking is "cool". The Ministry of Health adopts a multi-pronged approach to curb smoking amongst Singaporeans young and old, which includes a comprehensive mix of strategies, such as public education, provision of smoking cessation services, legislation controlling tobacco advertising, sales of cigarettes to minors and taxation. One key measure that addresses the role of social influence in smoking initiation is the Minimum Legal Age (MLA) for tobacco use. This was raised to 20 on 1 January 2020 and will be raised to 21 on 1 January 2021. This aims to denormalise tobacco use among youths below the age of 21, restrict their access to tobacco in their social circles, and hence reduce the likelihood of smoking initiation. To reduce the influence of positive communication around tobacco product brands which may contribute to its perceived "cool" factor, the standardised packaging of tobacco products with enhanced graphic health warnings will come into force from 1 July 2020. In the community and schools, HPB works with educators and community organisations to promote smoke-free living among our youths. HPB conducts smoking cessation training for educators and youth workers.”
“The Minimum Legal Age (MLA) for the purchase, use, possession, sale and supply of tobacco products was raised from 18 to 19 on 1 January 2019, and 19 to 20 years old on 1 January 2020. The MLA will subsequently be raised to 21 years old on 1 January 2021. Under the Tobacco (Control of Advertisements and Sale) Act, anyone caught selling tobacco products to persons below the minimum legal age is liable, on conviction in Court, to a maximum fine of up to $5,000 for the first offence and up to $10,000 for the second or subsequent offence. In addition, the tobacco retail licence will be suspended for six months for the first offence and revoked for the second offence. However, if any outlet is found selling tobacco products to underaged persons in school uniform or those below 12 years of age, the tobacco retail licence will be revoked, even at the first offence. From 2017 to 2019, 74 retailers were caught for selling cigarettes to underaged persons. The Health Sciences Authority takes a strong view against such errant retailers and will not hesitate to take prosecution actions against them. For appeals to be considered, the retailer would need to demonstrate that he had reasonable grounds to believe that the person to whom he sold the tobacco product was not an underaged person, and that he had done his due diligence to ascertain that the buyer was not an underaged person. We want to remind tobacco retail licensees that they are responsible for all transactions of tobacco products taking place at their outlets, as well as the actions of their employees.”
“Based on latest available data in financial year (FY) 2017, the Government's operating expenditure for long-term care services was about $580 million. About 60% of the expenditure was for residential long-term care. The remainder was for home and centre-based care, as well as other support schemes, such as active ageing programmes and the Seniors' Mobility and Enabling Fund. This is on top of the Government's development expenditure on new long-term care capacity. In the same period, approximately 14,100 Singaporeans used nursing home services; 1,300 used inpatient hospice services; and 29,700 used home and centre-based care services.1 About 90% of them were aged 60 and above.”
“The MediSave limit for CDMP was raised to $500 in 2018, and about two in 10 patients who withdrew MediSave for psychiatric conditions reached the yearly withdrawal limit. MediShield Life and MediSave limits are reviewed regularly to ensure that they cover the majority of subsidised patients’ bills. The ongoing review of MediShield Life, including the claim limits, by the MediShield Life Council is expected to complete by end 2020. Those who cannot afford their treatment even after subsidies, MediShield Life and MediSave can approach the medical social workers for MediFund and other financial assistance.”
“Singaporeans who require psychiatric treatments can receive subsidies of up to 80% of their bills at public healthcare institutions. MediShield Life provides additional coverage should they require an inpatient stay, and MediSave withdrawals can be made to offset the remaining cost of their bills. From 2016 to 2018, an average of 4,400 MediShield Life claims were approved and about $4 million paid out each year for inpatient psychiatric treatments. As MediShield Life is meant to cover medically necessary treatments for subsidised patients, the claim limit does not take into account patients with longer periods of stays that may generally be due to social reasons. Among subsidised patients, around two in 10 exceeded the 35-day cap, and another four in 10 were within the 35-day cap but exceeded the $100 per day limit. About 300 claims each year are excluded from coverage as they are for treatment of injuries resulting from attempted suicide. Over the same period, an average of 4,800 patients withdrew about $6 million from MediSave for inpatient psychiatric stays each year. Based on the latest available data, less than one in 10 subsidised patients exceeded the yearly withdrawal limit of $5,000, while less than three in 10 subsidised bills exceeded the daily withdrawal limit of $150 per day. For outpatient care, an average of 14,000 patients a year utilised MediSave for psychiatric conditions under the Chronic Disease Management Programme (CDMP) from 2016 to 2018. These conditions are selected in consultation with a Clinical Advisory Committee comprising clinical experts. The factors considered include level of disease burden, effectiveness of early intervention, and availability of clear clinical guidelines.”
“MOH has also implemented initiatives under the Community Mental Health Masterplan in 2012 to better identify individuals at risk of mental health conditions and support them with appropriate referrals to access care. The Tripartite Alliance for Fair Employment Practices (TAFEP) recently revised their guidelines for job application forms to state that declarations on mental health conditions on job applications forms are discriminatory and should be removed unless there is a good reason to require that information. This was a positive step in de-stigmatising mental health conditions in society. For individuals who feel they have faced unfair discrimination in the workplace, they can also approach TAFEP for advice and help. We continue to work towards a more inclusive society which supports those with mental health conditions.”
“Currently, under the Private Hospitals and Medical Clinics Regulations (PHMCR), all medical clinic licensees are required to provide itemised bills for medical treatment provided. This provides greater price transparency and enables the public to make informed choices. An employer is required under the Employment Act to pay for medical consultations of an employee who has worked for at least three months and received at least one day of paid sick leave as certified by a medical practitioner from an approved public medical institution or appointed by the company. While human resource practices for medical reimbursement may vary across companies, no further details on a patient's condition or medical treatment would be released to an employer by the medical institution without the employee's explicit consent, due to patient confidentiality. It is important to continue our efforts to reduce the social stigma of mental health conditions such that persons with mental health conditions will face less risk of discrimination. To this end, efforts have been made to increase awareness of and de-stigmatise mental health conditions. For example, the National Council of Social Service, in partnership with the Institute of Mental Health, has launched an anti-stigma campaign called "Beyond the Label", which seeks to facilitate conversation about mental health, positively influence the public's perception of individuals with mental health conditions, and to educate and equip the public to support them in their recovery. The Ministry of Health (MOH) also works with partners, such as the Health Promotion Board and the Ministry of Education to educate specific target groups regarding mental well-being, such as through workplaces and schools.”
“The Ministry of Health, in consultation with the Expert Committee on Immunisation, makes recommendations on vaccinations which the population should receive. Influenza vaccination is recommended specifically for children six months to below five years of age at high-risk for influenza complications, and older children with chronic medical conditions, such as asthma and heart disease. Since 2014, MediSave can be used to pay for influenza vaccination among these groups to encourage take-up. Although more children are receiving influenza vaccination, more can be done to improve the take-up. Based on voluntary notification to the National Immunisation Registry, about 14,000 children below five years of age received influenza vaccination in 2019, while the number was around 4,600 in 2014. My Ministry is looking into how to strengthen awareness on the need for influenza vaccination in the recommended groups, and to facilitate access to vaccination.”
“While polyclinics offer similar services and medications, each cluster may have a different operating model to suit the needs of its patients based on their profile. Therefore, their cost structures can vary from one another, and this may result in some fee variation across polyclinic clusters. Nevertheless, there should not be wide variation in charges for similar services and medications. Today, consultation fees are already very similar across the three clusters, and the Ministry of Health has been working with the polyclinics to review the charges of their services and medications to reduce unwarranted variations.”
“Sir, I mentioned in my speech that the fatality rate of SARS is about 10% and the fatality rate of this novel coronavirus is about 2% to 3% today. So, numerically, statistically, it is less fatal than SARS. But as I have said, it is still at the early stage of the development of the disease, the numbers will change over time. In fact, as more and more milder cases are detected, the denominator may tend to go up and, therefore, the number may come down. At the same time, those who are confirmed cases today and, progressively, they may die because of the progression of the disease. So, therefore, both number will change over time. But as of today, based on our statistics, it appears to be less fatal, because fatality rate for SARS was 10% whereas the coronavirus is 2% to 3%.”
“But generally, coronavirus affects people with underlying conditions mainly because your organs tend to fail progressively as the disease progresses. The second question is on the impact on our economy and can we provide clear guidelines on major events.”
“I am not a doctor. So, it is very difficult for me to describe the process of death in medical terms, but I would try to explain how it causes death. Basically, when the virus attacks your body, your body will try to mount a response, a defence. And very often, you find that when your body is unable to respond adequately to eliminate the virus, your body will go into a shock, your organs go into overdrive and, therefore, you may begin to see organ failures and, eventually, death will occur as a result. Therefore, because of this, chances are, if you already have underlying medical conditions, your body is already weak, your defences are weak and your organs may already be impaired, therefore, the risk of death is higher. It is important for us to ensure that we continue to stay healthy. At the same time, what the hospitals will do is to provide supportive care to ensure that you have time for your body to recover, for your body to be able to fight the virus on its own until we are able to develop a definitive curative treatment. I think that is how the process will happen. The Member is right, generally, coronavirus affect patients who have underlying conditions more, and, generally, the older people tend to have more underlying conditions and, therefore, they tend to affect the older people more. But there are also exceptions and even in this novel coronavirus situation, we see that there were some in their 30s and 40s who are also infected, and some may not have underlying conditions. At the end, it is also an issue of statistics. When you have a large enough number of people who died, at the end of the day, there will be some who are not so typical, who not necessarily have conditions, but they have more severe reactions for a variety of reasons. So, it varies.”
“Therefore, it is something that we are looking out for. Dr Chia Shi-Lu is right that this would be a problem if this occurs in Singapore, China or anywhere else, so it is something that we will continue to monitor.”
“I thank Dr Chia Shi-Lu for the questions. Dr Chia knows I am not a doctor, so I can only do what I can as a Minister for Health. First, the way I understand from my professional colleagues, that for patients, they will do two tests and both tests have to show negative, and they are usually one day apart to make sure that they are free of virus before they are considered for discharge. But on top of that, at the end, doctors usually will make an assessment at the end of the day despite all the tests that we do, to assess and be confident that the person is well, does not look sick, does not have symptoms and generally are quite well, and maybe he will keep him for a while longer to make sure that there is no further deterioration before his discharge. Generally, our doctors are very careful. We can leave it in their hands to make a professional judgement when is the appropriate time to discharge patient. And, Ministers, I must assure you, do not interfere in their discharge proceedings because it is purely professional judgement. The second question on "super spreader". Dr Chia Shi-Lu is right that we are all looking out for the risk of a "super spreader" emerging. This is where one particular patient may infect tens or hundreds of patients that come into contact with him and so on. These are potential multipliers that will cause a major outbreak in the premises, in the locality. We are all looking out for such an incidence. So far, we have not received any report of such an incidence. It may happen but it is not yet being detected. But we are all looking out for them. Sometimes, the "super spreaders", the patients themselves, may be quite well. Therefore, he is able to go around many places and spread a lot of potential contamination in the environment.”
“For each suspected case, we will need to ensure that our medical staff wear all the protective gear, because they are by nature suspected cases. Many of the suspected cases turn out to be negative and, therefore, if you see some of our healthcare colleagues donning PPE at your shopping centre and so on, do not assume that this is going to be a confirmed case, because it may just be precautions that they have taken to inspect and pick up the suspected cases. Eventually, it may turn out to be a negative case. The best is to exercise self-discipline, be socially responsible, make sure that you observe basic hygiene practices. I think that is the best way to protect yourself.”
“I thank the Member. In fact, the Minister for Communications and Information is part of the task force. One of his main jobs is to look at public education, to share with Singaporeans more information and timely information so that they are better prepared. Things like fake news or wrong information ought to be clarified so that they know exactly what to do, rather than to be misled. As I have mentioned earlier on, there is actually no way to certify a person fit for work and free of the virus. He has to go through the incubation period to make sure that he does not have symptoms, then he can go back to work. So, if you are in doubt, you have been exposed, the best is to exercise precaution, exercise self-discipline, be socially responsible and make sure you wash your hands very regularly. That is the best way to protect yourself and your loved ones. Whenever in doubt, whenever there is a suspected case or a confirmed case, we will advise the premises on how to clean it. Especially for the confirmed case, NEA officers will be on the ground to provide supervision and they will also have nominated contractors that are trained to follow a certain protocol to clean and disinfect the premises to prevent further spread of the disease. Practices are in place, protocols are in place, but the Member is right that we need to educate the general public so that they understand that these places are rendered safe and secure, and there is no need to stay away from these places. You can see the list getting longer and longer, because we do expect to see suspected cases emerging from time to time, going forward. Even though we have travel controls, we will continue to see suspected cases.”
“If they have potential risk of contamination, they will put them aside, give them a mask to wear so that they do not contaminate others. These are the practices that have been put in place. But whatever precautionary measures we have put in place, we must be very mindful and be very cautious. If we are careless, none of these measures will help us. Therefore, we constantly remind our healthcare workers to remember to be cautious, to protect themselves and, at the same time, protect the patients.”
“Healthcare workers are one of our most important resources in a disease outbreak like this, and they are right at the frontline, they are facing the disease and the patients every day, every hour, and, therefore, we need to make sure that they have adequate protection. Despite the best protection, in some cases, healthcare workers are infected. In cases like in China, for example, and very often, this happens at the initial stage of the outbreak because healthcare workers are unfamiliar with the virus, they may not understand that it is infectious or it is as infectious as we are seeing, so, therefore, the precautions may not be adequate. As time progresses, when we get to know the virus better, the protection measures will be enhanced. For us in Singapore, we have stepped up our protective measures and particularly because we have gone through the experience of SARS and several other disease outbreaks. These are very painful lessons in our memory and, therefore, our healthcare institutions have exercised extra caution when they deal with these infected patients. In NCID, for example, there are well-established protocols, including monitoring of how you put on your Personal Protective Equipment (PPE) or how you take it off. There is also a second person monitoring how you do it to make sure that you follow every step carefully. Once you miss a step and are exposed, you will have to be quarantined to make sure that you are not infected. Our healthcare workers and our healthcare institutions are very mindful of the risks that are involved. Our frontline workers, those who are in the Emergency Department, our GPs, they are also very alert to the potential risks. As soon as patients arrive at their clinic, they will be triaged.”
“I thank the Member. It is an important question. Maybe I should explain that in the event of widespread community transmission, wearing N95 masks is probably not the solution. N95 masks are generally used by the healthcare professionals. We have used it for the haze. In fact, we have kept telling people that you do not need the mask for the haze. Anyway, people still wear them for the haze. Therefore, as Ms Irene Quay has mentioned, if you do not fit it properly, the mask really does not protect you. In fact, we are most likely going to introduce social distancing, as I mentioned, manage the crowd gathering, minimising human-to-human interaction, rather than to introduce the N95 mask for general use. If need be, we will carry out the necessary education to reach out to Singaporeans to explain to them how to protect themselves. I think to teach each of them how to wear the N95 mask to be as effective as in the healthcare environment is going to be quite difficult and you may end up giving them a false sense of security. And as a result, you may end up with more infections, which is counterproductive. I would say that the N95 mask is not going to be the main focus for outbreak control, if there is extensive community transmission.”
“Mr Speaker, maybe I can just supplement what Minister Ong Ye Kung just said. The question from Mr Yee Chia Hsing highlights an important point, that for every measure that we contemplate about introducing, there will always be an impact on the society. And therefore, we have to evaluate and assess every measure very carefully, taking into account the impact on society, as I have mentioned in my speech. None of the decisions or measures is easy. We are always weighing the pros and cons and, eventually, we have to decide what makes sense for us. So, I would assure Mr Yee that when we make a decision, whether it is school suspension or any other decision, we will always take into account the impact on individuals, on the society, on different groups of people. We want to make sure that for those who are affected, we do our best to help them address their concerns and their problems.”
“One of the roles or duties of the task force is to make an assessment as the situation evolves and decide what are the appropriate measures to introduce when the time comes.”
“If we are able to react quickly, able to contain patient C and patient B, then we will be able to contain the spread. For example, if patient C is a contact of patient B, and we are able to trace patient C once we identified patient B, even it has been transmitted to patient C, then we are still able to say that patient C is probably contained. And therefore, the likelihood of a widespread community transmission is less likely. But there is also a scenario which I mentioned in my speech, where there is widespread community transmission, meaning there will be multiple clusters of infection where there are no clear links to any source of infection.Therefore, you would then assess that it may be transmitting from one person to another quite directly and there is no way for us to have contact tracing for them because they have many, many contacts. In such a situation, you may then need to assess what is the landscape at that time, what are the risks that are involved. As I mentioned in my speech, we may have to begin to look at how we can reduce or restrict human-to-human interaction. One example is to cancel or terminate all the major gatherings where you have thousands and thousands of people, as well as to minimise the risks of transmission. There is also the possibility that we may suspend some schools or all schools, depending on the situation so as to minimise the interaction of children at schools as well as the parent interaction. These are all possibilities. But exactly which steps we are going to introduce will depend on the exact nature of the community spread. We have a framework of various options that are available and each of them will be deployed depending on the situation prevailing at that point in time.”
“Thank you. There are collaborative efforts between our research institutions to look for a solution both in terms of treatment as well as vaccines. The first step is to better understand the virus and how it evolves and how it behaves so that we can then develop appropriate vaccines. There is already ongoing collaboration and we continue to explore opportunities. These collaborations are between our research institutions as well as companies which are involved in some of these development of vaccines. There are ongoing platforms for this collaboration. WHO and the various international organisations also provide platforms for sharing of knowledge and information. China, for example, has, very early on, already sequenced the virus and it was posted on the WHO website so that all the research institutions globally can have access to the sequencing, so that they are able to carry out their own research and enhance the knowledge and understanding of the virus. This area is quite vibrant and we have quite a few entities that are involved. Some of them, of course, involve commercial undertaking and, therefore, there will be some commercial sensitivity as well. There are avenues for this to continue and we want to also encourage more collaboration globally. The second question is: what are the protocols involved in a community spread? It depends on the different types of community spread. The first possibility is a very limited community spread, meaning it could spread from person A to person B, and then person B passes it on to person C. So, person C has no direct relationship to person A. And, therefore, it is a secondary transmission. It is also a form of community transmission but this transmission is likely to then be quite limited to one or two generations.”
“I could not quite get the first question. Could the Member repeat that?”
“I will deal with the first two questions and leave it to Minister Lawrence Wong to deal with the last question. First, on the status of the 18 confirmed cases, I gave an update in my speech earlier. All of them are isolated and being supported in our hospitals. Most of them are improving and we hope to be able to see a discharge soon. But that is something that we are working towards. We will continue to provide them with support. Currently, there is no known curative treatment. That means, we are not able to definitively cure a person. There will be news of possible discoveries because scientists are working overtime to make sure to put in efforts to discover ways to contain the virus and treat the virus and also to prevent the virus through vaccines. So, I think vaccines and curative treatment are being looked into. But I think it will take time to develop the method and to also test the treatment to make sure that they are effective and safe for patients. So, it is not going to happen overnight. It may take quite a while before we see a curative treatment being determined. During this period, it is better for us to focus on how we can manage, contain the spread and put in the necessary measures to protect our population.”
“I will ask Minister Lawrence Wong to answer the question on the quarantine facilities. On the masks, it is a more general question for children's masks. As we mentioned or explained multiple times, the mask is to protect the person not wearing the mask. So, the mask is to prevent the cough and sneezes from the person who is sick. So, for that purpose, for younger children, the mask can be used because it is just preventing them from spitting out their sputums or their sneezes, to prevent the droplets from going out. With some adjustments, the masks can be used for younger children. And if they really cannot be used, then what you should do is to use a handkerchief or whatever to cover the mouth to prevent it from spitting out and to observe hygiene. If you do that, please wash your hands. If you have to go to the hospital or clinic to see a doctor, you can use a mask. If the child is sick and if there is no need to go out, please do not take him out. Keep him at home so that he can rest and recover as soon as possible. Dr Vivian Balakrishnan asked me to read this. He said while I was giving my speech, he had observed that 13 out of 41 Members of Parliament sitting opposite us touching their faces within the 25 minutes. Therefore, touching face is not easy to avoid, but please wash your hands. So, it was not just Dr Intan Mokhtar, I just wanted to clarify. Between then and now, another 13 would have done it. So, please just observe personal hygiene, wash your hands regularly. That will protect yourself and protect many people.”
“But at the same time, part of the plan is to see how we can reorganise ourselves into an emergency crisis mode, an outbreak mode, so that we can operate differently. Some of the medical care that is non-urgent, some of the elective procedures, for example, may need to be postponed. We may manage them in a different way so as to lighten the load on our core medical manpower. All this is part and parcel of our contingency plans. We have the plans in place.”
“Let me address the first question and maybe Minister Ong Y Kung, with the permission of the Mr Speaker, can address the second question. On the manpower requirements, yes, in fact, there is a heightened need for manpower because of the intensity that we are going through – testing of the cases, quarantining them and managing them; and the management is quite intensive as you can imagine. We also need to look after the suspect cases to detect signs of infection when they occur. We require a lot of manpower and the rest of healthcare needs need to continue to be met. Therefore, we have been working with our clusters to ensure that there is sufficient manpower and to make sure that their schedules are also properly looked at. I reminded the group chief executive officers just recently that we need to plan for the long term. It is not dash to the end point because we need to be prepared that this may take months. Therefore, whatever duty schedules, rosters and so on have to be planned on a sustainable basis to ensure there is sufficient turnaround and sufficient rest given to our doctors, healthcare workers so that they are able to sustain in the long term. So, these are part of our plans. We do have contingency plans in place to ensure that we have sufficient manpower to cater to situations like these. In terms of volunteer manpower, yes, this is also part of the plan for our clusters, our hospitals to call back some of the volunteers. Some of those who are on leave also volunteered to come back and have said, "Why not I come back and help to supplement the manpower?" So, I think, all these are in place and, as we go along, we will continue to augment our manpower resources.”
“If there are any symptoms, wear a mask as you go to see a doctor and tell the doctor your travel history, that you have been to Wuhan or you have been to China, so that all these factors can be taken into account when we assess the patient. But please do not go to the hospital to ask for blood tests in order to get a certificate that you are free from coronavirus. It is just not possible for such certificates to be issued and you will just load the hospital unnecessarily. Secondly, Dr Lily Neo asked about ambulance services. We have ramped up our ambulance services in order to respond to this outbreak situation. And these ambulances are used to convey those who are suspected cases because we want to make sure that they are protected and isolated while we are transporting them to hospital for testing. In the initial first few days, there were some organisational difficulties among the service operators. We have sat down and discussed with them and the logistics are managed better now. Sometimes, when there is a peak, it may take a while, few minutes, an hour, but we try to respond as soon as possible. We have also set up a hotline for the doctors to call. This is operated by our College of Family Physicians that we help to answer queries, whether it is ambulance or any other thing. So, we do recognise that, in the initial days, we do have some logistics difficulties in organising our ambulance responses. And every time we change our case definition, it is also quite natural that it will suddenly have a larger number of suspected cases because, when you change the definition, the definition will include a bigger catchment and, therefore, we will need to adjust our logistics support accordingly.”
“I would like to thank Dr Lily Neo for her two very useful questions. I can expect her to raise very important questions like these. First, on the certificate for coronavirus-free individuals. Actually, there is no such thing as a coronavirus-free certification. The reason is because we test the patient based on his viral load and there is an incubation period during which the patient may have very low or zero viral load. But at the same time, because it is the incubation period, the virus may emerge later on. Therefore, at any point in time, when we test a person, when it is negative, it does not mean that he is virus-free. He may be virus-free at that moment, but he may already have been infected but is within the incubation period. So, it is not possible for our hospital or for any screening centre to give a certificate that this person is virus-free. We can only say that, for this moment in time, the test shows no virus detectable in his bloodstream. But the virus can emerge the following hour or the following day. Therefore, it is not possible to give a free-from-disease certificate, as what Dr Lily Neo was alluding to. I would also like to take this opportunity to urge employers not to send their workers to our hospitals for testing in order to certify their workers as virus-free. As I have explained, first, it is not possible for such certification to be issued; second, you are simply loading our hospitals unnecessarily. So, the best way to do it is to monitor yourself if you have been exposed to contacts, or, if you have come back from China, monitor your own health for 14 days. This is the incubation period.”
“Let me conclude by once again appealing to Singaporeans to work together with us in this fight. I am very heartened by the many examples of volunteers stepping forward to support our efforts. Indeed, this effort requires a whole-of-Singapore response. I have elaborated on the public health measures that we have put in place. Minister Lawrence Wong will elaborate on the other measures. We seek Singaporeans' understanding and cooperation. I would also like to acknowledge once again our healthcare workers on the frontlines and commend them for their bravery and selflessness. Let us stand together and show our support for them. We understand that Singaporeans may feel anxious, given the many unknowns about the novel coronavirus. Here, I want to reiterate the Government's firm commitment that we will spare no efforts in protecting our people. We will act swiftly and share information on the novel coronavirus openly and as soon as possible. We have overcome several challenges as a nation in the past – SARS, H1N1 and Zika. In the face of this novel coronavirus, we have built up our defences, our capabilities and we are stronger and more prepared. While we cannot be complacent, we must remain calm and confident. This is a fight that calls on every individual to do our part. We are confident that we can manage and overcome this challenge as a nation and emerge stronger together. [Applause.]”
“Secondly, there could be community spread locally. Despite our best efforts, this is a possibility that we must be ready for. The key to managing this is quick detection and limiting further spread, which calls on social responsibility from all of us. If the infected Singaporean wears a mask to protect others and promptly sees a doctor and gets triaged for testing, the risk of further spread can be greatly reduced. Even if there is spread, quick action will help to limit its extent. Once tested positive, the Government will contact-trace quickly, helping to reduce further spread to their close contacts. If the community spread becomes very extensive, we will need to consider measures to reduce human-to-human interactions, such as cancelling mass gatherings, suspending schools, paring down non-essential care services and introducing further infection control and monitoring measures, to slow the spread. Third, the virus could mutate to become more infectious and spread widely, resulting in a pandemic. This is the known unknowns. And we have to assess what best to do, depending on how the virus mutates. It may also become less infectious on the other hand and less severe, but it is a scenario that we worry about when it comes. On the healthcare front, we are stepping up preparations for these potential scenarios. For example, we have increased our capacity of isolation beds by around 100 in the past two weeks. We have also been increasing our testing capacity, to enable us to more quickly to confirm suspect cases. Overall, we must stay calm, but cautious. Our early intervention efforts have helped to contain the spread so far, but while we hope for the best, we must plan for the worst.”
“We have instituted strict safety policies and procedures in our hospitals and other healthcare providers. For example, healthcare workers managing cases are required to don personal protective equipment and this ensures that they are protected from the virus. Instead, let us stand together, stand behind them and support them in this period. They may be our friends and family, or even strangers that we meet on the streets or public transport. A smile, a kind word or an encouraging message goes a long way towards helping them keep their spirits up and know that we are behind them. I am also very encouraged by our various community-led efforts. For example, Akram Hanif and his youth volunteers have been engaging a group of about 45 young adolescents and youths at Marsiling Community Centre/Club (CC) to instil in them good values and character. Akram had organised the kids to draw a banner to thank our frontline medical staff from Tan Tock Seng Hospital and encourage them to press on. There could be a long road ahead. SARS took about eight months from the first detected case in November 2002 till the WHO declared the SARS outbreak contained in July 2003. We are not sure how long this virus will turn out. Therefore, we must stand ready to respond to new developments as the situation evolves. There remain risks ahead and we are preparing for the various contingencies. Let me share some of these scenarios. First, there could be community spread in more Chinese cities beyond Wuhan or in other countries. We may need to roll out additional measures to prevent the importation and to contain the virus. The decision to do so would again not be an easy one. We have to do what is necessary to protect the health and safety of our people and those who travel to Singapore.”
“Dr Lam Pin Min and I recently met a group of GPs, including representatives from the Singapore Medical Association (SMA) and the College of Family Physicians Singapore (CFPS), to hear their feedback and see how we can support them. Our hospitals will similarly isolate any individuals that present themselves at the emergency department who meet the case definition and test them to determine whether they are infected with the novel coronavirus. I would like to extend my sincere appreciation to all our healthcare workers and their families. They have worked tirelessly over the last few weeks, missing their holidays or reunion dinners. They work very hard to keep Singaporeans and Singapore safe. Their families may also need to take over caregiving duties at home or make alternative arrangements as these healthcare workers work overtime to manage the cases. Let me give Members an example. Dr Margaret Soon, the Director of Nursing at NCID. She is an exemplary leader. She was a veteran from SARS, and an Infection Control Nurse. Dr Soon immediately rose to the occasion when we activated NCID. She led her team to prepare the isolation rooms, held townhalls to update the NCID nurses and ensured that her nurses had adequate essential supplies, such as protective gowns and masks. Throughout this period, she was out of the house before sunrise and mostly back only after her family had gone to asleep. She had to cancel a family trip during the Chinese New Year period, but her family understood and was supportive. This included her daughter, whom she was pregnant with during SARS. Stories of such dedication like Dr Soon's abound in our healthcare community. I would also like to emphasise that there is no need to avoid our healthcare workers during this time.”
“All of our confirmed cases are Wuhan residents or persons who had recently travelled to Wuhan. There is no evidence of community spread in Singapore. Many of them stayed mostly at their hotels or with their family in their family's homes, and did not move around extensively. However, some of them did visit our tourism sites, such as Gardens by the Bay and Orchard Road, where any interactions would have been transient. The confirmed cases are being treated at various hospitals and their conditions are stable and most of them are improving. With each confirmed case, we will conduct contact tracing. We will check on the health of these contacts and if they are unwell with fever, cough or other respiratory symptoms, they will be classified as suspected cases. We will arrange for them to go to hospitals via a dedicated ambulance for isolation and testing. For contacts that are well, we adopt a risk-based approach. For close contacts, they will be put under quarantine for 14 days since their last contact with the confirmed case. For other contacts, they will be put on active surveillance with daily health checks by MOH, as the risk of infection is lower for them. The detection and management of suspect cases and proper care and isolation of these confirmed cases would not have been possible without our healthcare providers and professionals. They are our key partners in this war against the novel coronavirus. Our polyclinics and GP partners play an important role in identifying and notifying MOH of any cases that meet the case definition so that they can be followed up.”
“These include temperature and health screening at all checkpoints, land, sea and air, as well as international travel controls. Second, we have measures that help us to detect and contain the virus and prevent it from spreading further. We have good surveillance systems to identify cases. Our healthcare providers, especially our polyclinics and general practitioners, are right at the frontline. They are on heightened alert and stand ready to deal with cases as they emerge. Third, and perhaps most importantly, all of us must play our part and exercise social responsibility, to prevent or stem any possible spread of the coronavirus in the community. We should also be considerate for others around us and lend a hand as a community to support one another and stay united. None of these measures on their own is fool-proof. But when taken together, they will improve our resilience and ability to respond to this disease. Let me elaborate on the key role that the healthcare system plays in the defence of this novel coronavirus. Minister Wong will touch on the other measures. Our healthcare providers play a key role in the detection and isolation of suspected and confirmed cases. Our frontline doctors, polyclinics, general practitioners (GPs) and Emergency Department doctors are on high alert for persons with travel history and respiratory symptoms, such as fever and cough. Such persons will be assessed, isolated and tested for the novel coronavirus. We will also test samples from our influenza surveillance systems and hospitalised pneumonia cases for novel coronavirus to pick up unlinked cases, if any. Let me take the opportunity to provide an update on the confirmed and suspected cases.”
“In April 2018, a Joint External Evaluation by the WHO experts stated that Singapore had demonstrated strong leadership and high capacity to detect and respond to potential public health emergencies. We had followed the situation in Wuhan closely since December 2019 and we had responded rapidly, putting in place a series of measures to reduce the risk of import and spread of the virus since early January 2020. These include the implementation of temperature screening at the airport and we also alerted all our medical practitioners to be vigilant. Once we saw a significant increase in confirmed cases in Wuhan, I decided that it was necessary to set up a Multi-Ministry Taskforce. I asked Minister Lawrence Wong to co-chair this, and invited the Deputy Prime Minister as our advisor. The Taskforce is to plan and coordinate whole-of-Government efforts so that we can mount a national response quickly and effectively. Representatives from the Ministries of Home Affairs, Social and Family Development, Transport, Education, Manpower, Trade and Industry, Communications and Information, the Environment and Water Resources, and the Labour Movement are all involved. The list is very long, but it is a reflection of the multi-agency coordination that is required. As the global and local situation evolves, the Taskforce has stepped up our measures accordingly, taking into careful consideration relevant factors, including the impact on our society. We had set up multiple lines of defence to reduce the risk of imported cases and local community transmission. We have been stepping up our posture and efforts at each line of defence. First, we have measures that serve to prevent further importation of the virus into our shores.”
“So, this is when a mask is needed – when we are unwell and have to go out. Persons exposed to the virus may be well for a few days before developing symptoms, such as fever or cough. Some may develop pneumonia eventually. There is currently no known curative treatment for the novel coronavirus. Development of a successful cure may take time, maybe months or years. The current approach is to provide good supportive care for the patients to reduce complications and to allow time for the patient to recover. The current case fatality rate stands at about 2% to 3%. The majority of the deaths are among those with underlying medical conditions. The fatality rate seems lower than SARS, which was around 10%. But we are still at the initial stages of the outbreak and the actual severity can only be assessed properly in time to come. Regardless, the Government’s response has been, and will continue to be swift and decisive, to contain the spread of the virus here. Let me elaborate on the preparation we have made and measures that we have taken. We have been preparing for the possibility of an infectious disease outbreak like this one since SARS. We have been building capacity and capability in addressing infectious diseases, such as SARS, MERS, H1N1, and more recently Zika and Monkey Pox. We had strengthened our epidemiological surveillance and containment capabilities and our agencies hold regular emergency preparedness exercises to keep themselves operationally ready. In addition, we have set up the National Centre for Infectious Diseases (NCID), a purpose-built facility to strengthen our ability to manage the outbreak of infectious diseases. It is benchmarked to international standards and best practices for treatment and safety.”
“There is evidence of limited spread from a person without symptoms during the incubation period. However, this form of transmission may be uncommon and has so far involved isolated cases only. At this point, the evidence still points towards higher transmissibility when the person is displaying symptoms. As such, medical professionals both overseas and in Singapore have advised that the most effective way that we can protect ourselves is to practise good personal hygiene. We should regularly wash our hands with soap and water, and avoid touching our face with our hands. These may sound simple, but are actually very difficult to do because all of us touch our face all the time. Even in a meeting that we had with the Multi-Ministry Taskforce while I was speaking, I was touching my face until Minister Lawrence Wong nudged me with his elbow and said, "Stop touching your face". So, it is simple but effective in preventing all kinds of infection. Potential infection from asymptomatic persons, in fact, is less likely to be from coughing or sneezing directly because they do not have symptoms, such as sneezing or coughing, but more likely by touching contaminated surfaces, for which masks offer no protection. Wearing a mask when we are well often give us a false sense of security instead and we are more likely to touch our faces when we constantly adjust our masks, which is one way the disease spreads. At the same time, we need to protect others – our loved ones, friends, colleagues and fellow Singaporeans that we come into contact with. If we are sick, we should rest and recover at home as far as possible. If we do need to go out to see a doctor, for example, we should wear a surgical mask to protect others.”