Ong Ye Kung
Singapore
“The Ministry of Health (MOH) recently enhanced the Community Health Assist Scheme (CHAS) dental subsidies, which are tiered by income, for common preventive and restorative procedures.”
“Healthier SG GP clinics may also refer their enrolled patients to Active Ageing Centres and Community Health Posts to fulfill their social prescriptions and for subsidised services, such as medication management.”
“Public hospitals, such as the National University Hospital, the Singapore General Hospital and Tan Tock Seng Hospital, have deployed robotic-assisted surgical (RAS) systems for minimally invasive soft-tissue surgeries.”
“The Health Sciences Authority (HSA) welcomes drug producers to choose Singapore as part of their first-wave filings. As long as a pharmaceutical product is approved by at least one regulatory agency, such as China's National Medical Products Administration (NMPA), it would also qualify for the abridged route.”
“A decrease in estimated glomerular filtration rate in patients with diabetes can be due to multiple reasons. Doctors will first investigate the underlying cause before determining whether the patient should be referred to a specialist. Some causes are reversible and cause transient reduction in renal function.”
“Information on the Lasting Power of Attorney (LPA) cannot be made visible on the National Electronic Health Record system as it is protected under the Mental Capacity Act. Such information may only be disclosed by the Public Guardian to specified persons upon satisfactory submission of evidence(s) required under the law.”
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“While our healthcare workers are very busy and stretched, it is a different level of intensity as during the Delta wave. Some countries have reported that their healthcare workers are resigning in droves. Here, the attrition rates of doctors from our public acute hospitals have remained comparable to 2019, before COVID-19 hit, about 3% to 5%. For nurses, the average attrition during the two COVID-19 years of 2020 and 2021 is about 8%, comparable to 2019. Absenteeism rate due to COVID-19 has been manageable and is about 2% now. We do not take this for granted, and will continue to support our healthcare professionals. We are also working closely with clusters to help them recruit new healthcare workers. We will continue to monitor the key indicators closely to make sure our healthcare system can cope as we ride through the Omicron transmission wave. Once it has peaked and start to subside, we can look forward to easing our safe management measures.”
“Currently, we have around 130 patients who require oxygen supplementation, which is about 40% of the peak of the Delta wave. As cases rise, we expect this number to increase in parallel but with every hospital bed equipped with oxygen supply capability today, this is not a constraint. Finally, hospitalisation. There are about 1,200 COVID-19 cases who are currently hospitalised. Of these about 30% are "incidental cases". This means they are admitted for non-COVID-19 conditions and subsequently found to have COVID-19 during their stay because we test every patient. This group, typically, has no or very mild symptoms. In other words, they do not take up extra beds due to their infection. So, the extra workload on our hospitals is two-thirds of the 1,200 hospitalised cases. Further, most Omicron patients also have a short hospital stay of about three to four days, compared to five to eight days for patients infected with the Delta variant. It means beds are freed up faster. I would say hospital beds are probably the biggest constraint now. However, as symptoms of Omicron patients are often not very severe, there is a lot of scope for us to right-site the patients at COVID-19 Treatment Facilities (CTFs) instead. Today, we have approximately 3,800 CTF beds and only a quarter are occupied. We also have plans to ramp up to approximately 4,600 beds by the end of February. So, looking at these indicators, our healthcare system is able to handle the Omicron wave. But beyond beds and equipment, we need to monitor the state of healthcare manpower. Our healthcare workers have been battling the pandemic at the frontlines for more than two years now. They have persevered through the Delta wave and are now fighting the Omicron wave. I want to convey my deepest appreciation to them.”
“Because of these reasons, while the daily infection numbers are high, the vast majority of cases have mild or no symptoms, and very few develop severe illness and require oxygen supplementation or ICU care or have passed away. Let me start with what concerns us most, which is deaths. During the peak of the Delta wave, from late October to early November 2021, we saw about 13 COVID-19 deaths a day. In the past two weeks, despite cases being three times more than during the Delta wave, we saw on average two to three deaths a day. But there had been days where deaths were also more than five. We have to watch the trend very closely, but, for now, the case mortality due to the Omicron variant is not very different from the number of deaths related to various viral infections pre-COVID. Prior to COVID-19, over 4,000 patients a year (or over 10 a day) passed on due to pneumonia, usually caused by infections. Next, ICU. Currently, about 0.05% (five in 10,000) of our COVID-19 cases ever required ICU care. At the peak of the Delta wave, about 170 ICU beds were occupied by COVID-19 patients. Now, despite three times the daily caseloads, we have about 30 patients in the ICU across our hospitals. Of these, about 60% are intubated. Further, duration is also shorter, typically three to five days, compared to patients infected with the Delta variant, who would stay on average, 11 days. We have 113 ICU beds now and we can ramp up to 350 at short notice. This can be further stepped up to 500 ICU beds should the need arise. So, unlike during the Delta wave, the ICU wards are not coming under pressure and is in good shape. As for oxygen supplementation, about 0.3% of Omicron cases ever required it.”
“I will address this question along with Question No 39 for Written Answer on the Order Paper for 14 February 2022, and Mr Gerald Giam's Parliamentary Question filed for a subsequent Sitting. Members have asked if we can ease up on safe management measures and, specifically, to allow more social activities and groupings of more than five. As earlier indicated by the Multi-Ministry Taskforce, once conditions permit, we will do so and, like most Singaporeans, I am looking forward to it. Whether and when we can do so depends on the epidemic situation. One aspect is the daily infection numbers, which are around 10,000 cases a day. The week-on-week infection growth rate is close to two. All these are within our expectations. As I have updated the House earlier, because Omicron is highly infectious, we should expect daily cases to reach 15,000 to 20,000, or even more. The top line daily infection number tells us where we are on the epidemic curve. But as we have emphasised before, what is more critical is its impact on disease severity and on our healthcare capacity. So far, the impact has been significantly more moderate for the Omicron variant, compared to the Delta variant. There are two reasons. One, Omicron is, inherently, a less severe variant compared to Delta, as it tends to infect the upper respiratory airways. Two, the high percentage of our population having received vaccinations and boosters. Today, we still observe a significant difference in incidence of severe illness amongst the vaccinated and boosted, and the not fully vaccinated, especially amongst seniors. So, vaccines continue to make a huge difference.”
“This question will be answered in my reply to Mr Gerald Giam and Mr Yip Hon Weng in the next Sitting. [Please refer to "Assessment of Use of Non-mRNA COVID-19 Vaccines in Wider Population", Official Report, 15 February 2022, Vol 95, Issue 48, Oral Answers to Questions section.]”
“Between 11 October 2021 and 31 January 2022, about 887,000 Health Risk Warnings (HRWs) were issued. Close to 60% were household contacts of COVID-19 positive cases, while the remainder were identified by TraceTogether, SafeEntry or other forms of contact tracing. The proportion of HRWs who eventually tested positive for COVID-19 was 10%. Household contacts are more likely to be infected than workplace or social contacts picked up by TraceTogether.”
“MOH is also working in close partnership with private healthcare providers to help augment the capacity of our public healthcare system.”
“Public healthcare workers follow the same MOM advisory on work and leave arrangements for employees who test positive for COVID-19. Under these guidelines, those who are assessed by a doctor to be mildly symptomatic and of low risk will be given a 5-day medical certificate (MC) and advised to self-isolate at home for 72 hours. At the end of 72 hours, they can perform a self-test ART and choose to return to work if they are asymptomatic and the self-test result is negative. If they continue to test positive, they have to continue to self-isolate until they obtain a negative self-test result or until Day 7 (if vaccinated) or Day 14 (if unvaccinated) where Day 1 is the date of the first positive ART test. In addition, healthcare workers would be in appropriate personal protective equipment (PPE) for their work setting and follow the necessary workplace safe management measures. Healthcare institutions may deploy these recovered healthcare workers in lower-risk settings to minimise direct contact with seniors and vulnerable patients, or work in COVID-19 settings where there is no risk of reinfection. While the majority of those who are infected are physically well or have mild symptoms, public healthcare workers who need to care for an affected child or elderly parent in self-isolation will be allowed to work from home (WFH). If work from home is not possible, staff may be granted unrecorded paid leave for the duration where the child or elderly parent is unwell. To ensure that our healthcare system is not compromised, MOH is working closely with the public healthcare clusters to monitor the staff strength in each institution. Institutions may also adjust their internal manpower deployment across departments where feasible, depending on workload and staffing needs.”
“This question for written answer has been addressed by the oral reply to Question No. 105 on the Order Paper for 10 January 2022. [Please refer to "Necessity of TraceTogther SafeEntry Requirement Given New Protocols for COVID-19-positive Patients", Official Report, 10 January 2022, Vol 95, Issue 44, Written Answers to Questions for Oral Answer not Answered by End of Question Time section.]”
“MOH does not track the number of households in Singapore with at least one person requiring adult diapers on a regular basis. However, seniors requiring adult diapers can apply for subsidies, through the Seniors’ Mobility and Enabling Fund (SMF). Eligible seniors can receive up to 80% subsidy, up to the maximum annual subsidy cap. In 2021, more than 6,100 seniors applied for SMF for home healthcare items, of which about 5,700 applied for adult diapers. For these applicants, the median expenditure per person for the nine-month period between April and December 2021 was around $400 before subsidy.”
“The transport costs incurred by patients with mobility needs vary depending on the type of transport required, the frequency of appointments, and the proximity of the medical appointments to their homes. The Ministry of Health therefore does not track such costs. Seniors who are unable to travel independently for their medical appointments can tap on the Medical Escort and Transport (MET) service for medical appointments at hospitals, specialist outpatient clinics and polyclinics. Eligible seniors can receive up to 80% subsidy. Seniors who require MET services may call the Agency for Integrated Care’s (AIC) hotline or approach a nearby AIC Link for help.”
“The data required are as follows. 2021 data is not available. Public hospitals and polyclinics do not track the proportion of patients who have mobility needs or require caregiver assistance. All hospitals and polyclinics stand ready to assist patients with mobility needs. For example, service ambassadors or healthcare assistants would assist these patients during their clinic visits, including the loan of wheelchairs and supporting them in way-finding. Wheelchairs are also provided at facility entrances, clinics, and drop off points for patients who require mobility assistance.”
“Serious side effects caused by vaccines are rare. This applies for COVID-19 vaccines or vaccines protecting against other conditions. Most side-effects are mild, appear within the first three days and resolve with no treatment. Rarely, side effects can develop up to six weeks after vaccination. Applications for the Vaccine Injury Financial Assistance Programme for COVID-19 Vaccination (VIFAP), will be considered thoroughly, taking into account the details of the medical episode that occurred post-vaccination, together with scientific information and evidence.”
“Singapore has been closely tracking the development of COVID-19 treatments globally and actively engaging pharmaceutical companies to secure supplies of key therapeutics. To date, we have built up a portfolio of COVID-19 therapeutics comprising five classes of drugs – steroids, anti-virals, monoclonal antibodies, IL-6 inhibitors and JAK inhibitors. These are currently in use in our hospitals to treat COVID-19 patients with severe disease. HSA is currently reviewing the data for recently developed oral anti-virals Molnupiravir and Paxlovid, to ensure that they meet the requirements for quality, safety and efficacy for interim authorisation for use in Singapore. No regulatory filing has been received for SaNOtize’s nitric oxide nasal spray. The use of therapeutics reduces the risks of developing severe disease in COVID-19 patients, which consequently reduces the need for hospitalisation, oxygen supplementation and intensive care. Notwithstanding the use of treatments, a large number of COVID-19 cases could still result in a significant number of individuals requiring hospitalisation or intensive care, and place significant pressure on our healthcare system. It is therefore important that we prevent transmission through vaccines and safe management measures.”
“This question for written answer has been addressed by oral reply to Question Nos 13 to 15 on the Order Paper for 10 January 2022. [Please refer to "Assessment of Effects of COVID-19 Vaccines on Younger Children and Singapore's Decision to Extend Vaccination to Younger Children", Official Report, 10 January 2022, Vol 95, Issue 44, Oral Answers to Questions section.]”
“Currently, clinical psychologists are not registered under the Allied Health Professions Act. Hence, the Allied Health Professions Council does not have the power to investigate complaints against clinical psychologists. However, the services provided by psychologists in hospitals will be subject to the clinical governance framework of the hospitals and existing healthcare legislations such as the Private Hospitals and Medical Clinics Act. Our local degree programmes in psychology also ensure the supply of properly qualified psychologists.”
“The threshold of 24 weeks was based on scientific evidence of foetal viability outside the womb. In 2018, MOH conducted a review involving local medical experts on the threshold of 24 weeks. The review concluded that current guidelines should continue, as the survival for premature babies born at 24 weeks was about 50% and for premature babies born at 23 weeks was about 20%. The babies who survived had a very high risk of severe and long-term problems such as neurodevelopmental disabilities. Updated data for 2019 to 2020 from two local public hospitals showed that out of the 13 premature babies born at 23 weeks, only six survived to discharge. However, all six who survived also suffered from severe problems such as severe chronic lung disease, brain haemorrhage and retinopathy of prematurity. These neonatal conditions often lead to disabilities, poor quality of life requiring life-long medical treatment and a shortened life expectancy. MOH will continue to monitor these indices and take into account local expert advice and experience.”
“We need some time to collate the inputs from various HR departments of hospitals, in order to know the proportion of public healthcare workers who are unable to clear at least 50% of their accumulated leave in 2021. However, less than one-third of public healthcare workers will not be able to fully clear their accumulated leave for 2021. Our public healthcare institutions have allowed their staff to carry forward unused 2021 annual leave to 2022 and to also allow encashment of up to one-third of the 2021 annual leave entitlement. Thus far, less than 1% of staff have had to forfeit their accumulated leave in 2021.”
“There are various respite care options to support caregivers and seniors with short-term care needs. For example, caregivers can access respite care at senior care centres for a few hours in the day, or at nursing homes for seniors with higher care needs and who need round-the-clock care. As at end December 2021, we have over 450 respite care places. Providers do not maintain places to wait for demand, but will activate places to meet service requests. The availability of respite care places is therefore fluid and providers are generally able to meet the demand. The take-up rate for respite care has decreased during the COVID-19 pandemic as caregivers may prefer to minimise the community exposure of their loved ones. MOH will continue to monitor the evolving needs of our ageing population.”
“Based on the findings from the National Nutrition Survey 2018/19, Singapore residents consumed an average of 3.6g of sodium per day. This is about 1.5 teaspoons of salt. This is also more than the WHO recommendation for adults to consume less than 2g of sodium per day. HPB has encouraged the reformulation of reduced-sodium alternatives for home use. This has contributed to a good variety of reduced-sodium products available in the market, ranging from pre-mixes, soy sauces and soup broths. Since 2018, HPB has also been offering grant support to sauce manufacturers, particularly those supplying into the food service sector, to reformulate their products to meet reduced-sodium guidelines through the Healthier Ingredient Development Scheme. Lower-sodium guidelines was introduced into the Whole-of-Government Healthier Catering policy in May 2021, which requires all caterers engaged by Government procuring entities to use lower-sodium ingredients for all cooking and food preparation. HPB will expand the scope of its efforts to cover salt added during food preparation, which currently contributes more than half of sodium intake in our diet. We will also step up industry engagement to expand the supply and increase the uptake of healthier lower-sodium alternatives by F&B establishments. In addition, HPB will increase public education efforts to raise awareness on the need to reduce sodium in our diet and to generate demand for healthier options. More information will be shared when ready. There are countries around the world that have imposed sodium taxes on processed foods that are high in sodium. These include Hungary, Mexico, Fiji and Tonga. MOH will study this, along with other fiscal and regulatory measures, to see how we can help reduce the sodium intake of Singaporeans.”
“MOH is not aware of any local study examining the relationship between consumption of anti-depressants and suicide amongst youths in Singapore. There are overseas studies that have found an association between the consumption of anti-depressants and increased suicidal tendencies in children and adolescents. An association does not establish a causal link. Nevertheless, before prescribing or dispensing such medication, doctors and pharmacists have to counsel youths and their caregivers on the potential risks, side effects and symptoms that may require immediate medical attention. Particularly during the first few weeks of starting or changing an anti-depressant, caregivers will be advised to closely monitor the patient for new or worsening thoughts of self-harm, suicidal ideation and unusual behaviours; and to seek medical advice immediately if these symptoms present.”
“Singapore's registered doctor-to-population ratio and nurse-to-population ratio in 2020 were 2.6 doctors and 7.4 nurses per 1,000 population respectively. These ratios are on par or higher than other advanced Asian economies like Japan, South Korea, Hong Kong and Taiwan. However, Japan has a significantly higher ratio for nurses, at 11.8, but it also has a much higher proportion of elderly in its population compared to Singapore. However, our ratios are generally lower than western OECD countries. There are however many factors at play here, including clinical practices, operating environments, healthcare financing policies including the role of insurance and western advanced economies generally having more generous social welfare systems funded by higher taxes. All these factors contributed to higher demand and supply for healthcare services. We learn from all systems in the world, but our objective is not to blindly emulate the high ratios in the western system. Nevertheless, due to our ageing demography and rising incidence of chronic illnesses, we expect the demand for healthcare to increase significantly. This will lead to a concomitant increase in national healthcare professional workforce, from 73,000 today to 93,000 by 2030. Our bigger challenge, is not merely to increase manpower to meet demand, but to improve the health of our population and constantly evolve our model of care, to ensure we meet the healthcare needs of patients and keep costs affordable.”
“These questions have been addressed by the written reply to Question Nos 33 to 35 for oral answer on the Order Paper for 10 January 2022. [Please refer to "Impact of COVID-19 on Resignation and Recruitment of Healthcare Professionals", Official Report, 10 January 2022, Vol 95, Issue 44, Written Answers to Questions for Oral Answer not Answered by End of Question Time section.]”
“This question has been addressed by the written reply to Question Nos 36 to 38 for oral answer on the Order Paper for 10 January 2022. [Please refer to "Supporting Mental Well-being of Healthcare Professionals amidst COVID-19 Pandemic and Preventing Burn-out", Official Report, 10 January 2022, Vol 95, Issue 44, Written Answers to Questions for Oral Answer not Answered by End of Question Time section.]”
“MOH and the Agency for Integrated Care (AIC) work closely with residential care homes, or Homes, such as nursing homes, to support the socioemotional well-being of their staff and residents during the ongoing COVID-19 pandemic. Providers regularly check in on their staff’s well-being and provide support to help them cope with stress as well as provide gestures of appreciation for their contributions. Peer support programmes and staff counselling services were also stepped up. Providers also stepped up their use of technology to support their residents’ socioemotional needs, especially when face-to-face visits were suspended. For instance, providers helped residents to connect with their loved ones via video-conferencing on a regular basis. Residents also enjoy virtual activities, such as online programmes organised by partners, including National Heritage Board and Mandai Wildlife Reserves. As part of the transition towards COVID-19 resilience, we have resumed face-to-face visits for fully vaccinated or medically ineligible residents and visitors and we are piloting recreational activities outside of the Homes in a safe manner. For example, in December 2021, approximately 110 seniors participated in trishaw rides around their neighbourhood, as part of a pilot with Cycling Without Age, Singapore. Small group activities for residents, including volunteer-led ones, have also resumed, subject to prevailing safe management measures. We will continue to work closely with providers to monitor and introduce timely measures to enhance residents' and staff's well-being.”
“This question for written answer has been addressed by my reply to Question No 126 on the Order Paper for 10 January 2022.”
“A medicine could be made available over the counter without a doctor’s prescription if the ailment it treats can be self-diagnosed and the medicine is safe and appropriate for self-use without healthcare professional supervision. All medicines presently authorised for the treatment of COVID-19 are Prescription-only Medicines to be used under medical supervision and monitoring. Most of these medicines need to be injected into patients. The oral medicines carry potential risks of serious side effects and interactions with other medicines. Hence, a medical assessment by a doctor is needed, first, to confirm the diagnosis of COVID-19, and to then weigh the benefits and risks of initiating a given medicine for the specific patient, taking into account any pre-existing medical conditions. This is to ensure that the treatment is safe and suitable for the patient and that the risks of any adverse effects are minimised.”
“This question for written answer has been addressed by oral reply to Question Nos 13 to 15 on the Order Paper for 10 January 2022.”
“This question for written answer has been addressed by my reply to Question Nos 33 to 35 on the Order Paper for 10 January 2022.”
“As at end-2020, there were approximately 16,300 nursing home beds, 8,200 day care places and 10,000 home care places. The utilisation rates for these long-term care services were about 90%, 52% and 57% respectively. There is, currently, sufficient capacity for these long-term care services to support the needs of our population. We monitor capacity and utilisation rates regularly and adjust capacity plans accordingly to address changing care needs.”
“This question for written answer has been addressed by my reply to Question No 105 on the Order Paper for 10 January 2022.”
“In 2020, about 10% or 88,000 Singapore residents aged 60 and above lived alone1. We do not track the proportion who passed away alone at home. The Government works with various stakeholders to ensure that seniors, especially those at risk of social isolation, are adequately supported to age in place. Since May 2021, MOH has been rolling out the Eldercare Centre (EC) service model, which provides seniors’ activity, befriending, care and other services for seniors. Befrienders proactively reach out to seniors who require social support through regular home visits and check-in calls. To complement the efforts of the ECs, the Silver Generation Office (SGO) reaches out to seniors islandwide. Silver Generation Ambassadors (SGAs) conduct targeted outreach to seniors, including those who live alone or are frail. SGO will also refer seniors in need to Social Service Offices and Family Service Centres for care and support services. These initiatives keep vulnerable seniors visible and connected within the community and ensure they receive help as needed. Building communities of care is a whole-of-society effort. We need community partners, Government agencies and fellow Singaporeans to work together so that our seniors can age well and leave well.”
“"Long COVID" is not a distinct medical condition or a formal diagnosis and refers to persons who have lingering symptoms of COVID-19 infection. Such patients with persisting symptoms would be assessed and monitored by their physicians and, where needed, referred for specialist care. We have also issued guidance on the approach to patients with persistent symptoms after recovering from COVID-19, as part of broader COVID-19 clinical management guidelines. For vaccinated Singapore Citizens, Permanent Residents and Long-Term Pass Holders (SCs/PRs/LTPHs) who have recovered from acute COVID-19 infection, but continue to remain symptomatic, MOH provides coverage for follow-up Specialist Outpatient Clinic (SOC) visits for up to 90 days post-discharge, if the follow-up is required on public health grounds. In these visits, monitoring and/or retesting would be done to ensure that patients are no longer infectious. If other types of post-COVID-19 care is required, patients will continue to have access to the regular healthcare financing coverage, such as Government subsidies, MediShield Life and MediSave where applicable, to help pay for their bills. Should there be affordability issues, they may also be assisted by prevailing financial assistance schemes, such as the use of MediFund, if eligible.”
“For direct hire doctors, the proportion infected1 ranges from 1% to 2%, while, for nurses, it ranges from 2% to 4%. For outsourced doctors and nurses, the proportion infected is close to 0%. For direct hire administrative and ancillary staff, the proportion infected ranges from 3% to 5%. For outsourced administrative and ancillary staff, the proportion infected ranges from 3% to 6%, with the exception of NUH, CGH, KTPH and IMH2, where the proportion infected among outsourced staff was higher, ranging from 7% to 10%. For these institutions, the higher proportion infected was largely due to disease clusters among housekeepers and maintenance staff. These are jobs that are predominantly outsourced and there are very few workers in our institutions with comparable job descriptions. In general, the risk of infection for cleaners and equivalent job roles, such as housekeepers, is higher than that of the general community due to the nature of their work, such as removing rubbish and cleaning contaminated bedsheets. In addition, there was spread among housekeepers and maintenance staff due to lapses in compliance to safe management measures in staff rest areas. MOH has since worked with institutions to ensure appropriate use of personal protective equipment and reinforce safe management measures within the rest areas for staff in the public healthcare institutions.”
“The proposed integrated development at Jalan Damai, comprising the new Kaki Bukit Polyclinic, kidney dialysis centre and nursing home was first announced in November 2019 to be completed by 2025. However, we estimate that the completion will be delayed by one year to 2026. This is because additional time is needed to improve the design of the new polyclinic for better infection disease control. This will ensure that the new polyclinic can be future-proofed against new pandemics.”
“Among migrant workers (Employment Pass, S Pass and Work Permit holders) infected with COVID-19 reported between 1 January 2021 and 27 December 2021, 99.9% had no or mild symptoms, 0.11% required oxygen supplementation, 0.021% were in the intensive care unit and 0.0042% passed away from complications due to COVID-19 infection. The data is based on the worst-ever condition of each COVID-19 case.”
“All returning Singaporeans are eligible for the Quarantine Order (QO) Allowance if they were issued a QO and meet the eligibility criteria. Those returning from Category II, III and IV countries are required to serve isolation under a Stay-Home Notice (SHN) and will be issued a QO if they are identified as close contacts of a confirmed COVID-19 case. The Leave of Absence/SHN Support Programme, introduced in early 2020, is not applicable if the LOA/SHN began on or after 7 April 2020.”
“These questions for written answers have been addressed by oral reply to Question Nos 1 to 12 on the Order Paper for 10 January 2022.”
“The cycle threshold (CT) value indicates the viral load of the patient being tested. However, unlike internal body scans or blood tests which are clinical tests with reported results, a CT value is technical laboratory parameter, with calibrated cut-offs for positive results, that is not routinely reported to patients. Doctors can disclose the CT value and discuss its clinical significance with patients. In most situations, the CT values do not affect the clinical management of a COVID-19-positive case. The risk profile and severity of symptoms of the patient are more important. A recovered patient and a newly-infected person may both test positive and register high CT values, that is, low viral load, but the interpretation is entirely different and needs to take into account the clinical context. For a recovered patient, it is most likely that he is still shedding small amounts of dead viral fragments. For a newly-infected person, it is most likely that his infection has been detected early and the viral load is likely to increase in a few days, when he will become more infectious. Hence, the clinical management in these two scenarios cannot be similar just because the patients register a similar CT value.”
“MOH adopts a multi-pronged approach to dementia care. This includes raising awareness of dementia, expanding care capacity and capabilities in the community and hospitals and supporting caregivers of persons living with dementia. First of all, to support persons living with dementia and their caregivers after the initial diagnosis, the Agency for Integrated Care (AIC) and Social Service Agencies (SSAs) have set up community outreach teams and community intervention teams. They conduct public outreach and education to raise awareness of dementia and conduct interventions to provide timely support. We have also rolled out 14 Dementia-Friendly Communities to create a conducive environment for persons living with dementia and their caregivers to live well in the community. This is achieved by raising dementia awareness and providing more dementia-friendly services, among other measures. Next, to increase the accessibility of care services, MOH has set up dementia clinics in polyclinics so that persons living with dementia can receive medical care near their homes. We have also increased the number of Dementia Day Care places, over a five-year period, between 2015 and 2020. Lastly, we provide caregivers of persons living with dementia with respite care options through senior centres and nursing homes. For instance, the Night Respite pilot offers overnight respite for caregivers of persons living with dementia with behavioural and sleep issues. Families also receive financial support to defray long-term care costs. This includes subsidies for medical care and eldercare services, disability grants and insurance schemes. MOH will continue to review the dementia support required for our ageing population.”
“As of 2 January 2022, around 300 individuals have been certified to be medically ineligible for COVID-19 vaccines either by private or public doctors and reported to MOH.”
“Since 1 November 2021, female Muslim public healthcare staff, if they wish to do so, can wear the tudung as an add-on to their uniforms. After two months, and as of end December 2021, about 20% of female Muslim uniformed staff have begun wearing the tudung. Some staff have chosen not to do so, while some others may be considering. We respect the decision of each individual. Hospitals have put in place clinical guidelines and communicated them to staff, to ensure adherence to the infection control requirements for the safety of patients and staff. Staff who choose to wear the tudung have also undergone refitting for N95 masks. Thus far, feedback from both Muslim and non-Muslim staff has been generally positive, with Muslim staff expressing appreciation for this change, and patients respecting the wishes of the nurses. Some staff have also received compliments from patients on their neat and professional attire with their tudung.”
“The National Adult Immunisation Schedule (NAIS) provides national-level guidance on important vaccinations for persons aged 18 and older. Under the NAIS, all persons aged 65 and above are recommended to get the pneumococcal and influenza vaccinations to reduce the risks of infection and disease-related complications. They are also recommended to receive other vaccinations, such as varicella (chickenpox), if they have not been previously vaccinated or lack evidence of past infection or immunity All Singaporeans who meet the criteria in NAIS are eligible for vaccination subsidies at both CHAS GP clinics and polyclinics. MOH has been working with stakeholders, such as the Health Promotion Board, to increase the uptake of these vaccines, especially the influenza and pneumococcal vaccinations, by seniors.”
“As announced on 5 November 2021, the COVID-19 Healthcare Award (CHA) is intended to cover workers from outsourced service providers. However, there are many types of outsourced workers, including some who come into the hospital premises on an ad hoc basis to perform specific tasks. Hence, the general rule is to extend CHA to the outsourced workers whose primary workplace is the premises of public healthcare institutions (PHIs) and serve alongside permanent staff and play an integral part in keeping our publicly-funded healthcare services running smoothly. Hence, there will be recognition given to outsourced staff who are directly contracted by the PHIs and publicly-funded Community Care Organisations (CCOs) to provide on-site services. MOH is working with the PHIs and CCOs on the amount, eligibility criteria and implementation details, and the employers of these outsourced staff will be informed in due course.”
“The War on Diabetes is a multi-year effort. With longer life expectancy and an ageing population, the incidence of diabetes will increase. Hence, while the recent National Population Health Survey showed an increase in the crude prevalence of diabetes from 8.8% in 2017 to 9.5% in 2020, after adjusting for the ageing effect of the population, the age-standardised prevalence of diabetes has remained stable over the same period at 7.9%. There is some progress in blunting a hitherto increasing trend. However, obesity amongst children is rising, which is not a good sign. There are many possible contributory factors to this – a sedentary lifestyle, change of diet in the younger population and the effects of COVID-19. These are issues which we will have to tackle. Ultimately, there needs to be a change in lifestyles, involving a healthier diet, being physically active, regular screening to detect pre-diabetes and timely intervention are key to preventing diabetes. To that end, the Health Promotion Board (HPB) has been mounting promotional campaigns, encouraging an active lifestyle. We are implementing mandatory nutrition labels for less healthy pre-packaged sugar sweetened beverages and encouraging individuals to come forward for regular screening.”
“This question will be answered by my reply to Dr Lim Wee Kiak and Mr Louis Ng Kok Kwang for the next Sitting. [Please refer to "Number of Singaporeans Who Have Given Up Smoking in Past Two Years and Proposal to Consider Total Ban on Sale of Tobacco Products", Official Report, 11 January 2022, Vol 95, Issue 45, Oral Answers to Questions section.]”
“This question will be answered by my reply to Dr Lim Wee Kiak and Mr Louis Ng Kok Kwang for the next Sitting. [Please refer to "Number of Singaporeans Who Have Given Up Smoking in Past Two Years and Proposal to Consider Total Ban on Sale of Tobacco Products", Official Report, 11 January 2022, Vol 95, Issue 45, Oral Answers to Questions section.]”
“This question will be answered by my reply to Dr Lim Wee Kiak and Mr Louis Ng Kok Kwang for the next Sitting. [Please refer to "Number of Singaporeans Who Have Given Up Smoking in Past Two Years and Proposal to Consider Total Ban on Sale of Tobacco Products", Official Report, 11 January 2022, Vol 95, Issue 45, Oral Answers to Questions section.]”
“This question will be answered by my reply to Dr Lim Wee Kiak and Mr Louis Ng Kok Kwang for the next Sitting. [Please refer to "Number of Singaporeans Who Have Given Up Smoking in Past Two Years and Proposal to Consider Total Ban on Sale of Tobacco Products", Official Report, 11 January 2022, Vol 95, Issue 45, Oral Answers to Questions section.]”
“MOH and PHIs adopt a zero-tolerance policy towards abuse and harassment of healthcare staff and will take action against persons who abuse and harass our staff. Public healthcare staff who are on duty will receive enhanced protection under section 6 of POHA.”