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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“As announced in MOH's press release on 24 June 2021, we recently brought forward supplies and accelerated our vaccination programme. We are working with suppliers of other promising vaccine candidates, such as Novavax, to submit applications under the Pandemic Special Access Route (PSAR). This will provide more options for individuals. It is important to note that all vaccines can have adverse effects. We encourage eligible individuals to receive the current mRNA vaccines, which have well-documented efficacy and effects, and have proven to be safe and effective.”
“The Healthier Choice Symbol (HCS) is a front-of-pack label with a simple, visual identifier to help consumers identify healthier food products and ingredients easily. Products with the HCS are lower in fat, saturated fat, sodium, sugar or higher in dietary fibre, calcium and wholegrains compared to regular products within the same food categories. Compared to a graduated scale, such labels enable consumers to process basic nutritional information more quickly. Hence, there are currently no plans to develop a food health rating system on a graduated scale. The HCS is widely recognised and used by Singaporeans to guide their food purchases. It has also spurred food manufacturers and suppliers to reformulate and launch healthier products, leading to an increase in market share of HCS products from 18% in 2016 to 28% in 2020. A recent study conducted by Duke-NUS found that HCS positively influences consumer demand for healthier foods. The Ministry of Health and HPB regularly review the HCS nutrient guidelines to stay relevant to the latest consumption trends and new scientific evidences, and to address nutritional gaps in Singaporeans’ diets. This is done through extensive review of literature, local market conditions and consultation with food industry and academic experts. For example, in response to findings from the National Nutrition Survey (NNS) 2018 on Singaporeans’ increasing sugar intake from foods such as confectionary, desserts and sauces, the HCS criteria for sugar were lowered for selected sugary foods (for example, ice-cream and yoghurt) in 30 April 2020.”
“As at 3 July 2021, a total of 17,296 unique individuals have received one dose of the Sinovac-CoronaVac vaccine. Some individuals cannot take the mRNA vaccines due to medical reasons. Providers will not charge these groups of individuals for the vaccination and MOH will reimburse the providers directly. Vaccination with Sinovac-CoronaVac started on the 18 June 2021. As at 29 June 2021, two non-serious adverse event reports have been received. MOH and HSA will continue to monitor this and will provide an update if any significant safety concern is detected.”
“From 1 January 2021 to 28 June 2021, 64 individuals working in environmental services, providing services such as cleaning and housekeeping, were infected with COVID-19. Five of them were deployed in frontline settings including hospitals and community care facilities. Phylogenetic sequencing was successful for 61 of them. Of these, 59 cases were found to be infected with the Delta variant and the remaining two were infected with B.1.466.2 and B.1.524, which are non-Variants of Concern.”
“To ensure drug supply resiliency, MOH monitors international developments that could affect our supply closely, and works with the Agency for Logistics and Procurement Services (ALPS), healthcare institutions (HCIs), drug companies via the Singapore Association of Pharmaceutical Industries (SAPI) and local pharmaceutical distributors. As part of our supply arrangements, drug companies keep a healthy buffer of stock in Singapore. If companies face challenges bringing drugs into Singapore, there is an established channel to highlight to MOH to resolve the issue. In the event of supply disruptions, alternative suppliers have been identified and can be activated as needed. HCIs may also dispense medication for shorter periods, to ensure sufficient supply for all patients. This could be more inconvenient for some patients, but it is mitigated by direct delivery of medications to the patients’ homes.”
“The Health Sciences Authority (HSA) is still awaiting additional data to complete its evaluation of the Sinovac-CoronaVac vaccine for its safety and efficacy standards. The vaccine is therefore not yet authorised for use by HSA under the Pandemic Special Access Route (PSAR), and is not recommended as part of the national vaccination programme by the Expert Committee on COVID-19 Vaccination. Hence, individuals should be aware that they will not be eligible for the Vaccine Injury Financial Assistance Programme (VIFAP) should any serious side effects occur. Only a small group of persons would be contraindicated for the mRNA vaccines. These include (a) persons who had allergic reactions to the first dose of mRNA-based vaccine, and (b) persons who are allergic to other vaccines and are assessed by an allergist to be unsuitable for mRNA-based vaccines. For these persons, MOH has ringfenced sufficient Sinovac-CoronaVac vaccine stocks for their priority use.”
“Vaccination is a critical factor in determining the pace of our transition to living normally with COVID-19. As no vaccine provides 100% immune protection and we continue to encounter more transmissible variants, there will continue to be uncertainties and surprises. It will therefore not be wise to define a definitive threshold for a full reopening. It will also not be very useful to devise an index to guide our public health actions, because each aspect of the effort against COVID-19 is important, and deserves dedicated attention. However, the more we get ourselves vaccinated, the better protected we are and the more we can achieve normalcy. We have set ourselves milestone targets, namely, getting half of population fully vaccinated by the second half of July, and two-thirds around National Day. We should aim for even higher vaccination rates beyond that, especially for our seniors. Our roadmap for restoring activities and travel will have to be planned around those milestones.”
“Rostered routine testing (RRT) is applicable to workers in higher risk settings such as our borders, the Construction, Marine and Process (CMP) sectors, as well those living in high density environments such as dorms. Inpatient healthcare personnel also go through RRT to allow for early detection of cases to preserve hospital capacity. By mid-July, workers in settings where there are unmasked individuals or where there is prolonged contact with clients, will also be required to undergo RRT. This includes workers in settings such as dine-in F&B establishments, personal care services, and gyms and fitness studios. We use Polymerase chain reaction (PCR) tests for RRTs but are also considering alternative tests. There are Fast and Easy Tests such as Antigen Rapid Tests (ARTs). As more people are vaccinated and more alternative testing methods are made available, we will adapt our RRT regime parameters, such as frequency and mode of testing, and review whether RRT continues to be relevant at all.”
“From 2018 to 2020, an average of 140 patients per year with selective mutism were seen at the public hospitals. Children aged seven to 12 years old formed the largest group (48%), followed by children below seven years old (31%), 13 to 16 years old (16%) and above 17 years old (5%). A multi-disciplinary team, comprising psychiatrists, social workers, psychologists and clinical counselors, provides assessment and interventions for children with selective mutism by working closely with parents. The interventions include psychotherapies, pharmacological treatment, counselling and education, tailored according to the age of the child and clinical progress of the condition. For school going children, the Response, Early Intervention, Assessment in Community Mental Health (REACH) teams works with schools on special accommodations for oral examinations and learning. KKH also provides a hospital-based support programme for parents, which focuses on behavioural adjustments of parents in response to their children. Communit- based support groups are also available on social media platforms.”
“Since February 2021, vaccinations have been prioritised for Persons with Disabilities (PwDs), particularly those who live closely in residential homes, or attend daily centre-based services. In addition, since June 2021, vaccinations have been rolled out for students at Special Education (SPED) schools. MOH is also working with MSF and SG Enable to vaccinate PwDs who are home-bound. As all Singapore Citizens and long-term residents aged 12 and above are now eligible to register for their vaccinations, we encourage all who are eligible, including special needs individuals with difficulty wearing masks, to register for vaccinations.”
“The Ministry of Health closely tracks the available data on the efficacy and safety of COVID-19 vaccine and therapeutics candidates under development globally, including nasal sprays. We take a portfolio approach and enter into agreements with pharmaceutical firms early, once we have identified promising candidates.”
“The objective of MediSave is primarily to help Singaporeans with large medical bills due to hospitalisation and surgeries, after subsidies and MediShield Life. The MediSave500/700 scheme serves the secondary objective of helping patients pay for out-of-pocket expenses for the treatment of their chronic conditions. This is in view of the recurrent nature of their treatment. In line with the above, A&E fees are claimable from MediSave if the patient is subsequently admitted. Patients who require basic investigations and services are charged a flat subsidised attendance fee at the A&E department. This ensures that processes at A&E departments are kept simple for hospitals to provide timely vital emergency services to patients. Nevertheless, we understand that there are patients who visit their General Practitioners (GPs) and are subsequently referred to A&E departments for further treatment. In light of this, we implemented the GPFirst programme, where patients referred to the A&E by participating GPs will receive a $50 subsidy on their A&E fees, in recognition of the charges incurred at the GP clinic. This is so that they do not bear additional costs compared to an individual who had gone straight to the A&E. This programme is currently in place at GP clinics around Changi General Hospital (CGH), Ng Teng Fong General Hospital (NTFGH), National University Hospital (NUH), Khoo Teck Puat Hospital (KTPH), Sengkang General Hospital (SKH) and the Urgent Care Centre @Admiralty Medical Centre.”
“From 2010 to 2020, the overall number of staff1 in the Intermediate and Long-Term Care (ILTC) sector2 increased fourfold, from around 3,200 to 16,550. The breakdown of staff by their age, gender and citizenship status across the years is provided in Table 1. The data from ILTC providers does not cover educational qualifications. Data on work arrangement (that is, full-time or part-time) is available only for registered professionals using data from their respective professional boards3 from 2018 onwards.”
“MOH does not collect data on the number and breakdown of persons employed in the private healthcare sector. The number and breakdown of nurses and registrable Allied Health Professionals (AHP) collected by the Singapore Nursing Board and Allied Health Professions Council respectively are in Tables 1 and 21. From 2014 to 2020, the overall number of nurses in the private healthcare sector increased by 27%, from around 9,000 to 11,4202. From 2018 to 2020, the overall number of AHPs in the private healthcare sector3 increased by 13%, from around 1,200 to 1,350.”
“From 2013 to 2020, the overall number of nurses in the public healthcare1 sector increased from 19,180 to 23,050. Over the same period, the number of Allied Health Professionals (AHPs) increased from 3,990 to 5,400 while the number of Administrative and Ancillary (AA) staff increased from 14,600 to 18,080. Due to changes in data definition, we are only able to provide the breakdown of staff groups by their age, gender, citizenship status, and highest educational qualifications from 2013 onwards. Data on whether they are working full-time or part-time is available for registered nurses and AHPs from 2014 and 2018 onwards respectively, can be found in the Tables below.”
“Since February 2021, we have progressively offered vaccinations to taxi and private hire vehicle drivers. As of 1 July, about 92% (48,846 of 53,268) active Private Hire Car and Taxi Drivers have been vaccinated with at least one dose of vaccine, of which 86% (46,054 of 53,268) have completed both doses. We would like to thank the taxi and private hire vehicle drivers’ community for their strong support in the vaccination programme.”
“SELENA+ is a National AI pilot project that is being implemented in a few phases. During the first phase, a total of 38,215 patient cases at six polyclinincs had their retinal photographs processed by SELENA+ and the results were compared to the current image grading performed by non-physician technician readers. Based on preliminary analysis, we found that the accuracy of SELENA+ in detecting vision-threatening diabetic retinopathy, glaucoma suspects and late stage age-related macular degeneration is comparable to current standard of care. We have commenced the second phase of SELENA+ since December 2020, with the trial extended to an additional six polyclinics. In this phase, we will study if non-physical technician readers can better detect diabetic eye complications with the AI support. SELENA+ will also be evaluated for its potential to improve efficiency and consistency by automating the current grading process and transfer of digital retina images, for mild to moderate diabetic cases. As diabetes may result in eye complications such as diabetic retinopathy, Singaporeans are encouraged to go for regular health checkups and follow ups. Adults above aged 40 are encouraged to go for regular screening for chronic illnesses, including diabetes. With subsidies under Screen for Life at all CHAS GPs, Singaporeans pay between $0 and $5 for each screening visit. All diabetic patients are also recommended to be screened for eye complications annually. This is why we have made eye screening a subsidised core service to be provided for diabetic patients across all polyclinics as well as at GP clinics participating in the Primary Care Networks scheme. MOH will continue to explore the possibility of using technology to improve quality and cost effectiveness of care.”
“As of 28 June 2021, we have done a total of 13.6 million PCR swabs, of which around 2.8% were performed for persons under the age of 21. The scientific literature suggests that while there is risk of minor complications from swabbing, there are no significant risks of serious or lasting adverse effects. There have been very few reported adverse events. Testing is a key enabler in our efforts to contain COVID-19. It allows us to detect cases early and draw a wider ring with special testing operations where there is a risk of significant hidden transmission. This, along with other public health actions such as contract tracing and quarantine, has limited the local spread of COVID-19. We have also implemented rostered routine testing for identified groups who have a higher risk of exposure to COVID-19, such as those at working at our frontline COVID-19 operations, including the borders, hospitals and community care facilities. This protects the workers and also provides reassurance that our containment efforts have been effective. We know that undergoing repeated regular testing can be uncomfortable and we thank all our frontline workers who have been extremely cooperative and understanding about the need to do so.”
“Since 15 June 2021, we have required public-facing venues with high visitor throughput to deploy the SafeEntry Gateway. Such venues include shopping malls, places of worship and ticketed attractions. Higher-risk venues like dine-in food and beverage outlets are required to do likewise. These venues may apply for the SafeEntry Gateway box. Alternatively, they can use the SafeEntry (Business) App which includes a SafeEntry Gateway function. Both options are available at no cost. Patrons, stallholders and stall assistants at wet markets are thus similarly strongly encouraged to perform check-in at all these venues via the SafeEntry Gateways or to check-in via the SafeEntry QR codes. These are placed at the natural ingresses of the markets, as well as at all entrances to toilets. Stallholders will also encourage patrons to check in via the QR codes displayed at their stall fronts, where available. Roving Safe Distancing Ambassadors with the SafeEntry QR code on hand can also help patrons to check-in on the spot. The TraceTogether Token and App provide a convenient way to do these check-ins. We encourage everyone to carry their TraceTogether Token or keep their TraceTogether App active to facilitate contact tracing, and help protect us all.”
“The most significant factor in determining our border policies is the COVID-19 situation in the source country. For instance, we have unilaterally opened to visitors from very low-risk countries and regions. These visitors, regardless of vaccination status, are only subject to an on-arrival test, and if negative, can proceed with their activities without quarantine or controlled itinerary. As we achieve a higher vaccination rate locally and other places are able to control the pandemic and vaccinate their populations, we will have greater confidence in opening up travel. One possibility will be to consider setting up vaccinated travel lanes.”
“Before the outbreak of COVID-19, MOH had established a system to monitor global public health developments, with a focus on public health events that may have an impact on Singapore. Over the years, this system has provided MOH with vital information on potential pandemic threats from outbreaks of emerging diseases happening around the world. In addition, MOH receives information from the World Health Organization, experts and academic networks, and scientific publications. On COVID-19, overseas missions have been providing further information on the situation abroad. Given the uncertain trajectory of COVID-19, and its tendency to mutate, we have to continue to watch developments closely and make timely assessments of any emerging public health threats from overseas.”
“Pre-departure (PDT) testing is already required for all travellers above the age of two arriving from higher-risk countries/regions. Even with PDTs, all travellers from higher risk countries are still subjected to prevailing health measures. This includes an on-arrival COVID-19 PCR test, and a 14-day Stay-at-Home Notice (SHN) at dedicated SHN facilities with PCR tests done before the end of their SHN duration.”
“The Ministerial Committee of Ageing (MCA) hence brings together multiple Government agencies to holistically respond to our ageing society. In 2015, the MCA launched the Action Plan for Successful Ageing, a national blueprint to enable Singaporeans to age gracefully and confidently. Since then, we made progress in areas such as employment, learning and volunteering opportunities and senior-friendly infrastructure. Planning for ageing is a continuous journey and the MCA will refresh the Action Plan so that we continue catering to the evolving needs of current and future seniors. The refreshed Action Plan will centre around "Care", "Contribution" and "Connectedness", where we encourage seniors to stay active, healthy, and engaged. We also update our healthcare and ageing-related policies to keep pace with our demographic shifts. For example, to support the social and emotional needs of our seniors living alone, we are rolling out a new Eldercare Centre service model from 2021. These centres will provide a suite of services, including active ageing programmes, befriending or buddying, and information and referral to care services that will enable all seniors to stay well. They will become the go to points in the community, for seniors. The Silver Generation Office (SGO) also proactively reaches out to our seniors, and befriends lonely seniors living alone to pre-empt social isolation. In healthcare funding, we have revamped the ElderShield scheme into CareShield Life, to offer better protection against old age disabilities. We have implemented the Pioneer and Merdeka Generation packages, to help seniors have greater peace of mind as they ages. The MCA and MOH will continue to build an inclusive society that amplifies opportunities from ageing.”
“For example, Rolling Good Times is a falls prevention programme that seeks to improve seniors’ strength and balance through exercises, raise awareness of common falls situations and teach seniors how to minimise the risk of injuries during a fall. In addition, the Healthy Ageing Promotion Programme for You (HAPPY) programme combines physical and mental exercises to delay the onset of cognitive and frailty conditions. We will continue to promote these programmes and reach out to the elderly.”
“With an ageing population, we have seen an increase in the number of elderly with mobility issues. Based on the Singapore Census of Population, the number of residents in resident households aged 65 years and over who had mobility issues grew from around 25,500 to 50,000 between 2000 and 2020. This represents 11% and 8% of the resident population aged 65 and above in 2000 and 2020 respectively. MOH is cognisant of the needs of the elderly who live alone and have put in place measures to help them have convenient access to various services. These measures include subsidies under the Seniors’ Mobility and Enabling Fund (SMF) for seniors requiring assistive devices such as wheelchairs and motorised devices so they can be mobile, senior-friendly housing such as the new Community Care Apartments for seniors to age independently in the community, as well as befriending or buddying services under the new Eldercare Centre service model so there is someone they can turn to for support. Seniors with mobility issues are also assisted through Medical Escort and Transport services to attend medical appointments or treatment, and there are daily meal deliveries through our Meals-on-Wheels programme for home-bound seniors. MOH will continue to review and strengthen our policies, services and programmes for seniors to age well in the community and provide the necessary support especially to those living alone. We agree with the importance of health promotion and preventive efforts to delay the decline in physical ability. There are active ageing and frailty prevention programmes in community nodes such as Community Centres, Residents’ Networks, Active Ageing Centres and Active Ageing Care Hubs.”
“The Government allowed the vaccine from Sinovac to be used under the Special Access Route (SAR) because this is precisely the purpose of this prevailing scheme – to allow the use of unregistered therapeutic products in instances where there is a specific medical need. In this case, the individuals do not wish to take the approved vaccines under the national vaccination programme and it is better that they get some form of protection against COVID-19 than no protection at all. Persons who experience serious side effects from receiving COVID-19 vaccines, whether under the national vaccination programme or under SAR, can continue to receive support through applicable healthcare financing schemes, such as MediShield Life and subsidies at our public healthcare institutions, or private insurance, where applicable. We continue to encourage individuals to take the two vaccines under our national vaccination programme. They are free, proven to be safe and effective, and will be covered by the Vaccine Injury Financial Assistance Programme (VIFAP).”
“Health Sciences Authority (HSA) has approved two vaccines, namely Pfizer-BioNTech/Comirnaty and Moderna, to be used in the national vaccination programme. They are safe, effective and are fully subsidised by the Government. However, as we are mindful that some Singaporeans prefer other vaccines, MOH has allows vaccines approved by the World Health Organization to be on its Emergency Use Listing to be brought into Singapore under HSA’s Special Access Route. These vaccines have not been authorised for use by HSA based on their safety and efficacy profiles. Subsidising these vaccines will therefore be inconsistent with their approval status. Nevertheless, Government has a stock of vaccines from Sinovac and has released them free of charge to private clinics to administer them under the SAR. We continue to urge all who are medically eligible to receive HSA-authorised PSAR vaccines under the national vaccination programme.”
“Caregiving arrangements vary across households depending on their household circumstances and the care needs of the care recipient. MOH does not track the number of full-time caregivers which may include migrant domestic workers and family members. However, we estimate that there are currently about 35,000 caregivers for persons with permanent moderate disability living in the community, who may be caring for the care recipient on a full-time or part-time basis. We do not have data on caregivers by their household income. Notwithstanding this, we recognise the important roles that caregivers play and will continue to strengthen our support for caregivers. Families who need help with caregiving services can approach the AIC Link or the Social Service Office for assistance.”
“One of the ways to encourage the use of COVID-19 self-test kits is to make them generally available. Hence, Antigen Rapid Test (ART) self-test kits have been available for sale at most retail pharmacies since 16 June 2021. From 16 July 2021, we will extend the sale of the ART self-test kits to general retailers like supermarkets and convenience stores. The ART self-test kits are currently sold with instructional materials on what to do following an ART self-test. Individuals are advised that if they tested positive, they should visit any one of the over 630 conveniently located Swab and Send Home (SASH) clinics islandwide immediately for a confirmatory Polymerase Chain Reaction (PCR) test which is fully funded by the Government. We hope individuals will exercise responsibility to help keep the community safe. We will also leverage employers to ensure that test protocols are observed. By mid-July, workers in settings where there are unmasked individuals or where there is prolonged contact with clients, such as those in the Food and Beverage sector, will be required to routinely test themselves using Fast and Easy Tests (FETs) such as ARTs.”
“We are working closely with stakeholders to encourage the take-up among seniors through outreach, education and engagement. To make it more convenient for our seniors to get vaccinated, all Vaccination Centres in the community accept walk-ins for individuals aged 60 and above, without the need to register or book an appointment in advance. Seniors who are not mobile can request to be vaccinated at their homes by home vaccination teams. The vaccination programme is now open to all Singapore Citizens, Permanent Residents and Long-Term Pass Holders aged 12 and above, so everyone, including retail and delivery staff working at the frontlines, can book a vaccination appointment and choose from multiple time slots. Please do so as soon as possible. Singapore Prison Service have also extended the vaccination programme to prison inmates. Thus far, about 80% of eligible inmates have received at least the first dose of the COVID-19 vaccine. To date, there is no evidence to suggest that the Delta variant will adversely affect children more than adults. We are actively monitoring ongoing vaccine clinical trials conducted by pharmaceutical companies on children under 12 years old. Achieving as high a level of vaccination coverage as possible in our population will help reduce the risks of community transmission and large outbreaks. It is a vital part of our strategy to deal with COVID-19 and to protect us all. If you are eligible to be vaccinated, please book an appointment today.”
“My answers will also cover questions filed by Dr Lim Wee Kiak and Mr Yip Hon Weng1 for future Sittings. We continue to make good progress with our national vaccination programme. As of 3 July, we have administered more than 5.7 million doses of the COVID-19 vaccine. Around 3.5 million individuals, or about 63% of our population, have received at least the first dose of the vaccine and 2.1 million people have received their second dose. Our rate of vaccination depends upon our vaccine supply. We have agreements to bring in more than enough vaccines for everyone in Singapore. We have been able to bring forward the delivery of some vaccine supplies, allowing us to accelerate our vaccination programme. Now we can administer up to 80,000 daily doses, up from around 40,000 in May 2021. More COVID-19 vaccines are undergoing clinical trials. The Health Sciences Authority is reviewing the progress and other vaccines may be available in the future. One trial in the United Kingdom is studying the combination of the AstraZeneca vaccine (an adenovirus vector vaccine) for the first dose, and an mRNA vaccine for the second dose. This is known as a heterologous prime-boost combination. We will monitor their findings to assess the suitability of using such a strategy. All Singapore Citizens, Permanent Residents and Long-Term Pass Holders aged 12 and above have now had the chance to register for their first doses. We have set ourselves an ambitious target to complete vaccination for two-thirds of the population by National Day. We understand some seniors may be hesitant to take the vaccines for a variety of reasons. For example, concerns about potential side-effects, vaccine safety and efficacy, or they have difficulties with care arrangements, or do not see the need for it.”
“Just like fighting the COVID-19 pandemic, the transition to endemic COVID-19 will also need to be a whole-of-society effort, of all stakeholders working together, each person doing his or her part, and trusting each other.”
“In line with that, we have identified a couple of milestones, such as getting 50% of our population fully vaccinated sometime in the second half of July, and then two-thirds around National Day. Whether we achieve these milestones depends heavily on the willingness of our people to step forward and get vaccinated. We are planning our transition and public health measures around these milestones. If we are confident enough to be more definitive, we will, and will announce our plans publicly. Members also asked about when specific measures will be reviewed, including the winding down of TraceTogether at some point. There are several significant transition points. When we imagine endemic COVID-19 and achieving normalcy, these significant changes may not come across our minds. For example, we need to review how we want to treat individuals who are infected with COVID-19, whether they need to be hospitalised or can recover at home. We need to review the relevance of contact tracing and quarantine, and the focus and extent of testing for COVID-19. We will have to explore opportunities to open up quarantine-free travel corridors with countries and regions that are safe. We need to review the timing for winding down TraceTogether, monitoring and reporting the number of people who falls very sick as opposed to daily infections, and reducing mask wearing requirements. They are all significant departures from the COVID-19 pandemic practices that we have grown accustomed too. So each change will require a psychological shift. We have to study each move closely, implement them progressively and when appropriate. At all times, the public needs to feel assured, and confident of the steps we are taking.”
“I thank the Members for their interest in Singapore’s transition to an endemic COVID-19 state. In this pandemic, every month or week makes a big difference, so in that context we are at a very early stage of our transition. Vaccination is key to the transition, but we have to grapple with many uncertainties, from further virus mutation or sudden outbreaks, and many twists and turns along the way. So it is against this backdrop that I will try to provide answers to the questions from Members. In the past 18 months, we have managed our approach to COVID-19 by considering factors such as the number of COVID-19 infection cases, the trajectory of the pandemic, whether the infections are linked or unlinked, our testing capacity, and more recently, the proportion of our population that has been vaccinated. Another very important factor is the psychology of our people. Along the way, our polices are continually adjusted to ensure that the number of cases do not rise exponentially, causing our healthcare system to be overwhelmed because that will cause a lot of harm to many patients. I can understand the desire for a definitive road map, with relaxation of public health measures and travel restrictions pegged to certain transparent benchmarks. We have seen how other countries tried to do this, but they had to delay the lifting of restrictions, or reverse earlier decisions such as removal of the requirement to wear masks in public. So I think a definitive roadmap may not be a realistic approach, given the uncertainties of the pandemic and the evolution of the virus. But the direction we are heading towards is clear, and we are determined to do our best to make the transition. A major factor determining the pace and extent of the transition is vaccination.”
“I thank the Member for his questions. This question for written answer has been addressed by oral reply to Question Nos 3 and 4 taken on 11 May 2021.”
“As traffic volume is currently low, the intersection is currently unsignalised. As traffic demand will increase, given the upcoming residential developments in the vicinity, LTA plans to install a traffic signal at this intersection by mid-2022.”
“The COVID-19 pandemic has led to disruption to material supplies and manpower, hence, delaying the construction of our rail projects by up to a year. That said, the construction works and testing of trains and systems for Thomson-East Coast Line Stage 2, or TEL2 for short, have been substantially completed. TEL2 comprises six stations: Springleaf, Lentor, Mayflower, Bright Hill, Upper Thomson and Caldecott. It will open in the third quarter of this year. The rest of TEL will progressively open in three stages, from 2022 to 2025. For the Jurong Region Line, or JRL, construction works for most of the stations and viaducts are underway. Contracts for all the rail systems have been awarded and JRL is scheduled to be completed by 2029. As for the Cross Island Line, or CRL, construction works have started for Stage 1 of the line. CRL Stage 1 and the CRL – Punggol Extension are scheduled to open in 2030 and 2032 respectively. Details for subsequent stages of the CRL will be announced later, after engineering studies have been completed. We remain fully committed to our plans to expand the rail network from 230 kilometres today to 360 kilometres in the early 2030s. This will bring our rail network closer to home, work and school for more Singaporeans, increase options for commuters and enhance network resilience.”
“Over the past three years, CAAS has received 82 reports of laser lights being shone at aircraft landing at or taking off from our airports. Most of these appear to originate from outside Singapore. They can potentially distract or even cause injury to pilots. Fortunately, none of these incidents has resulted in disruptions to flight operations or pilots having to seek medical attention. CAAS takes a serious view of such activities. Any person convicted of such an offence may be fined up to S$20,000 for a first offence and fined up to S$40,000 and/or imprisoned for up to 15 months for a subsequent offence.”
“I think never be complacent, not even when you are vaccinated; never be complacent. What are we doing? I put out some information two nights ago, but let me just briefly recap. The first thing when something like that happens is to press the reset button and contain the problem. Put two rings immediately, that Minister Lawrence Wong and Minister Gan Kim Yong mentioned. First ring, who are the close contacts, quarantine and then isolate. Second is the wider ring, who could have been affected; put them all through testing. So, today, we are putting several thousand through a one-time special operation. It should be carried out these few days; started yesterday. Members should expect that, as we do such special operations, we will be picking up cases in the next few days. So, please do expect some cases coming out from the airport because we are doing a very massive one-time sweep. Beyond that is to put in place greater, more effective segregation measures, so that airport workers who are more risky do not mix with other workers or members of the public. So, places like the canteen and food court, we now do takeaways for them, so that we do not mix them. Thirdly, we continue to do surveillance and the testing. One thing we can possibly do – and I have to discuss this with the Minister for Health, besides the PCR test once every 14 days – is how can we intersperse it with something like the antigen test, something faster? We are also developing a breathalyser test, something that can pick up quickly even though it may be less accurate. But the speed with which we pick up cases is absolutely critical. And, lastly, push those that have not gone for vaccination to go for vaccination as fast as we can.”
“Thank you, Mr Speaker. I thought I would just add more to the answer that the Minister for Education had given to Mr Ang Wei Neng on the lessons learnt for Changi Airport. We know that the sea port and the airport are points of vulnerability when we have a pandemic. So, in fact, just this morning, we got information that, in Taiwan, their biggest airline has been infiltrated by the virus. So, they are tightening up rules on pilots. So, even for Taiwan, which has kept itself domestically very safe, the virus will find itself through the borders. Airport, sea port, causeway, these are our points of vulnerabilities, regardless of where the variants and the virus come from. We have been implementing a very tight posture both for sea port and airport. The workers all observe safe management measures, masks on, some are even in full PPE when they carry out their work. We test them regularly – some on a seven-day cycle, some on a 14-day cycle – which is why we are able to pick up these cases quite quickly this round when we had the outbreak of cases. Thirdly, it is to push them for vaccinations. They were one of the first to go for vaccination. Mr Ang asked about the airport. At the airport, in total, we are talking about 46,000 workers; 26,000 are what we consider more high-risk. They may come into contact; actually, they do come into contact with travellers, so they are higher risk. For that group, 92% are fully vaccinated. Then, there is an outer ring that does not come into direct contact but we, nevertheless, consider them exposed to some risk. That is another 20,000. And for that group, more than 80% have had at least one dose. So, we have taken all these measures, but the mutant virus still found its way through the kink in the armour. So, what are the lessons learnt?”
“The Government has several measures in place to ensure that persons with disabilities can access point-to-point transport services. Foldable wheelchair users can commute on regular taxis, as LTA requires taxis to have sufficient boot space to accommodate luggage and most foldable wheelchairs. Users of motorised and high-back wheelchairs and personal mobility aids can book SMRT’s London Cabs, which are subsidised by MSF. In addition, recognising the potential financial difficulties faced by persons with disabilities, the Government has also put in place schemes to defray transport costs in a targeted manner. Persons with disabilities who have been medically certified to be unable to take public transport and are dependent on taxis for their travelling needs can apply for SG Enable’s Taxi Subsidy Scheme (TSS) for travelling to school, work or employment-related training. The TSS covers up to 80% of their transport costs. We are glad that the Member agrees that ensuring the affordability of point-to-point transport services for persons with disabilities is important. The Government will continue to support persons with disabilities, including ensuring their access to affordable point-to-point transport services.”
“Operators obtain the full grant quantum if they achieve 1 million MKBF or better. I had earlier reported to the House that every year, the Government spends about $1 billion on annual operating subsidy for rail. The RRI is part of this $1 billion. Last year, SMRT and SBST both received the full RRI as they achieved MKBF of more than 1 million train-kilometre for the lines they operate. The incentive is based on a rate of 0.3 cents per place-kilometre. The total amount worked out to $173 million, and the amount that each operator received is proportionate to the operating capacity that they provide. We must also invest in building up the capabilities of our operators. To this end, the Government developed the Rail Manpower Development Incentive (RMDI) to encourage rail operators to accelerate workforce upskilling and reskilling in core and emerging technical capability areas, such as automation application, data and statistical analysis, and asset management. More than 1,300 workers have completed their training under RMDI to date. We have also established the Singapore Rail Academy to professionalise the rail workforce and deepen workforce capabilities in rail engineering, operations and maintenance. The Academy has also partnered Institutes of Higher Learning and the industry to develop innovative technical solutions for rail reliability. We will continue to work with operators and other stakeholders to provide reliable rail services in a sustainable manner.”
“Since 2011, LTA has been working with rail operators to enhance their maintenance regime. Everyone played their part. LTA upgraded rail operating assets such as signalling and power systems, and invested in infrastructure, such as the simulation centres to test signalling systems, back-up operation control centres, and now the Integrated Train Testing Centre. The operators have put in place a higher maintenance tempo and over time, made a significant shift to more preventive instead of corrective maintenance. They increased the frequency of inspections, used sensors to troubleshoot, invested in digitalisation and are replacing components more frequently. As a result, reliability of train services improved over the years. But so did maintenance cost. In train-kilometre terms, reliability increased by 10 times over the past six years. While overall this is a good development, especially from the point of view of the commuter, it raises issues concerning the financial sustainability of the rail network as the operators will make huge losses. The Government, therefore, decided to enhance our subsidy for rail operations. But instead of an outright subsidy, we devised an incentive system called the Rail Reliability Incentive (RRI), a temporary grant from 2020 to 2023. Rail operators are held to a set of performance standards on both the operation and the maintenance of the rail system. LTA may impose financial penalties if there is a breach of these requirements. Conversely, if operators can meet the performance targets, they will be eligible for the incentive. To qualify for the grant, rail operators must achieve at least 500,000 train-kilometre in Mean Kilometres Between Failure (MKBF), and fulfil other requirements relating to operational performance and safety.”
“I thank the Member for his questions. I have addressed them in my reply to Question Nos 32 to 36 at the 10 May 2021 Parliament sitting.”
“Given these land constraints, it is not possible to adjust the NSC alignment to avoid affecting the Building or other buildings along Thomson Road.”
“A thorough impact assessment study of 68-74 Thomson Road ("the Building") was conducted in early 2020. Inspections and non-invasive tests, in accordance with international practices and guidelines, were conducted. The study found that the Building’s foundation would need to be strengthened to withstand the excavation works for the North-South Corridor (NSC) tunnel and therefore, demolition was not required. To ensure safety during the strengthening works, LTA assisted the occupants to move out of the Building. However, after the residents had vacated the premises, LTA, as part of its due diligence, conducted further detailed and invasive tests to validate the Building’s concrete strength. It was through these tests that LTA found that the actual concrete strength was lower than required to safely carry out the strengthening works. This test would not have been part of the first test, which was to ascertain if the building foundation requires strengthening in view of the excavation works of the NSC. BCA concurred with the test results and assessment. The Government therefore decided that for safety reasons, the Building has to be demolished before excavation works for the NSC tunnel near the Building can commence. The NSC alignment was announced in 2011 after an extensive study by agencies and takes into account the fact that the Thomson area is very densely built up with buildings next to the road reserve and underground MRT tracks in the vicinity. Due to site constraints, the two NSC tunnels, one tunnel for each direction of traffic flow, are already designed to be vertically stacked, instead of being built side by side, under the road reserve of Thomson Road.”
“Recumbent devices are not considered personal mobility aids, which refer only to motorised wheelchairs and mobility scooters. Instead, two-wheeled recumbent devices, by convention, are classified as bicycles, whereas three-wheeled recumbent devices are classified as non-motorised personal mobility devices. LTA has received requests from owners of three-wheeled recumbent devices to use them on roads. It is currently studying such requests, with safety as our primary consideration. LTA is keeping an open mind, and its decision will be informed by the Active Mobility Advisory Panel’s on-going review of existing rules for both cyclists and motorists to strengthen road safety. An assessment will be made after this review is completed.”
“Over the past year, LTA impounded 1,378 personal mobility devices (PMDs) and three personal mobility aids (PMAs). LTA impounds devices when they do not comply with technical standards. For example, they could exceed weight and width limits, which means they cause serious injury if they knock down a pedestrian. The device may also not be UL2272-certified and thus pose a fire risk. We do not return these devices because they pose a danger. LTA also impounds devices where the offender had displayed egregious behaviour, such as riding on roads or reckless riding. In such cases, impounded devices will generally be returned to owners if they comply with device criteria. In the past year, about 17% of all impounded devices were compliant and could be returned. For straightforward cases, it generally takes about three weeks before owners are notified if their devices may be returned. For more complex cases, this can take a few months.”
“Operators obtain the full grant quantum if they achieve 1 million MKBF or better. I had earlier reported to the House that every year, the Government spends about $1 billion on annual operating subsidy for rail. The RRI is part of this $1 billion. Last year, SMRT and SBST both received the full RRI as they achieved MKBF of more than 1 million train-kilometre for the lines they operate. The incentive is based on a rate of 0.3 cents per place-kilometre. The total amount worked out to $173 million, and the amount that each operator received is proportionate to the operating capacity that they provide. We must also invest in building up the capabilities of our operators. To this end, the Government developed the Rail Manpower Development Incentive (RMDI) to encourage rail operators to accelerate workforce upskilling and reskilling in core and emerging technical capability areas, such as automation application, data and statistical analysis, and asset management. More than 1,300 workers have completed their training under RMDI to date. We have also established the Singapore Rail Academy to professionalise the rail workforce and deepen workforce capabilities in rail engineering, operations and maintenance. The Academy has also partnered Institutes of Higher Learning and the industry to develop innovative technical solutions for rail reliability. We will continue to work with operators and other stakeholders to provide reliable rail services in a sustainable manner.”
“Since 2011, LTA has been working with rail operators to enhance their maintenance regime. Everyone played their part. LTA upgraded rail operating assets such as signalling and power systems and invested in infrastructure, such as the simulation centres to test signalling systems, back up operation control centres and now the Integrated Train Testing Centre. The operators have put in place a higher maintenance tempo and over time, made a significant shift to more preventive instead of corrective maintenance. They increased the frequency of inspections, used sensors to troubleshoot, invested in digitalisation, and are replacing components more frequently. As a result, reliability of train services improved over the years. But so did maintenance cost. In train-kilometre terms, reliability increased by 10 times over the past six years. While overall this is a good development, especially from the point of view of the commuter, it raises issues concerning the financial sustainability of the rail network as the operators will make huge losses. The Government therefore decided to enhance our subsidy for rail operations. But instead of an outright subsidy, we devised an incentive system called the Rail Reliability Incentive (RRI), a temporary grant from 2020-2023. Rail operators are held to a set of performance standards on both the operation and the maintenance of the rail system. LTA may impose financial penalties if there is a breach of these requirements. Conversely, if operators can meet the performance targets, they will be eligible for the incentive. To qualify for the grant, rail operators must achieve at least 500,000 train-kilometre in Mean Kilometres Between Failure (MKBF), and fulfil other requirements relating to operational performance and safety.”