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Safe management measures (SMMs) in Singapore can be eased once the Omicron transmission wave peaks and starts to subside, Health Minister Ong Ye Kung said in Parliament on Feb. 14.

Making sure "our healthcare system can cope" with the Omicron transmission wave is key, Ong said, adding that MOH "will continue to monitor the key indicators closely".

Whether restrictions can be eased depends on epidemic situation

Ong was responding to questions on when the Covid-19 measures, such as the restrictions on number of people dining in and group sizes, can be lifted.

Queries were filed by Lim Biow Chuan, Gerald Giam and Christopher de Souza, the Members of Parliament for Mountbatten, Aljunied and Holland-Bukit Timah respectively.

Ong's written reply said whether and when the safe management measures can be eased "depends on the epidemic situation".

The epidemic situation constitutes the following factors:

Daily infection numbers

Ong said the daily Covid-19 infection numbers of around 10,000 cases each day is "within our expectations".

However, he added that the government had expected the daily cases to reach 15,000 to 20,000, or more, due to Omicron being highly infectious.

While the "top line daily infection number" reflects where Singapore is on the epidemic curve, Ong said the disease's severity, and its subsequent impact on healthcare capacity, is "more critical".

He said the Omicron variant's impact "has been significantly more moderate" compared to the Delta variant for two reasons.

One, Omicron is less severe and generally infects the upper respiratory airways, and two, a high percentage of the Singapore population has been vaccinated or boosted.

As a result, a vast majority of the cases have mild or no symptoms, and very few develop severe illness and require oxygen supplementation or ICU care, or have passed away, despite the high daily infection numbers, Ong said.

Deaths

In the past two weeks, Ong said there has been an average of two to three deaths, despite new cases being three times more than what was experienced during the Delta wave.

There were around 13 Covid-19 related deaths each day during the peak of the Delta variant wave from late October to early November 2021.

Ong said the case mortality due to the Omicron variant is not very different from the number of deaths related to various viral infections pre-Covid-19, where over 4,000 patients each year, or 10 patients a day, passed on due to pneumonia caused by infections.

Despite this, Ong said MOH will "watch the trend very closely".

ICU occupancy and oxygen supplementation

Ong said about five in 10,000, or 0.05 per cent, of the current Covid-19 cases require ICU care, and added that there are about 30 patients in the ICU presently, of whom 60 per cent are intubated.

He compared this to the peak of the Delta wave, where there were 170 ICU beds occupied by Covid-19 patients then.

Duration of ICU stay is also currently shorter, about three to five days, compared to those infected with the Delta variant, who would remain in ICU for an average of 11 days.

Ong said unlike during the Delta wave, ICU wards are in "good shape" and "not coming under pressure".

However, he added that the number of ICU beds can be ramped up from 113 to 350 "at short notice", and this number can be boosted further to 500 if need be.

The rise in daily infection numbers, and the subsequent patients requiring oxygen supplementation, is "not a constraint" either as every hospital bed is equipped with oxygen supply capability, said Ong.

About 0.3 per cent of Omicron cases required oxygen supplementation, and there are currently around 130 patients who require oxygen supplementation, which is around 40 per cent of the peak of the Delta wave.

Hospitalisation and the healthcare system

Ong stressed that hospitals beds are the "biggest constraints" currently, and there are around 1,200 Covid-19 cases hospitalised now.

Of this number, 30 per cent are "incidental cases" as they were found to be infected only after they were tested when admitted for non-Covid-19 reasons.

Fortunately, this group of infected individuals do not take up extra hospital beds as they tend to have very mild symptoms, or none at all.

This means that the "extra workload" on hospitals is "two-thirds of the 1,200 hospitalised cases", said Ong.

As Omicron is less severe, beds are also freed up faster and Omicron patients have a shorter hospital stay of three to three to four days, compared to the five to eight days for those infected with the Delta variant.

As a result, those infected with Omicron can be directed to Covid-19 treatment facilities (CTF) for treatment instead.

He said a quarter of the approximately 3,800 CTF beds are occupied presently, and added that there are plans to ramp up the number of CTF beds to 4,600 by end of February.

Healthcare manpower

Basing off of the number of beds and equipment, Ong said the healthcare system in Singapore is "able to handle the Omicron wave".

However, Ong emphasised that the state of healthcare manpower has to be monitored as well.

He said healthcare workers "are very busy and stretched", albeit at a "different level of intensity" compared to during the Delta wave.

While there have been reports of healthcare workers "resigning in droves" overseas, Ong said the attrition rate of doctors from public acute hospitals in Singapore have remained at 3 to 5 per cent, and is comparable to the pre-Covid-19 rate in 2019.

This is similar for nurses, where the average attrition during Covid-19 in 2020 and 2021 is comparable to that of 2019 and is about 8 per cent, Ong said.

Additionally, absenteeism rate caused by Covid-19 has also been manageable, and is at about 2 per cent currently.

"We are also working closely with clusters to help them recruit new healthcare workers," said Ong, who added that support will continue for healthcare professionals.

He also thanked healthcare workers, who have been battling the pandemic at the frontlines for more than two years now.

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