Singapore's current Covid-19 border regulations are appropriate, given the current context and circumstances, Health Minister Ong Ye Kung said in Parliament on Jan. 9.
In recent weeks, China has ended its zero Covid policy, paving the way for ease of travel in and out of the country, but it has also reportedly seen a surge in Covid-19 cases.
Some countries have imposed additional restrictions on travellers from China, such as India and Japan, but Singapore has so far not done so.
Singapore kept some border measures in place
Ong said he previously highlighted that the pandemic is not yet over, and there are risks and uncertainties when China opens up, as the virus will be "sweeping through" a population of 1.4 billion.
In addition, the Singapore government anticipated a new wave of infections which is currently happening in countries experiencing winter such as the U.S., South Korea and Japan.
Ong then said that prior to the current situation, many countries have dismantled all of their border measures. However, Singapore did not.
"A few have now reinstated the measures and announced new measures. As for Singapore, we have never dismantled all our border measures, and have kept relevant measures precisely because we anticipated these risks."
Number of flights between Singapore and China is low
In his ministerial statement, Ong responded to concerns raised about a fresh infection wave, and a potential return of restrictions over China's halt to Zero Covid.
Currently, travellers from China account for a very small percentage of imported infections and severe cases, despite China experiencing a big infection wave. This is due low travel volumes between Singapore and China throughout the pandemic.
There are 38 weekly flights from China to Singapore, which translates to around 700 to 1000 arrivals every day.
This number of daily arrivals is less than 10 per cent of the pre-Covid period, which had around 400 weekly flights, Ong noted.
Another reason for the low number of infected travellers from China is the maintenance of the pre-departure test (PDT) requirement for at-risk travellers, he said.
"Travellers have to be either fully vaccinated based on WHO (World Health Organisation) vaccination definitions or produce a negative pre-departure test or PDT result before heading to Singapore."
This is why Singaporeans who are overseas have to produce their vaccination certificates at the point of check-in, Ong added.
"This is so that the airlines know and we know whether you are required to produce a negative PDT result before you're allowed to board the plane."
He noted that some Singaporeans have submitted feedback saying that this rule causes "a lot of inconvenience."
Different countries have different responses to China's opening
In emphasising the importance of maintaining such a rule, Ong explained that unvaccinated and infected travellers coming from anywhere in the world are at risk of severe infection and can add to Singapore's healthcare load.
Another country that has adopted the same requirement is Spain -- a highly-vaccinated country, Ong pointed out.
This means that there are now three groups of countries with varied responses to the situation in China.
The first group is most of Asean, Middle East, Africa, South America and New Zealand, which are not imposing any border measures.
The second groups consists of several countries, namely Australia, Canada, several EU countries such as Belgium, France and Germany, India, Japan, UK and the U.S., which are imposing 100 per cent pre-departure test requirements on all travelers from China.
As for Singapore and Spain, they fall into the third category, in which both countries have implemented the policy of being either fully vaccinated or having a negative PDT result, Ong added.
Infected cases from China have accounted for less than 5 per cent of all imported cases in Singapore in 4-week period
Elaborating on why the government feels the current measures are working, Ong pointed out that imported infections currently account for between five to 10 per cent of the total cases reported daily.
The minister also highlighted that the four weeks running up to Jan. 1, 2023, was "probably" one of the most difficult periods of the Covid-19 epidemic in China.
On the number of infected travellers from China during this period, Ong said that around 200 travellers were detected to be Covid-19 positive. This is a relatively "low number" given that the daily number of cases is around a thousand, he added.
It also means that for this period of four weeks, infected travellers from China accounted for less than five per cent of Singapore's total imported infections.
In comparison, Asean countries accounted for over 50 per cent, 15 per cent from the rest of Asia, 11 per cent from Europe and nine per cent from the Middle East, he said.
There have also been no severe infection cases coming from China since Jan. 1, 2023, while the four weeks before the new year saw only one such case out of a total of seven, he added.
Scientists believe current infection wave is subsiding
Many scientists believe that the current infection wave in China has started to subside, especially in the major Chinese cities, Ong noted.
This will probably take a few more weeks for the trend to be very clear, following which Singapore can then progressively restore pre-Covid flight volumes between the two countries.
"China’s opening up to the world is great news and something we are looking forward to, so that we can restore our rich and substantive people-to-people links. Nevertheless, MOT (Ministry of Transport) will carefully calibrate any adjustments from the current low travel volume, at least until the infection wave has clearly subsided in China."
He acknowledged that Singapore could not be complacent, however.
While the measures might work now, they will not work permanently and the government will continue to assess the situation and make adjustments if needed.
Possible emergence of new variant remains a key concern
This led to Ong's next point that with Covid-19 continuing to spread throughout the world, the emergence of a new, unknown and more dangerous variant remains a key concern.
A new variant may possess worrying characteristics such as being able to escape vaccine protection, be more infectious or more likely to lead to more severe illnesses which will be "very" bad news, he said.
Such a scenario can knock Singapore back to "square one" in which the country must be prepared to hunker down and reinstate measures such as strict border controls, quarantine for travellers and social restrictions, including a limit on group sizes, until a new and effective vaccine is developed.
As for the detection of such a variant, this requires an "effective" global surveillance service where samples from infected people all around the world are systematically collected, viral genomes are sequenced and then shared on a global platform.
This is best done by countries for their own local cases, rather than relying solely on traveler surveillance because they can only provide a delayed snapshot, he said.
A pre-departure test also does not help to detect a new variant, as it only indicates whether a traveller is infected with Covid-19.
As for a surveillance system, one such system exists in the form of the most commonly-used global Covid-19 genomic sequence platform run by the non-profit organization called GISAID.
Singapore actively contributes to this platform and it has established a base in Singapore in collaboration with A*STAR and MOH.
Variants circulating in China have already been detected for many months
Ong also highlighted:
"Today, Beijing, Shanghai, Guangzhou, Zhejiang, Jiangsu, Fujian, Inner Mongolia contribute up-to-date viral genome sequences to GISAID, on a weekly basis....The data are analysed and processed from their office in Singapore."
Thus far, the data shows that the epidemic in China is driven by variants that are well-known and have been circulating in Singapore and other regions of the world -- BA.5.2 and BF.7.
Local sequencing efforts on infected travellers from China also support this picture, Ong added.
In addition, Singapore's assessment is consistent with that of the WHO’s Technical Advisory Group on Virus Evolution, which released its findings on Jan. 4, 2023.
"This is a huge relief. What we fear and worry most – a new dangerous variant that evades vaccine protection coming out from China as the virus spreads throughout their population – has not materialised yet. But we will continue to stay vigilant and plug ourselves deeply into the global surveillance system."
Top image via MCI/YouTube