Fourth Update on Whole-of-Government Response to COVID-19

12.00 pm

The Minister for Health (Mr Gan Kim Yong): Mr Speaker, Sir, thank you for allowing me to update Members on the COVID-19 situation. Minister Lawrence Wong and I will address Oral Question Nos 1 to 19 and Written Questions 19 to 23 from yesterday's Order Paper, and Question Nos 1 and 2 from today’s Order Paper, as well as a question filed by Mr Seah Kian Peng¹ for a future Sitting.

Sir, it has been 16 months since our fight against COVID-19 started. I last updated the House in January this year when we rolled out the national vaccination programme.

To date, we have confirmed a total of 61,378 cases of COVID-19 infections, and 31 of them have passed on. The COVID-19 situation remains fluid. Globally, we are seeing surges in daily new cases in several countries. Locally, after half a year of low community cases, we have seen several clusters of infections over the last two weeks – a cluster involving an ICA officer and his family members, one at Tan Tock Seng Hospital (TTSH), another at Tuas South Community Care Facility (CCF), a cluster at Pasir Panjang Terminal and, most recently, a cluster at our airport terminals.

We have also detected several unlinked cases, 10 in the last week. This suggests that there are unknown cases in our community that caused these infections, which is a cause for concern because, for each unlinked case, there is an unknown source. That is why it is called "unlinked". For as long as we cannot identify the source, there is a risk that they may be spreading the infection.

New COVID-19 variants have also emerged that challenge our knowledge on the virulence and transmissibility of COVID-19. To date, we have detected 10 different COVID-19 variants among local and imported cases. A detailed breakdown was shared in MOH’s press release on 4 May.

Such variations in viral strains are not unexpected. It is in the nature of viruses to mutate. Therefore, we must expect to see new variants emerge from time to time. However, some variants are of greater concern because of their increased transmissibility, severity of illness caused or ability to break through vaccines.

It is also not surprising to discover variant strains in Singapore. We cannot completely shut out our borders, close down the causeways, our seaport and airport because Singapore is not self-sufficient in many things and we need to maintain our supply lines and global connections to survive. The virus will then find ways to infiltrate us.

Sequencing results indicate that the recent clusters at TTSH, ICA and Tuas South CCF were driven by the B.1.617.2 variant that was first detected in India. Three of the recent cases at our airport terminals also tested preliminarily positive for B.1.617.

While the definitive characteristics of this variant remain unknown, the large clusters and rapid transmission we see locally are concerning as they suggest that infections of this strain can spread quickly and widely. This is similar to the overseas situation where resurgence of cases is likely driven also by new variants.

The emergence of several clusters, new variants as well as the rising number of unlinked cases mean the risk of community transmission has gone up. Therefore, we must stay vigilant and tighten our safe distancing measures in the community to slow down and prevent transmission of the virus, even as we make progress in our vaccination programme. We have also tightened our border measures to reduce the risk of importing cases. Minister Lawrence Wong will elaborate on these shifts in his Statement later.

Let me give an update on the cluster at TTSH. The first case of the TTSH cluster was confirmed on 28 April. It was a staff nurse who developed acute respiratory infection (ARI) symptoms that day. She dutifully reported her symptoms. She was immediately tested and, despite the fact that she had completed her vaccination earlier in the year, she was confirmed to be COVID-19 positive. I should point out that this does not mean that she is the first infected case and had brought COVID-19 into the wards. Investigation is still on-going. But her responsible act enabled us to pick up the cluster at TTSH.

Our immediate priority in such situations has been to contain and isolate the infections so that they do not spread to the larger community. Hence, we immediately threw a containment ring around this first detected case, quarantining close contacts and testing everyone who could have been in contact with the individual. This included all staff and patients of the affected Ward 9D. By the next day on 29 April, we had identified three staff and six patients of Ward 9D who were infected.

One of these patients had started to display COVID-19-type pneumonia symptoms at this time too. As he had entered Ward 9D earlier on 20 April, testing and quarantine were, hence, further extended to all staff who worked in Ward 9D from 20 April, as well as discharged and current inpatients and visitors to Ward 9D from 20 April. Testing was also expanded to include all in-patients and all staff working in the main ward block.

After this first round of testing was completed, all other TTSH staff were also screened. For additional precaution, patients and staff from the main ward block were also retested a second time. We then threw a larger ring around TTSH, inviting discharged patients and visitors who were in the hospital during the affected period to also be tested. They are not close contacts and, hence, have a lower risk of infection, but we offered to test them out of an abundance of caution and to give them peace of mind. For every case detected, a large ring was drawn around them for testing and isolation, and we locked down all wards that had exposure to the infectious cases.

In total, as of 10 May 2021, close to 2,500 individuals had been quarantined; 12,500 individuals had been tested as part of the special testing operations. This is in addition to 12,000 staff, 1,000 patients as well as those who have been quarantined. A total of 43 cases were confirmed, comprising 10 staff, 26 patients and seven visitors or household members. We will continue to monitor these individuals who have been exposed and retest them where necessary, as some of them may be incubating the infection.

Of the 43 COVID-19 cases in the TTSH cluster, seven staff and two patients had received full doses of the COVID-19 vaccine. They were all either asymptomatic or only exhibited mild symptoms and none of them required oxygen support. Of the 34 individuals who were not fully vaccinated, six required oxygen, two are in intensive care and one has, sadly, passed away from COVID-19 complications.

While the numbers are too small to draw firm conclusions, the findings do indicate that vaccination provides critical protection even against COVID-19 variants. We know that while vaccination does not eliminate the risks of infection totally, it does provide significant protection against infections and help to reduce the severity of the disease. It is also likely to reduce onward transmission. I, therefore, urge everyone to get vaccinated when it is offered to you and continue to comply with safe management measures even if you have been vaccinated. This will help to keep all of us safe.

TTSH has implemented a series of measures to prevent further spread within the hospital. Besides locking down the affected wards, TTSH has also stopped all new admissions to the hospital, restricted visitors and reinforced infection control, hand hygiene and PPE compliance for all staff.

Even while we were dealing with the cluster, work was also on-going to understand the source and cause of the infection. Investigation is still on-going and more will be shared when it is ready.

We have also learnt several important lessons.

(a) This particular B1.617.2 strain appears very infectious and there will be other variants just like this.

(b) Without vaccination, infection among healthcare workers would have been much worse.

(c) While vaccine breakthroughs are possible, vaccines can help to prevent severe illnesses.

(d) Vaccines can also reduce risk of further transmission, although the extent of which this is true is still being investigated.

(e) It is clear that vaccination is most effective when it is part of a whole suite of precautionary measures, such as mask-wearing, safe-distancing, accurate testing, thorough contact tracing, and timely isolation. I will talk more about vaccines later.

Since the TTSH cluster happened, there have been reports of healthcare workers there being shunned in public or refused services. I know this comes from a small minority of Singaporeans. The great majority are thankful for the sacrifices and contributions of our healthcare workers, including those from TTSH. We know you have been working tirelessly in difficult and uncertain conditions. Despite the stressful situation caused by the outbreak, you continue to do your best to care for our patients. I believe I speak for the great majority of Singaporeans, all of us in MOH and everyone in this Chamber, that we are all solidly behind you. [Applause.]

Sir, while we are in the midst of what appears to be a re-emergence of cases in our community, we are in a stronger position today compared to a year before. We know more about the virus. We have strengthened our healthcare system, built community care facilities, expanded our testing capacity, enhanced our contact tracing capability, introduced safe-distancing measures and embarked on vaccinating our population, which I will touch on next.

We started COVID-19 vaccinations in Singapore at end 2020 and we continue to make steady progress with our vaccination programme. As of 9 May, about 1.8 million individuals have received at least one dose of the vaccine and of which about 1.2 million individuals have received their second dose and completed the full vaccination regimen.

Take-up has been encouraging. About two-thirds of eligible persons aged 45 and above have received the COVID-19 vaccination or booked their vaccination appointments. However, we need to continue to encourage more to be vaccinated especially among the seniors, given their age, they are the most vulnerable. I urge all of us to encourage our elderly family members too.

We will be inviting subsequent age bands to receive vaccinations from the latter half of May. However, as vaccine supplies continue to be limited, vaccinations will be progressively extended in smaller age-bands. We thank everyone for your patience. If vaccine supplies arrive as scheduled, we will complete the vaccination programme by the end of this year.

Sir, I spoke about vaccine effectiveness earlier. We knew from the start that vaccine breakthroughs are possible. But vaccination would still significantly reduce the chances of infection. For example, based on a study published in Lancet, Pfizer vaccines can reduce risk of asymptomatic infection by 91%. Vaccination also prevents severe reactions to the infections and is likely to reduce onward transmission.

Locally, as of 10 May 2021, 30 local fully vaccinated cases tested positive for COVID-19. There were another 24 imported cases that were already vaccinated.

Most of our local cases of infected vaccinated individuals were asymptomatic. None had severe COVID-19 disease requiring more intensive care. This is consistent with the international experience and emerging evidence that vaccines are highly efficacious in protecting against severe COVID-19 disease and likely to reduce the risk of transmission.

There is also a question on re-infected cases, which are known to be possible from overseas and local experiences. As of 10 May 2021, 26 cases have been assessed to be re-infections. We are still investigating whether these are due to the general waning immunity over time or the lack of cross-protection against specific variants of COVID-19 that the individual is naïve to. We will provide an update when we know more.

Overall, the benefits of the Pfizer-BioNTech and Moderna COVID-19 vaccines continue to outweigh the known risks and we must continue to encourage Singaporeans to be vaccinated.

One area of concern is the emergence of new COVID-19 variants from time to time. There is intense on-going global scientific evaluation for these variants, which our experts are also participating in. The current global consensus is that COVID-19 vaccines that have been approved can provide protection against these variants because these vaccines elicit a broad immune response involving a range of antibodies and cells. We will continue to monitor development in this area and assess whether our vaccine programme needs to be adjusted.

Members have also asked about vaccination for children below 16 years old, people with mild allergic reactions and the need for a third booster shot.

Pfizer-BioNTech and Moderna are currently only approved for use in persons aged 16 and 18 years old and above, respectively.

The initial data provided by Pfizer-BioNTech and Moderna at the time of the Pandemic Special Access Route (PSAR) interim authorisation did not include data regarding their use in younger populations. The Health Sciences Authority (HSA) has been examining the supplemental data that has since been submitted for the Pfizer-BioNTech vaccine to assess if the vaccine meets safety and efficacy requirements for authorisation under PSAR for use in adolescents aged 12 to 15 years. HSA will also do so for the Moderna vaccine when data is submitted to them. We will share more details when the studies are completed.

As for children below 12 years of age, clinical trials are still on-going and may take more time before enough data is available.

Mr Gerald Giam asked if patients who experience mild allergic reactions from the first dose can take their second dose. Persons who have been assessed by a doctor to be allergic to the first dose of the COVID-19 vaccination are currently contra-indicated from the vaccine and should not continue with the second dose.

We understand that individuals who cannot be vaccinated or cannot complete the vaccination may be concerned that they are not protected from COVID-19. These people are kept in our records and we will inform them when there is a suitable vaccine for them or when new evidence that shows that current vaccines can be administered to them is available. At the same time, as more of us are vaccinated, we also protect them indirectly.

As for booster shots, data on the need for it is still emerging from both international and local studies. We will share more when we know more. Meanwhile, get the two shots first.

HSA and the Expert Committee for COVID-19 Vaccinations will continue to monitor on-going studies in areas, such as the extent to which vaccines can prevent onward transmission, the durability of protection provided by vaccines and the effectiveness of vaccines against emerging variants of concern, and will provide updates when available.

Members have asked about adverse effects following vaccinations. As of 18 April 2021, HSA has received 2,796 suspected adverse events reports associated with the use of COVID-19 vaccines. This represents 0.13% of doses administered but the majority are non-serious adverse events. Only 0.004% of our doses administered had reported serious adverse events.

In general, the observed trend of adverse events within Singapore is consistent with those reported overseas. The most commonly reported adverse events are not serious. This includes dizziness, fever, muscle ache, pain at the injection site, headache and allergic reactions. These symptoms generally resolve within a few days.

Most of the patients here have recovered or are recovering from these adverse events. We have also not seen any local cases of unusual blood clots associated with low platelets that have been reported with other vaccines used overseas.

HSA has released the details of reported adverse events on 6 May 2021, which will continue to be published on a routine basis.

HSA continues to actively monitor and review the safety of the COVID-19 vaccines. In addition to monitoring reports from international regulatory counterparts, HSA also reviews reports from local healthcare practitioners on adverse events following vaccination regardless of whether causality can be established. HSA has appointed three expert panels to review neurological, cardiac and hypersensitivity adverse events, such as anaphylaxis, which occur following vaccination. This will allow for prompt and appropriate actions to safeguard public health and advance vaccination safety.

Ms Sylvia Lim asked for an update on the Vaccine Injury Financial Assistance Programme, or VIFAP for short. As of 3 May, 104 applications have been received. Of the 75 applications reviewed so far, 45 applications have been rejected and 30 applications were assessed by the independent clinical panel to have met the qualifying criteria. These include 21 cases of hypersensitivity allergic reactions, four neurology-related cases, three cardiology-related cases and one haematology- and dermatology-related case each. All of them have since been discharged from hospitals. The remaining 29 applications are pending.

Miss Cheng Li Hui asked if we will recognise overseas vaccinations that are not approved by HSA. As Members are aware, the Minister for Transport, Mr Ong Ye Kung, has shared that we are in discussion with several regions on the mutual recognition of vaccination certificates for purposes of travelling. We will release details once arrangements are finalised.

A few Members have asked about the progress of the evaluation of Sinovac and other vaccine candidates.

As part of our efforts to secure a diversified vaccine portfolio to improve our chances of securing a suitable vaccine that is safe and effective for our population, we entered into what we call advance purchase agreements (APAs) with several pharmaceutical companies, such as Moderna, Pfizer-BioNTech and Sinovac, last year, even before these vaccines completed their clinical trial. This was how we managed to start our vaccination drive with Pfizer-BioNTech and Moderna vaccines early.

Based on the schedules that had been planned for and committed under the advance purchase agreement with Sinovac, Singapore has taken delivery of a shipment of the vaccine. HSA is currently carefully evaluating Sinovac and a few other vaccines for use in Singapore and we will update the public when we have made progress.

While there has been a concerted effort to encourage the take-up of COVID-19 vaccinations, such as educating the public on why vaccinations are needed, we are aware of vaccination misinformation too. Mr Pritam Singh asked what we are doing about this and how we can address this.

Overall, public education remains a cornerstone of our vaccination programme. Government agencies have been using multiple platforms, including print and broadcast media, social media, direct messaging platforms and Gov.sg, to communicate essential information about COVID-19, including its vaccines, to all segments of society.

When the situation calls for it, we will also not hesitate to use legislative levers, such as POFMA Correction Directions, to stop individuals from spreading misinformation and fear-mongering.

All of us have a role to play in stemming the spread of misinformation. Once again, I urge everyone to check that the information they receive comes from reliable sources and make the effort to verify before sharing them.

Sir, we have hit a bump on our path to recovery and the coming few days and weeks are critical as we seek to uncover and break all chains of transmission. This came at an unfortunate time as I know many Singaporeans are looking forward to the upcoming Hari Raya and Vesak Day celebrations. However, the recent community cases show that there remain risks of COVID-19 outbreaks locally and we need to remain vigilant to avoid an uncontrolled resurgence of community cases.

I want to thank Singaporeans for your understanding and appeal to everyone to follow the safe distancing measures to prevent further spread of COVID-19 and keep Singapore safe even during these festive seasons.

The past year has been a tumultuous year. One of the biggest challenges was striking a right balance between saving lives while preserving livelihoods. Our response has not always been perfect. But we have built many new capabilities to meet the new challenges as they emerge. We will continue to learn, improve, be nimble in our response and adapt as the situation evolves.

COVID-19 is a global crisis. Our recovery is contingent on the world's ability to contain the COVID-19 pandemic. With the pandemic still raging in many parts of the world, our fight against COVID-19 will continue for a while yet.

I will be handing over MOH to Minister Ong Ye Kung shortly but I will continue to co-chair the Multi-Ministry Task Force together with Minister Lawrence Wong and Minister Ong. I would like to take this opportunity to thank members of the task force for their support, which has allowed us to mount a whole-of-Government response to the pandemic.

I want to particularly thank the healthcare professionals – doctors, nurses, allied health – both in the public and private sectors for their support in our public health and medical aspects of our COVID-19 response.

Finally, I want to thank all Singaporeans for your support and your patience. Sometimes, we had to move very quickly and adjust our measures in quick succession, which we know can be very disruptive. I am glad that Singaporeans could come together as a nation, make personal sacrifices to adapt to the new normal and all of us can stand shoulder to shoulder in our fight against the COVID-19 pandemic.

This ability for all of us to strive together is the most critical element in our response to COVID-19 that will make all the difference in the eventual outcome. Let us continue to work as one and I am sure we will emerge stronger together from this crisis. [Applause.]

Mr Speaker: The Minister for Education will be making a related Ministerial Statement. I will allow Members to raise points of clarifications on both Statements after this Statement. Minister Wong.

12.27 pm

The Minister for Education (Mr Lawrence Wong): Mr Speaker, Sir, we have been fighting this virus for more than a year. From the start, we have said this is a marathon, not a sprint. Really, no one knows how long the pandemic will go on for. Vaccination is a key to ending the pandemic but it will take a very long time to vaccinate the world.

Meanwhile, the virus is not waiting for us. It is changing and mutating quickly. New variants are spreading faster than the current pace of vaccinations worldwide. These variants are more infectious and potentially more virulent and more resistant to the current vaccines.

So, there is still a long road ahead of us in this fight against COVID-19. We do not know how the path of the pandemic will evolve and we must be mentally prepared for a long road ahead with many curveballs and many more twists and turns.

One scenario is that the virus will never go away. It becomes endemic to the human population. We will then have to learn to live with it. At a personal level, this means we try to lead our lives as normally as we can but manage the impact of the virus by getting vaccinated every year and taking sensible precautions.

As a country and economy, we will then continue to connect with the world to earn a living but we set up strong border defences, establish protocols for safe business travel, partner safe countries to open up our borders and keep hospitalisations and fatalities as low as possible.

We are not there yet but we are planning ahead, looking at different scenarios of how the pandemic will unfold and preparing our drawer plans and responses. In this journey, we are bound to face some bumps and setbacks. We worked together to overcome some of these difficult challenges last year.

After we exited the circuit breaker, we set out a three-phase roadmap to re-open our economy and to resume activities. We highlighted then that this re-opening process was not going to be a straightforward one and there would be potential stops and starts along the way because the virus has not been eradicated in our community and new cases can leak through our borders despite our precautions and safeguards. So, the more we open up and the more activities we undertake, the higher the risks of new cases breaking out in the community.

How do we manage COVID-19 and protect both lives and livelihoods under these very difficult circumstances? Several Members – Mr Yip Hon Weng, Mr Don Wee, Mr Alex Yam, Mr Liang Eng Hwa, Ms Jessica Tan, Mr Saktiandi Supaat, Mr Leong Mun Wai and Mr Seah Kian Peng – have raised questions about our border measures. So, let me provide some perspectives.

One option for us is to shut our borders and minimise the flow of people into Singapore. Larger, continental-sized or resource-rich countries like China, Australia and New Zealand have taken this approach. They are able to keep things going with their own resources and people and sustain a living with their own domestic demand.

But Singapore is in a completely different position. We are a little red dot fully plugged into the world. Trade and travel are our lifeblood. For us, these are not just good-to-have; they are existential issues. They are how, as a country, we earn a living and remain relevant to the world. In other words, we can keep our borders closed for a short time, but not over a prolonged duration. That is why after we exited the circuit breaker last year, we also progressively lifted our travel restrictions and allowed travellers to come in, but in a controlled and safe manner.

We recognised then that there would be a risk of some imported cases leaking into the community and we had taken several steps to strengthen our precautions and safeguards. For example, we put in place a system of regular testing for those working at the checkpoints and borders. We prioritised vaccination for them and those working in our Stay-Home Notice (SHN) facilities – the hotels. Vaccination rates are now above 90% for aviation and maritime; and 85% for the SHN facilities. We stepped up our testing protocols with pre-departure and on-arrival PCR tests. We tightened our SHN regime and ensured that the hotels we use for SHN have proper infection controls and security measures.

We also continue to update the SHN regime to respond to the evolving public health situation here and abroad. Some Members have suggested extending the SHN to 21 days. Indeed, we did so initially for the incoming Construction, Marine and Process (CMP) workers, because they would be living and working in higher risk settings. So, these workers would serve out 14 days in the SHN facility, followed by seven days in the Migrant Worker Onboarding Centres.

We also applied a 21-day SHN for arrivals from the few countries where the variant strains originated: the United Kingdom, South Africa, India. But these strains are now circulating everywhere in the world. So, it has become increasingly difficult to target just countries where the strains originated.

I should clarify that there is still no medical evidence that the new variants have a longer incubation period. But variant or not, there is always a very small tail risk of such long incubation cases. That is why we have moved recently to a tighter 21-day SHN regime for travellers from all higher risk countries during this period of heightened alert.

Ms Nadia Samdin asked if it is possible for vaccinated citizens and PRs who travel abroad to serve their SNH at home. At this stage, we prefer to take a more cautious approach and have all travellers from higher risk countries serve the SHN in dedicated facilities. But we will continue to review and consider options for the future, especially as we gain a better understanding of the new variants and when more of our population are vaccinated.

Mr Yip Hon Weng also asked about the business travellers who do not need to serve SHN. We have explained before that we allow a small group of such travellers for essential work reasons. We control the risks tightly by keeping the numbers small and requiring them to adhere strictly to a controlled itinerary. We also subject them to frequent testing while they are in Singapore to ensure they are free from the virus. The scope and usage of such travel passes are subject to constant review and close monitoring to ensure they are used in a safe manner, while minimising risks to the community.

Importantly, besides the SHN and testing protocols, we control tightly the overall flow of travellers coming into Singapore. This is a dynamic process. We adjust the travel flows from each country regularly based on our assessment of the public health situation. Once we observe any deterioration in any country or region, we will throttle down the numbers and impose stricter border restrictions for that country or region.

That was the approach we took recently because of the rapidly deteriorating COVID-19 situation in India. In April, we reduced entry approvals for long-term pass holders and short-term visitors from India. Later, we moved to ban all travellers from India. This ban was extended to the entire South Asian region from the start of May.

Let me share some numbers to provide a better perspective. Pre-COVID-19, we had 200,000 travellers coming through Changi Airport every day, both on transit as well as entering Singapore. This plummeted during the circuit breaker when we closed our borders temporarily. After the circuit breaker, as I mentioned, we eased some of our travel restrictions. By November last year, we had about 820 arrivals a day. Eight hundred and twenty arrivals a day, compared to 200,000 transit and arrivals. Between December and March this year, the figure has been stable at about 1,200 arrivals per day.

One reason for the increase in arrivals is that we had taken in more migrant workers for the Construction, Marine and Process (CMP) sectors as well as foreign domestic workers. This group was also the largest contributor to our imported cases – they account for about 40% of the imported cases over the recent six months. But even as we increased the flow of these workers, we also implemented a tighter screening and quarantine process for them. So, these imported cases were already in SHN when we detected them and they were not in contact with the community.

But the inflow of CMP workers we have allowed up to now is still unable to meet our needs. Because every day, every week, every month, many migrant workers have left to go back to their home countries. Whatever numbers we are bringing in barely replace those who have left. Our companies, including many SMEs, urgently need new workers to make up the shortfall and have been applying to MOM for approval to enter Singapore, as you have heard just now in the Parliamentary Question that was posed to Minister Tan See Leng. The application backlog has been building up significantly, even before we imposed the latest set of travel restrictions on the South Asian region. And now, the manpower crunch has worsened.

I fully understand and share the desire amongst many to be tight on our border measures. In fact, we have maintained a tight posture, as I have explained, and we will continue to do so. But we also need to be very clear what this means for Singapore and Singaporeans.

Contractors will be especially hard-hit. Building projects will be delayed. In particular, we can expect many new BTO projects to be delayed by one year or more. Private home buyers may also face delays of varying lengths.

Likewise, companies in the marine and process sectors will be badly affected. They will find it hard to deliver their existing projects on time and a few may even have to forgo new opportunities and projects. These are important sectors that we have taken decades to build. They hire thousands of Singaporean engineers and executives, and they remain crucial sources of highly skilled jobs.

The manpower shortage will not be confined to the CMP sector; it will have a cascading effect on the whole economy. In fact, any company seeking to bring in workers from higher risk countries will now face considerable delays. The waiting time for an entry approval could be more than six months. Our big concern is that if companies continue to face difficulties or are forced to close, we could then end up with higher unemployment and job losses for Singaporeans.

Stresses will be felt in our society too. Singaporeans will find it harder to reunite with their families abroad. Families applying for new foreign domestic workers to care for their children or elderly will have to wait for at least two months.

These are the consequences of keeping our borders tight. I hope Members will help to explain this to your constituents when you receive appeals, be it to shut down borders completely or to relax the restrictions to allow their workers or foreign domestic workers to come in.

Meanwhile, the Government will do more to assist the CMP sector which is bearing the brunt of the impact. The industry has been working very hard to become more manpower-lean. But this will take time. That is why MND has set out new legislation to allow existing construction contracts to be adjusted to take into account the increase in manpower costs; we are debating that later.

As announced recently, CMP firms will receive higher Foreign Worker Levy rebates from May to December 2021. The rebate for each Work Permit Holder will be increased from $90 per month to $250 per month. We will also continue to work with the CMP employers to find safe ways to bring in workers to alleviate the manpower shortage.

Beyond the CMP sector, as well as the aviation and tourism-related segments, there are signs of improvement in the broader economy. Barring a setback to the global economy and provided we are able to keep the COVID-19 situation under control, we should be able to continue with our recovery trajectory.

But things are very fluid and the outlook remains uncertain. The Government will continue to keep a close watch over the economic situation and consider how best to support those who need more help to adjust. At the same time, businesses will also need to be more agile and to start factoring the need to pivot plans or operating models at short notice. We will all need to learn to adapt quickly and be more nimble in this new uncertain and rapidly changing environment.

Even with the tightest of border controls, there may still be imported cases leaking into the community. I shared earlier that countries like China and Australia have adopted a tighter border regime than us because they can afford to rely on a larger base of domestic resources and demand. But even these countries have detected cases of new variants in their communities.

So, we cannot just rely on border measures to keep out the virus. We also need to have a full suite of protective measures and safeguards in our community. When a new case pops up, we move in quickly to isolate all the close contacts and ring-fence them, as we have been doing. We cast a wide net and conduct mass testing for all persons with possible exposures to the infected case, like what you have seen recently, when we went in quickly to test everyone in the schools or everyone working in the airport. Thus, we try our best to prevent large clusters and outbreaks from happening.

Despite these efforts, there will be a few occasions when we will need more general movement restrictions. For example, with the recent Tan Tock Seng Hospital (TTSH) cluster, the transmission was detected some time after the virus was introduced into the ward. We have tested all the hospital staff, patients as well as visitors and tried to ring-fence the cluster. But we could not be sure if there were still hidden cases out there in the community. That is why we have decided to tighten the overall rules pre-emptively – to reduce our movement and social contacts more generally, so that we can reduce the risks of transmission and curb any further spread of the virus.

I recognise that these measures pose considerable inconvenience to all Singaporeans. As Minister Gan Kim Yong said just now, there are several public holidays coming up in the month of May. Many activities and plans have had to be adjusted. I know, in particular, this must be very disappointing for our Malay/Muslim community, having to observe these strict rules during Hari Raya and to curtail your normal family visits for a second year. Likewise, for the Buddhist community during Vesak day.

I hope everyone understands why the latest measures are necessary and I thank everyone for taking them in your stride. I seek your cooperation to abide by them – not just with the letter of the law but also the spirit of it. I think it is very important for us to understand that we are now on the knife's edge and our community cases can go either way over the next few weeks.

We have a chance of getting things under control by the end of the month. But, as we know from experience, it only takes one lapse or one irresponsible action for an infection to spread and that infection may end up being a super-spreader event in the community. So, let us all do our part: work from home, cut back on social activities and interactions, and stay home as much as possible during this period.

This is not the first time we have had to deal with spikes in community cases. But compared to a year ago, our capabilities have significantly strengthened. Our testing capacity is much larger. We tested about 35,000 swabs per day in the past week and have the lab capacity to test up to 73,000 per day, or even more, with pooled testing.

Trace Together and SafeEntry are now more pervasive, which means we can contact trace and ring-fence cases more quickly. We are also regularly testing persons in higher risk settings and undertaking surveillance testing for symptomatic individuals, which was how we uncovered many of the cases reported over the recent days.

Importantly, vaccination is a major game changer. We have not vaccinated everyone yet but we have covered most of our older population as well as our healthcare and frontline workers at the air and sea ports and our SHN hotels and dormitories. This puts us in a much safer position.

Our experiences over the last year have shown that if we act quickly to contact trace, isolate, test and, if we all exercise individual and social responsibility, we can effectively suppress the spread of the virus. We have brought down infection rates in the community before and we can do it again.

We must also continue to support one another. Many have been fighting COVID-19 for more than a year. For example, our healthcare professionals testing, vaccinating and treating patients; our contact tracing teams; our public officers across multiple Government agencies; our Safe Distancing Ambassadors and Enforcement Officers and many, many more serving on the frontline. It has been very tough for all of them. So, to them, we say, "Thank you, keep your spirits up and all of us are behind you every step of the way." [Applause.]

The best way to support our frontline workers is to take all the prevailing measures seriously – do our part to reduce the risks of transmission and, when vaccination is offered to you, take it up as soon as possible. Avoid spreading falsehoods or unverified information that can cause needless fear or foster divisions and suspicions in our society. Remember, the virus does not respect ethnicity or nationality. This is not a Chinese virus or an Indian variant. This is a global pandemic – the virus and its variants are out there everywhere in the world. So, there is no place for discrimination, racism or xenophobia here in Singapore. We must continue to stand together, look out for one another, so that we can all get through this together. [Applause.]

Mr Speaker, working together over the past year, our overall situation has improved. Yes, we have had our share of setbacks, but we have learned and we have bounced back from them. Importantly, we have seen the Singapore spirit shine brightly throughout these challenging times. So, let us draw confidence from what we have been through; let us brace ourselves for the rest of the marathon, complete the race together and emerge stronger at the finish line. [Applause.]

Mr Speaker: Dr Tan Wu Meng.

12.49 pm

Dr Tan Wu Meng (Jurong): Mr Speaker, I thank the Ministers for their detailed statements. I am a healthcare worker, with brothers and sisters in the Labour Movement in the Healthcare Services Employees' Union (HSCU). I have got brothers and sisters on the TTSH frontline.

Sir, it has been very hard for many healthcare brothers and sisters at TTSH. I hear of nurses who have been told by their landlords to move out at short notice. I know of a young mother of a newborn at home, her husband works at TTSH. He has had to move out of the home to keep her and her fellow healthcare workers working at another hospital safe from COVID-19 transmission between hospitals.

Can I ask the Ministers what is being done to help affected TTSH workers: nurses who cannot find a place to stay, healthcare workers who cannot find a Grab or a taxi to bring them to the hospital or to take them home after a shift; families which have been separated by necessary COVID-19 precautions who need help with childcare, help with getting the kids to continue in school? Is there a hotline for affected TTSH staff to call? Can the Ministry set up a care team connecting the different Government agencies to provide help to affected TTSH healthcare workers, especially for challenges that may be beyond the reach of individual hospital management?

Mr Gan Kim Yong: Sir, I thank Dr Tan for raising this issue. Indeed, this is a very worrisome trend. As I have mentioned my speech, we have observed a minority of our resident Singaporeans taking steps to protect themselves at the expense of our healthcare workers' well-being. Some of them have been asked to move out of their homes by their landlords. Some of their co-workers are shunning them. I think these are wrong.

We are struggling because, on one hand, we know this is wrong and we should not condone such actions. But on the other hand, we are concerned about the well-being of the healthcare workers and we do need to find ways to help them and support them. So, MOH and the Multi-Ministry Task Force have been working together with the hospitals – TTSH as well as the other hospitals – to provide support for the affected workers. In fact, we have moved in to arrange with hotels for accommodation, to provide alternatives to these healthcare workers who have been affected.

Let me say that this should not be an excuse for the landlords to kick them out on the basis that there is now alternative accommodation and say why not just move over to the hotels rather than staying on in the flat? So, I think it is still our preference to encourage our landlords to understand the situation, to play their part to support our healthcare workers in the work that they do. I also want to urge Singaporeans to show their support to these healthcare workers. Because they are putting themselves in harm's way in order to protect us. So, let us work together to protect them.

Mr Speaker: Mr Seah Kian Peng.

Mr Seah Kian Peng (Marine Parade): Mr Speaker, first, I want to thank the two Ministers for their comprehensive Statements. And, certainly, I think all of us want to thank all the healthcare workers for continuing to protect all of us, given that this COVID-19 pandemic will continue to throw more curve balls at us.

I have a few supplementary questions for the Ministers. Minister Gan has mentioned that the vaccination supplies are limited. Indeed, they are, and very precious at that. First, what other drugs are being tested by HSA? We know that two of them have been certified; Sinovac is being tested. What if Sinovac is not approved? Do we have arrangements with the other drug companies that can increase the supplies from the other two companies, so that Singaporeans who have not been vaccinated can be assured that they will certainly get that vaccination?

The second supplementary question, I know it is a bit further ahead, but we always like to plan ahead: booster jabs and second jabs. Soon, for those of us who have had our jabs, one year will be up. What next?

And the third supplementary question is, I would like to know what is the all-in cost for each vaccination that is given. I think it is important that every Singaporean and everyone who is working here knows how much we are spending to get all of us safe.

And that leads me to the last question. Minister Lawrence Wong talked about the implications, the overall costs of all this. All of us, whether in Government, business and public, consumers, we need to expect that for all these, there are consequences; that the end of the day, somebody has to pay for all this. I think consumers, the public, probably also would have to expect that certain costs will have to go up. I think we just need to be prepared for all these. Businesses need to absorb, need to find ways to work around some of these. The Government, I am sure, will continue to help subsidise some of these. But I think the public and consumers too need to think about what are the implications for all of us, as all of us are in this together.

Mr Gan Kim Yong: Sir, I thank Mr Seah for the clarification.

First, on the vaccine supply. Indeed, the vaccines continue to be limited in supply. Also, partly because there is still a resurgence of new cases every day in many other countries and, therefore, the global supply of vaccines is limited and not just the quantity but the logistics are also challenging. Therefore, we need to do what we can to diversify our sources and to ensure that our supplies that we have contracted arrive on schedule. And when we roll them out, we encourage Singaporeans to get vaccinated as soon as possible.

As to what other vaccines are being studied, we have a diversified portfolio beyond Pfizer-BioNTech, Moderna and Sinovac. We have several other alternatives with which we have entered into advance purchasing agreements. But I am not at liberty to share the details because many of these agreements contain confidentiality clauses that limit us and our ability to share details. But as and when these contracts materialise, as and when we are able to supply and to deploy these vaccines, we will share more details with fellow Singaporeans.

Mr Seah also asked about booster jabs. As I have mentioned, let us focus on the current vaccine roll-out. I understand that some Singaporeans are anxious and want to know, should the booster jab be required, what we need to do about it. Let me share that we have put in place a planning team to look at how we can deploy booster shots, starting probably next year, towards the end of the year or beginning of next year. So, the operational plans are being drawn up and we will be able to deliver booster jabs, if it becomes necessary.

At the end of the day, it may turn out to be similar to the flu jabs that we get every year. Because of the variants, because of the different virus and bacteria that we are confronting, so we need to continue to have booster jabs for our flu vaccines. Similarly, for COVID-19, it may come a day that we have to continue to have regular booster jabs. And we are putting in place plans to operationalise that.

In terms of the cost of vaccination, it varies from vaccine to vaccine. Actually, a significant part of the cost is not in the vaccine Itself but in the logistics of it. The cost in organising the vaccination centres, mobilising the healthcare professionals, providing support for vaccine recipients; and all these are costly.

But if you compare it with the cost of the impact on lives, on livelihoods, I think it is a small price to pay and we need to continue to prepare ourselves and to focus on the vaccination programme. Roughly, it may cost about – and this is off the top of my head and I need to verify that – off the top of my head, roughly, it costs about $100 per vaccine per regimen and that it will include some of these peripheral costs and so it is not cheap. But it is important for us to continue to press on with the vaccination programme to minimise the cost on the economy and the cost of lives.

Mr Speaker: Mr Murali Pillai.

Mr Murali Pillai (Bukit Batok): Mr Speaker, Sir, I also would like to thank the two hon Ministers for their detailed Ministerial Statements. The point made by Minister Lawrence Wong about not engaging in xenophobia is something that chimes with me.

Sir, hon Members would know that there was a serious incident that was reported in the press yesterday that strikes at the very core of what we are as a nation.

It was alleged that a Singaporean woman of Indian descent was assaulted by a man who used racial slurs and kicked her for not wearing a mask. This and another racial incident come in the wake of the community spread, once again, of COVID-19, this time, attributable to a variant coming from the Indian subcontinent.

The tension appears to be fanned by posts with false or misleading narratives in the social media and circulated through WhatsApp and other platforms.

I seek clarification from the Minister for Home Affairs for his assessment of the security situation arising from these racial incidents connected to the pandemic. What steps will the Government take to nip this in the bud to address the situation?

Mr Speaker: Minister K Shanmugam.

The Minister for Home Affairs (Mr K Shanmugam): Thank you, Mr Speaker, Sir. I thank the Member for his question.

The facts we have are as reported in the media. Last Friday, 7 May, in the morning, a 55-year-old Indian lady was brisk walking towards Chua Chu Kang stadium. She said that she lowered her mask below her nose to prevent breathlessness. A man wearing a light-coloured t-shirt, accompanied by a woman, shouted at her to put her mask above her nose. She told him that she was exercising. The man then shouted at her again, used a racial slur, and she responded to him, "God bless you" and began to walk away. She said that the man then ran towards her and landed a "flying kick" on her chest, causing her to fall. She had scratches on her arms and hands. She lodged a Police report that night and she said that she would seek medical attention on 10 May – yesterday.

The matter is under investigation. The attacker is believed to be a Chinese. Investigations need to be done before we can come to any conclusions. But such conduct, unfortunately, is consistent with some of the other things that have been happening and, if the facts are as stated by the lady, then it appears to be racist conduct.

We have seen racism around the world during this pandemic: in the US, for example, Asians, particularly Chinese, being attacked; the virus being described as "Chinese virus" or "Wuhan virus", as if viruses have nationality. And we condemn that. Equally, we have to condemn such behaviour in Singapore.

I have said previously there has always been racism in Singapore like in other countries but we have managed it and, over time, we have sought to reduce it. But it has been stirred up recently.

Around the world, economic pressures have led to populism and the populists have been seeking political profit by exploiting people's fears over jobs and economic insecurity, blaming foreigners and blaming immigrants for all of a country's problems.

In Singapore, we have avoided the worst of such populism but people are concerned for their jobs, and naturally so. Amongst Singaporeans, there are legitimate concerns about foreigners taking over our jobs. The concern is fair and the Government's duty is to protect Singaporean jobs.

But these concerns have been fuelled by unacceptable practices, for example, unfair employment practices that favour hiring foreigners and discriminate against our locals. It is a minority who behaves like this, but it naturally makes Singaporeans unhappy. MOM has taken steps to deal with these bad practices.

But what has been happening also is that parties have been deliberately stoking the fears, encouraging racism, xenophobia and dog whistling, much like what we have seen in the US. That is dangerous and dangerous for Singapore because, first, it will be expatriate Indians, then it will come to Singaporean Indians. Anyway, not everyone can distinguish between foreign-born Indians and Singaporean-born Indians. The lady who was attacked has been a citizen for 25 years.

If we go down this route, eventually, all Indians can be targets of hate, the so-called "outgroup" which I referred to in a Ministerial Statement a couple of years ago. It is not the case now – far from it – but expression of overt racism is still there only amongst a minority in Singapore. The majority of Singaporeans are decent and not racist. But if we continue to fan the flames of racism, we will get to a more uncomfortable position.

There are also websites which deliberately fan racism. They are anti-Government; that is perfectly okay, but do not play with race. Comments on these sites – Indians being called cockroaches, rapists and so on – we should be ashamed that in the name of free speech, we allow such comments. This bad behaviour and open expression of racism, I invite all here to condemn. And when called out, we cannot seek to justify such racist behaviour by saying, "Oh, it is because of Government policies" or "It is because of the India-Singapore Comprehensive Economic Cooperation Agreement (CECA)" or that the Indians are behaving badly or that we are entitled to be racist and xenophobic because of these things.

Just ask whether racism and xenophobia can ever be justified on these grounds.

There have been several canards about CECA, promoted by a whispering campaign. If anyone here believes that CECA is a problem, put it up for a Motion, debate it openly and let us hear whether Singaporeans benefit or lose from it. I am looking at you, Mr Leong. I invite you to put up a Motion to debate CECA. You know that most of what is said about CECA is false.

And what is happening on the ground? We are picking up from different coffeeshops. This morning, a friend of mine overheard in a coffeeshop a conversation among five elderly gentlemen. They discussed the incident covered in the media of an Indian expatriate family. We do not know the facts; several highly racist comments targeting Indians. So, it is getting into the ground and being repeated. This will become normalised if we are not careful.

I hope responsible Opposition parties will take a stand on this, notwithstanding that many of these sites that promote xenophobia support you.

Singapore is 725 square kilometres of rock. We have to make a living by being open to the world. We will fail if we allow racism and xenophobia to become prevalent. It is contrary to everything that has made us successful and proud to be Singaporean. [Applause.]

Mr Speaker: Mr Leong Mun Wai.

Mr Leong Mun Wai (Non-Constituency Member): Thank you, Mr Speaker. In reply to the Minister's comments just now, we are very interested to take up the CECA issue at some point in time. I think we still need to understand the situation more, like what the Minister has said.

However, I must state at the outset that the Progress Singapore Party (PSP) and myself are not being xenophobic. We are just stating the economic effects some of these free trade agreements have had on our economy – the feedback gathered from many suffering Singaporeans.

We still need to know the situation better but we are definitely not xenophobic and, definitely, racism has no place in our overall thinking. It is all about economics, about livelihoods and, today, we are here talking about COVID-19. It is also about livelihoods, about lives over economy. Sometimes, we may have to give up some of our economic benefits for the sake of lives. But at the end of the day, we still need to balance and see what is good for our overall livelihoods.

So, I will take up the challenge from the Minister – that we will take up this issue at an appropriate time in the future.

Mr Speaker: Mr Gerald Giam.

Mr Gerald Giam Yean Song (Aljunied): Thank you, Mr Speaker. I thank Minister Gan for his reply to my Parliamentary Question and that those who have experienced allergic reactions to the first vaccine would not be able to take the second dose. I just want to confirm that that is correct. Can I confirm that this applies to all allergic reactions or is it only to anaphylaxis? And what kind of adverse events will rule out patients from taking the second vaccine? I am concerned that if we set the threshold too low, many people will be ruled out from their second dose after reporting allergic reactions and this will impact the overall immunity rate of our country.

Secondly, I understand that all hospitals have started mass swapping all their staff and patients. When COVID-19 cases were discovered in Tan Tock Seng Hospital (TTSH), the hospital completely stopped accepting new admissions and many patients were diverted to other hospitals. Should cases be uncovered in other hospitals after the mass testing, will they, too, stop accepting new admissions? If so, the remaining hospitals may get overwhelmed.

I am not saying that we should not conduct mass testing, but do all hospitals have a business continuity plan to avoid a complete lockdown if new cases are discovered?

Mr Gan Kim Yong: Mr Speaker, Sir, I agree with Mr Giam that we need to be very careful in calibrating the criteria for exclusion from the vaccination because we do want as many Singaporeans as possible to be vaccinated. But I must say that I am not a doctor. So, I cannot give the Member a medical advice here. My suggestion is that if you go down to the vaccination centres, there are medical professionals there, they will make an assessment and it will have to be on a case-by-case basis.

Generally, if you have anaphylaxis, you will be excluded from the vaccination. But different forms of allergic reaction will have to be assessed by the medical professionals. But generally, if the allergic reaction is mild, you should be able to continue to receive vaccinations.

But we have to be careful because we do want to minimise adverse reactions, particularly those which are more severe. So, it is a calibration and we will have to leave it to the medical professionals to make an assessment on the ground.

Mr Giam also asked about our contingency plan for hospitals if there are cases where clusters are found. They all have a contingency plan and they will continue to see their patients. What we want to do with Tan Tock Seng Hospital is because the clusters are big and we need time for us to ascertain that there are no other underlying transmission of infection within the hospital before we reopen the hospital for new patients. So, this is something that we are working on.

But it is again important for us to test all our workers at this point in time because we are concerned that similar situations might happen in other hospitals. If we do not detect the clusters and cases fast enough, it will become a widespread transmission within the other hospitals and this will be an even bigger problem.

Sometimes, some may say it is better not to know. But, as far as I am concerned, I think it is better to know than not to know. At least, if we know that there are cases, we can deal with it, we can implement contingency plans to manage the patients and to also help the healthcare workers in these hospitals.

So, I would urge Singaporeans to also refrain from going to emergency departments. If it is not an emergency case, not an urgent case, then go to our primary care clinics and get your issues attended to. If it is an emergency, if you are having a stroke or have a heart attack, if you have problems, do go to the emergency departments and we will take care of you.

Mr Speaker: Dr Tan Yia Swam.

Dr Tan Yia Swam (Nominated Member): Mr Speaker, thank you. I want to thank Minister Gan for acknowledging the dutifulness of the staff and all of Tan Tock Seng Hospital (TTSH). I am married to a TTSH staff and many TTSH families are now made to live apart to reduce risk to other hospitals, to better support the needs of Singaporeans.

But I am concerned about possible on-going community spread. Would there be a consideration to make it compulsory to swab all patients visiting a hospital, whether inpatient or outpatient?

Mr Gan Kim Yong: It is something that we are studying but it is not easy to swab all patients because some of them would already have symptoms and some of them may already have pre-existing conditions. Some of them, even after swabbing, could be negative. They could also be infected by visitors and they could also be within the incubation period and they can become positive thereafter. So, it is important for us to put in place safe distancing, safe management measures even within the hospital to ensure that precautions are taken. The staff, healthcare workers must wear the necessary protective wear, whether it is PPE, depending on the setting; even in the inpatient wards or outpatient areas, precautions have to be adopted.

We cannot assume that after swabbing, everyone would be safe. But we are looking at to what extent we can extend the testing for visitors and for patients that are admitted into hospitals.

Mr Speaker: Mr Ang Wei Neng.

Mr Ang Wei Neng (West Coast): Many of my residents and friends who have taken the jab at the vaccination centres, they have had very good experience. They said the staff are patient and efficient. Kudos to the staff at all the vaccination centres in Singapore. Meanwhile, I have supplementary questions for the Ministers.

We know that Changi Airport Terminal has a cluster and it is developing. So, what are the lessons learnt from the clusters as they are developing in Changi Airport and what impact does it have on the upcoming Shangri-La Dialogue and the World Economic Forum that are to be held in Singapore?

Last but not least, I would like to touch on a point by Dr Tan Wu Meng to say that taxis are shunning the Tan Tock Seng Hospital (TTSH). Before I proceed, I would like to declare my interest as the ComfortDelGro Taxi CEO. I would like to assure the House that the taxis, especially the ComfortDelGro taxis, are not shunning TTSH or other clusters like Changi Airport. In fact, a cabby had just texted me that he has been encouraging his fellow cabbies to not shun TTSH.

Mr Lawrence Wong: Mr Speaker, the experience from the latest cases picked up in Changi Airport as well as the clusters we have seen from ICA and Tan Tock Seng Hospital so far suggests that, as Minister Gan mentioned in his earlier speech, this strain or the variant that we are experiencing now is more infectious. Each time we pick up an infected case, we are seeing larger clusters. More people are being infected than, say, the experience last year.

So, what this means for us is that we really need to take this seriously. We should take all the safe management measures and all the infection protocols very seriously. People who need to wear PPE need to be very diligent about this. Those who are in close contact or doing high-risk jobs need to be very diligent about wearing of masks, for example, and make sure they are wearing a proper mask. So, these are all basic things but I think it is worth re-emphasising.

The other point is that testing can be a big help. We have seen how, through very frequent testing, either by doing a special sweep of everyone or doing it on a regular basis, we are able to pick up cases very quickly. So, that is an important point that we should not give up. Vaccination is important but testing remains an important way for us to detect the virus quickly.

When we talk about events that are coming up, certainly, we will apply all of these lessons – infection control, safe-management measures and frequent testing – to ensure that these events can be conducted safely.

Mr Speaker: Ms Sylvia Lim.

Ms Sylvia Lim (Aljunied): Thank you, Speaker. I have a clarification for the Minister for Health and one for the Minister for Education.

First, to the Minister for Health. Before I do that, I would just like to assure him that I, too, feel nostalgic that this may be the last time that I would have the chance to pose health-related questions to him after the last 10 years. So, the feeling is mutual in that sense.

On to my question, it is about the Vaccine Injury Financial Assistance Programme which he gave some figures on just now. Earlier, he said that there were 104 applications received and about 30 applications were adjudged to have met the qualifying criteria. So, does that mean that these 30 claims are going to be allowed and some payment is going to be made on these 30 claims? Then, he also mentioned that there were 75 that were rejected. I would like him to clarify the reasons for rejection because, from the portal for submission of the application, it appears that every application has to be accompanied by a doctor's certification that the side effect is related to the vaccination. So, for these 75 rejected cases, was there actually an accompanying medical certification that the side effect is related to the vaccination? And could he clarify why those applications were rejected?

For the Minister for Education, the recent round of tightening measures included some that affected the fitness industry. I think he is aware that this has caused a lot of unhappiness and anxiety, as it affects the livelihoods of trainers and also the customers. Subsequently, there was a slight adjustment to this announcement to say that low-intensity activities would be allowed to carry on indoors. But I understand that this has been accompanied by a requirement that the patrons have to bring their own equipment to the fitness studios or the gyms, which, to most people, would be a disincentive to go to the place in the first place because these are things you go to the studio for because you cannot do them at home.

So, I would like to ask him whether the Government will review this requirement because it is already setting capacity limits, it is saying that the activities have to be low intensity, masks have to be on at all times. If there can be some additional measures, such as requirement to wear gloves and so on, would the Government re-look at this requirement for customers to bring their own equipment to the fitness studio?

Mr Speaker: Minister Gan. I am actually interested in the answer to the second question. There is an impact on our gym here in Parliament as well.

Mr Gan Kim Yong: Thank you. Let me just clarify that 75 have been evaluated; 45 were rejected, 30 were approved. That is the number; not 75 are rejected. Among those that were rejected, some of them, the panel will have to assess whether it is more likely to be associated with vaccination or not. There is also a balance of probability that they have to assess. And some cases did not qualify because the severity did not meet the mark of a severe reaction. Some of it may be rashes, maybe some swelling, but does not require extensive medical care and, therefore, may not qualify for the application.

So, there are a variety of reasons. But suffice to say that they are all assessed thoroughly by an independent panel before they were approved or rejected.

Mr Lawrence Wong: Mr Speaker, our approach towards these high-risk activities has been consistent, in the sense that if you look at what we have done for nightclubs, karaokes, for example, we have not allowed these activities which we think are of higher risk, but the premises have been allowed to pivot to other activities which are permissible. Last year, Members will recall, Zouk, maybe even now, has been transformed and changed to different kinds of activities.

So, in that sense, we continue to apply the same approach now to gyms and fitness centres. Why did we specifically identify this activity? Because we have seen evidence of spread in other places, we have had infected persons use gyms and fitness centres in Singapore, and we have been very worried of large clusters potentially breaking out in these settings. Because in a gym fitness centre, it is an enclosed space, many people are there, very often without masks on, spreading a lot of droplets each time you are exercising, shouting or whatever you are doing in the gym, Zumba or whatever that lesson is, the chances of a spread within that environment is very high. That is why we have decided, during this period of heightened alert, this is one of the highest risk kinds of activities; better to put a stop to it temporarily. But if the operators are able to pivot or do something differently, something of lower risk, then we will be able to allow it.

On the specific issue of equipment, we will be prepared to look at it. There is concern, obviously, because there will be infection, not just through droplets but also fomites and touching the surfaces. Remember how last year we encouraged everyone not to use your hands to touch your face? That basic advice still remains. You can still get infected by contact.

So, that is the reason why we suggested people bring their own equipment, but we will continue to monitor the situation very closely. And we will see if there is any possibility of modifications along the way, depending on how the next few days and weeks unfold.

Mr Speaker: Minister Ong Ye Kung, you have a clarification?

The Minister for Transport (Mr Ong Ye Kung): 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? 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.

Mr Speaker: Mr Leon Perera.

Mr Leon Perera (Aljunied): I would like to thank both Ministers for their very helpful Statements. Just two points of clarification for the Minister for Health.

Firstly, he mentioned that HSA is studying the use of the Pfizer-BioNTech vaccine for adolescents and children. I understand that the US Food and Drug Administration has just approved the use of the Pfizer vaccine for children aged 12 to 15, and this is just a very recent development. So, I am wondering, assuming that HSA finds that it is safe to do so, can we assume that we will proceed to vaccinate school-going children above the age of 12 with the vaccines that we have?

My second clarification is on the vaccination effort. I think the Minister for Health shared very heartening figures about the progress that we have made. The majority of people over 60 years old have been vaccinated. Given how key this vaccination effort is to our fight against COVID-19, I am wondering if MOH is studying the example of a handful of countries which have been very successful and made very rapid progress in vaccination – Israel is one example. I believe roughly 90% of those over 60 years old in Israel have been vaccinated in a very short time. Are we studying those examples to see what lessons we might be able to learn in order to accelerate the speed of this vaccine roll-out in Singapore?

Mr Gan Kim Yong: Sir, as I have mentioned in my speech, HSA is now evaluating the use of Pfizer-BioNTech for the younger population. And I believe the results should be out quite soon. Once the results are out and if it is, in fact, deemed effective and safe for deployment to the younger population, we will roll out the programme to vaccinate the younger population, also shortly. So, be patient with us, we are doing the assessment. I have to also explain that the assessment differs from country to country. While WHO and some countries may have approved the use, we still need to assess the efficacy and safety of this vaccine in our own context. So, it will take some time and I believe the results should be out shortly.

Mr Perera also asked about whether we have learnt the lessons from other countries on the promotion of vaccination. Yes, indeed, we watched what the other countries do and we try to learn as much as we can from them, whether it is through promotion, through messaging and even through family members to encourage them.

I think all of us will understand that every country is different, the culture is different, the context is different and beliefs are different. Therefore, we also have to evolve our own system of outreach to encourage people to sign up for vaccination. I must say that I am encouraged by the take-up rate so far. But I think it is always the last 20% to 25% that is most difficult to reach. Therefore, I would encourage all of us, Members of Parliament, as well as grassroots leaders, to do what we can to reach out, especially the harder to reach, the older population, to help to explain to them the importance of vaccination.

I do house visits myself, before the recent tightening of the measures. I bring along my grassroots leaders to see whether we can persuade the individuals, the seniors at home, to sign up and we help them sign up on the spot because many of them are waiting for their children, and their children will be very busy and unable to help them. So, we tried our best to reach out to them and make it easy for them to sign up. We also organise activities on the ground; to invite the seniors to come down, explain to them why vaccination is important and to also help set up a station to help them sign up on the spot.

I think there are quite a few things that we can do and we can have our own way of reaching out to the seniors, to see how we can further promote vaccination among them. Again, it is also important to stamp out false information, misinformation and rumours that may stop them or discourage them from getting vaccinated. So, I would encourage all of us to verify our message that we have received before we virtually just forward them to all our friends. Please verify them. If they are not true, please do not forward them.

Mr Speaker: Ms Ng Ling Ling.

Ms Ng Ling Ling (Ang Mo Kio): Thank you, Mr Speaker. I would like to thank both Ministers for the updates and the tremendous efforts put in by everyone to safeguard life and livelihoods for Singaporeans during this difficult time. One clarification is that with the resurgence of the community cases happening just a few months after our Phase Three re-opening from end of December last year, and with the roll-out of vaccination, what is the learning? And how might we plan our re-opening differently this round, after the current tightening measures, ending May, especially with the June school holidays coming up? Should we be prepared for the measures to maybe last for a longer period?

Mr Lawrence Wong: Mr Speaker, as I think we have highlighted and shared, there is no place for complacency. Assuming we are able to curb the current community cases, bring things back under control, yes, I think there is a chance we will be able to then get back on track with our re-opening plans. But really, even if we were to be able to do that, there is no place for complacency in our community.

We all still need to realise, whatever we do on our borders as you heard just now, even for places that have been very, very tight – China Australia, Taiwan – cases leak through. Leaks will happen. Even in our community, it is not likely that we have ever throughout this whole period been able to eradicate the virus. There has always been a low level of circulation.

So, even if we can get today's outbreak under control and we start resuming more activities, there is no place for complacency. We must remain alert, vigilant and uphold all the necessary safe management measures.

Second, vaccinations, as I have said, is an important game changer. Today, you have heard where we are now, we are making good progress. By May, June, July, we will continue to scale up and get more of our population vaccinated. The more we do so, for example, once we cross 50% of the population getting vaccinated, all the models and all the studies suggest that then, even if a cluster were to happen, the number of people infected will not be as large. It would be more contained and we will be safer.

So, if we stay alert, stay vigilant, uphold all the prevailing safe management measures, continue to press forward with our vaccination programme, then I think there is a good chance we can remain on track with our re-opening plans.

Mr Speaker: Leader of the Opposition.

Mr Pritam Singh (Aljunied): Thank you, Mr Speaker. First, a quick response to Minister for Home Affairs on his short statement. Yesterday, the Head of the Workers' Party media team, Mr Leon Perera, put out this Facebook post, this is 13 hours ago: "It is important that as a society, we each do our part to help make sure that difficult times bring out the best and not the worst in Singapore. We should take heed of incidents like this as it is a reminder of the part we all play to deny acceptability to acts of hate such as this appears to be." This was in response to the Police announcement that it was investigating a man accused of using a racial slur and kicking a 55-year-old woman. Insofar as the Minister for Home Affair's statement is concerned, indeed, we are in agreement. There is no place for racism in Singapore – no "ifs", no "buts".

I have two supplementary questions with regard to the Statement by the Minister for Health.

The first pertains to the HSA safety update that was recently released. It covered the suspected adverse event reports and I think this is a very important document released by MOH, because there is significant misinformation fuelled by not just misinformation alone, but different understanding of the safety of the vaccine. So, it is not necessarily misinformation, but genuine concerns that people may have. As usual, when you are concerned, you tend to be more animated and this can take on a life of its own. So, my request to the Minister is to consider whether this very useful document can be made into an infographic for easy sharing amongst members of the public, particularly the last 20% to 25 % that Minister said is hard to get through to with regard to the messaging on vaccination. The Workers' Party Members of Parliament have been doing their part to encourage older Singaporeans, in particular, to get vaccinated.

My second question is, again, to the Minister for Health. This pertains to the cluster at Tan Tock Seng Hospital. We have some residents – as I am sure Members in this House also have – who are in Tan Tock Seng Hospital because of some terminal illness or who are very ill. And the cluster at Tan Tock Seng Hospital has resulted in the visitation hours for family members of some of these patients to be severely curtailed. I am requesting the Ministry to consider whether there could be some regime to help these family members to have a bit more face time with their ill or terminally-ill family members.

Mr Gan Kim Yong: Sir, the answer to both questions is yes. We will try to make our report as easy to understand as possible. Maybe we will rely on "Mr Phua Chu Kang" to help us convey some of these messages. I believe some of you have seen the recent video that we have put out, which has been very effective in communicating some of these messages. We will see how we can make it simpler, easier to understand and to also avoid misunderstandings and rumours.

Secondly, on the visitation to Tan Tock Seng Hospital, I think the Member would understand why we need to tighten our visitation rules because we do want to prevent any infection that is in the hospital from spreading to the community and also to prevent visitors bringing in new infection to the hospital that will complicate the management process at the moment. But we do understand that there are family members who want to visit their elderly, their frail loved ones, particularly those who are terminally ill. They want to spend time with them and the hospital will make exceptions. And if you do come across any of these cases, you can either appeal to the hospital or to me. We will make adjustments and we will make allowance for them to visit as much as possible, but to also take into account the various precautionary measures that have to be put in place.

1.44 pm

Mr Speaker: Order. End of Ministerial Statement. The Clerk will now proceed to read the Orders of the Day.