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

The Minister for Health (Mr Gan Kim Yong): Mr Speaker, Sir, thank you for allowing me to update Members again on the COVID-19 situation and address some of their questions.

When I spoke in March 2020, we were seeing the centre of the pandemic shift away from China, and a rapid increase in cases globally. Close to 80% of our cases then were imported, mainly from returning Singaporeans. We tightened our border controls and our import cases have drastically reduced. In the past week, we had no imported cases, down from around 16 a day on average in March.

At the same time, we have seen a rise in community cases from nine a day in March, to 31 a day on average in the week before circuit breaker, with an increasing proportion of unlinked cases, suggesting that there is underlying community transmission. We decided to do the hard thing – to impose circuit breaker measures from 7 April 2020, and introduced stricter measures following that on 21 April 2020. We also extended the circuit breaker measures to 1 June 2020.

There are signs that our circuit breaker measures are working. The average number of new community cases had fallen from 31 in the week before the circuit breaker, to 11 last week. The average number of new unlinked community cases a day had similarly reduced from 12, to five over the same period.

This suggests that our circuit breaker measures are effective. Let me take this chance to acknowledge the many sacrifices of our people, workers and businesses during these past few weeks of the circuit breaker. It has not been easy, but you have all played a part in bringing these numbers down and I want to express my heartfelt gratitude. But we are not out of the woods yet.

While the community cases are coming under control, we have seen a rise in migrant worker cases, particularly in the dormitories. We moved in quickly, set up medical posts in all the purpose-built dormitories and provided mobile medical support for the factory converted dormitories. MOH worked with the Inter-agency Task Force led by MOM to ensure the medical needs and welfare of the workers are taken care of. We are grateful for the assistance of the Task Force's members including the SAF and SPF and our healthcare workers from our public healthcare institutions as well as from the private sector. We are making progress and will continue to do our best to care for our migrant workers. Minister Teo will elaborate on this in her Statement.

Notwithstanding stringent precautions, there have also been cases at our Nursing Homes and at one Welfare Home. As these facilities serve the elderlies who are a vulnerable group, we take such cases very seriously. MOH has ramped up more aggressive testing for staff and residents at these Homes, working jointly with MSF. This is to protect our vulnerable seniors, by quickly picking up hidden cases if any, to isolate them and care for them and thus protect the rest of the Homes' residents and staff. We have started this, but it would take some time to complete.

Meanwhile, we may see cases picked up at these Homes as a result of the active screening. In addition, we are also arranging lodging for staff who interact with residents at designated accommodation facilities on-site or at hotels, to reduce their exposure to the community during this circuit breaker period. Both these steps complement existing safe distancing and infection control measures, so as to enhance protection to our seniors in these Homes.

Overall, despite our high case numbers, we have managed to keep death rates low so far. This is partly because most of our patients are younger and partly due to the tireless efforts of our healthcare workers in providing good and timely medical care for all our COVID-infected patients. We must continue to do all we can to save patients who become gravely ill and keep fatalities as low as possible.

In preparation for the expected increase in the number of cases, especially from the dormitories, we have rapidly expanded our healthcare capacity. This includes both medical facilities, and also healthcare manpower.

We have seen countries whose healthcare systems were overwhelmed and this quickly led to high numbers of death among patients. Ms Irene Quay has asked if we have an ethical framework to allocate use of healthcare resources. We are working hard to avoid getting to this point. We have planned ahead, created and ramped up many different types of healthcare facilities to support the specific needs of COVID-19 patients. In addition, our healthcare system has the flexibility to stretch our capacity to respond to increasing demand. Let me elaborate.

First, on hospital and ICU beds. To ensure that there is available hospital capacity to care for COVID-19 patients, public hospitals have postponed non-urgent elective procedures and discharged medically stable long-stayers to step-down care facilities. Public hospitals have also repurposed and converted existing wards into isolation rooms and progressively opened more wards for COVID-19 patients. Our number of isolation beds has increased from around 550 in January this year, to close to 1,500 as of 2 May 2020. NCID has also increased their capacity from about 100 to more than 500 negative pressure isolation beds in the same period.

Currently, 28 COVID-19 patients are in our ICU, as the majority of the cases are mild. We have about 150 vacant ICU beds and can quickly bring another 300 online. But we are not taking any chances as we must preserve our buffer capacity.

Mr Leon Perera had asked about our ability to further ramp up. The public hospitals have put in place plans to ensure that their infrastructure, equipment, medications and manpower are in place to add another 450 ICU beds by mid-May if needed. We have also ensured a sufficient supply of ventilators and other ICU accessories to support the care of ICU patients.

The majority of our COVID-19 cases have only mild symptoms. Hence, we have expanded our medical facilities to care for patients with mild symptoms and those who are on the recovery path and no longer need extensive medical support. These facilities allow the hospitals to focus resources on providing care to those who require emergency and intensive care. The Community Care Facility (CCF) is one such facility for patients with milder symptoms. At the CCFs, patients continue to be monitored and have access to appropriate medical care when needed.

Currently, we have more than 10,000 beds in our CCFs for our patients. These include places such as the D'Resort at Paris Ris, Singapore Expo Halls 1 to 6 and part of Changi Exhibition Centre. Another 10,000 are being set up. Building up our CCF capacity called for a multi-agency effort comprising Government agencies and the private sector. Many teams had worked round the clock to make this possible, and I want to extend my gratitude to all of them.

For example, for the first hall in Expo, this was made possible through the hard work of individuals from Temasek Holdings, Singapore Expo, Surbana Jurong, the Integrated Health Information Systems, Resorts World Sentosa as the managing agent, PSA, ST Engineering, Certis Cisco, Parkway Pantai and the Woodlands Health Campus as well as the SAF. The list is long, but this gives us a sense of the complexity of the operations and how closely everyone had to work together. Through the efforts of everyone involved, we managed to set up the first hall in a week. This is truly an exemplary example of a Whole-of-Society effort.

Next, let me talk about Community Recovery Facility (CRF). We have also set up these CRFs which is a step-down facility for recovering patients. Based on epidemiological evidence and research by local and international infectious disease experts, patients who remain well at day 14 of their illness are past the critical stage and are unlikely to need further medical care. However, they still have to be isolated to reduce the risk of transmission. Hence, patients past their day 14 of illness can be safely transferred to the CRFs before they are assessed for discharge.

We currently have around 2,000 CRF bed spaces, with some of them within our dormitories and others in selected SAF camps. We will be expanding CRF capacity to more than 10,000 beds by end June. As our CRF facilities increase, we can also free up space at the CCFs.

With this layered set of healthcare facilities customised to patient needs, we will be able to provide the most appropriate care for patients while also ensuring sufficient healthcare capacity to meet our needs. All these efforts require close coordination among multiple agencies, as the example of CCF @ Singapore Expo illustrates, to ensure operations are optimised, facilities are well-managed, patient flows are facilitated and tracked, while keeping watch on the capacity utilisation overall.

MOH has set up a Medical Operations Task Force (MOTF) with the support of the SAF to oversee and coordinate our efforts on the ground. I want to thank our partners and SAF in particular, for their support and efforts.

Looking ahead, while we take heart in the progress made, especially in the community cases, we should not be complacent. There are still unlinked cases and cases picked up from our surveillance programme, indicating the presence of hidden cases in the community. Globally, the number of cases also continue to increase. Even countries and regions with low daily numbers, such as China, Hong Kong, South Korea and New Zealand, are watching out anxiously for a second wave of infection that may result in another prolonged outbreak.

Hence, we must continue to do what we can to keep our cases low, to keep the lid tight even as we gradually roll back some of our circuit breaker measures. We are now at the end of the two weeks of tighter circuit breaker measures. Last Saturday, the Multi-Ministry Task Force announced the gradual resumption of selected activities and services in the coming weeks, subject to the necessary safe management measures being in place. The rest of the circuit breaker measures will continue to apply till 1 June.

If we work together, by 1 June, we hope our situation would have improved further, with community cases remaining low or coming down further. Migrant worker cases in the dormitories will hopefully by then be clearly under control. We can then consider further opening up. This is important to enable our people to start going back to work. It is also important for Singapore to protect our strategic position in the global supply chains as the global economy recovers from COVID-19.

We will still need to open up in a phased and calibrated manner, to avoid a second wave of outbreak. There will likely still be cases of infection in the community as the virus is difficult to eradicate. What is key is to keep the number of cases small and reduce the risk of big clusters, through various safeguards and enablers. It would take a while before the COVID-19 outbreak subsides globally or before a vaccine is available. Thus, we will have to adapt to a new way of life and social interactions.

Ms Sylvia Lim asked what indicators we will look at in considering lifting the circuit breaker measures. We will consider a variety of factors.

First, numbers are important but they are not the only thing. We need to be assured that community transmission locally is stemmed or very low. Community cases should ideally fall to zero or single digit daily, with very low numbers of unlinked cases and not just for one day but sustained over a period of time. We also need to see a decrease in migrant worker cases. These cases are high today partly due to proactive case-finding in some settings. While we have been able to keep local community cases low despite higher number of cases among migrant workers, it is equally important to reduce the migrant worker cases over time, though it will take a while longer. Otherwise, we will continue to be at risk of a spillover from the dormitories into the wider population.

Second, we need to make an assessment of the situation globally and for individual countries to inform the extent and approach on reopening our borders. We will review the rate of transmissions in other countries as well as what they have done to contain the spread. For any reopening of our borders, we are likely to start small and selectively, and to continue to impose a mix of isolation and test requirements to protect ourselves from new imported cases leading to community spread.

Third, we must put in place a system to allow us to open up safely. When we allow more business and social activities to resume, there will be more interactions and higher risks of virus transmission at the workplace and in the community. Therefore, we need to step up our capability and capacity to test and detect cases early, contact trace quickly, ringfence close contacts promptly and establish the original source of the infection to stop other undetected transmission chains, if any. These are the key enablers which will give us confidence to reopen.

Let me start with the testing as the first key enabler. To date, we have conducted over 140,000 tests for COVID-19, or 2,500 tests per 100,000 people in Singapore. This is among the highest testing rates in the world. But we plan to do more and will continue to expand our testing capacity and to strategically deploy them to yield the greatest impact.

Members have asked about different tests and their uses. Today, we use mainly the polymerase chain reaction, or PCR tests, to detect confirmed COVID-19 cases. The PCR works by detecting the virus RNA from a nose or throat swab and is the gold standard for detecting current infection. To the question by Ms Sylvia Lim, we use PCR testing for three key purposes: (a) to diagnose suspect cases to provide early treatment and isolate close contacts; (b) to do screening and active case finding of individuals at risk, such as migrant workers decanted from their dorms before they return to work; and (c) to do surveillance to monitor undetected cases in the community.

Currently, we have the capacity to conduct more than 8,000 PCR tests a day in total across our community and migrant workers in the dormitories, up from 2,900 a day in early April. We are working with various private and public sector partners to progressively increase our testing capacity further to up to 40,000 a day.

With this increase, we will widen the net that we cast for diagnostic testing for symptomatic cases, active case finding, screening and surveillance testing in our community and among workers, including migrant workers. We will also do more testing and monitoring to pick out asymptomatic and pre-symptomatic cases among priority groups such as nursing home residents and staff to prevent clusters from developing. Testing is crucial as risk of infection will increase when we allow more economic and social activities to resume.

Ms Sylvia Lim and Ms Foo Mee Har had asked about another type of test called serology testing. This works by detecting antibodies produced by the body to fight against the virus from a blood sample. Based on our local studies, the effectiveness of such tests is very low in the first 10 days of illness as it takes time for the immune system to develop antibodies. Therefore, unlike the PCR testing, serology tests are useful to indicate past infection but it is not very useful for early diagnosis because of the time lag. Many such tests in the market are also still under review and validation.

Notwithstanding this, NCID has begun to use serology testing to study the level of infection among various groups, including healthcare workers, close contacts of COVID-19 patients and the general population. Their study was published last week and found that among close to 2,000 samples from our healthcare workers, volunteers and general population, none had antibodies pointing to a past infection. This shows that the infection rate among our healthcare workers and general population is low.

The study also showed that among close contacts, around 2.5% had antibodies despite not having had symptoms during their quarantine. That means they had been infected earlier but recovered, and remain well without any symptoms. This points to the need to continue our efforts to quickly isolate close contacts of confirmed cases. We will continue to do more of these studies to help us understand the extent of spread and immunity in the community. I should add that scientific evidence of protective immunity is still under intensive study currently.

There have been some suggestions to do asymptomatic testing for the entire population. We will study this. As there is no widespread community transmission here, the yield will be very low if asymptomatic testing is done indiscriminately for the whole population. To be effective, it may also need to be done repeatedly as it does not reflect immunity and those tested can be infected after the test. It might not be best way to use our testing resources.

Instead, we will and have started doing asymptomatic testing selectively for priority groups. For example, we currently test asymptomatic young children if they are in the same household as COVID-19 patients since they may not be able to articulate their symptoms well. In addition, a key priority is to protect vulnerable groups. This includes seniors, particularly nursing home residents. As mentioned, we have started to test staff and residents at MOH and MSF Homes with a high proportion of seniors such as nursing homes and welfare homes. Such tests complement existing precautionary measures, such as good infection control practices and close monitoring for symptoms in staff and residents. They will allow us to intervene early where needed to protect the elderly residents.

As more businesses reopen, we may also do more tests for essential service workers. At our borders, we can also deploy tests for arrivals to reduce the risk of local transmission from imported cases.

In all, as we build up our testing capacity, we will be able to test more and for more purposes. This will be important as we start to open up so that we can pre-emptively detect and break any potential transmission chains.

The second enabler is our contact tracing capacity. After we have confirmed a COVID-19 case, we will need to contact trace and isolate high-risk close contacts to limit the spread in the community. This needs to be done fast and has to be scalable and thorough for it to be effective. This will allow us to quickly ringfence and prevent further spread. We have set up 50 contact tracing teams, up from 20 since my last update in March. But we must scale up quickly if there are more cases or large clusters and to discover less obvious links. To do so manually will be very difficult.

Many countries have leveraged on technology to help them contact trace effectively and efficiently. We will also explore how we can tap on SafeEntry and TraceTogether as well as other technological solutions.

Even as we build our capability and capacity for testing, contact tracing and healthcare infrastructure, we need the support of our healthcare workers. They are at the centre of our fight against this COVID-19 outbreak. We deeply appreciate their sacrifices, long hours as well as personal and professional commitment to care for each patient. This will be a long campaign and we will need the support of our healthcare workers, and we need to support them and to take care of their needs.

Many Members of Parliament have asked about the well-being of our healthcare workers. I would like to reaffirm our commitment to take care of them in every way. Our key priority is in keeping them safe and healthy by ensuring adequate supply of personal protective equipment to protect our healthcare workers and provide them training on the proper usage.

I thank Dr Chia Shi-Lu for his concern on the infection rate among our healthcare workers. As of 26 April 2020, there were 66 cases of confirmed COVID-19 infections among healthcare workers. Forty six cases were from healthcare workers whose work involved direct contact with patients. Based on investigations thus far, there are no established epidemiological links of a healthcare worker being infected in the line of duty for caring for their patients, except for one case in a private healthcare institution where we are unable to rule out the possible link between the doctor and a COVID-19 patient.

Our healthcare workers have taken an extra level of care at their workplace to protect themselves and their families. The recent NCID study also did not detect any past infection among a sample of healthcare workers. Nevertheless, we cannot be complacent. We have reminded our healthcare workers constantly that they should take adequate precautions during their work to protect themselves, the patients as well as their family members.

In the event that our healthcare workers fall sick, we will ensure that they are well taken care of and our healthcare institutions will provide them with the necessary support.

It is also important for us to take care of the mental well-being of our healthcare workers. Even before the COVID-19 pandemic, the healthcare clusters had measures in place, such as counselling clinics, helplines and peer support programmes. We have since stepped up our efforts. For example, our institutions have rostered breaks and staff rotations to ensure that healthcare workers have sufficient rest periods in between work days. The clusters have also been actively working with the NTUC and, in particular, the Healthcare Services Employees' Union (HSEU) with initiatives such as the distribution of care packages, the launch of GrabCare to provide transport for our frontline workers and collaboration with MindFi, a mindfulness app.

The many gifts and words of encouragement from members of the public to our healthcare workers mean a lot to them and have helped to keep up their morale. Members of the public have been writing thank you messages and buying breakfast for our healthcare workers. As part of the SG United initiative, close to 9,000 messages for our healthcare workers were collected from appreciation zones across Singapore. On behalf of our healthcare workers, let me thank you for your continued support.

Compensation is another important area, which Miss Cheryl Chan asked about. We recognise the invaluable contributions of our workers and will ensure that they receive due recognition for stepping up during this challenging period. The Deputy Prime Minister had previously announced a special bonus for our public healthcare workers working on the frontline. Healthcare workers are also paid shift or overtime allowances if they take on longer or more shifts during this outbreak.

However, we recognise that no monetary compensation is ever enough. I want to again acknowledge and thank our healthcare workers for their hard work and dedication. One great example is Ms Tovelle Loh, an assistant nurse clinician from NCID. Ms Loh supports training of staff to ensure that they are updated on infection control policies and recommendations and also helps to review infection control workflows at NCID and other settings. Despite the heavy work load, she remains spirited and committed to do the best for her patients. And it helps that her husband has been very supportive.

Examples like Ms Loh abound, among our frontline workers, support staff and also researchers in our testing and research labs.

Another key part of our strategy is to augment the healthcare workforce, which Mr Murali Pillai had asked about. While our public healthcare sector currently has sufficient healthcare professionals, they are stretched, and there is a need to rotate and refresh staff periodically, as the fight against COVID-19 is likely to be a long one.

To address these sustainability concerns, MOH has given the public healthcare institutions some flexibility to deploy staff across institutions to meet pressing operational needs on the ground and to support one another as one public healthcare system, with strict infection control protocols in place.

MOH has also looked to external sources to augment our public healthcare workforce. This includes tapping on healthcare professionals in the private sector and encouraging retired and non-practicing staff to return to public practice through the newly launched SG Healthcare Corps. We have expanded the scope to include those without prior healthcare experience, for whom training will be provided to enable them to take on supporting roles, such as performing swab procedures and basic care roles. As of 3 May, we received more than 11,000 sign-ups altogether.

I am heartened by this overwhelming response from Singaporeans. So far, we have matched about 800 Corps members to various needs on the ground, and they are being progressively deployed and we will do more. Members of the SG Healthcare Corps will be remunerated for their time and contribution when they are deployed to work alongside our healthcare workers on the ground.

Third, we also use technology as a force multiplier, to deliver the same or enhanced outcomes, with less time and resources. For example, in the CCFs, round-the-clock care is made possible through the use of medical kiosks and teleconsultations. Devices such as pulse oximeters and health apps are also used to monitor patient well-being. Healthcare institutions have also started teleconsultation services for follow-ups on their patients.

Through all these initiatives, we aim to ensure that our public healthcare services remain available to those in need, and our healthcare workers are well taken care of during this challenging period. This enables us to have a sustainable healthcare workforce in this long-term fight. Even as we fight COVID-19, we need to continue to address long-term health issues. I am glad that Prof Lim Sun Sun asked about this, and let me share what we have been doing in this area.

We have temporarily deferred launching any new initiatives to allow staff to be re-deployed to more critical areas of COVID-19 work. But for selected programmes, such as measures on Sugar Sweetened Beverages, banning Partially-hydrogenated Oils, and standardised packaging for tobacco products, we will continue to push ahead.

To support our safe distancing measures, we have already suspended all on-ground activities such as general health screening, but we will continue to encourage Singapore residents to practice healthy habits and fight diabetes through less resource-intensive alternative platforms. For example, HPB continues to provide on HealthHub, bite-sized videos and articles on practising good personal hygiene, healthy eating, physical activity, and mental well-being.

We must also never let our guard down on dengue. The total number of dengue cases in 2020 has exceeded 6,000 – more than double that over the same period in 2019. With the traditional dengue peak season approaching, NEA officers are on the ground conducting dengue inspections at common areas and construction sites, where construction site operators continue to be responsible for vector control measures, even during the circuit breaker period. A worrying trend that NEA observed was a 50% increase in Aedes mosquito breeding in homes over the past three years, compared to the preceding three years. Minister Masagos has asked me to urge everyone at home to be vigilant, to do the Mozzie Wipeout to remove potential mosquito breeding habitats. NEA also brought forward the National Dengue Prevention campaign to 22 March to rally all members of the community. Our efforts on all these fronts continue even as we battle the COVID-19 outbreak, to keep Singaporeans healthy.

Mr Speaker, let me conclude. In this fight against the COVID-19 pandemic, everyone can play a role, during and after the circuit breaker period.

We acknowledge that the circuit breaker measures are difficult, and we appreciate everyone's support and sacrifice to stay home and adhere to the measures. For our frontline officers, including those in healthcare, and dorm operations, we stand behind you, and want to express our enormous gratitude for your efforts. Our collective efforts are not in vain, and we have seen a decrease in our community numbers.

We are looking ahead, and making preparations for post 1 June. We must make calibrated moves to prevent a resurgence of cases and clusters. We must put in place key enablers and safeguards to allow us to contain the spread and care for future cases, even as we roll back our circuit breaker measures and re-open.

We must remain vigilant and not let our guards down. If we all do our part, we can overcome and emerge stronger. Let us work together and move forward together, as one SG United. [Applause.]

Mr Speaker: Minister Lawrence Wong.

3.37 pm

The Minister for National Development (Mr Lawrence Wong): Mr Speaker, Sir, during our last update to Parliament, I said that the situation was uncertain and fluid, and that we would have to expect daily changes. Indeed, over the past month, our battle against COVID-19 has escalated sharply. Now, we have ramped up our resources significantly in response to the challenges, and today, we are continuing to fight the virus on two main fronts.

First, we are doing all we can to control the serious outbreak amongst migrant workers in the dormitories, and to take care of these workers. We have had a huge spike in cases at the dormitories. The infection is mostly concentrated amongst workers in the construction sector. We now know that the transmission amongst this group has been happening for some time, and occurred not just in the dormitories, but also in common worksites and in places that they went to with their friends after work and on their rest days. And that is why we had clusters outside of the dormitories too – amongst construction workers living in shophouses and private apartments.

To determine the extent of the spread, we have undertaken extensive testing amongst these workers. Many of the workers have very mild symptoms and they sometimes brush this aside as a very mild cold. So, we are testing not just the workers who report sick, but also those that are asymptomatic and well. This intensive testing explains the large numbers that we are still picking up amongst migrant workers in the dormitories, and we expect this to continue for a few more weeks.

To minimise the risks of spread to the wider community, we have stopped the movement of workers in and out of all dormitories, and put the construction workers living outside the dormitories on a stay-home requirement. At the same time, we have implemented a comprehensive set of support measures to look after the health, well-being and welfare of these workers, which Minister Josephine Teo will elaborate on later.

We are very mindful of our responsibility to these migrant workers who have contributed so much to Singapore, and we will continue to ensure that they get the care and support they need.

The second major front is in suppressing the spread of the virus in the community, through the circuit breaker. We implemented the circuit breaker on 7 April; two weeks later, on 21 April, we tightened the circuit breaker measures, and also extended it to 1 June. We know the restrictions have not been easy and have created considerable inconveniences. But Singaporeans have been resilient and have taken all these in your stride. For this, we want to thank everyone for doing their part.

Through our collective efforts, we are now seeing some results – daily infection numbers have started to come down, although they are not yet at single digits. That is why we extended the tightened measures for another week till 11 May. Thereafter, we will allow some gradual easing, as we had announced over the weekend, but the key circuit breaker measures will largely remain till 1 June.

I must strongly caution that the easing of some measures in the coming weeks cannot be taken as a signal that we can now take it easy and start to go out more. Remember, the fight is far from over. This battle against the virus is not a sprint; it is a marathon, and we are not even at the halfway mark! And if you have done a marathon, you will know that the second half is typically harder than the first. So, we must expect more challenges ahead. The virus can flare up again anytime. So, we cannot afford to slacken. But we must stay vigilant, maintain our discipline, continue to stay home and minimise our contacts with others.

As we continue this fight against the virus, we also learn more about how the virus is transmitted. So, we update our risk assessments and adjust our measures accordingly. And as I said just now, we must expect more challenges along this journey, which may require us to take further adjustments in our measures or to take additional precautions.

For members of the public, I can appreciate that it is sometimes difficult to keep up with all the changes. But I hope that everyone appreciates and understands that we are responding to a dynamic and fast changing situation. In every case, we will carefully consider the latest scientific evidence and medical advice and the impact on our people before making a change. Our overriding objective has always been and will continue to be the health and well-being of Singaporeans.

For example, at the start of the outbreak, we had to implement many new travel restrictions and adjust them quickly as we tracked how the virus was spreading from country to country. Later, in coming up with specific measures for our community, we too had to adapt and adjust as we learnt more about the virus. This has happened not just in Singapore, but everywhere around the world. We are dealing with a new virus, and scientists everywhere are discovering more about the virus, even today, and the disease it causes. As Prof Leo Yee Sin, Executive Director of NCID has said, "for us to be ahead of the virus... we [need to] know the enemy very well", and right now, "we're still on the learning curve". It is not just Singapore which is on the learning curve, the whole world is still on the learning curve.

And that is why we updated our guidance on masks as we learnt more about the virus, and then we made it a requirement for everyone to wear masks when they go out. We also explained then, that the wearing of mask is not the only, nor the most important protective measure. Remember that the virus can spread through surfaces as well. So, the wearing of masks must be complemented with other precautions that we have emphasised from the outset, including safe distancing and good personal hygiene.

Mr Sitoh Yih Pin asked if we should make it compulsory to wear masks when you are out in all circumstances; even when ones engages in strenuous exercise outside. Actually, the issue here is not just about the wearing of masks. Requiring people to wear a mask when engaging in strenuous exercise is not advisable because it can pose a health risk. The more fundamental issue is whether we want to allow people to go outside to exercise in the first place.

So, we looked at this very carefully. Going out for exercise is beneficial for your immunity and health. There is a risk of transmission only if you are in close contact with another person for some time. But if you exercise alone in the open with safe distancing, as you are required to, this should not pose a problem. There is also no local evidence of transmission occurring among people exercising in the open. On the other hand, prohibiting outdoor exercise altogether and keeping people cooped up at home for a long time can be harmful.

So, on balance, we decided to allow outdoor exercise by yourself, in your own neighbourhood, so long as safe distancing is in place. This is a balance which other countries have struck too – take the example of the Czech Republic. I mentioned this because there was a video going around earlier on how they were amongst the first European countries to impose a requirement for people to wear masks. In the Czech Republic today, you can go out to exercise and you do not need to wear a mask, so long as you maintain a safe distance from others.

Some think we do not need to bother with these very careful calibrations and just go for a "full lockdown".

But if you look at the countries on lockdowns, the measures they implement are not the same, even if they use the same term. What is more important is to understand the specific measures that are needed in our own context and circumstance.

Of course, one of the most effective ways to slow down the spread of the virus is to restrict movement altogether, get everyone to just stay home. As Minister Ong Ye Kung puts it – he coined a very catchy phrases to explain this to the elderly in Mandarin: "如果你不出门, 你就不会见人; 如果你不见人, 病毒就不会进门". In translation, "If you don't go out, you won't meet people; if you don't meet people, you won't bring the virus home." It does not have the same ring in English but you get the point.

Staying home can be an effective measure but keeping everyone at home also has substantial social and economic costs. The impact is likely to be felt disproportionately by the lower income and the vulnerable groups. They are also less likely to be able to telecommute for work so staying home will clearly affect their incomes and livelihoods. Being isolated at home for long periods is also not good for their health and overall well-being.

And that is why we considered very carefully before we decided to implement the circuit breaker and then later to extend it for a month. It was a difficult decision to make because we knew businesses and workers are already hurting. But in the end, we decided we had to proceed with this move, so as to break the transmission chain and slow down the spread of the virus.

To mitigate the impact, we supported businesses, workers and Singaporeans at large with the Unity, Resilience and Solidarity Budgets – more than $60 billion in total, including drawing on our national reserves with the President's permission.

For all Singaporeans, we have the Solidarity payment of $600, with more support for those with children and other support, such as the COVID-19 Support Grant and the Temporary Relief Scheme.

Looking ahead, as we think about easing some of the circuit breaker measures, we will adopt this same evidence-based approach to assess the transmission risks, and then make careful and calibrated adjustments. Where possible, and where we assess the risks to be low, we will consider easing and allowing some flexibility on the ground.

So, to Mr Henry Kwek's question, we do allow one change of address during the circuit breaker period, for care-giving needs, such as for parents to move in with their children's grandparents through that circuit breaker period. So, no shuttling to and fro but you move one time and you stay there.

But there will also be many requests we have to reject. We are already getting appeals for more relaxation for more businesses to open, for my favourite shop to open. And you can guess which one is top on the list, going beyond what we have announced.

But we have to hold the line for now and I hope Singaporeans understand why we need to be firm and why everyone must do their part to cooperate and comply with these measures.

Several Members – Assoc Prof Walter Theseira and Ms Anthea Ong – had asked for a review and inquiry into the cause of the outbreak in the dormitories. We do want to review and learn. We do want to continue taking feedback and suggestions to improve. That is our basic attitude – to keep improving, learning and doing better.

But we are now still in the heat of battle. When all this is over, we will certainly look back and learn from the experience. We do that each time, after a crisis. For example, our lessons from SARS have helped us a lot in dealing with COVID-19. Likewise, at the right time, we will comprehensively review this pandemic and our responses – not just the outbreak in the dormitories, but the entire crisis from start to finish, and our overall response, and we will seek to learn and improve. And I have no doubt that we will find many things where we could have done better and many changes we should make to be better prepared the next time.

But for now, let us stay focused on the urgent priorities ahead of us – we have to bring the outbreak under control on the two fronts, in the community and in the migrant worker dormitories, so that we may then resume activities gradually.

And indeed, looking ahead, the key challenge for us and for countries everywhere, is to work out how we can exit from the circuit breaker and resume normal activities safely, without the virus flaring up again.

Easing on the measures prematurely and without proper safeguards can result in a second wave of transmission and then force a second round of tightening, which I am sure no one wants. This has happened in other countries and it reinforces the need for us to move cautiously.

As we take these steps to resume activities, there will be major challenges to tackle. Take the construction sector as one example. Over the years, we have made progress in construction productivity. We now have more pre-fabricated construction. But there are still 270,000 migrant workers in this sector alone.

A construction worksite will typically have hundreds of workers coming from multiple dormitories. One single infected worker – mild or asymptomatic – can spread the virus to their co-workers at the worksite. They in turn can bring the infection back to where they live and also to places they gather with their friends. When that happens, large clusters will quickly form, as has happened. How do we avoid this from happening again?

We will have to work with the industry to fundamentally change the way we go about construction activities. We will need a whole range of measures covering the worksites, the accommodation and transport of workers, as well as additional precautions taken by the workers themselves.

I have highlighted construction as an example. But this applies to all sectors of the economy. All firms will need to change their work culture and practices. Life after the circuit breaker will not be a return to status quo ante.

That is why MTI and MOM are engaging industry associations, business chambers and firms, to help them adapt to these new realities. For example, telecommuting will have to be a default option extended to all staff and for those who cannot telecommute, strict safe management practices will have to be implemented. There will need to be split team arrangements with no cross-deployment of staff, staggered working and lunch break hours, higher hygiene standards, amongst a whole range of different measures. Within the workplace, there should not be any gathering of staff in groups at any time, be it in the pantry or the staff canteen. Very simple measures, but every company has to take them seriously.

Wherever possible, we should make full use of technology to enable the implementation of these measures. And all of these safeguards must be in place before we can allow workplaces to re-open more and allow more people to resume going to work.

When we do so, we will start with industries that are critical to the economy and to local employment and that keep us connected to the world and global supply chains. Some sectors will have to wait for a bit more time, for example, entertainment outlets or activities that attract crowds or people in close contact with one another. I do not think we can restart these activities anytime soon.

Likewise, it may take some time for us to allow dining in at F&B outlets. I understand many people are looking forward to doing that with their family members and friends, but we will have to assess the risks and consider this very carefully, considering that this particular activity is a known vector for transmission.

Religious gatherings and services too may take a while to resume. In fact, all our communities have experienced or will be experiencing their religious observances and holidays under very different circumstances. From Qing Ming and Easter in April, and soon Vesak Day and Hari Raya in May. We know it has not been easy and we really appreciate everyone's understanding of the adjustments that have to be made to keep ourselves and our families safe during this period.

And to open up safely, we will need to do two other things which Minister Gan highlighted just now – to ramp up testing and to harness technology for faster contact tracing.

A nation-wide testing strategy is being developed, even as we scale up testing capacity, as shared by Minister Gan earlier. It will involve more extensive community surveillance, so that we are better able to detect any unlinked cases in the community.

We will also prioritise the testing of higher risk and more vulnerable groups, like the residents and staff of nursing homes and welfare homes as well as healthcare workers that have high touch-points with the community. And then, we will progressively expand testing to the rest of the essential workforce and the broader community, in line with the expansion of our testing capacity.

On the technology front, we have implemented two key tools. The first is SafeEntry, which is a digital check-in/check-out system to log the visits by individuals in all business premises and venues. The second is a TraceTogether app, which uses Bluetooth on your phones to quickly identify whom you have been near to, so that we can track your close contacts when the need arises. The team is now working with Apple and Google to enhance this app and to make it more effective, especially on iOS phones.

Now, we are also developing solutions for the elderly and young who may not have smartphones. So, that is also a group we are focusing on. And there is a whole series of work around the technology front. When the work is ready, we will announce more details.

Expanded testing and faster contact tracing are our two key strategies. But they are not a substitute for personal responsibility. All of us still have to play a part, by practising good personal hygiene habits, wearing a mask when we are outside and seeking medical attention immediately when we are unwell. These are basic fundamentals that we all have to uphold. But with these enablers and the safeguards in place, we can then plan for a safe and gradual resumption of activities in June – provided, as we said just now, we see a continued decline in our community numbers.

Mr Speaker, it has been more than three months since we started our fight against the virus. The entire team has been working flat out over this period. They include our healthcare workers; contact tracers and infectious disease experts; researchers, scientists and lab technicians; our communications team who help to put out accurate and timely information; our safe distancing ambassadors and enforcement officers deployed all over Singapore; our officers manning our checkpoints, isolation and quarantine facilities; the SAF, SPF, SCDF officers mobilised across different areas; and public officers from all Ministries working hard to support the overall effort – they are mobilising volunteers, securing more spaces for the different needs we have, helping with relief measures and mask distribution – a whole range of work.

As Co-Chair of the Task Force, I get a front row seat in seeing the best of Singapore at work during this crisis. And this has been truly a humbling and inspiring experience, because everywhere I go, I see people who are tired but they remain fully committed and focused on the mission and they are still going all out to get the job done.

Some have had to quickly adapt to the new requirements of working from home. Like our teachers who have been busy designing new curriculum and engaging students on home-based learning; and they are now getting ready for the first batch of students returning to schools in two weeks.

For others, it has been a complete change in their job scope. For example, Ms Jaime Lim, who is a Deputy Director at MOM said, and I quote, "My work went from being desk-bound to manning safe distancing measures ops command and now I am at a dormitory gazetted as an isolation area. Stationed at the dormitory, weekends and weekdays have merged into a blur. I am now used to foggy face shields, powdery palms from glove wear and facial marks made by masks".

Many others, like Jaime, have gone above and beyond the call of duty. So, a big "Thank You" goes out to everyone on the frontline. [Applause.]

They are working their guts out, taking care of fellow Singaporeans, fighting the virus and controlling the outbreak.

We also deeply appreciate all who are in essential services, who have kept Singapore going through this circuit breaker period. They include our cleaners, facilities managers, technicians, refuse collectors, workers in the power and water industries, public transport workers, social service professionals, security guards, delivery riders, taxi drivers and so many more.

It is also very heartening to see many ground-up initiatives from community groups. Our SGUnited portal saw a seven-fold increase in the total donations in this period compared to the previous year. Many social service organisations are helping the more vulnerable groups cope with the circuit breaker and providing additional support to our migrant workers. Thousands of volunteers have signed up for initiatives ranging from mask distribution, helping with applications for Temporary Relief Funds and appreciating our frontline workers.

So, to everyone out there working during the circuit breaker, to those working from home and to those supporting the fight in whatever way you can, we also want to say “Thank You” for your contributions and sacrifices. We are all on the frontline in this fight against the virus. Every contribution counts and helps in our overall efforts.

As we go about tackling this crisis, we see also many shining examples of SG United in action, like how we went about setting up very quickly Community Care Facilities at the Singapore Expo and the Changi Exhibition Centre – truly, a public-private partnership at work. These examples show us how much more effective we can all be when we stand together and combine our efforts across the public, private and people sectors.

Mr Speaker, at some point, this COVID-19 crisis will pass. It will leave in its wake a permanently changed world. Uncertainly and instability may rise in some countries. Societal divides and inequalities may sharpen in others. But a few will emerge from this stronger, more united and more resilient than before. Singapore will endeavour to be in this group. To do so, all of us must continue to work together and support each other. This is the time for us to stand as one nation – to beat the virus, overcome the crisis and emerge stronger together. [Applause.]

4.02 pm

The Minister for Manpower (Mrs Josephine Teo): Mr Speaker, around the world, the COVID-19 pandemic has threatened lives and livelihoods. Likewise, in Singapore.

MOM has been supporting the fight on the economic front and also on the public health front. Our priority is to protect the livelihoods of Singaporeans. That remains so even as a new battlefront emerged. Equally important now is to take care of our migrant workers' health. In my statement today, I will cover both aspects.

Last week, I updated the public on the labour market situation. COVID-19 hit us mainly from February onwards. In January, the economy was humming along. The circuit breaker started only in April. Therefore, in the first quarter of the year, the full impact of COVID-19 was not yet felt.

Even then, total employment contracted sharply. But the impact was not even; foreign employment fell significantly while local employment still managed some growth. Retrenchments have risen moderately.

There are signs that employers are trying hard to cut costs to save jobs. They, too, want businesses to restart quickly when conditions allow. They are being helped by the significant wage support through the Unity, Resilience and Solidarity Budgets, as well as the tripartite consensus on managing excess manpower.

In April, over $7 billion were paid out to employers through the Jobs Support Scheme (JSS). This will help co-fund wages of over 1.9 million local employees. Later this month, more than $4 billion will be paid out additionally.

The Government provided levy waivers and rebates to help employers meet their obligations to their foreign employees during the circuit breaker. By May, over 62,000 employers would have received rebates totalling $675 million. Another $675 million is expected to be paid out by July.

Besides support for their employers, we are providing more direct support for our lower wage workers. Many of them are in essential services and are continuing to work. They will get enhanced Workfare payouts which took effect in January, of up to $4,000 annually. In addition, 400,000 workers will get extra $3,000 each in cash support through the Workfare Special Payment. This will be in two tranches – in July and October. Total Workfare payouts this year will be about $2.2 billion.

Inevitably, even with Government support, troubles with business can strain labour relations. In dealing with the disputes, the tripartite partners agree to uphold the principles of fairness and shared responsibility. Not all employers have been impacted to the same degree. Those in better shape financially should use all the Government support to provide their employees with a more generous baseline wage. Others who are financially stressed and face poor business prospects should be frank with their unions and employees. They should work out together how to use the Government support to help each other get through this period of difficulty.

One thing is clear: employers should not act unilaterally and put their employees on prolonged no-pay leave or reduced pay without the employees' consent. To Mr Dennis Tan’s question, employees who need help can approach the Tripartite Alliance for Dispute Management for advisory and mediation services.

The National Wages Council also issued a helpful set of guidelines in March. For example, it encouraged companies to use any lull in their business to train their workers.

SkillsFuture Singapore has an Enhanced Training Support Package that covers up to 90% of course fees for employers in selected sectors. Many courses come with absentee payroll that give employers in all sectors extra wage support – 90% of the hourly basic salary, up to $10 an hour.

The SkillsFuture Enterprise Credit of $10,000 further helps employers pay for up to 90% of out-of-pocket expenses that are not already subsidised by the Government.

This time round, the Government has made a special effort to also support freelancers and self-employed persons (SEPs). We expect the SEP Income Relief Scheme (SIRS) to pay out close to $1 billion of cash support to over 100,000 SEPs, with the first payment in end of May. The SIRS scheme was designed and implemented in record time. Those who qualify need not apply and are instead automatically included.

We know, as a result, that there may be deserving SEPs who should also be considered. We, therefore, appreciate NTUC for stepping forward to help with the appeals. More than that, NTUC is helping through the SEP Training Support Scheme (STSS) which now provides an hourly training allowance of $10. This comes to about $400 for a week-long course. While modest compared to the income SEPs may have earned in the past, it will still help defray their daily expenditure as they learn new skills during this downtime.

I am very encouraged that already, about 1,800 SEPs will benefit from the scheme. One of them is 34-year-old Jovan, who has been a freelance band director for MOE schools for the past 10 years. Since the suspension of CCA programmes, Jovan has made good use of time freed up and attended seven different courses. They include SkillsFuture for Digital Workplace, Setting up and Running a Business and How to Pitch Like a Pro, all of which he finds useful.

Whether for SEPs or regular employees, finding a job at such times will not be easy. This is why we launched the SGUnited Jobs initiative in March. By now, more than 16,000 immediate jobs vacancies have been made available. This is already higher than our initial target of 10,000 jobs. This initiative has helped jobseekers like Wendy who had a steady job as a flight attendant. When she was placed on furlough, her friends encouraged her to check out the SGUnited Jobs Virtual Career Fair. She now works as a part-time cashier at Prime Supermarket while waiting for the aviation industry to recover.

The public sector has taken the lead to partner NTUC's Job Security Council at e2i, unions and employers to place more than 3,000 individuals from affected sectors to take on jobs such as safe distancing ambassadors and care ambassadors, in various hospitals.

In sectors that are still hiring, for example, security, WSG will ramp up the capacity of Professional Conversion Programmes. Through the SkillsFuture Mid-Career Support package, employers can also receive a hiring incentive which provides 20% salary support, capped at $6,000 over six months. This is for new hires aged 40 and above hired through an eligible reskilling programme.

I share the concerns of Mayor Denise Phua, Mr Liang Eng Hwa and Ms Rahayu Mahzam regarding fresh graduates from local and overseas institutions. This is why we launched the SGUnited Traineeships Programme to help them gain industry experience, build up their resumes and boost their chances of securing jobs in the future. The Government funds 80% of the monthly training allowance for up to 12 months.

Our young people are absolutely critical to our future. There are now more than 4,000 traineeship opportunities offered by 280 organisations. We hope more host companies can come forward to help build up the pool of traineeships and give our young graduates the much-needed opportunities to start their careers. Graduates can apply for these opportunities from 1 June onwards.

Mr Speaker, economic conditions will remain challenging for some time. Given the strong budgetary support provided by MOF, we are holding the line on the economic front. We recognise the many efforts by businesses and workers to adjust to the new situation as it evolves, and help one another weather the storm. As much as we can, MOM will continue to work with our sister agencies to support businesses and protect livelihoods.

Let me now turn to how we are supporting our healthcare colleagues in the fight against COVID-19.

This has been one of the most unusual periods for MOM. We work mainly in the economic and social spheres. Workplace safety and health have always been high on our agenda. Now, it has taken on new meaning.

Early in the outbreak, MOM was mobilised to help prevent imported cases. Progressively, we limited the return of work pass holders coming through mainland China, South Korea, Iran, Italy and then worldwide. In total, we processed about 80,000 applications to return but could only approve a minority. Our officers dealt with many appeals.

To keep the community safe, MOH introduced the requirement for returning persons to serve a 14-day Leave of Absence, which was later tightened to be a Stay-Home Notice (SHN). MOM was tasked to ensure strict compliance. With the help of GovTech, we developed in double-quick time a system of monitoring and enforcement. The system was later adapted for Singaporeans returning from abroad, to protect their families.

Singapore was largely able to curb imported cases due to the combined efforts of many agencies on this front.

Then, in mid-March, Malaysia announced that they would implement the Movement Control Order (MCO). This came as a surprise to businesses who had workers commuting daily across the border. They scrambled to find alternative accommodation. Overnight, MOM worked with MND, HDB, MTI, the Singapore Tourism Board (STB) as well as community groups to source for suitable accommodation to help these businesses.

Most of the affected Malaysians have settled into new accommodation in Singapore. About one in 10 subsequently returned to Malaysia, especially when Singapore introduced the circuit breaker.

Throughout this period, migrant workers were also on our radar. A day after the first confirmed case in Singapore, MOM reached out to dormitory operators to be more vigilant and to step up hygiene. In fact, one of the earliest media conferences that Minister Lawrence Wong and I held was in Tuas View Dormitory, after we inspected their quarantine facilities.

We produced materials in the workers' native languages to encourage them to take steps to protect themselves. Subsequently, non-essential facilities in the dormitories like gyms and TV rooms were closed. Meal times and recreational hours were staggered. Intermixing between blocks was stopped. MOM officers also fanned out on weekends to advise migrant workers to observe safe distancing measures and disperse big groups that were gathering at popular hangouts.

The most prominent cluster of infected migrant workers was from Seletar Aerospace Heights, which was detected in February. It involved five workers, all staying at five different locations, only two of which were dormitories. Thereafter, there was no indication of higher prevalence of COVID-19 amongst the migrant workers, compared to the general community.

Like Mr Ang Wei Neng and Assoc Prof Walter Theseira, we are very keen to understand how the virus later spread among migrant workers. The epidemiological studies provide some preliminary clues.

Within the dormitories that have clusters, not all blocks or rooms are equally affected. Across different dormitories, infected workers were linked through common work sites. At work sites, it was not uncommon for the infected workers to take breaks together, share food and utensils. Likewise, infected workers from different dormitories had gathered during their rest days to socialise and shop, for example, at Mustafa. Back in the dormitories, workers spent time with their friends, cooking, eating and relaxing together.

The virus may have spread through all of these activities, much like how it spread among family members, religious groups and even colleagues.

One recent finding is that most of the infected workers have mild symptoms, likely because they tend to be young. When asked if they are unwell, even after testing positive, some workers say they feel fine. Many were uncovered only because of active case-finding or swab exercises. This may explain why, up to the middle of March, the cases of workers at the dormitories testing positive were few and far between.

Once evidence emerged that the virus had spread in the dormitories, we decided to deal with it squarely and quickly and mobilised the whole-of-Government resources. An Inter-agency Task Force was set up, comprising officers from MOM, SAF, Home Team, MOH, MCI, MND – many agencies. Including the private sector recruits that supplement our efforts, nearly 3,000 staff are now deployed to look after the health and well-being of our migrant workers. Every day, we are joined by thousands of volunteers, especially those from the Migrant Workers' Centre.

Multiple channels of transmission among migrant workers, as appear to be the case, also means that we have to deploy a multi-faceted approach to dealing with the outbreak. A focus on rooming arrangements on their own may not prevent a recurrence. This consideration underpins the comprehensive approach of the Task Force.

About three weeks ago, I explained their three-pronged strategy. First, contain the spread of the virus in the dormitories where clusters have formed; second, prevent spread in those with no clusters; and third, move out and test all workers who are still needed for essential work.

I had also explained the three key enablers to implement these strategies effectively: (a) the Forward Assurance Support Teams (FAST); (b) a medical support plan that is holistic; and (c) roping in dormitory operators and employers to improve hygiene and provide necessities.

The task force has gone about its work professionally, with a clear focus on the workers' well-being.

In the first phase, it was about getting the basics right. This was already an enormous undertaking and there were certainly hiccups along the way. Nearly 200 FAST teams are now deployed and they have helped greatly.

Among the safe distancing measures introduced, we had to stop communal cooking. Officers then worked round the clock to ensure that meals suitable for the varied diets were delivered in a timely manner. More than 10 million catered meals have been served.

They coordinate schedules for workers to use toilets so as to prevent mixing, make sure the dormitories are kept clean and attend to workers' feedback and requests, such as getting paid and money remittances.

More than 10,000 workers in essential services were moved out and progressively tested so they can continue to work safely. Workers from dormitories that had been gazetted as isolation areas were not moved as they would pose a higher risk of infecting others. We then stopped further movements in and out of the dormitories to prevent cross-infections in both directions.

In addition, we provided WiFi access and distributed nearly 300,000 SIM cards so the workers can keep in touch with family and friends.

In the second phase, it was about getting the medical operations right.

The medical support plan was fully fleshed out, the infrastructure and personnel steadily built up. The Regional Healthcare Systems deployed teams of doctors, nurses and technicians to each of the 43 large dormitories. They tend to workers who are unwell, swab those who have shown acute respiratory symptoms, manage the cases that need to be sent to other facilities and assess if the workers are well enough to return to their rooms. They work with the FAST teams to set up on-site isolation facilities and organise safe conveyance from one location to another.

We have also set up four medical posts at the Tuas South, Kranji, Woodlands and Kaki Bukit migrant worker recreation centres to cover the larger factory-converted dormitories (FCDs) and construction temporary quarters (CTQs). For workers in the smaller FCDs and CTQs, we brought in the private healthcare groups as well as the nationwide network of Public Health Preparedness Clinics (PHPCs) and Polyclinics.

If any worker was unwell, they got the same care as any Singaporean would. The worker from Bangladesh who was transferred to a general ward after spending two months in ICU shows the extent of care. Furthermore, the cost of all tests and treatment is borne by the Government.

Members of Parliament like Mr Liang Eng Hwa are naturally keen to know if these measures are working.

The situation within the 43 large dormitories is largely stable now. The picture among the thousand-plus factory-converted dormitories and construction temporary quarters is much more mixed and taking up much bandwidth. In many dormitories, there are active case-finding and swab exercises so that we can isolate and treat infected workers and break transmissions.

Most of the workers are well and those tested positive are on the path to recovery. The full results of these efforts will, however, take time to show.

Outside of the dormitories, we identified another concern. Infection among workers in the construction sector was noticeably higher than the general community and has not tapered off.

Supported by the health assessment of our MOH colleagues, MOM and BCA decided we needed to take further precaution and act quickly. We required all work permit holders and S Pass holders in the construction sector and their dependants to be placed on mandatory Stay-Home Notices.

Excluding the workers already in dormitories, this requirement put another 100,000 workers out of circulation. While they may not be infectious, it is safer to minimise their interactions with each other and the broader community. To decisively break the cycle of transmission, the SHN was extended from the initial two weeks to four weeks in total.

Mr Speaker, in spite of the current challenges, we must now get ready for the third phase where it is about getting the recovery right.

This involves building up community recovery facilities (CRFs) and housing recovered workers in suitable accommodation to minimise the risks of recurrent transmissions. We must work out a way to allow recovered and uninfected workers to go back to work safely. This will again be an enormous challenge and not just the logistics of it.

Many workers will be re-housed and have to get used to new friends and habits, as Mis Cheng Li Hui alludes to. Many employers will have to adjust to their workers being in different locations with new arrangements.

We will have to develop new strategies to monitor the health of the workers. For example, we plan to issue pulse oximeters and require the workers to take readings regularly. We will also have to plan for a more sustainable medical support operation. With telemedicine, we can still attend to unwell workers promptly.

The Task Force is focused on getting its job done. Altogether, they are looking after about 400,000 migrant workers, bigger than the size of two Ang Mo Kio GRCs. It is just mind-boggling when you think about it. For those on the ground, there are no ready-made solutions. Many officers simply roll up their sleeves, work with the stakeholders to improvise.

One such officer is Muhammad Hafiz Ibrahim. A Factory-Converted Dormitory (FCD) operator spoke to Hafiz and said he urgently needed to add extra toilets in a dormitory in order to effectively segregate the usage. It was near impossible to get new ones built anytime soon. Hafiz thought to himself what could be done and promptly sourced for suppliers of portable toilets, bringing much relief to the dorm operator and residents.

The Task Force did not forget to bring some cheer to the dormitories when some of the workers marked their New Year. It worked with the Hindu Endowment Board and community groups to share sweet treats, for example. We are now in the middle of Ramadan. With the help of the Majlis Ugama Islam Singapura (MUIS), special arrangements were made for the Muslim workers to get their sahur, or pre-dawn meals, at 3 am, which means that the caterers also has to be preparing the food, well, around midnight and to get it delivered. Over 1.5 tonnes of dates had been distributed.

In every phase, the situation has demanded a scale and speed of response that is unprecedented. The task force is keenly aware of its mission. They know it is critical to get things right and to do it with heart. We will fulfil our commitment to the workers and pave the way for work and business to resume safely when conditions allow. Let us give the Task Force our full support.

Mr Speaker, some Members want to know MOM's plans to deal with the housing standards of our migrant workers. A bit of historical background is useful here. During the 1970s to early 1990s, most migrant workers in the construction industry came from Thailand and Malaysia. Most of them rented HDB flats or private residential properties. In the early 1990s, many more construction workers came from China, Bangladesh, Myanmar and India.

To support their housing needs, the Government allocated land for companies to build self-contained dormitories with recreational amenities for their workers. Building and Construction Authority (BCA), HDB and Jurong Town Corporation (JTC) tendered out these sites. One important consideration was, "what would a migrant worker want at the end of the work day, if he cannot be with his family?" Well, it is to be with his friends, cook a meal that he would liked, practise his religious belief.

These dormitories were therefore designed for communal living. To enable workers to live close to where they work and reduce the need to travel, the Government allowed some factories to convert part of their space for dormitory housing, subject to standards being met. Today, there are about 200,000 workers housed in the 43 large dormitories and about 95,000 housed in 1,200 FCDs. Most of these workers are from the Construction, Marine and Process sectors.

We have 20,000 workers housed in Construction Temporary Quarters (CTQs). Another 85,000 Work Permit and S Pass holders from the Construction sector live in HDB flats, private residential properties and other premises. Landlords must meet requirements and can be investigated for breaches.

The Government also set aside land to build recreation centres for migrant workers, where they can access supermarkets, remittance services and sports fields. Today, there are eight recreation centres located in areas where there are more dormitories.

Over the years, we have taken steps to raise the housing standards of our migrant workers. A key milestone was the enactment of the Foreign Employee Dormitory Act (FEDA) in 2015. The FEDA imposes higher standards on dormitories that accommodate 1,000 or more workers. For example, licensed operators were required to provide common recreational facilities like TV rooms, gyms as well as provide access to amenities like mini-marts and WIFI in common areas. They are also required to have health facilities like sickbays or isolation rooms and draw up contingency plans for quarantine arrangements. MOM officers regularly inspect licensed dormitories to ensure compliance.

In fact, the Government reviewed these plans with the dormitory operators at the end of last year and conducted a table top exercise – what do you do if you have an outbreak? But no one was quite thinking of something of the scale of COVID-19. In early February, MOM asked all FEDA-licensed dormitories to each put aside at least 10 quarantine rooms. Those were the rooms that Minister Lawrence Wong and I went to inspect. Today, in dormitories with few infected workers, this provision has helped us to quickly isolate the close contacts. Those who are infected, of course, are removed as soon as we can. But the close contacts, you can isolate them and keep them for a while.

Ms Anthea Ong asked about smaller accommodation types. Though not covered by the FEDA, they must still comply with a whole range of regulations. These include BCA's standards for building structural safety, SCDF's Fire Safety Code and NEA's rules on sanitary facilities.

To questions by Mr Png Eng Huat and Assoc Prof Walter Theseira, regulatory agencies all conduct inspections. MOM alone has about 100 dormitory inspectors, full-time, who work under the supervision of the Commissioner for Foreign Employee Dormitories, two Deputy Commissioners and eight Assistant Commissioners. Last year, these officers conducted 1,200 inspections and 3,000 investigations across all housing types. There will be many more when other agencies are included.

Every year, MOM alone takes an average of 1,200 employers to task for unacceptable accommodation under the Employment of Foreign Manpower Act and about 20 operators for breach of FEDA licence conditions. Where lapses are found, dormitory operators must rectify them immediately. For offences under FEDA, dormitory operators can be fined up to $50,000 and/or jailed up to 12 months. Under the Employment of Foreign Manpower Act, employers can also be fined up to $10,000 and/or jailed up to 12 months.

Other than enforcement, MOM proactively engages workers, employers and dorm operators. We conduct roadshows at the dormitories to hear from the workers themselves on improvements they would like to see. We survey the workers. About nine in 10 say they are satisfied working in Singapore and would recommend their friends or family to come here.

Still, we educate the workers on what is acceptable accommodation and encourage them to alert MOM if they see something is not right. We also involve the community. For example, MOM started a "Colour my Dorm" programme about two years ago. A wall mural at Kian Teck dormitory was painted by youths as a gift to the residents.

Housing standards for our migrant workers have progressed over the years. Mr Speaker, may I have your permission to show some photographs of what the newer dormitories look like.

Mr Speaker: Yes, please. [Slides were shown to hon Members.]

Mrs Josephine Teo: This is one of those that have been built since FEDA was passed into law. This is a slightly older one, but as Members can see, it resembles some of our earlier HDB housing estates. When I visited Westlite Toh Guan, it really felt very much like that. This one has got ensuite facilities, meaning that company takes a room, the room comes with sleeping areas but also their own kitchen, their own toilet facilities. Next one, this what some of them look like inside. It depends on the size of the room, how many can be allowed to be accommodated. The next one, this is S11 where we have the highest number of infected workers so far. This is what a typical room looks like. I would say the size of the room, if you consider a badminton court, halve it and add maybe about 20% of circulation space, that is what you get.

The next one, one of the dormitories has got a supermarket which the migrant workers can use to buy the food they wish to cook. The next slide shows – this is before safe distancing – what a gym might look like in the bigger dormitories. So, these are the newer ones. We will see how standards can be further raised. But, keep in mind that there are also older dormitories, which perhaps, have not quite reached these standards yet.

What changes will be effective in reducing the transmission risks? Will these changes require different space provisions and technical standards or stronger regulatory levers that Mr Louis Ng has asked about?

Inevitably, in any sort of environment where people gather in groups, there could be significant transmission. For example, the two places where there are substantial transmissions are homes and workplaces. Likewise, when you have a large number of people living together, in a communal setting, there is a very high likelihood of transmission.

There was a significant spread for example on the US aircraft carrier, the Theodore Roosevelt, with 950 sailors getting infected within a few weeks. They were 20% of the crew. The virus respects no housing type, no nationality, no occupation. We will therefore need to re-look how everyone interacts with one another at home and at our workplaces. Even the way we socialise will have to change. We will need a focus on public education. So, the same for our migrant workers.

But as Minister Lawrence Wong said earlier, we are still in the heat of battle. We must be focused on bringing the outbreak under control and work out how we can exit from the circuit breaker and resume normal activities safely. When this is over, we will reflect and thoroughly look into areas where we could have done better, so that we will be better prepared the next time.

In conclusion, Mr Speaker, the last few months have been nothing short of extraordinary for the MOM team. Whether on the economic or health frontlines, it has been a real privilege to work with so many dedicated colleagues to tackle what our Prime Minister describes as "the challenge of this generation".

Our tripartite partners have stepped up, and so have many employers and workers who are going out of their way to support one another. Many people take the time and trouble to send words of encouragement, including a hand-drawn card from a little girl, my resident in Bishan.

The MOM team has also been very moved by the many offers of support for our vulnerable workers, including our migrant workers. The Migrant Workers' Centre (MWC) set up the “Care Line” that operates 24/7. The volunteers manning the line are migrant workers themselves. Temasek Cares has mobilised its networks to distribute re-usable masks and care packs to more than 650,000 migrant workers including domestic workers. The corporate community is also stepping forward, such as the contribution of 300,000 sets of toiletries by Procter & Gamble. Among grassroots supports, Mdm Magdalene Poh from Kreta Ayer-Kim Seng sourced for and donated 10,000 bottles of hand sanitizers. Ba'Alwie Mosque donated 450 boxes of dates to eight FCDs.

The Inter-agency Task Force (ITF) is especially thankful to a group of 10 NGOs and community groups. such as the Alliance of Guest Workers Outreach, COVID-19 Migrant Support Coalition – which was introduction from Mr Louis Ng; we are very grateful for that – and also Crisis Relief Alliance. These NGOs and community groups deliver food, masks and care packs to migrant workers outside the 43 large dormitories who may not be getting enough support from their employers. HealthServe launched a free virtual counselling clinic. To support the migrant workers’ emotional well-being, the sessions are conducted in the vernacular languages by volunteer counsellors, psychiatrists, social workers and interpreters.

Minister of State Zaqy Mohamad now holds weekly engagements with these partners to coordinate efforts while protecting the health and safety of the volunteers.

Mr Speaker, in the past few weeks, there have been many views shared from all quarters. On such occasions, it is refreshing to hear what the migrant workers themselves say. Yes, there were initial problems with food. Yes, it is hard to be cooped up in the rooms. Yes, they miss their families and want to go home.

But listen also to the voices from their hearts, an example of which is captured by the Facebook post of a certain Mr Mirza, who lives in a dormitory. This is what he had to say, “I on behalf of all Bangladeshi migrant workers in Singapore, want to thank the entire Singapore Government, Police, MOM, MOH and every security, every cleaner, every food supplier. They provide us food, daily needs items, mask, sanitizer, free WiFi/SIM card for our time spent in the room. Medical camp in every dormitory. And I am here today promising here in public if I got a chance to do something for Singapore, I will do it at any cost because they are doing their best for me. I will also do my best for them.”

On behalf of all Singapore, I thank Mr Mirza for sharing his heartfelt acknowledgement and promise. His words are not fanciful but they remind us what this is about: doing our best for each other in times of hardship.

We have said right from the beginning that we have a responsibility to our migrant workers. Many of them made personal sacrifices to come to Singapore to work and they have made significant contributions which we appreciate deeply. We will do everything within our means to make sure that they too win the fight against COVID-19 and reunite with their families in time to come. [Applause.]

Mr Speaker: Er Dr Lee Bee Wah.

4.51 pm

Er Dr Lee Bee Wah (Nee Soon): Thank you, Mr Speaker, Sir. First of all, I would like to thank the Ministers for their very comprehensive updates. I have four supplementary questions. In Mandarin, please.

(In Mandarin): [Please refer to Vernacular Speech.] To many Singaporeans, TCM is an important part of life. Many Singaporeans rely on TCM to regulate their body. Here, I would like to ask the Minister four questions.

First, we have both pharmacies and Chinese medical halls in Singapore. Why the pharmacies are considered essential services and can remain open, whereas Chinese medical halls are not allowed to operate?

Second, tomorrow is 5 May, Chinese medical halls with a resident TCM practitioner are allowed to operate again. Many Singaporeans are very happy to hear that and I would like to thank the Ministers. However, when Singaporeans found out that the TCM practitioners can only do acupuncture, not tuina and cupping, they are very disappointed. I would like to ask the Minister whether you have discussed with TCM practitioners before you reached that decision.

Third, authorities will allow shops selling ice cream, cakes and desserts to resume operation from 12 May, but other Chinese medical halls are still not allowed to open. I would like to ask why it is so. Is it because Chinese medicine is not as tasty as ice creams and cakes?

The last question, under what circumstances will Government allow all Chinese medical halls to resume operation? Many neighbourhood medical halls do not have a resident TCM practitioner. A lot of residents find it very inconvenient if the medical halls remain closed. Thank you.

Mr Gan Kim Yong: Mr Speaker, I would like to thank Er Dr Lee Bee Wah for her questions, very important questions. But before I answer her questions, can I just make a correction. I mentioned in my earlier statement that we have 28 patients in ICU currently and the number is wrong. We currently have 22 patients in our ICU. That is just for the record.

For the Traditional Chinese Medicine, we have always allowed some operation of the Traditional Chinese Medicine clinics to attend to chronic diseases and to attend to urgent cases. But we have further relaxed some of these rules to allow acupuncture and to also allow medicine halls, which have resident Traditional Chinese Medicine practitioners there, to allow the medicine hall to be open and able to sell retail products, particularly the Traditional Chinese Medicine products in these shops, for the convenience of residents in general.

As I mentioned in my Statement, we are beginning to allow some of the business activities to resume and for life to begin to return to normal, but we need to do so in a very careful way, in a very calibrated way, step by step, while in the meantime putting in precautionary measures. So, the overriding priority is still to encourage Singaporeans to stay at home as much as possible, go out only when necessary. And similarly even for business activities, including TCM practices, we would also want to make sure that we open it in a safe way to minimise the risk of further transmission and further infection. Particularly in medical practices, including TCM practices, there is a lot of close personal contact and interactions. So, we want to be particularly careful with this, and therefore, the answer is not totally "no", but we need to watch very carefully. And if we are able to continue to keep the infection numbers low and are able to put in place additional precautionary measures, we will progressively open many of these services and facilities.

Mr Speaker: Mr Pritam Singh.

Mr Pritam Singh (Aljunied): Thank you, Mr Speaker. I have one question for Minister Josephine and four questions for Minister Gan. The first question is to Minister Josephine Teo. This is with regard to MOM's efforts on the economic front, the first half of her statement. The key objective of the JSS was to encourage companies to retain workers. However, some employers are indicating that the COVID-19 circuit breaker measures have made their businesses are no longer viable and retrenchments for Singapore workers are inevitable. There has also been some evidence of residents coming up to us and saying employers have instituted wage cuts, no pay leave. This is even amongst established companies. Does the Ministry have any estimate of the retrenchment numbers it is anticipating. What is it working with? And is the Government planning additional support measures, particularly for the low- and middle income.

The next questions are for Minister Gan. The first pertains to COVID-19 testing for foreign workers, which number up to 1.1 million in Singapore as of December 2019, excluding foreign domestic workers. Does the Government have a roadmap to potentially test all the foreign workers progressively, starting with construction workers? And is there a timeline for this?

Secondly, how many foreign workers specifically have been tested so far out of the, I believe, 140,000 figure that Minister shared.

The third question pertains to the impediments to widespread testing early on in early April when the task force said that about 1,500 to 2,500 tests were conducted daily. This number is potentially to be scaled up to 40,000, as the Minister just shared. Can the Minister share what were the impediments and how these impediments were overcome to reach this number? And by when can we expect 40,000 tests to be conducted on a daily basis?

Finally, there is the question I had of the SafeEntry app, which I believe was shared by Minister Wong. By when does the task force expect all commercial establishments to institute or to ensure that the SafeEntry app is used before Singaporeans can enter the those premises?

Mrs Josephine Teo: Mr Speaker, it is not possible for us to tell at this point in time what the retrenchments and the job losses are going to be like during this period. We are watching very carefully. For the time being, we have an added challenge which is that data collection during this period is not as easy as it was. Surveys that are sent to companies may not be picked up in time, because some companies work from home. So, if we have their emails, we will send it to them. Some companies expressed their difficulties to us, for example, in accessing their own databases in order to provide information to MOM. So, we have some of these challenges to overcome.

Nonetheless, I think there is not much point and value in us speculating what the retrenchment and unemployment numbers will be like. I think the key is working with the tripartite partners to plan for recovery of economic activities. Earlier in the Ministerial Statement that Minister Lawrence Wong made, he talked about very important changes that we need to make at workplaces. One thing he said – I am not not sure if Members picked up – was the idea of safe management. Meaning, depending on the workplace situation, how do you ensure that workers can continue to come to work and remain safe. So, we are focusing all of our efforts on that front.

In the meantime, of course, we are in discussion with economic agencies – MTI and, very importantly with MOF – to see if additional support is needed. I think Finance Minister and Deputy Prime Minister Heng Swee Keat has made the Government's position very clear; and that is, where more help is needed, it will be provided.

Mr Gan Kim Yong: Sir, I mentioned earlier that we have tested a total of 21,000 foreign workers sometime last week. By now, the number would have grown to close to 30,000 foreign workers.

Do we have a plan to test all foreign workers? Currently, we do not plan to test all foreign workers. Our testing is still very targeted for specific purposes. We do testing on dormitories generally to establish the baseline level of infection in each dormitory so that we are able to strategise how we respond to the dormitories. And we also do baseline testing of workers in general to have a sense of where we are in terms of the infection rates. But for those who are infected in selected dormitories, we also do aggressive testing in order to allow us to identify infected workers so that we can isolate them and to protect those who are not infected. So, these are strategies that we have put in place for the management of a dormitory and the testing will be aligned with the strategy in managing these dormitories.

At the same time, we are also looking at testing more of the essential workers that are going to continue to work in the community. These would include the foreign workers as well as Singaporean workers. For the foreign workers who are continuing to work in the essential industries, we will have to test them, not just once but repeatedly because they would continue to be exposed in the community and at the workplaces. Therefore, there may be a need to repeat the test on them. These essential workers, the number will grow as we begin to restore more of the business activities. And therefore, it is important for us to do so in a safe way. Testing, as I mentioned, is an important part of the strategy to ensure the safe opening and the safe restoration of some of the business activities.

How do we get to 40,000? There are several constraints. One is the availability of test kits. We will need to look at how we can source for more test kits, both manufacturing locally as well as through procuring internationally to allow us to have more capacity to do testing.

At the same time, we are also looking at materials because each test will also require materials for the testing, such as the reagents that will be needed for the extraction of the RNA materials. It is not enough to just ensure that we have the test kit, but we also need to have the RNA extracted and therefore, we have to make sure that we have sufficient supplies of these materials. And thirdly, there are manpower requirements because we can do the swabs but having swabbed the individuals, we still need to process the swabs, document them, test them and have the results properly recorded. This requires laboratory capacity.

So, there are infrastructure and manpower requirements at every stage of the test. We are progressively raising the capacity and we hope to reach 40,000 as soon as possible. I would not be able to promise you when but we are doing our best to ramp it up. Today, we are able to do about 8,000 per day and we hope that in a short period of time, we will be able to reach 40,000 soon.

At the same time, we also have to be mindful that, in fact, there is a global shortage of some of these test kits and the reagents. And therefore, we have to ensure that we have a continued supply and stock of these materials to allow us to continue and sustain this high level of testing.

Mr Lawrence Wong: Mr Speaker, on the last question on the SafeEntry system, we are mandating that for all business premises and venues from 12 May.

Mr Speaker: Mr Alex Yam.

Mr Alex Yam (Marsiling-Yew Tee): Mr Speaker, two questions. One is related to the personal protective equipment (PPE) that our medical staff use. Can I ask if we still have sufficient supply in Singapore and stockpile? And related to that, we spoke at the last Sitting on upping local production capabilities for some of this equipment, could the Minister update the House on the progress on this?

Secondly, for home-based businesses (HBBs). I note that for F&B related HBBs, they will be allowed to restart on 12 May. Some other HBB residents have written in to me asking if there was a reason why they, who do not run F&B HBBs but take similar precautions in dealing with delivery men, are not similarly allowed to continue, if the risk for both groups are the same.

Mr Gan Kim Yong: Sir, on the PPE, we are monitoring this very closely. Currently, we have sufficient supplies, but we should not take this for granted. We should always try to preserve our PPE because this is going to be a long fight and whatever stockpile that we have, we will continue to need to require the supply chain to be preserved so that we are able to continue to import more of the equipment. And it is not just the PPE. We also need medication. We continue to need masks and so on. So, I think we will have to continue to remain vigilant to conserve our supplies and the key strategy is really to keep the number of cases low. Once we have a lower number of cases, then we will consume less of our medical supplies.

Mr Lawrence Wong: Mr Speaker, for home-based businesses (HBBs), our key consideration is to draw the line for essential services where food is concerned. So, in providing food for Singaporeans, whether it is a physical outlet or it is a home-based provision, then you can do so, and delivery and take-out is permitted. But beyond that, other kinds of retail, whether it is a physical retail outlet or a home-based retail, we are still at this stage not allowing but as we said, we continue to monitor the situation closely and we will see whether the conditions permit for further easing of the measures.

Mr Speaker: Mr Liang Eng Hwa.

Mr Liang Eng Hwa (Holland-Bukit Timah): Thank you, Sir. Two questions. The first if for the Health Minister. In the United States, there has been development on the potential COVID-19 treatment known as the remdesivir. And it has been approved by the US FDA and the company has announced it will donate the first 140,000 doses in May to hospitals in the United States and around the world. Can I ask the Minister what is MOH's position on this new treatment and if MOH is reviewing this as a potential treatment for our patients?

My second question is for the Manpower Minister. In Mandarin, please.

(In Mandarin): [Please refer to Vernacular Speech.] Singapore is not the only country that has migrant workers. Many countries have a large number of migrant workers to complement their manpower. I would like to ask the Minister, why is it that other countries do not seem to have large scale infection among migrant workers, yet it happened in Singapore?

Mr Gan Kim Yong: Mr Speaker, on remdesivir, Singapore is part of the consortium of multi-centre clinical trials for remdesivir. As part of the trial, we get certain allocation of this drug for testing and treatment of our patients. We are also concurrently discussing with pharmaceutical companies to see whether we are able to have access to additional allocation over and above what is allocated for the trial. So, the discussion and negotiation are on-going.

Mrs Josephine Teo: Mr Speaker, I will also answer the Member, Mr Liang's question in Mandarin.

(In Mandarin): [Please refer to Vernacular Speech.] There are about 10 million migrant workers who leave their hometown and come to Southeast Asia to work. Only a small portion of them come to Singapore. There are a lot more of them working in Malaysia and Thailand.

Countries have their own ways of dealing with the COVID-19 outbreak, including how they want to handle the health issue of their migrant workers and other migrant worker related matters. We need not to speculate whether the infection rate among migrant workers in other countries is higher or lower than Singapore. What we can say is that, each country will have its own considerations and constraints, especially when it comes to testing and treatment which may not be the same as Singapore.

Our stance is to tackle this issue comprehensively, including setting out clear strategies and providing sufficient resources, and very importantly, ensuring a tight organisation. If a migrant worker is infected, we will make sure that he receives the same good care as a Singaporean until full recovery.

Of course, with the COVID-19 situation, migrant workers not only worry about health, but also their livelihood. We see cases reported in other countries. Quite often, their hometown was also under lockdown or affected by different measures, therefore their family’s livelihood is also under threat.

So, when we deal with the migrant workers related issues, besides ensuring that their meals are taken care of, we also look after their other needs, such as getting wages and remitting money back to their hometown. Our comprehensive approach ensures their health as well as their needs in daily life are being taken care of.

If we continue to go in this direction, even if some migrant workers are infected, the symptoms are very mild. We should focus all our energy on helping them recover.

Mr Speaker: Ms Anthea Ong.

Ms Anthea Ong (Nominated Member): Thank you, Mr Speaker. I have a question for the Minister for Health and then two questions for the other Ministers.

To Minister Gan, I understand that there is a lot of concern regarding the mental well-being and mental health of the migrant workers. And I also understand that for all the 43 purpose-built dorms (PBDs), there is already an on-site medical team in place. So, is the Minister planning to mandate that within this medical team, that there would be at least a mental health professional in the form of a counsellor or a psychologist with the medical team?

With regard to the factory-converted dormitories, which clearly are more dispersed, teleconsultation is being used to support the physical health needs of the migrant workers. Is the Minister looking to also include psychological services through these teleconsultation support?

The other two questions, the first which I actually highlighted in my Parliamentary Question. I agree with Minister Lawrence Wong that this is clearly a colossal task at hand, so it is not the time to look into a review. Anyway, the crisis is still on-going. But would the Ministers assure Singapore and our migrant workers that a Commission of Inquiry would be appointed when we are out of the eye of the storm and when that would be likely, so that we can be committed to making the structural changes needed and be better prepared for the next epidemic or pandemic. We know that the experts are saying it is not a "if", it is a "when". I think this is especially so given that the Foreign Employee Dormitories Act (FEDA) provides very explicitly for quarantine preparation and testing. So, we have learned that that legislative provision may or may not be enough.

The third is to all the Ministers and also, since the Prime Minister is here, is will the Government consider issuing an apology to the migrant workers, given the dismal conditions that they are currently in, because of the conditions of dormitories and all the other conditions, and especially now that they are in complete lockdown for the sake and safety of Singaporeans?

Mr Gan Kim Yong: Allow me to address the issue on mental health and then I will leave the other two Ministers to address the other two questions.

Indeed, mental health is a part of a very important consideration in our healthcare system and particularly on the ground, with regard to dealing with our foreign workers who are in the dormitories.

Our medical teams on the ground are linked back to the various Regional Healthcare Systems. Within these Regional Healthcare Systems, they have support from the entire healthcare system, including mental health as well as other healthcare services. They have a full range of services available to them and they will assess the situation on the ground and decide in what form the mental health support is needed. They will also be dealing with the individual cases, assessing each individual patient. Even those who are non-patients, those who are not infected with COVID-19, could also have mental health issues and we are quite mindful of their mental health needs. The medical team on the ground is paying attention to the mental health conditions of the workers in the dormitories, as well as those outside the dormitories, where these medical teams are involved in.

Beyond the medical teams, we also have a FAST team, as Minister Josephine Teo highlighted. Within this team, they are also very mindful of paying attention to the well-being of the foreign workers in the dormitories. These include not just their meals, their hygiene and their daily activities, but also their mental well-being. The inter-agency task force looking after these dormitory operations is very mindful of the mental health needs, is paying attention to this and is working with the medical team on the ground with strong support from the various Regional Healthcare Systems to provide mental health services to those workers who may need them.

Mr Lawrence Wong: Mr Speaker, I thank Ms Anthea Ong for her question. I am somewhat puzzled by it because the question almost presupposes that we do not want to do a review despite me saying explicitly in my speech just now that we want to.

I think if you heard my speech just now, I said that we are committed to doing a comprehensive review after the crisis. It is more than just a review on dormitories. It is a review on the whole pandemic from start to finish and our response, and we are committed to learning and improving from this experience. That is what I said, so let there be no doubt that we are not wanting to do this because after the crisis is over, we will do a full review.

The actual nature of it, the form of it, the timing of it – clearly, it is not possible to say it today when we are still fighting a battle for which we do not know when it will end. But after that, we are committed to doing a review, and we will announce it as and when we are ready.

Mrs Josephine Teo: Mr Speaker, Ms Anthea Ong asked about an apology. We interact very closely with the workers themselves on a very regular basis at the dormitories and even outside the dormitories, whenever our FAST teams follow up on their requests and feedback. I think that what they are focused on is how we can help them to handle this present situation – not fall sick and if they fall sick, how to take care of them, how to ensure their wages are being paid, how to ensure that they can send money home.

These are the things that they have asked of us. I have not come across one single migrant worker himself who has demanded an apology.

Mr Speaker: Mr Louis Ng.

Mr Louis Ng Kok Kwang (Nee Soon): Thank you, Sir. Let me start by thanking MOM and all the agencies and NGOs on the ground for helping the migrant workers and for all their hard work. I think they are doing a lot to help with the food, the sanitation, the healthcare, but I hope that Minister Josephine can also look into the gross floor area that I raised in my Parliamentary Question.

At the current 4.5 sqm – which, if you break it down, is about 2.1 by 2.1 metres and that includes the kitchen, the dining and the toilet areas. It is very hard for some of the workers to practise safe distancing. And that is my worry. If we have a second wave of infections and the workers go back to this 4.5 sqm, then I think that we will get large clusters in our dormitories again. Could I ask Minister Josephine if we can review this urgently?

Mrs Josephine Teo: Mr Speaker, the short answer to Mr Louis Ng's question is that we will consider all aspects that are necessary in order for us to move into a safe recovery mode. So, everything is being considered.

Mr Speaker: Miss Cheryl Chan.

Miss Cheryl Chan Wei Ling (Fengshan): Thank you, Mr Speaker. I have got two supplementary questions. The first one is for Minister Gan. Some individuals who are in the Community Isolation Facilities (CIFs), they are clinically well but they continue to be tested positive in repeated tests. And some of them have been in the CIFs for more than a month. Understandably, they themselves or even their family members are anxious. What more can be done medically to assist their discharge, especially those who are asymptomatic?

The second supplementary question is for Minister Josephine Teo. How does MOM keep track of the residential locations of all the work permit holders or the S Pass holders? Will contact tracing still be required in future on the group of foreign workers who are in the essential services due to their proximity at their workplace and also their social culture? How can we better implement the tracing of these workers and ringfence any possible issues that may arise from the workers who are living outside the dormitories?

Mr Gan Kim Yong: Mr Speaker, this is a very interesting and important question. Indeed, we do find many patients in our CCFs as well as in our hospitals and in our isolation centres who continue to test positive. The theory is that many of these tests may be picking up fragments of the virus and some of these viruses may no longer be viable. But nonetheless, the test will be able to pick them up. The test is not able to determine conclusively whether these are fragments or viable viruses, but when the scientists try to culture this virus, they find it very difficult to culture them after a certain number of days – usually after 14 days. After 21 days, it is even more difficult to culture these viruses. So, in effect, many of the scientists have come to the conclusion that probably, the RNA that has been detected are fragments of the virus and they are no longer viable.

So far, we have been keeping them in the Community Care Facilities (CCFs). The Member is right that to keep them in the CCF is also not very good for them because they are not able to move around freely. We are exploring with our infectious disease experts to see what else can we do beyond just testing them. For some of them, you may still test positive after months because they just continue to have these fragments which may not be viable anymore. So, we may need to think about what we can do to help them so that they can be discharged, go home and go back to normal life if they are no longer infectious.

So, I think these are some things that we are looking and discussing with the infectious disease experts' community to see how we can come to some way to helping these patients so that they can be discharged and go home.

Mrs Josephine Teo: Mr Speaker, sorry, can I respond quickly to Miss Cheryl Chan's question?

We keep track of the workers' whereabouts or where they live through the Online Foreign Worker Address Service (OFWAS). Sometimes, the workers move from one place to another at the request of their employers or if they have found new accommodation. So, I must say that this updating is not as prompt as we would like it to be. We will have to look into better ways of encouraging the workers and their employers to update this database. If necessary, we may have to put in place stronger measures to make this happen. Because, as this episode shows, it is quite important for us to be able to know their exact whereabouts. As Miss Chan says, in future, for contact tracing purposes, it is not just their residential addresses, it may have to be some other means as well.

Mr Speaker: Mr Yee Chia Hsing.

Mr Yee Chia Hsing (Chua Chu Kang): Thank you, Mr Speaker. My question is for Minister Gan Kim Yong. It is reported in many countries, including the US and the UK, that due to fear of the virus, even people with serious health emergencies such as heart attacks or strokes are not going to the hospitals. I would like to ask MOH if we are seeing the same thing happening here and if MOH can educate the public about the symptoms of heart attacks, strokes and other serious conditions which require immediate medical attention and to urge them to go to the hospitals if they have these symptoms.

Mr Gan Kim Yong: Thank you. Indeed, it is important for Singaporeans to understand that if you have a serious medical condition, do go and see a doctor or do call the ambulance so that they can send you to an emergency department to be attended to. I think it is important for us to encourage Singaporeans to seek medical attention whenever necessary.

From the hospitals' point of view, even though we have deferred some of the more stable patients' appointments, we do continue to keep in touch with them, including through teleconsult, to make sure that they remain all right and stable. For these patients, we are keeping a close watch and if it is necessary, the hospital will call them back for treatment and for surgery, if necessary. We need to continue to monitor these patients. We want to encourage Singaporeans to continue to seek medical care when the situation arises, when they need to do so.

So far, we have not seen signs of patients who are staying away despite having a heart attack or stroke. We will continue to educate them on the signs of critical illness and when they ought to seek medical attention.

Mr Speaker: Ms Joan Pereira.

Ms Joan Pereira: Thank you, Mr Speaker. I have two supplementary questions for Minister Gan. I am very glad to note that MOH is providing mental well-being support for our frontline workers, especially doctors and nurses who face patients. But how about healthcare support workers? Like frontliners, they also face heavy workloads, physical and mental stress. That is the first question. The second one is, if mental well-being support is provided, what is the type of support that is being done for them?

Mr Gan Kim Yong: I actually mentioned that in my statement. Maybe I have not been that explicit. The support that we provide goes beyond just medical professionals, but also the support staff. And much of this support includes counselling sessions, supervisors talking to them as well as ways for them to seek help, including support groups within the work spaces. All these are part and parcel of the mental health support that we are giving to our healthcare workers, both on the professional side as well as the support staff. So, we do for all staff who are on the frontline.

Mr Speaker: Mr Leon Perera.

Mr Leon Perera (Non-Constituency Member): Thank you, Mr Speaker. Sir, just four questions for Minister Gan and one for the Minister for National Development. To Minister Gan, firstly, in terms of testing, is the Ministry looking at testing sewage? Apparently, this is something that is being looked at in Switzerland and Australia and is a way to determine where there could possibly be clusters of infection in a particular building or particular locality. Is that something that we will be looking at going forward?

Secondly, the Minister mentioned that testing load is being ramped up from 8,000 moving towards a 40,000 target per day. As far as I understand, currently people with acute respiratory symptoms, not all of them currently are being tested for COVID-19. I am not sure if my understanding is correct. Is that something that the Ministry is looking to review?

Thirdly, right now, when you have close contacts of a confirmed COVID-19 case in the community, some are given Stay-at-Home Notices. Is there going to be a commitment to test all of the people who are close contacts of a confirmed COVID-19 case going forward since our capacity is being ramped up?

Fourthly, this is on vaccines. I think Minister Gan talked about vaccines in his speech. The developments in this space seem to be moving very rapidly and there is news coming from different teams around the world. What is MOH's thinking right now about when we might see a vaccine available? Are plans being made to push that out, roll that out to the population and prioritisation being given to seniors and so on?

My last question is for Minister Lawrence Wong and it is on HDB commercial leases. There is feedback from some micro businesses and SMEs about the rules for re-assignment of HDB commercial leases. There is a logic to those rules, not to allow re-assignment. But would HDB consider allowing a micro business – rather than having to break the lease, give notice, vacate and reinstate the premises, which is time-consuming and costly – to re-assign to another business that might want to take it up, just as a short-term measure during this crisis period?

Mr Gan Kim Yong: Thank you. First, let me talk about sewage testing. In fact, we are doing trials to see whether we can pick up fragments of the virus from the sewage to allow us to have an assessment whether a particular vicinity, whether it is a dormitory, nursing home or hospital – in a hospital, probably you find a lot, because there are a lot of patients there who are infected with the COVID-19 – or housing estates if they have outbreaks. But there are challenges because sewage, by nature, would have been significantly diluted because it is a collection of quite a large population. So, we will need to test the sensitivity and see whether we are able to pick up sufficient fragments to be able to determine whether there is significant infection in the particular target areas. It is something that we are studying but it has its inherent challenges and we may not be able to deploy it for all kinds of settings. But in the high concentration settings, that may be possible. But, then, if there is a high concentration of infected cases, you probably would have detected these cases in any case. So, it is something that we are continuing to study and see whether we could deploy them in a meaningful way.

Testing capacity, yes, we are ramping up and we are hoping to, first, test all prolonged ARI cases, those with prolonged acute respiratory symptoms so that we are able to detect more cases. We are also looking at whether we can expand beyond just PARI to see whether we can enhance or increase the number of tests that we do on the ARIs, that is, those with acute respiratory illnesses. But we also have to bear in mind that we have to assess whether it is productive and going to be effective because the number of cases that would turn positive from the ARIs may be quite low and, therefore, you may end up testing a lot, but not being able to pick up a very meaningful number of cases.

But having said that, we do have, as I have mentioned earlier, a surveillance system where we sample ARI patients and those with flu-like symptoms to have a sense of what is the prevalence level in the population, in the community, to assess whether there is widespread community transmission. As I have mentioned earlier, it does not seem to be so at this moment. But we will continue to monitor. But to be effective in case finding, we may need to be quite targeted in our testing strategy. So, we are planning to expand it to cover all PARI and, hopefully, we are able to ramp up somewhat for the ARI cases in a more targeted way.

For the confirmed cases and those who are in quarantine, whether we will test all of them, so far, our testing for the persons under quarantine is on a very selective basis. As I have mentioned in my speech as well, we do a risk assessment for those who have very close contacts and including the children who are not able to explain whether they feel ill or not. So, those we will quite aggressively test them to make sure that they are not infected. And for the rest of those quarantined, it will also depend on the risk assessment. And as we have more capacity, we hope to be able to test more of them to minimise the risk of transmission.

Mr Pereira also asked about vaccines. It is still very early days. I think there are a lot of news media reports about the progress made. In fact, there is progress made. But from here to testing, to eventually being approved for use by the population, I think there is still some way off. I think we cannot count on the vaccine to solve our immediate challenges of infection cases in the community. We need to do what we need to do. But we hope that the vaccine will come soonest possible and we are involved in some of the collaborative research work internationally. So, we are tapped into the progress and we hope that the vaccines will come out soon. But I think it will still take some time. It is better for us to now focus on the immediate tasks that we need to address.

Mr Lawrence Wong: Mr Speaker, on the assignment of HDB commercial units, I think Members might recall that, some years back, HDB had actually put in place some restrictions on such transfers or re-assignment practices because there was speculative behaviour, property play and then these things led to high assignment fees which led on to these costs being passed down to residents. So, restrictions were put in place for a good reason.

We will consider whether some flexibility might be extended during this time. But I think we should not lose sight of the underlying objectives and rationale for why some of these measures were put in place to begin with. I think, again, we should look at it in a broader context. There are many measures that have been put in place to help businesses, including rental rebates and measures that MOF has announced through three successive Budgets. So, let us look at this holistically to see what is the best way to help our businesses.

Assoc Prof Walter Theseira (Nominated Member): Thank you, Mr Speaker. I have three supplementary questions for Minister Gan on the testing of migrant workers. Reports suggest that due to resource constraints, we are prioritising testing of and isolation of older migrant workers because of the higher health risks as well as essential services workers. The Minister has explained that earlier in the statement, I think. So, my first question is, how are we managing then the risk resulting from the fact that some of the younger workers may not be tested, detected and isolated for now while we still have these resource constraints. And I am referring here to the risk within dormitories, not so much the wider community.

Second, have we been communicating the reasons for these testing strategies to migrant workers and Singaporeans sufficiently? Again, the migrant workers may not be aware of why some of these strategies are being carried out.

Lastly, are the strategies for testing aligned between the different dormitories? Then we have been hearing some reports that the strategies may differ, depending on who is in charge on the ground and various other operational considerations.

Mr Gan Kim Yong: Thank you for the questions. For the foreign workers in the dormitories, whenever they have symptoms, we assess them and the key priority is to make sure that all the workers in the dormitories receive appropriate medical care to make sure that they are taken care of, their illnesses are treated and, if they are at risk of serious or deteriorating conditions, particularly for the older workers, we take them out. Whether or not they are COVID-19, we will take them out so that we pay particular attention in attending to their medical needs. Most of these workers who are older or who have more serious conditions, will be sent to hospitals and when they arrive in hospitals, they will be tested and they will be given appropriate treatment based on their test outcomes. But for the foreign workers who remain in the dormitories, the priority is to make sure that their well-being is taken care of, provide them with the medical attention without having to wait for the test results. And within the dormitories, there are isolation facilities. Where possible, we put them in the isolation facilities where some of them may be cohorted together because they all have similar illnesses.

For the different dormitories, we align them in terms of our strategy or approach. This is coordinated again by the inter-agency task force that is managing the dormitories and they have a comprehensive framework of how to manage each dormitory. Each dormitory is different. It varies. There are some bigger ones and there are some smaller ones, and there are dormitories which have a higher level of infection and there dormitories which have relatively low level of infection. The approach would have to be quite different, depending on the nature of the infection within these dormitories. But the key priority is to make sure that all infected patients, all ill patients are taken care of.

There are also patients who report sick which are not related to COVID-19 and not related to infection, and we continue to take care of them and to treat them where necessary and appropriate. And there are cases where they need hospital attention which are not related to COVID-19, we also will have to send them to hospital for medical attention. So, the key is to ensure that each worker in the dormitory is taken care of. When they have medical needs, we must respond to their medical requirements to make sure that they are taken care of and, at the same time, do what we can to minimise fatalities among our COVID-19 patients.

Mr Murali Pillai (Bukit Batok): Thank you, Mr Speaker, Sir. My supplementary question is on the issue of leveraging technology for aggressive tracing – a topic that the hon Ministers, Mr Gan Kim Yong and Mr Lawrence Wong touched on in their Ministerial Statements.

I understand that the take-up rate for the TraceTogether app is about 17%, which is relatively low. As I understand, the efficacy level is 75%. Since we are about four weeks away to the end of the circuit breaker measures, I wonder whether there is any step to mandate or at least offer this on an opt-out basis so that there will be a higher take-up rate and we will be able to leverage on technology to conduct aggressive tracing.

Mr Lawrence Wong: Mr Speaker, I would like to thank Mr Murali Pillai for the question. We are, indeed, looking at this matter. As I have mentioned just now, our first priority now is to enhance the TraceTogether app, particularly in use with the iOS phone. In fact, Apple and Google themselves have come out to talk about putting out a protocol that will be more effective when such apps are in place on their phones.

So, the technical teams are working very closely with Apple and Google to enhance the effectiveness of the app. When that is done, we will certainly look at the next step, which is to see how the take-up rate of the app can be a lot more than what it is today.

Mr Speaker: Ms Sylvia Lim.

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

For the Minister for Health, regarding his answer to what metrics the Government is using to decide whether to loosen the circuit breaker measures, he gave quite a comprehensive answer. But he did not mention this recognised indicator used by other countries called the effective reproduction number (or RE) of the virus in Singapore. For instance, the New Zealand Prime Minister told her country that they were able to ease their lockdown measures because the RE of the virus in New Zealand had gone from 2 to 0.48, meaning that a person is likely to infect less than one other person at that particular time. So, I would like to ask the Minister for Health whether our Government is actually tracking the RE of the virus in Singapore and if he could make that known and, if it is not, then why is the Government not using that indicator.

For the Minister for Manpower, she touched earlier on the viral outbreak in the dormitories and how it might have been spread through contact, such as within dormitories and also at the construction sites. I would like to ask her whether the Government has also tried to ascertain the origin of the virus in the dormitories. For example, could it be linked to the workers returning from China?

Mr Gan Kim Yong: Mr Speaker, I want to thank Ms Sylvia Lim for the question on the reproductive number. We are, indeed, tracking the number very closely. But as I have said, the numbers are important, but they are not everything. In fact, the reproductive number will be affected by the safe distancing and the circuit breaker measures that we have put in place. The stricter the measures we put in place, in fact, we are suppressing the reproductive number. So, the risk, of course, is that once you remove the circuit breaker measures, the reproductive number may go up again because this basically measures how many persons you are likely to infect for a particular infected person.

So, if you have very tight safe distancing and circuit breaker measures, even if you are infected, you do not have a chance to interact with other people and, therefore, you are not likely to infect more people. But once you remove these circuit breaker measures, you have more interaction and the risk of you transmitting the infection to other people will go up and, therefore, the reproductive number will go up. It is something that we watch and monitor. Of course, if you still have very high reproductive numbers, it is very difficult for you to liberalise your circuit breaker measures because it will just go up even further. But even if you have very low reproductive numbers, you have to be very careful in opening up because, as you open up, the reproductive number may go up as well.

So, it is something that we monitor and watch very carefully. At the moment, I think the reproductive number in the community is significantly lower. It is also reflected in the total number of cases that you see. But in cases like the Safra outbreak, for example, you would expect the reproductive number to be significantly higher during that period of time. If you look at the current infection in the dormitories, the reproductive numbers in the domitories are also likely to be higher. So, therefore, you need to look at the number quite carefully. It means different things in different contexts.

Therefore, I would prefer not to produce one single number and try to peg our metrics on that number. I think we need to take into account all the factors in order for us to be able to restore some of the activities safely.

Mrs Josephine Teo: Mr Speaker, I thank Ms Sylvia Lim for her question. I think the short answer to her question is, no, we do not exactly know how the transmission in the dormitories got started. We also do not want to speculate about its exact origins because it is not helpful to risk any group within the dormitories being targeted for blame. The important thing right now is that it has happened. We have to try and bring it under control and then we have to focus on getting ourselves onto the recovery path. Very importantly, we also want to set our sights on how a recurrence can be prevented.

Now, granted, in order to prevent a recurrence, we have to study and understand more deeply how it occurred in the first place. But we may not have that luxury of a full understanding and still have to make adjustments in the best possible way based on whatever scientific knowledge and understanding we can muster at this point in time and applying the best of the technology and resources that we have available to us. That is the focus right now.

Mr Speaker: Mr Png Eng Huat.

Mr Png Eng Huat (Hougang): Thank you, Sir. My questions are for the Minister for Manpower. In her Facebook post, the Minister said that each time the MOM attempts to raise the standard of living in these dormitories, it would face objections from employers due to the added costs that come with the move. My first question is: under the Foreign Employee Dormitories Act, the licenced operator and dormitory owner should be the parties to be held accountable to raise the standard of living in the dormitories in the interest of public health and safety. So, what did MOM involve the employer in the application of the provisions of this Act in this instance? Any intention of the dormitory operator and owner to pass down the cost should be a separate matter for the parties to resolve later as the attempt by MOM to raise the living standard in the dormitories is done in the interest of public health and safety.

My second question is: under the Act, operators must develop a quarantine plan in the event of an infectious disease outbreak. Since the onset of the outbreak, taxpayers have been footing the bill for the quarantine exercise at these affected dormitories. As this is a pandemic, would these dormitory operators and owners be held accountable for a share of the containment and quarantine costs?

Mrs Josephine Teo: Mr Speaker, if I may respond to Mr Png's question this way. Every month, the employers pay a certain sum to the dormitory operators to accommodate their workers. Usually, the rooms are rented by one single employer. So, in any particular dormitory, you may have 400 or 500 rooms, whatever the number may be, and one employer takes one room. Within that room, depending on the size of that room, size of that unit, a certain number can be accommodated. So, if as a result of a change in standards where we say that instead of accommodating X persons in one unit, eventually, they can only accommodate X-2 or X-3 persons per unit, then the cost per employee accommodated naturally goes up. Certainly, to the employer, this is something that they have to bear. And whatever the business the employer is in, this goes into his cost considerations and, ultimately, he will pass it on to whoever buys his products and services. So, that is something that we must always keep in mind. It is not so difficult for MOM, by the stroke of a pen, to change some numbers here and there. But we have to consider the overall implications and whether it is bearable for the employers. So, that is on the first part.

On the Member's second question on whether the costs eventually have to be apportioned, I think, the scale of COVID-19's impact on businesses and, certainly, even in the dormitories, it is just unprecedented. At this point in time, if we were to start calculating the costs, I think it is very hard to move things; it is impossible to get things done. Right now, the priority must be to keep the situation under control, bring it under control, and then, at the appropriate time, we can look at what are the right considerations in terms of handling the issue of costs.

Mr Speaker: Er Dr Lee Bee Wah.

Er Dr Lee Bee Wah: Thank you, Mr Speaker, Sir. Just now, the Minister did not answer any of my four questions when I asked them in Chinese. Now, I would like to ask them again in English.

Mr Speaker: Perhaps, there is no need to repeat them. Does the Minister need the questions to be repeated?

Er Dr Lee Bee Wah: Does the Minister need me to ask in English or he will answer them?

Mr Gan Kim Yong: I will answer them. Let me see whether I can remember.

First, let me just state that the TCMs play an important part in our healthcare system. It is complementary to our western medicine and we do want to allow them to continue to operate in a safe and managed way. Therefore, we have always been allowing these TCM practices to continue, particularly through teleconsult, and for helping to look after the chronic patients. For chronic patients, we have always allowed them to purchase medicine from the medical halls when they consult the TCM practitioners. We have now actually liberalised it and we allow medical halls which have resident TCM practitioners to open, to be able to serve other customers. But we will continue to look at whether we can liberalise it further. But as I have said, as soon as the task force announced lifting some of the circuit breaker measures, we have a list of appeals from quite a lot of people all wanting to be part of the liberalisation. I can understand the anxiety of everybody because we have been on this circuit breaker for about a month, and tighter circuit breaker measures for about two weeks and I think everyone wants to see whether we can go back to normal. I must share with you that we have very heated debates within the task force to decide what to liberalise and what not to liberalise. But the top of our concerns is to make sure that infection remains under control, the reproductive number remains low. Therefore, it is important for us to do it in a calibrated way, in a managed way.

I know there is still a lot of interest to open it up and we will continue to do so and we will be happy to get the task force to look at where else we could do so in a safe way. For the TCM practitioners, we consult them, we get their views and we also want to share with them our plans going forward. But I would assure Er Dr Lee Bee Wah that we will continue to engage them. At the appropriate time, when we are more confident, and having done this first step of opening, if all goes well, we hope to be able to liberalise further.

Mr Speaker: Er Dr Lee Bee Wah.

Er Dr Lee Bee Wah: Sorry, one last request, Minister.

Mr Speaker: Is it the same question from before or is it a new one?

Er Dr Lee Bee Wah: It is my third question that was not answered. A lot of my residents have requested to go to TCM shops to buy medicine to "bu tong" to build up their immune system. So, can this be considered as one of the priorities? If you are allowing dessert shops to open on 12 May, I am sure TCM shops can also observe safe distancing, wearing of masks and so on.

Mr Gan Kim Yong: Thank you. I must say that we had the same debate in the task force. It is not an easy decision, but I will take Er Dr Lee Bee Wah's feedback seriously – I always take her feedback very seriously – and we will look at whether or not we could further liberalise for TCM practitioners, including the medical halls. But, today, medical halls that have a resident TCM practitioner are already allowed to do so. Basically, this is starting from the point of view that these TCM halls have to be opened. When the TCM practitioners are seeing patients and they cannot give them the medicine, then how are the patients going to be treated? Therefore, we allow the medical halls to be opened if the TCM is seeing a patient. Previously, we only allowed the patient whom the TCM practitioner had seen to purchase from the hall. Now, we have opened the hall to other people who can purchase from these halls. Even your residents can go to these halls to purchase their medication and we will look at how else we can expand this further.

Mr Speaker: Order. I propose to heed Er Dr Lee Bee Wah's advice and seek more nutrition. I call for a break now. I suspend the Sitting and will take the Chair at 6.20 pm. Order.

Sitting accordingly suspended

at 6.00 pm until 6.20 pm.

Sitting resumed at 6.20 pm.

[Mr Speaker in the Chair]