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

Mr Speaker: Ministerial Statement. Minister for Health.

The Minister for Health (Mr Gan Kim Yong): Mr Speaker, Sir, thank you for allowing me to give an update to Members on the COVID-19 situation and, specifically, on our plan to vaccinate our population. Minister Lawrence Wong and I will address earlier Parliamentary Question Nos 2 to 14 and Question Nos 15 to 18 for Questions for Written Answer from today's Order Paper, as well as questions filed by Members of Parliament for future Sittings.

With your permission, I may also call upon my other colleagues to address supplementary questions that may follow, as we work as a team under the Multi-Ministry Task Force.

Sir, it has been almost a year since we had our first case. We have come a long way. We strengthened our healthcare system, enhanced our contact tracing capability, expanded our testing capacity and introduced safe distancing measures. All these efforts work together as a multi-layered defence system to keep us safe from COVID-19.

With the continued support and sacrifices of everyone in Singapore, we have brought the situation under control and kept community transmissions low. We have now moved into Phase Three and are making steady progress towards a new normal.

However, this is not the moment to be complacent. Globally, daily infection numbers and deaths continue to rise in many countries, constantly setting new records, including countries that had been successful in containing their outbreaks previously. We have also seen the emergence of new variants that appear to be more transmissible and have had to tighten some of our border restrictions as a precaution.

We must, therefore, be prepared that, despite best efforts, new infections will still occur here from time to time. We face the continuing risk of new clusters and outbreaks and the danger of a new wave of infections getting out of control. This will be the new normal for a long time to come. That is why we still need to keep up our multi-layered defence. In fact, we must further strengthen it as we continue our journey through Phase Three.

Vaccination is a new line of defence we must put in place. Vaccination is a critical shield to protect us and our loved ones against COVID-19 even as the global situation remains volatile. It will also be a key enabler, allowing us to return to normalcy.

The Expert Committee on COVID-19 Vaccination – comprising professionals in infectious diseases, immunology and other relevant fields – has studied the available data on the vaccine, reviewed the reports from the Health Sciences Authority (HSA), deliberated at length and considered carefully safety and efficacy aspects of the Pfizer-BioNTech vaccine. The Committee has concluded that the vaccine meets the safety and efficacy requirements of the World Health Organization and other international regulatory authorities as well as that of our own HSA. It recommended that everyone who is medically eligible should be vaccinated so that Singapore can achieve as high a level of vaccination coverage as possible. Vaccinations should, however, be voluntary. The Government has accepted these recommendations in full.

A high level of vaccination coverage will maximise protection for the population and minimise the proportion of persons still susceptible to COVID-19. This will, in turn, reduce the risk of large outbreaks and continue to keep community cases low and allow us to further reopen the economy and resume more normal, social activities.

We received our first shipment of vaccines from Pfizer-BioNTech at the end of last year. Our first vaccinations were conducted at the National Centre of Infectious Diseases last week. This is an important milestone and we are beginning to see the light at the end of this very long tunnel.

Dr Lim Wee Kiak and Mr Louis Chua asked about the number of vaccines that we have secured. I am not at liberty to disclose the specific quantity ordered due to commercial sensitivities and confidentiality undertakings in our advance purchase agreements with the vaccine manufacturers. However, I can assure Members that we have secured enough vaccines for all Singaporeans and long-term residents in Singapore. A team headed by the Head of Civil Service led the efforts and undertook this very urgent, complex and difficult task.

The vaccines will arrive in Singapore in batches, given high global demand, especially from countries with high rates of infection. Pharmaceutical companies will also need time to scale up vaccine production and distribution. Following the first shipment of the Pfizer-BioNTech vaccine at the end of last year, we are expecting more deliveries in the next few months, including from Moderna and Sinovac. If all goes according to schedule, we will have enough vaccines for everyone by the third quarter this year.

As recommended by the Expert Committee, we will prioritise vaccinations of groups that are most at risk. This is also consistent with the World Health Organization's guidance and similar to what other countries are doing. We will, therefore, begin with the healthcare workers and staff working in the healthcare sector as they work in direct care of patients or in supporting roles. We will also prioritise COVID-19 frontline and other essential personnel, including swabbers hired by the Health Promotion Board, staff working at Government Quarantine Facilities, Community Care Facilities and dedicated Stay-Home Notice Facilities.

We plan to start vaccinating our elderly and those at greater risk of severe disease from COVID-19 infection starting from February 2021, beginning with seniors aged 70 and above. We will also prioritise others who are in jobs or settings where risk of super-spreading events is high, such as the construction, marine and process sectors, including migrant workers. Thereafter, we will progressively broaden our vaccinations to include other Singaporeans and long-term residents who are medically eligible.

As more vaccines are approved for use, we will adjust our vaccination programme, depending on the vaccine supply as well as the disease epidemiology at that point in time.

The national effort to vaccinate the population will require considerable resources to implement. This is one of our key focus areas this year.

The last time we did a vaccination of this scale was in 1959, in response to an outbreak of smallpox where slightly over one million people were vaccinated. The scale of the current effort is larger but we are also much better prepared. We started planning for this very early on. We have put in place end-to-end processes to meet the cold-chain logistics requirements – from delivery and receipt at the airport, through to storage and then transport to vaccination sites – so that the quality and efficacy of the vaccines are not compromised.

While our healthcare workers are receiving their vaccinations within their healthcare institutions, we are concurrently readying clinics and vaccination centres for others to be vaccinated when it is their turn. Prior bookings will be necessary, given the cold-chain requirements at the vaccination sites and multi-dose vials of the vaccines. It will also ensure operational efficiency and minimise individual wait times. More information on how to make the booking will be provided later.

We encourage everyone to come forward for your vaccination when your turn comes so that we can increase our coverage as soon as possible. We should also bear in mind that some vaccines, such as the Pfizer-BioNTech vaccine, will require two doses, 21 days apart, and it will take up to another 14 days after the second dose to achieve maximum protection against the virus.

At the same time, we will test our systems thoroughly before ramping up to ensure that vaccination operations proceed smoothly and patient safety is not compromised.

There were several questions from Members, including Ms Foo Mee Har and Ms Sylvia Lim, on the safety and efficacy of the vaccines. These concerns are understandable, given the extraordinary speed at which the COVID-19 vaccines have been developed and brought to the market. The speed achieved is the result of a strong and concerted global response to a major pandemic rather than a compromise of safety standards.

Let me assure you that the safety and well-being of Singaporeans is the top priority in our vaccination efforts.

First of all, the vaccine must be approved by HSA. Under HSA's Pandemic Special Access Route (PSAR), HSA's scientific and clinical experts apply strict international standards to assess COVID-19 vaccines to ensure that they meet the stipulated high standards of quality, safety and efficacy. These standards are the same as those used for full vaccine evaluations except that long-term data from clinical trials will only be evaluated later as the data becomes available.

The data that has been reviewed includes those from pre-clinical studies done in laboratories, clinical trials on human volunteers, manufacturing and quality controls as well as the on-going experience with the actual use of the vaccines.

The assessment and recommendations for the vaccines are also reviewed by HSA's Medicines Advisory Committee and Panel of Infectious Diseases Experts.

HSA will only allow a COVID-19 vaccine to be used if it is assessed to be sufficiently efficacious and safe for use and only if the benefits of the vaccine are assessed to outweigh the risks of any potential adverse effects from the vaccination. HSA has put the Pfizer-BioNTech vaccine through this rigorous review process and has authorised its use. The Moderna and Sinovac vaccines are also currently undergoing the review process.

Following HSA's approval, the independent Expert Committee appointed by MOH has also reviewed the clinical data on the safety and efficacy of the Pfizer-BioNTech vaccine and has been briefed by HSA on the full range of considerations in granting interim authorisation. The Expert Committee concurs with HSA – that the vaccine is suitable for use in Singapore, for persons aged 16 years and above, for the prevention of COVID-19.

In assessing the suitability of vaccine candidates for specific population groups, the Expert Committee took into consideration four key criteria – vaccine safety, vaccine efficacy, vaccine tolerability and data adequacy of clinical trials.

The Expert Committee has assessed that the Pfizer-BioNTech vaccine demonstrated a high vaccine efficacy of 95% in reducing symptomatic COVID-19 disease among persons aged 16 and older and its safety profile is consistent with that of other established and registered vaccines used in immunisation against other diseases.

Mr Melvin Yong asked whether there is any data to show that the current COVID-19 vaccines are effective against the new strain seen in the UK and Europe. Mutations occur in viruses naturally and different strains can emerge from time to time, especially in a long-drawn pandemic. While this B.1.1.7 strain from UK does appear to be more transmissible, there is currently no evidence that current COVID-19 vaccines are less effective against this strain.

Experts have said that it is unlikely that mutations would impact effectiveness of current vaccines.

Vaccine producers such as Pfizer-BioNTech and Moderna have also come forward to reassure that their vaccines should protect against the B.1.1.7 variant, and are undertaking studies to formally confirm this. MOH will evaluate the data as it emerges and review our vaccine strategy and border measures, if necessary.

Miss Cheng Li Hui, Mr Lim Biow Chuan and others have asked about potential side effects. Both HSA and the Expert Committee have studied the data, from clinical trials as well as actual experience from vaccinations carried out in other countries. They have factored this into their evaluation before granting authorisation or making a recommendation on the use of COVID-19 vaccines.

Based on data available today, people who receive the Pfizer-BioNTech vaccine may experience side effects such as pain in the injection site, fatigue, fever, muscle aches, or headaches. These are similar to side effects for other established vaccines and they usually resolve on their own in a few days.

As with all medications and established vaccines, there is a small risk of very rare but serious adverse events that may occur post-vaccination, including allergic reactions.

HSA and the Expert Committee have therefore recommended that those with known severe allergies should not be vaccinated. All vaccine recipients should also be observed on-site for 30 minutes post-vaccination, so that any severe allergic reactions such as anaphylaxis can be detected and treated promptly.

MOH will also introduce a vaccine injury financial assistance programme to provide support for persons who suffer a serious adverse event that is assessed to be related to COVID-19 vaccines administered in Singapore. While we expect few to need this, the programme will give a greater peace of mind for those taking the vaccination. Further details on the programme will be provided in due course.

In addition, HSA requires vaccine manufacturers to submit new information continually for active review. HSA and the Expert Committee will also continue to monitor and review the efficacy and safety of COVID-19 vaccines in the local population and internationally. This includes data on specific population subgroups such as those below age of 16, persons with immunosuppression, or pregnant women that were excluded from initial clinical trials. HSA and the Expert Committee will also look at long-term safety data to detect rare and severe adverse events, and study the durability of protection provided by the vaccines. This on-going monitoring is the norm expected for any vaccines that first come into use.

Mr Dennis Tan asked whether there will be a need to separate blood collected from donors who have and have not received COVID-19 vaccinations. There is no need to do so. The COVID-19 vaccine does not cause infection.

While the COVID-19 vaccination will be voluntary, we strongly encourage everyone who is medically eligible to get vaccinated when the vaccine is offered to you. This will not only provide protection to yourself, but also indirectly protect those who cannot be vaccinated due to medical reasons. This collective protection would be more effective the more are vaccinated. In turn, we can keep the number of cases low, minimise the stress on our healthcare system, ensure that those who are ill get the treatment that they need and allow us to return to normalcy sooner.

Some may feel that there is no urgency to get vaccinated given the current low number of community cases and the local situation is under control. We must not be complacent or wait till an outbreak and then rush to be vaccinated. We have seen a few community cases in the last few days, which shows clearly that there are hidden cases among us. We are also seeing new variants that are more contagious. Any of these cases has a risk of sparking a major outbreak as we have seen in other countries. The best time to vaccinate is now. If people wait until an outbreak has happened to get themselves vaccinated, it will be too late – both to protect themselves and to prevent the outbreak in the first place.

As the Prime Minister has said, we have every confidence in our experts and the process that has been put in place. The Prime Minister and our Cabinet colleagues, including myself, will lead on this. We will be getting vaccinated as early as possible when our turn comes.

To ensure access to the vaccine, COVID-19 vaccination will be free for all Singapore Citizens, Permanent Residents and long-term residents in Singapore, which includes Employment Pass, S Pass, and Work Permit holders, Foreign Domestic Workers, and Dependent Pass, Long-Term Visit Pass and Student Pass holders – totalling about 5.7 million people. This excludes Short-Term Visit Pass holders, such as tourists.

I understand Mr Yip Hon Weng would like to know whether those who are not vaccinated will have their job scopes reviewed, in order to reduce exposure to the virus. In most instances, redeployment of non-vaccinated employees is unlikely to be necessary, unless there is a resurgence of local cases. But all workers should continue to take the necessary precautions such as mask-wearing, and where required, donning of Personal Protective Equipment or PPE, and undergoing Rostered Routine Testing or RRT. That said, there may be specific cases such as researchers or laboratory staff working directly on the COVID-19 virus or those who face very high risk of exposure to infected individuals. MOH and MOM are reviewing the issue of vaccination of workers in such workplace settings and will provide further advice later.

Ms Foo Mee Har asked if individuals will be issued vaccination cards after receiving the COVID-19 vaccination. Every person who is vaccinated will receive a physical vaccination card and this will help remind them of their appointment to return for their second dose, indicate clearly which vaccine was administered and provide brief post-vaccination advice. In addition, any person who is vaccinated will have their record updated in the National Immunisation Registry, and individuals will be able to check their vaccination status digitally.

Mr Louis Chua asked if individuals will be given a choice of vaccines when more than one has been approved for use. The allocation of vaccines will largely be based on medical indications of the different vaccines and the suitability of the vaccine for the different population groups, as well as availability of the vaccines. Any COVID-19 vaccine that is approved for use will have to meet the stringent safety and efficacy requirements. Therefore, it is not necessary to allow individuals to have choice of vaccines, which will unnecessarily complicate the already complex vaccination programme. Anyway, in the immediate term, only the Pfizer-BioNTech vaccine has been approved for use. So, there is no choice.

Mr Alex Yam and Ms He Ting Ru asked about our public communications strategy. Government agencies have been using various channels to understand public sentiments on the COVID-19 vaccines, including ground outreach and surveys. Our findings showed that more than half – close to 60% – say they would get vaccinated if a vaccine becomes available in Singapore. About a third were more cautious, saying they would prefer to wait for more data before deciding.

We will continue our efforts to reach out to our population to explain the importance of vaccination and to assure them of the safety and efficacy of the vaccines we are using. I hope parliamentary colleagues will also help to share the information with your constituents.

I would also like to urge everyone to refer to official or credible sources of information and not to forward unconfirmed or untrue information. For example, there were claims that six people had died due to the Pfizer-BioNTech vaccine during clinical trials. However, the facts are that only two of the six individuals were given the vaccine and the other four were given the placebo. Investigations revealed that there was no causal relationship between the vaccine and the two individuals’ deaths. Spreading such misinformation undermines our efforts to protect Singapore and Singaporeans against COVID-19.

Let me conclude. We have come a long way in the past year. We have been through the circuit breaker. Many have missed their vacations for the whole year. We have had to learn and manage with safe distancing measures when we are out and about. It is only through everyone’s concerted efforts that local transmission is now low in Singapore. However, the global situation is still far from under control.

Vaccinations will be a key enabler for us to return to normalcy. We have secured enough vaccines for the whole population. Every vaccine will meet all our safety and efficacy requirements before being approved for use. And I strongly encourage all Singaporeans and long-term residents to get vaccinated when the vaccine is offered to you, to protect yourselves and your loved ones.

This will be the key focus of the MTF over the next few months. Let us all do our part, so we can overcome and emerge stronger together. [Applause.]

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

3.26 pm

The Minister for Education (Mr Lawrence Wong): Mr Speaker, Sir, our key priorities for the year are to implement the vaccination programme smoothly and to continue with our re-opening plans safely while keeping the infection under control. Minister Gan has just given an update on our vaccination plans. Let me now elaborate on our other areas of focus and what we should be prepared for over the coming months.

We have worked hard together over the past year to get to where we are today. It has not been an easy journey. We have been tested severely. We have put in place some very tough measures. I thank everyone for cooperating with them and taking them in your stride.

In a crisis like this, we have learnt to expect the unpredictable. You can have the best laid plans. But new issues will inevitably crop up and some things will go wrong. What matters most at the end of the day is our ability to rally and work together, to adapt along the way and to regain our footing after setbacks.

That is how we were able to bring things under control, keep community transmission low, and move to Phase Three on 28 December last year. It is a careful acknowledgement of our state of readiness to resume more activities in a controlled manner. The specific adjustments from Phase Two to Phase Three may not seem like a lot. Indeed, in his Parliamentary Question (PQ), Mr Leong Mun Wai said there’s “little change”.

But let us not trivialise these hard-won gains. They are the result of the efforts and sacrifices by many people over the course of the year.

Importantly, we are not out of the woods yet. We cannot afford to relax and let our guard down. As Minister Gan highlighted just now, the global situation continues to escalate rapidly.

Cases continue to climb in many countries, including in places which had previously established good control over the virus. In Singapore, in recent days we have already seen two family clusters. Marine workers went on board ships, they got infected and they spread the virus to their family members, including their spouses and children. One of the children had a school-mate who visited the home and was infected. Fortunately, this happened during the school holidays, so they had limited contact with other students. But it is a sobering reminder of how easily new infection clusters can break out. it only takes one super spreader event to spark another major outbreak, so we must continue to stay alert and vigilant.

The emergence of new viral strains that may be more infectious, such as the B.1.1.7 variant, is indeed very worrying. And I share the concerns raised by Mr Murali Pillai and Mr Melvin Yong.

Where necessary and practical, we will tighten our border restrictions to limit importation risk. For example, from the UK and South Africa we have introduced additional testing and requirements, as well as restricted the number of travellers. We have also recently tightened the testing regime and safe management measures for those working in the aviation and maritime sectors, as they are the ones who are most likely to be interfacing with travellers and crew from overseas.

For example, for air crew who have layovers in higher risk countries, we are testing them more frequently after they return to Singapore and requiring them to self-isolate for a few days. Likewise, we are doing a one-time sweep to test all marine workers and we are increasing the frequency of testing for marine workers going on board vessels. We are testing them every seven days instead of 14 days.

This is not the first time we have picked up new strains of the virus. Nor will it be the last.

The fact is that the virus has always been mutating, and will continue to do so. Other new strains will continue to emerge. We do not know what their cumulative effects will be like. So, we will have to constantly monitor the latest developments around the world, review the data and evidence, and update our measures accordingly.

With the virus raging around the world, we clearly cannot afford to freely open our borders at this time. But neither can we close ourselves completely from the world and simply stop all flights or ships coming to Singapore. Trade and travel are our lifeblood. This is an existential issue for us because we do not have the luxury of a hinterland to depend on.

Therefore, we take a calculated risk-based approach in managing our borders. Minister Ong Ye Kung recently made a Ministerial Statement on this. So, I will just reiterate the key points.

To facilitate essential business and official travel, we have established special travel arrangements with certain countries and territories. We control the number of travellers on these schemes tightly, and we require the travellers to stick to a controlled itinerary and strictly limit interactions with the wider community.

For example, we have a Fast Lane between Singapore and six provinces and municipalities in China, established in June last year. Miss Cheng Li Hui asked how many have taken this up. Around 500 travellers have arrived from China under this arrangement. Since early November, we have also allowed short-term Chinese visitors to enter Singapore via the Air Travel Pass.

In order to promote both Singapore’s economic interests and our status as a global business and transportation hub, we will continue to negotiate and formulate additional travel arrangements with other like-minded countries or regions while ensuring that public health is not compromised.

Recently, we also announced a new travel lane, called Connect@Singapore, aimed at a limited number of business, officials and high economic value travellers coming to Singapore for short-term stays. As it would not be practical for these travellers to serve a 14-day quarantine, we manage the risk by placing a “bubble wrap” around these travellers. So, the travellers will only stay at dedicated facilities and will not be allowed into the community. They will also undergo regular testing and observe all prevailing safe management measures.

Besides these special travel arrangements, we have, on a daily basis, a far larger number of travellers who are returning Singaporeans, PRs and long-term pass holders. There is also a continued flow of new migrant workers coming in, mostly construction workers and foreign domestic helpers. We need them to build our homes and infrastructure, and to support the care-giving needs of our families.

For these returning residents and essential workers, we allow their inflow on a controlled basis, but we require those who are from higher risk countries to serve a 14-day Stay Home Notice or SHN at dedicated facilities. They will be tested at the end of their SHN. Travellers from countries with new virus variants will serve their SHN at designated hotels to further minimise the risks of spread. This system ensures that we are able to tightly ring-fence imported cases and minimise the risk of leakage into the community.

Since 18 November, we have required all non-citizen and non-PR travellers from higher risk countries or regions coming to Singapore to take a pre-departure test within 72 hours prior to their departure. We have not required this of citizens and PRs because we do not want to place additional barriers for them to return home if they have urgent need to do so. Additionally, as paediatric testing services may not be so easily available in some countries, those aged six and below are also exempted from this pre-departure test. But through the SHN, we ensure that community transmission risks are minimised for these travellers, even in the absence of a pre-departure test.

So, in response to Mr Gerald Giam’s query, between 18 November and 27 December last year, there have been over 12,000 travellers, including citizens and PRs, from higher risk countries and regions who entered Singapore without pre-departure tests. So far around 100 or 0.85% have tested positive. Importantly, none of these cases has resulted in local transmission.

We recognise that our containment measures depend on good management of the hotels which are used as SHN facilities. We make sure these facilities have strict protocols in place to segregate persons on SHN from all other guests. These include placing them in segregated blocks, wings or floors, clearly demarcating their route of movement and instituting regular cleaning and disinfection regimes.

Persons on SHN are not allowed to use common facilities in the hotels. Once there is a confirmed case, comprehensive contact tracing and ring-fencing of contacts, including staff working in SHN facilities, will be done to prevent further transmission. And any links between confirmed cases from the same facility will be thoroughly investigated.

Even with the multiple layers of safeguards, the risk of leaks, though small, remains. And the recent incident at Mandarin Orchard Hotel is a case in point, as Mr Ang Wei Neng highlighted.

Based on our preliminary investigations, there had been no breaches in SHN protocols at Mandarin Orchard Hotel. But investigations suggest that infection protocols can be improved, for example, through better crowd regulation as well as having good ventilation systems to circulate more fresh air. We will continue to work closely with all SHN hotels to ensure that infection prevention protocols are robust.

As an additional safeguard, all hotel staff in contact with SHN individuals will henceforth be placed on a 14-day rostered routing testing regime or RRT.

Monitoring genetic information of the virus in Singapore’s COVID-19 cases has been important in uncovering the Mandarin Orchard Hotel incident and is required to detect any importation of new COVID-19 strains into Singapore.

Specific to Dr Tan Wu Meng’s question regarding whole-genome sequencing in Singapore, this is an established capability within the National Public Health Laboratory or NPHL. Where possible, whole-genome sequencing can be performed rapidly and directly on clinical samples of COVID-19 positive cases. However, in samples that have low viral loads, it may be necessary for the virus to be cultured before the sequencing can be done. We will continue to assess available and emerging laboratory technologies so we can improve our capabilities and enhance our responses.

One important issue is whether we can relax our border measures for persons who are vaccinated. We are studying this issue very carefully. As mentioned earlier, the main benefit of the vaccine is that it offers protection to the vaccinated individual. It is likely that the vaccination can also reduce the risk of transmission of the virus. But at present we still do not know the extent of the reduction.

There are several on-going studies on the effectiveness of vaccines in reducing transmission risk and we are monitoring these very closely. To Ms He Ting Ru’s question, if there is clear evidence that transmission risks can be lowered significantly, then we will certainly consider some relaxation to the SHN regime for vaccinated travellers.

But for now, we will continue to take a more cautious approach. In other words, vaccinated travellers will continue to be subjected to prevailing border measures and SHN requirements. We will fine-tune our approach over time, once we have understand the effect of the vaccine better.

Of course, border measures are just one part of our overall system of defence against the virus. Within our community, we must continue to adopt a calibrated approach towards resumption of activities in Phase Three and minimise the risks of any further flare-ups during this period.

The tools for us to do so are not new – we have repeatedly emphasised them throughout the past year, but I think they bear repeating as we begin this new year because memories are short, as we all know.

First, we must uphold safe management measures. Under Phase Three we can go out in larger groups of eight people. By all means, use the opportunity to catch up with family members and loved ones. But please do so responsibly and in accordance with prevailing rules and restrictions.

Unfortunately, there are a few who persist in pushing their luck and disregarding the rules. We have stepped up checks over the festive period. Firm enforcement actions have been taken and will continue to do so against any such breaches.

Let us also not forget some of the basic measures that we have put in place. All the good practices that we have emphasised and cultivated over the past few months remain very important – wearing a mask, practising good hygiene, washing of hands regularly, not using your hands to touch your face. Remember we talked about all these repeatedly at the start of the outbreak last year. Let us not forget them. They are simple but still very effective.

Second, testing remains important and we are continuing to deploy more tests as widely as possible, so that cases can be detected quickly.

Anyone who sees a doctor with acute respiratory infections or flu-like symptoms will be advised to take a PCR test. On average, we have tested more than 14,000 individuals every week in December last year, through this surveillance mechanism. That was how we picked up several of our recent cases. So, it is very important for anyone who feels unwell to see the doctor immediately. And if the doctor advises you to be tested, please comply with the doctor’s instructions.

For those engaged in higher risk activities, we are putting them on a rostered routing testing regime or the RRT. This already applies to workers in the construction, marine and process sectors, as well as to airport and marine workers, and now to staff in the SHN hotels, as I mentioned just now.

Beyond the RRT, we undertake special testing operations from time to time to do a sweep around specific areas or groups of individuals, whom we assess to be at higher risk of transmission. Over the past few months, we have done such tests amongst staff of nursing homes, hawkers, as well as bus and taxi drivers. This month, we will be testing the students staying in our University hostels.

We have also been stepping up the use of antigen rapid tests. They are useful as a pre-event measure for larger scale activities. They are also a very good complement to the PCR tests which are more sensitive but take longer to obtain results. The costs of these rapid tests have been coming down. The first of such rapid test kits administered in Singapore cost about $80 per person. That is not just the test itself, but also the operation and manpower costs. Now, it is possible to do this for under $50 per person, and the cost is likely to come down further.

Over time, we can expect more innovative rapid test kits that are cheaper, faster and more convenient to administer. These will enable us to test more extensively and conveniently, to detect positive cases and protect our population more comprehensively.

When we first deployed testing in a significant way, I know there were concerns amongst certain groups. Some thought it would be a hassle. Others were worried that there would be a stigma associated with being identified for testing. But I hope by now we can all appreciate and understand the reasons why testing is important and necessary.

Frequent and widespread testing is a critical enabler, which we intend to ramp up over the coming months. We must all start getting used to the idea of regular testing being a part of our lives during this pandemic period.

Third, we will continue to strengthen our contact tracing capabilities. Despite our best efforts at safe management measures and testing, we know that cases will still slip through from time to time. That is why we need to be able to quickly identify and trace the contacts, and ring-fence the clusters.

The TraceTogether and SafeEntry Programme has been, and will continue, to be a key part of our contact tracing operations. Before TraceTogether or TT, we had a good contact tracing system but it was manpower intensive. It worked well for SARS, but not for COVID-19, where the virus spreads much faster, well before the onset of symptoms and even in cases who themselves remain asymptomatic. In the past it took two days for us to interview an infected person, establish all of his close contacts and then get in touch with these people and put them on quarantine. Two days. That was too slow. Today, with TT and SafeEntry, we are able to do all this in a matter of hours.

Once we identify the contacts, we test them immediately, at the start of their quarantine. For those who are positive, we in turn get their TT data to identity their contacts and then, initiate the tracing process. In this way, we try to get ahead of the virus and contain clusters before they get any bigger.

Our ability to do all of these is not just because of the TT programme. It is fundamentally because of the confidence and trust that Singaporeans have in our system – the way we handle the data, the way they go about doing contact tracing.

I thank everyone for their cooperation and support because this has enabled our contact tracers to do their work and to keep cases under control.

To date, we have spent around $10 million on developing both the TraceTogether app and SafeEntry system. Mr Gerald Giam asked if the cost is justified. Well, the results speak for themselves – TraceTogether has stopped the transmission of the virus in many instances and has helped save many lives. So, I have no doubt about the cost-effectiveness of the programme.

Of course, in developing the programme, we remained mindful of the need to ensure value for money. For example, Mr Dennis Tan had filed a question on whether we could work on a rechargeable version of the TraceTogether tokens. Doing so would inevitably increase the cost and also the time needed for manufacturing. Instead, we have designed the tokens using off-the-shelf components where possible to minimise manufacturing complexity, time and costs.

More than 4.2 million people or around 78% of Singapore residents now participate in the TraceTogether programme. And we certainly encourage an even higher take-up. Not all of them use the token. Quite a number, around two million or slightly less than half, just use the TraceTogether app on their phones. I am one of them because I think that if I have the token with me, I quite likely to lose it. So, I just use my phone and that works well for me. But we recognise that some people want the tokens and that is why we made them available and distributed them across all the Community Centres or CCs.

Given that the TT app was easily available, we had initially not expected such a strong demand for the tokens. On the supply side, there were also some delays in the manufacturing schedule. That is why, as mentioned by Mr Lim Biow Chuan, we were not able to complete the distribution of the tokens across all the CCs. We have been steadily building up the inventory of the TraceTogether tokens and will soon be able to resume distribution in the CCs that are currently closed. As announced previously, we will also be distributing the tokens to school students who have not yet collected them, through the schools.

After everyone who needs a token has had a chance to collect one, we will put in place the requirement to use TraceTogether only at the SafeEntry checkpoints. In other words, we have what we call TT-only SafeEntry where the SafeEntry checking in/checking out is done either through the app or the token. We will give further information on this once the details and timelines are firmed up, and will provide adequate advance notice to all the affected establishments, so that they can gear up and prepare.

Mr Speaker, 2020 was undoubtedly a difficult year, but we can take heart that we have learnt and grown tremendously in our abilities to cope with the virus.

I thank everyone who has worked so hard and made many sacrifices to get us to where we are today. Our healthcare workers and frontline officers – contact tracers, safe distancing ambassadors, our swabbers, enforcement officers, immigration and security officers, airport workers, our SHN operators – have all been working hard round the clock. There are also many who have contributed; many unsung heroes all over Singapore doing their part.

Toward the end of last year, Minister Gan and I held a simple appreciation event – in accordance with all safe distancing rules, of course – to thank the people involved in setting up the COVID-19 Community Care Facility. This is at the Expo and Big Box.

Members will recall this was a pivotal moment in our fight against the virus. At the peak of the pandemic, we had more than 1,000 cases per day, and our healthcare system was at risk of being overwhelmed. The team came together from both the public and private sectors. In the spirit of SG United, they got the facility up and running in a matter of days. They truly made the impossible possible.

Now, we have stood down the facilities at the Expo and Big Box because we do not need them for now. I told the team we will do our best to avoid calling on them again. I think they were quite relieved to hear that. But I was also very heartened when they said, "Don't worry, if the need arises, we will be ready to respond anytime".

That is the indomitable spirit that gives me confidence in our fight against COVID-19. We must not allow this prolonged vigilance to wear us down. We must not falter; we must not weaken or tire. Let us approach the new year with the same spirit of fortitude, solidarity and unity that we had shown over the past year. Let us finish the job and complete our mission together. [Applause.]

Mr Speaker: Dr Tan Wu Meng.

3.51 pm

Dr Tan Wu Meng (Jurong): I thank the Ministers for their Statements. I would like to ask one clarification to highlight a group of individuals who may well benefit from expedited access to the COVID-19 vaccine. These are Singaporeans who serve Singapore overseas. Often in jurisdictions where COVID-19 may be very prevalent and even with the best protective measures, they may come face-to-face with a COVID-19-infected person during their overseas duties. These include our public officers at overseas missions, whether from MFA, MTI or MINDEF.

Another related group would be our national sports women and sportsmen, some of whom may be training overseas, some of whom may be back home in Singapore right now, like one of my residents, but at the same time worried about what will happen when they return overseas for studies, when they go overseas to train, and may again come face-to-face with a COVID-19-infected person while flying Singapore's flag.

So, I would like to ask the Ministers what is the policy approach that will be taken to support Singapore Public Service officers and our Singaporean sportswomen and sportsmen who represent us overseas, often in jurisdictions where COVID-19 is running rampant?

Mr Gan Kim Yong: Thank you. I would like to thank Dr Tan for his questions and clarification. In fact, these are issues that the Multi-Ministry Taskforce is discussing. We are also consulting the expert committee on vaccination on how to deal with the various priorities. As I mentioned earlier, the key priority today is to focus on healthcare workers because they are at the frontline and they are dealing with the patients and some of them could be, in fact, infected with COVID-19. So, our priority is to first protect the healthcare workers, ensure they can continue to preserve our healthcare system.

Secondly, we look at those who are at a high risk of a severe outcome, should they be infected. This includes vulnerable seniors. Therefore, this is the second group that we will be focusing on.

Beyond this, we are also looking at different categories of people including key entities like our military, our Police force, which are very important in ensuring law and order, and national security, as well as our foreign representatives, our embassies overseas, particularly in countries where there is a high prevalence of COVID-19. They are protecting Singapore's interests and we should find ways to protect them as well.

So, all these are factors that will be taken into consideration. But as the Member pointed out, there are many groups and many of them are also facing challenges. We do want to protect them as much as possible. So, the key really is to expand our vaccination as quickly as possible to cover as many people as possible. If it is your turn, please come forward and get vaccinated, do not wait. This is the only way for us to protect individuals as well as to protect one another.

I take the Member's point that there will be different groups that have an interest and that require protection. We will see how we can manage our vaccination programme to meet their needs. But bearing in mind that the priority is still to protect our healthcare system, our healthcare workers and the next priority are the seniors, who are vulnerable to severe outcomes.

Mr Speaker: Dr Lim Wee Kiak.

Dr Lim Wee Kiak (Sembawang): Thank you, Mr Speaker. Let me thank both Ministers for the Statement. The pandemic itself is a war. When we first saw the first shipment of the vaccine that arrived in Singapore with Minister Ong receiving at the airport, we were very happy.

But, subsequently, we were a little bit disappointed with the speed of the roll-out of the vaccine. In fact, in Canada, during the Christmas period, they closed the vaccination centre and they were being slammed, "Why did you close the vaccination centres during Christmas?" They should be speeding on now to quickly vaccinate as many people as possible. As from today, Israel has already vaccinated 12% of their population.

Initially, I was hoping that Singapore should be the first country in the world to get the whole country vaccinated. If any country can do it, Singapore can do it. We can show the world. Because we are small, we are fast, we are efficient, we are organised. If this is a war, I would say that vaccination, initially, I was hoping it would be made mandatory. Of course, the Government has chosen to make it voluntary.

I know that vaccination is a personal choice, but it has public consequences. I certainly urge everyone to be vaccinated as soon as possible. So, I hope that the Ministers now can consider rolling out this vaccination programme faster than what we are talking now. Because as it is now, I am not sure what are we waiting for. We should be vaccinating more people now. In fact, I hope that the healthcare workers should be vaccinated within the next two weeks and it should be completed as soon as possible.

Next, I would also like to ask when will the Speaker, Deputy Speakers and the Members of Parliament be vaccinated.

Mr Gan Kim Yong: First, let me thank Dr Lim Wee Kiak for his enthusiasm and his strong support for our vaccination programme. In fact, I do agree with him. Our objective is to roll out our vaccination programme as quickly as possible, but we have to bear in mind that we have limited supplies, we need to progress based on the supplies that we can receive.

Secondly, I must also stress that we did not rest over the Christmas or the New Year. The key reason for our approach is to adopt a cautious one because vaccination is a very complex process, particularly bearing in mind that we need to ensure the ultra cold-chain is intact to ensure the quality and efficacy of the vaccine will not be affected. So that is one.

Next, we also want to make sure the safety of those who are receiving the vaccination, making sure that there is a proper queuing system, they are registered properly, and data are captured accurately. It is quite a complex situation. We conducted a trial recently, last week. And we will be rolling out full-scale vaccination for the healthcare workers.

Hopefully, soon we will be able to make it available to Speaker as well as Members of Parliament. It is important that we also roll out for the rest of Singaporeans. So, I agree with Dr Lim and I am equally anxious to cover as many Singaporeans as possible. I look forward to Members to help support our effort and to convince your constituents to step forward when their turn comes for the vaccination.

Mr Speaker: Ms Sylvia Lim.

Ms Sylvia Lim (Aljunied): Thank you, Mr Speaker. I have two clarifications for the Minister for Health. The first is whether the Health Sciences Authority or HSA works with any threshold for efficacy before it approves any vaccine. I read, for example, that in the US, the regulators need a minimum efficacy threshold of about 50%. Does HSA have some minimum threshold that it works with before considering approving any vaccine? So, that is the first question.

The second clarification concerns HSA's approval of the Pfizer-BioNTech vaccine. HSA has announced that it is actually an interim authorisation and that further data – probably longer term data – will need to be submitted by the manufacturer before the vaccine can be given full registration. So, I would like the Minister for Health – for public consumption – to explain what additional information the manufacturer needs to submit in order to get full registration for the Pfizer-BioNTech vaccine. Thank you.

Mr Gan Kim Yong: Thank you. First, on the question of efficacy threshold, it is true that WHO and the US, have a threshold of 50%. We, too, have a minimum threshold of 50%. But I think that the efficacy threshold has to take into account the potential risk that the vaccine may create, the potential risk of adverse incidents, as well as other factors. So, it is not a clear-cut threshold that once it is 50.1%, we will approve it. If there is greater uncertainty, then we will require a higher level of efficacy for us to be assured of the benefits versus the risks.

We also have to take into account the current situation of the pandemic. If it is a very severe pandemic, then it is important for us to ensure that we vaccinate our population as quickly as possible and, therefore, we may have to accept a lower threshold of efficacy. If the pandemic is less severe – low mortality and so on, we may require a higher level of efficacy. Basically, it is a balance of benefits and risks. So, it is a holistic assessment that HSA's experts will have to take into account in coming to a conclusion whether or not it will be approved for use. It is not just a single number.

Secondly, Ms Sylvia Lim asked about the meaning of "interim approval" and what long-term data we are looking at. Because this vaccine has been made available only in recent months and it has only been applied for a couple of months, we still need to monitor how it is applied in real life. Manufacturers are required to report any adverse incidents that happen so that we can keep track of the performance of the vaccine on the ground as well as the potential risks that it may carry.

We need to do this continuously for a prolonged period of time – usually one year, two years or maybe longer – so as to give us assurance of the long-term effect of this vaccine. This is part of the reason why HSA has not given a full authorisation because a full authorisation will require these long-term data to be available before we do so.

But in view of the pandemic that we are facing today, HSA has given an interim approval for the use of this vaccine, accepting the fact that long-term data will only be available in the long term and we will need to continue to monitor and to make our assessment in the long term.

Mr Speaker: Ms Foo Mee Har

Ms Foo Mee Har (West Coast): Thank you, Speaker, and thank you, Ministers, for the comprehensive responses. I have two supplementary questions.

First, we take comfort from Minister Gan's report that Singapore has secured sufficient supplies for the entire Singapore local population and that vaccination is anticipated to complete by the third quarter of 2021. I would like to ask the Minister: what are the risks of Singapore not getting delivery of our vaccine orders even though we have secured them – whether they will be delivered as we compete with other nations to get hold of the vaccines? That is the first supplementary question.

The second supplementary question is, testing has been a key requirement for travel under COVID-19 conditions. I would like to ask the Minister whether the Government will add vaccination in the future as a qualification for travel and perhaps even for employment in certain occupations or engagement in certain social activities. Particularly, also related to this question on vaccination, how would vaccination be featured in the upcoming World Economic Forum (WEF) to be hosted in Singapore in May?

Mr Gan Kim Yong: Thank you. On the delivery of our advance order for vaccines – there is always a risk of non-delivery or a delay in delivery. So, we are in close contact with our manufacturers that we have entered into contract with and we are monitoring their delivery schedule, and if our vaccination programme has to be adjusted.

We are also looking forward to more vaccines being approved so we have alternatives. We want to make sure that we diversify our sources of vaccines so that even if one shipment is delayed, we have access to other supplies. This way, we ensure that we have adequate vaccine supplies for the whole of Singapore.

With regard to the questions on travel, I will leave them to my Co-Chair to respond.

Mr Lawrence Wong: Mr Speaker, it is important that we look at vaccinations as just part of the broader suite of measures that we have to protect ourselves, including safe management, testing and contact tracing. Vaccination is not a silver bullet. It is just part of that overall system.

As I have mentioned just now, we are still assessing the extent to which vaccinations can help reduce transmission risk. We know when you get vaccinated, you are protecting yourself. You do not know how much you can protect others. Yes, there will be some beneficial impact but what is the extent? It is still under consideration. So, until we understand the effects of the vaccine, I think we will not be able to make any changes to our measures, be domestic or travel measures.

But if the results indicate that vaccinations do offer protection to others, then, clearly, we can make some adjustments.

What are some of the adjustments that are possible? For example, if there is a concert being held today, typically, under today's rules, we would require a pre-event test for everyone going to the concert. Potentially, if you have been vaccinated, we might say: well, someone who has been vaccinated need not take such a pre-event test. That is conceivable.

Subsequently, if we have, again, more evidence, we might say, for travellers, well, you do not need a vaccination to travel but, if you are vaccinated, you travel and you come back, I might consider the extent to which I impose the Stay-Home Notice (SHN) conditions or the number of tests you are required to take. These are also possible. So, those are the things that we are looking at and these are all being studied very carefully

For purposes of the WEF event which Ms Foo highlighted, well, if the travellers come in on a vaccine and if we have the data and evidence, then, indeed, we can review the requirements that we impose on these travellers. Otherwise, the basic arrangements for the WEF event will be through existing prevailing measures. For example, we will bubble wrap a facility. We will put the travellers under frequent testing to ensure that they are safe. We will have safe management measures in place. All of these measures are still effective and we should still continue to rely on them.

Mr Speaker: Mr Louis Chua.

Mr Chua Kheng Wee Louis (Sengkang): Mr Speaker, I have two follow-up supplementary questions for the Minister.

Firstly, I understand that because of commercial sensitivities, the exact number of doses of vaccines cannot be shared but, perhaps, the Minister can share with us, in aggregate, the number of doses that have been secured to give people the assurance that there is more than sufficient. As alluded to by Dr Lim Wee Kiak as well as Ms Foo Mee Har, I think you will also give Singaporeans comfort to know of the expected delivery timeline of when they will be able to be vaccinated in the rest of the year.

The second question is also a follow-up question to what the Minister has said in terms of individual autonomy to choose the vaccines. For people who are within the same category, for example, who are Singaporeans, who are male and of a certain age, what is the approach or process by which the vaccine is being administered, given that should there be more than one that has been approved? Would the Ministry provide the up-to-date information as to the different side effects, efficacy rates as well as various clinical trial data for people who are being administered a particular vaccine to have a sense of these are?

Mr Gan Kim Yong: Thank you. I thought I have answered the question on quantity. I will not be able to give a specific number but suffice to say that we have secured a sufficient quantity for the whole population. Our strategy is also to ensure that we have a portfolio of vaccines and not just rely on a single supplier. Today, we have approved the Pfizer-BioNTech vaccine and we are continuing to evaluate two other vaccines that I have mentioned in my speech.

With regard to the second question, I am not quite sure what the question was about. How do we administer the vaccine if there are different types? As I have mentioned, it will be based on the assessment. If there are significant contra-indications for a specific vaccine that, say, for example, is not suitable for young children and another vaccine is suitable, then we will use the vaccine that is suitable for young children, depending on the indication that is provided by the manufacturer.

But if the indications are similar, then it will also depend on the availability of the vaccines at the point in time, whichever stock is available. So long as we are able to administer them, we would use the vaccine that is available to us. The key is that whatever the source of the vaccine, all of them must meet our safety efficacy requirements. From a safety and efficacy point of view, they should be treated similarly.

But at the same time, as the Member has pointed out, we do provide information on these vaccines. I think HSA's assessments are published, reports are available and the manufacturers also shared a lot of details with regard to the potential side effects of these vaccines and I have mentioned some of the side effects in my Statement earlier.

Mr Speaker: Mr Alex Yam.

Mr Alex Yam (Marsiling-Yew Tee): Thank you, Mr Speaker. I thank the Ministers for their Ministerial Statements.

With regard to my question, the answer provided by the Minister earlier is that, based on the recent surveys, over 60% of Singaporeans were prepared to be vaccinated. I would like to ask the Minister three follow-up questions.

One is: this figure of 60% "satisfactory" to the Multi-Ministry Taskforce (MTF), should it be higher, because we had mentioned that we should be looking at above 70% vaccination rate?

Second question is: as more vaccines come on stream or are approved for use in Singapore, the sentiments with regard to different vaccines – will that also be similarly surveyed?

Thirdly, on when these additional vaccines come on stream. Anecdotally, over the weekend, as I was speaking to residents as well as family members, quite a number of older Singaporeans seemed to indicate a preference for CoronaVac, which is the vaccine that is developed by Sinovac, which is not using the new technology. For some reason, they indicated that it is because it is older technology, it is more established. If it comes on stream, they would like to choose to have that.

If, in the event that, at the time that they are assigned to take their vaccinations and these other variants of vaccines are not available and they reject the current vaccines, how soon, when new vaccines come on stream, will they be eligible to be vaccinated?

Mr Gan Kim Yong: Thank you. Let me say that we hope that more than 60% of Singaporeans – in fact, ideally, everybody in Singapore – should be vaccinated. Therefore, regardless of whether it is 60% or 70%, we must work hard to try to get the last person to get vaccinated. The Government alone cannot do this. We need everyone to chip in to help – the professionals counselling your patients and their family members to get vaccinated and Members of Parliament going down to the ground, persuading their constituents to step forward and get vaccinated.

I think we want to push the coverage to as high as possible a level, so that we provide protection especially for those who cannot be vaccinated because of medical conditions and/or for various reasons; and there are some for whom the vaccine may not be effective because effectiveness is 95% for the Pfizer-BioNTech vaccine.

Therefore, we need to protect them by making sure that all of us are vaccinated to the extent possible. I urge Members to continue to help us to share this message that we want to encourage Singaporeans to step forward to get vaccinated.

With regard to Sinovac or any other vaccine that has not been approved, my advice is, do not wait for them because we do not know when they will be available and we also do not know whether they will be approved at all. Because until we have the full information, until we have completed the review, I cannot assure you that these vaccines will be available in the short term or even in the long term. So, let us not depend on something that is far away. Focus on what we have today, that is the Pfizer-BioNTech vaccine and get vaccinated. When additional vaccines are available, we will share the details with Singaporeans including the safety efficacy data and everything.

We aim to be as transparent as possible, even side effects, adverse events, we share with everyone so that we can all collectively make an informed decision. So, I think it is important to be transparent, so that we can maintain the trust between the Government and the people and so that we can embark on this vaccination programme together as a country.

Mr Speaker: Mr Dennis Tan.

Mr Dennis Tan Lip Fong (Hougang): Thank you, Mr Speaker, Sir. I thank the two Ministers for their Ministerial Statements. Minister Lawrence Wong made some comments in respect of the Parliamentary Question I filed for tomorrow's sitting. Essentially, I have asked whether the Government is considering or working on a rechargeable version of the TraceTogether token and whether battery replacement for the current version will be provided without charges.

I would just like to see some clarification from the Minister following his comments. Does it mean that the Government will provide free replacement of the current token, free replacement with similar models, not a rechargeable version when the battery runs out, say after six months? I read the literature that the battery will last about six months.

My second clarification is, has the Government already computed at this current non-rechargeable version, if supplied free of charge to all Singaporeans, will cause the Government less in the longer term as compared to a rechargeable version? And this is not forgetting the environmental costs arising from the current model.

Mr Lawrence Wong: Mr Speaker, we had indeed considered these factors on whether or not to have a battery or rechargeable version. I think if you consider the imperatives of what we had to do – roll out the token very quickly and get it distributed in a short time – there is no question, we have to use a version that allows us to use off-the-shelf components. We do not have to incur more costs. We do not have to incur greater complexity in manufacturing. So, that was very clear.

In terms of battery replacement, yes, for the tokens that we have today, the batteries will need to be replaced and we will put in place an implementation process to facilitate that for free, for everyone. Some of it can be done through a simple replacement. Depending on the version of the tokens, because there are different versions. Some of them can be done just through true a simple replacement of the battery, you need not do a one-for-one swap. In other instances, it may be easier to do a one-for-one swap.

But we have indeed taken into consideration all of these factors including the fact that with the current model, you may need to do a one-for-one swap, but we overall still think that this approach, given the circumstances, given the urgency of rolling out the tokens, was a better approach.

Mr Speaker: Mr Lim Biow Chuan.

Mr Lim Biow Chuan (Mountbatten): Sir, many of my residents have expressed concern about the speed of the development of the vaccine. And the Minister's assurance was very helpful in allying their fears. Sir, I wish to ask the Minister for Health, I recall that in the 1950s and 1960s, there was this wonder drug thalidomide, which had severe side effects for pregnant women. So, let me ask the Minister, what assurances are there that, there would not be adverse side effects which may show up perhaps a few years later, especially for pregnant women.

Another clarification which I wish to ask Minister Lawrence Wong is about the TraceTogether token. Sir, I hear what Minister had said about residents collecting tokens, even though they have apps in their smartphones. I feel bit disconcerted because I feel that for residents to collect them and keep them as a reserve, is really quite a waste of resources. And the literature, as the hon Mr Dennis Tan had said, states that the battery runs out in six months and you will be given a free replacement of the battery. If it is damaged, there will be free replacement of the token. If you lose it, there will be a first free replacement as well.

I feel that we should encourage our residents not to waste resources like this. Use the app if they have it in a smartphone and for those who do not have the smartphone, then yes, we want to encourage them to adopt this TraceTogether programme by collecting the token. But certainly, for those who have smartphones, I hope that the Minister can reconsider and ask those with smartphones to not collect or not seek a replacement when the battery wears out.

Mr Gan Kim Yong: Sir, let me address the first question on the long-term side effects for pregnant women. Minister Lawrence Wong can deal with TraceTogether token.

In my speech, I explained that specifically for pregnant women, because the data is insufficient for the time being, therefore, we have advised pregnant women not to be vaccinated for the time being. We are continuing to do research to study the effects on pregnant women. The manufacturers are doing that. As data emerges, we will look at the data and reassure ourselves whether it is safe for pregnant women to take the vaccination. That is a safety precaution we are putting in place.

They are also looking at indications even from a short-term reaction to see whether they are likely to have long-term effects on a pregnancy. These are the part of the scientific work that is on-going. Rest assured that HSA as well as the Expert Committee will take into account all these data before recommending vaccinations for pregnant women.

Mr Speaker: Mr Lawrence Wong.

Mr Lawrence Wong: Sir, I just want to say I fully agree with Mr Lim Biow Chuan. Thank you for making the plug for the app. For those who have smartphones, there is really no need to collect the token. I have not collected my token. I do not see a need to collect my token either because I am quite happy using my app.

So, we will continue to strongly encourage everyone with the app – use the app. We will try to make the app more useful, add more features and hopefully, when we do that, it will further tilt the balance and encourage more people in favour of using the app as opposed to the tokens.

But to the extent that Singaporeans want to collect the tokens, I think we do want to make them available, reduce any anxieties associated with the roll-out of to TraceTogether-only SafeEntry and that is why we are doing this one time distribution. We will complete that soon and then, we will transit, as I said, to this new phase of having TraceTogether-only SafeEntry.

I share Mr Lim's concerns and I would strongly encourage all of us to put the message out to our residents, the app is just as effective perhaps even more effective when new features are added on, so, please use the app.

Mr Speaker: Mr Leong Mun Wai.

Mr Leong Mun Wai (Non-Constituency Member): Mr Speaker, I thank the Ministers for giving us so much information today. To the Minister for Education, I like to clarify that I am not trivialising the effort that the Government has put in from bringing us from Phase Two to Phase Three. However, I am also reflecting some sentiments of many Singaporeans that since there is not much change from Phase Two to Phase Three, we would like to know a longer roadmap whereby we will get closer to the pre-COVID-19 situation. Although it is a new normal, we would like to see this new normal to be far more liberal than before.

So, we would like to know – we would like the Minister to enlighten us on that. Some areas that perhaps we would like to ask is that, one, if we attain a certain level of vaccinations, are we going to open up? Two, if we attain a certain level of testing capability, especially in the rapid test capability, are we going to open up? Three, can we upgrade further the way we use our tracing technology?

For example, just now we were talking about the token, why the Government actually introduced token when we could have push everybody into smartphone, in the first place? So, there are all these questions that on the mind of many Singaporeans. And to open up, can any of these conditions be satisfied or a combination of these conditions will allow us to be closer to the full opening up?

Mr Speaker: It would be useful not to repeat some of the questions that have been answered, please. Thank you.

Mr Lawrence Wong: Mr Speaker, Mr Leong reflected the sentiments, he says that people have, that these changes from Phase Two to Phase Three are not very meaningful. But in fact, in fact, when you go from five to eight, in groups of five to groups of eight, you are adding a lot of risk. Particularly, if one person goes out multiple times, each time a group of eight persons eating, dining, visiting, you are adding a lot of risk. So, I would say, "Don't sweat the small stuff".

It may appear small but these are significant moves that we are making. I think people do appreciate that they can meet in larger groups, meet with their family members, meet with their loved ones and every time we make one step forward, relax a measure, we are adding risk and all of the risk, do add up.

So, it is not just simply saying, "The situation looks very good, let's all keep opening up, let's keep opening up." But each time we make a move, we have to be very sure that we have the tools and the enablers to keep the infection under control.

With regard to these different tools on testing, on tracing, we have already reached quite a high level. We have reached the desired capacity of testing that we wanted to build up. We have the capacity to test more frequently and we are going to do more, using rapid test. We have 78% of people in Singapore on TraceTogether. It is already a very high percentage, probably the highest in the world on a contact tracing system; and we will still try to get a higher rate. So, on these, we are doing quite well.

The one thing that can allow us to open up more is vaccination. But we will only be able to get people vaccinated, a significant number of people vaccinated, as we said, by the third quarter of the year. So, between now and the third quarter of the year, let us not rush to make big changes and big relaxations. We have to do this in a controlled manner, recognising that the risks are there and the virus is raging everywhere in the world. There are new strains emerging. So, let us do this in a very controlled, careful, calibrated manner.

Even after we have had a lot of people in Singapore being vaccinated, it does not mean that everything is over. Because no country is safe until everyone in the world is safe and it will take some time for the whole world to get vaccinated.

So, yes, getting all of us in Singapore vaccinated is important. It will enable us to move further in terms of relaxation of measures for travel, for our own resumption of activities within Singapore. But if your hope is to get back to a pre-COVID-19 sort of normal, I think we still have to be circumspect and we still have to be realistic. The virus is still going to be raging in many other parts of the world, vaccinations will take time to distribute to every country, to everyone in the world. So, we have to be prepared to live with COVID-19 for quite a while.

Mr Speaker: Assoc Prof Jamus Lim.

Assoc Prof Jamus Jerome Lim (Sengkang): Thank you, Mr Speaker. Let me start by thanking both Ministers for not just the update but their hard work, and, indeed, the work of all Government Ministries and agencies. It has been a long road to get us here and I, for one, feel very thankful. I have two clarification questions that should be very quick to answer.

The first is, given that the endorsement for the usage of the vaccine is only for those over 16 and, understanding that, access is voluntary, would it be possible for those under 16, if they wish, to be able to do so, be vaccinated?

The second question is, if I could clarify the definition of residents able to obtain the vaccination, would this generally include LTVP, Employment, Work Pass holders?

Mr Gan Kim Yong: Sir, for the second question, it is in my speech. So, I think I have answered the question, in order not to waste time for the House.

On the first question, I would strongly discourage those below 16 to volunteer for vaccination, primarily because the initial clinical trial did not include those below 16. So, if you do take the vaccine, you will be taking a risk. And I am sure my healthcare professionals would not be in a position to give you a vaccine that has not been authorised for use. So, I would say, please, do not get vaccinated if you are below 16.

We are monitoring. The trials are on-going, manufacturers are continuing to trial on the people below 16. When the data is available, and we are able to verify that they are safe and efficacious for those below 16, we would roll it out for those below 16.

Mr Speaker: Mr Darryl David.

Mr Darryl David (Ang Mo Kio): Thank you, Mr Speaker. I thank both Ministers for patiently and thoroughly explaining the process to us. I would like to ask one clarification which is related to what I think Minister Lawrence Wong said earlier about, for whatever reason health – emotional, psychological – should individuals choose not to get vaccinated, is there any possibility that they could, therefore, end up being excluded from certain activities, from certain places. I think Minister mentioned that they might have to take more thorough tests but I think this was raised to me by a couple of my residents and they said they might choose not to take the vaccination, "Will I be stopped, say, for example, going to watch a movie? Will I be stopped from going to school? Will I be stopped from doing certain things if I do not get vaccinated?"

If Minister could, perhaps, clarify this and give the assurance that, perhaps, the Government will not go down this path? It would be useful, I think, for those who do not get vaccinated to know.

Mr Lawrence Wong: Mr Speaker, as we have highlighted before, without a vaccination, there will be all the various measures that are in place – whether it is testing, whether it is safe distancing, whether it is, you know, tighter control around a particular venue. These are all the prevailing measures that we are used to. They will continue.

When vaccination comes in, we may relax some of these requirements. Many of us are not vaccinated today except for the healthcare workers. But we can do many activities subject to prevailing guidelines, prevailing safe distancing measures.

The idea is that when you get vaccinated, perhaps some of these measures can be relaxed. And we are studying what are the potential changes and adjustments that we might allow and consider.

So, it is not going to be a situation where we say, "No, you can't do this." But it is more likely to be a situation where vaccination will allow you some benefits in terms of activities, in terms of being exempted from certain requirements. Exactly what these are, as I said earlier, it is under study and when we have the data, evidence, when we are clear about what changes are possible in our guidelines and measures, we will put that out to the public.

Mr Speaker: Minister Gan Kim Yong.

Mr Gan Kim Yong: Just to add to Minister Wong's comments. From MOH's point of view, at the moment, that is not the important question to ask. The important question, the important issue is to please get vaccinated. So, do not worry too much about what if you are not vaccinated. Focus on encouraging your constituents, "Please go ahead and get vaccinated." Reassure them that we have gone through thorough assessment on the safety and efficacy of the vaccines. We encourage all of you to get vaccinated when your turn comes.

Mr Speaker: Mr Gerald Giam.

Mr Gerald Giam Yean Song (Aljunied): I thank the Ministers for their Statements. I have clarifications on travel and vaccinations.

I am concerned about the increase in the imported cases. Can the Minister clarify which categories of travellers are excluded from the Pre-Departure PCR Test. I believe he only mentioned Singapore Citizens, PRs and children under six and below? Did all the 12,000 travellers who entered Singapore without a Pre-Departure PCR Test, fall under these categories and, of the 100 imported cases who did not have a Pre-Departure PCR Test, were any of them supposed to have had the test but did not do so?

On vaccinations, since our vaccine programme has already started with healthcare workers, to give the assurance to everybody, including healthcare workers, that the vaccine is safe, should not our senior public servants, including Ministers, already have been vaccinated by now? So, this is not a cheeky question but I believe it will give Singaporeans more assurance to take the vaccine.

And, lastly, is HSA evaluating the Oxford-AstraZeneca vaccine which was already approved by the UK on 30 December?

Mr Lawrence Wong: Mr Speaker, the categories of people who do not require to take the Pre-Departure Tests are spelt out publicly – Singaporeans, PRs who are returning home, children. Those are the key categories. So, I have not looked at the data in great detail but, based on the information we have put out, that the 12,000 which I cited, would largely comprise of these visitors or these returnees.

But as I have highlighted and emphasised, whether someone does a Pre-Departure Test or not, so long as they come into Singapore from a high-risk country, we subject them to a quarantine, SHN. It is quite tight and we make sure that these cases, if they were to emerge, are isolated and ring-fenced and do not leak into our local community. That is the more important point. And we have continued to do so.

Mr Gan Kim Yong: There was a second question with regard to our senior public servants and the politicians, whether we should take the lead. In fact, we will be taking the lead. As the Prime Minister has said, he will be among the first when his cohort comes. At the same time, we also do not want to be accused of jumping the queue, that we go ahead of the others. Therefore, we have to manage the process to ensure that the first priority is given to the healthcare workers because they are exposed and they are at risk. Every day, they see the patients and care for the patients, they themselves are exposed to potential infection. And therefore, the priority must be given to the healthcare workers first and we are focusing on that. Among the healthcare workers, Prof Leo Yee-Sin who is the CEO of NCID, was among the first batch to get vaccinated. That is how she demonstrates her leadership and confidence in the vaccine.

So, I think when our turn comes, I am sure all my colleagues would be very happy to step forward to get vaccinated.

Mr Speaker: Mr Christopher de Souza.

Mr Christopher de Souza (Holland-Bukit Timah): Mr Speaker, first, let me say that I am pro-vaccine. We have learned quite a lot about new strains or mutations across the globe. Look at UK. My question is, does this vaccine we have subscribed to anticipate resistance to future strains or are we to get further vaccinations over and above what we have subscribed to? So, is this a moving target, over and above what we are going to get vaccinated for?

Mr Gan Kim Yong: Thank you. We will continue to monitor the mutations of the virus. I think the scientists around the world are watching and monitoring carefully. As I mentioned in my speech, mutation happens from time to time. In fact, it happens quite regularly as the virus, basically, is like a photocopying machine so it copies itself and every time it makes copy, it will be slightly different from the version previously. There will be some specks here and there, some dots here and there that are different. That is how photocopying works.

By and large, up to today, there has not been evidence to show significant shift in the severity of the virus or the impact on the effectiveness of the current vaccines that are being approved or reviewed in Singapore. So, we continue to monitor.

It is possible that one day, the virus may mutate and we may need to modify our vaccine in order to respond to the new virus. With the current vaccines that have already been developed, I think it will facilitate the development of the new vaccines if it becomes necessary to respond to new strains of the virus, particularly, with the platform of mRNA, it is much easier for us to replicate, to produce new vaccines in response to variations or mutations in the virus.

Mr Speaker: Mr Leon Perera.

Mr Leon Perera (Aljunied): Thank you, Mr Speaker, Sir. I thank the two Ministers for their detailed Statements. Just three supplementary questions for the Minister for Health.

In regard to where the vaccines will be administered, can we take it that they will be administered at polyclinics, public hospitals? Will GP clinics also be involved? Will every effort be made to ensure that the vaccines can be administered in locations that are close to where people are living in diverse locations across the country?

The second question is, will every effort be made to bring the vaccination process to elderly Singaporeans who are in nursing homes, senior care centres and so on, who may not exactly be very ambulatory?

And, thirdly, just to follow up on the question that my colleague Mr Gerald Giam asked, I do not believe it was answered. Is the Government evaluating the Oxford-AstraZeneca vaccine as well?

Mr Gan Kim Yong: Thank you. I think there are quite a number of vaccines that we are currently evaluating. I would not be at liberty to go into details of which are the vaccines that we are evaluating.

It also depends on the data that we are able to get. HSA has now adopted a progressive rolling review approach. As and when data is made available, publicly or bilaterally from the manufacturer, we review them and we get ourselves updated as much as possible so that when the application is made by the manufacturer for the vaccine to be registered, we will then be ahead of time to be able to make a quick assessment, rather than to start from scratch. Therefore, we do this rolling review approach in order for us to speed up the approval process.

So, I would say that most of the vaccines that are currently being developed, HSA has been keeping a watch on them, and is assessing and reviewing the data as and when they become available. As and when the vaccine has applied for registration, we will then go into a full swing evaluation. I would not be able to share what are the vaccines that have applied, beyond the three that I have mentioned earlier.

The other question that where would vaccination sites be, I would say that we will generally take into account accessibility and convenience for those who are receiving the vaccination. For the healthcare workers, most of them will receive the vaccination within their healthcare institutions. They have an existing system to vaccinate their staff and we will tap on those.

For the general public, we will set up vaccination centres across the island. We will also tap on the polyclinics that are available, operating today, but bearing in mind that the polyclinics also have their usual patients that they need to attend to. So, we would not be able to squeeze everyone into the polyclinics for vaccination and that is why we also will need vaccination centres.

We will also be working with private General Practitioners (GPs) clinics to help us to administer the vaccine, especially for those who are less mobile and will need to get to a clinic that is nearby. We will work with the private clinics as well.

Having said that, we have to bear in mind that this particular vaccine – the Pfizer-BioNTech vaccine – is quite challenging to handle. As you are aware, it requires ultra cold-chain, minus 80 degree Celsius and it needs very careful handling during the administration of the vaccine to the individual. It is not so easy to make it available conveniently at all the private clinics. We will need to work with specific clinics and specific chains as well as work with specific, selected vaccination sites so that we are able to construct the infrastructure that is needed for this extra cold-chain storage and administration.

For nursing homes and senior care centres – yes, we will make special arrangements to make sure that we are able to vaccinate them because many of them are not mobile. We are planning to set up mobile vaccination teams that will be deployed to some of these nursing homes and senior care centres to provide vaccination services for them.

Mr Speaker: Order. End of Ministerial Statements. Introduction of Government Bill. Minister for Communications and Information.