Number of Children in Singapore Infected with Delta Variant of COVID-19 and Safeguarding Their Health Before Vaccination

1 Dr Tan Wu Meng asked the Minister for Health (a) to date, what is the number of children in Singapore diagnosed with COVID-19 and what proportion has the Delta variant; (b) how many needed supplementary oxygen at any time during their illness; and (c) how does this experience compare with countries with significant numbers of COVID-19 Delta variant infections in children.

2 Mr Yip Hon Weng asked the Minister for Health (a) how can the safety of children be ensured before a suitable COVID-19 vaccine for them is available, especially children who are immunocompromised; (b) whether the Ministry is monitoring the trend of long COVID-19 symptoms in children; and (c) whether adequate resources are available to provide healthcare and emotional support for children who contract long COVID.

The Senior Minister of State for Health (Dr Janil Puthucheary) (for the Minister for Health): Mr Speaker, may I have your permission to take Question Nos 1 and 2 together, please?

Mr Speaker: Yes, please.

Dr Janil Puthucheary: Mr Speaker, in Singapore, we have had 367 COVID-19 paediatric cases to date, with 172 infected with the Delta variant. Children below the age of 12 account for 0.6% of all local infection cases.

Amongst these COVID-19 paediatric cases in Singapore, 13.6% or 50 cases were aged zero to one, 22.6% or 83 cases were aged two to four, 20.7% or 76 cases were aged five to six and 43.1% or 158 cases were aged seven to 12.

Global data show that a very low proportion of COVID-19 infected children experience a severe illness, as compared to adults. The percentage of infected children who experience severe illness and require intensive care is 0.7% in Israel, 0.3% in the Republic of Korea and 0.6% in France. There is evidence suggesting that children with underlying medical conditions, such as genetic, neurologic, metabolic conditions, medical complexity, congenital heart disease, obesity, diabetes, asthma, chronic lung disease, sickle cell disease, or immunosuppression might be at increased risk for severe illness from COVID-19.

Fortunately, in Singapore, no child thus far has developed severe illness requiring oxygen supplementation or ICU care. So, the percentage of infected children that experience severe illness in Singapore is zero. We are, however, mindful that the number of cases in the community is rising and there may be more children infected with COVID-19 in the future. We will ensure that these children receive appropriate care, if their illness is more severe.

There are things parents can do to minimise the risk of their children getting infected or developing severe illnesses. All family members should maintain good hygiene and keep their home clean. When out, keep your masks on and cut back on social activities where masks are off or the interactions are prolonged, because such interactions account for the large majority of infections. When unwell, do a self-test or see a doctor immediately.

These effective safe management and surveillance have been implemented to further keep our children safe, particularly in large settings where children congregate, such as preschools and schools. These include mask-wearing, limiting the group size, personal hygiene and requiring those children with a higher risk to take leave of absence. Family members should also get vaccinated to reduce the risks of being infected and transmitting COVID-19 to the child.

Immunocompromised children are at risk from COVID-19 and other infectious diseases. They and their family should exercise additional precautions, such as avoiding crowded places and minimising the number of visitors.

As for "long COVID", it is an informal term that refers to persons who have continued symptoms of COVID-19 infection. The underlying reasons for continued symptoms vary, as do the symptoms themselves. Locally, infected children have, generally, not had prolonged symptoms. We will offer care to all patients with long COVID, if this occurs, and especially those that require support from different clinical teams, depending on their conditions.

Mr Speaker: Dr Tan Wu Meng.

Dr Tan Wu Meng (Jurong): Mr Speaker, I thank the Senior Minister of State for his answer. I have got two supplementary questions.

Sir, as background, a number of Clementi parents have reached out, sharing about their worries for their young children, children who are too young to be vaccinated, parents who are watching the case numbers in the community go up. Some parents have been watching what has happened overseas in some other countries: long COVID as well as the Multi-system Inflammatory Syndrome in children reported in some countries where COVID-19 is widespread; some parents also look at what happens in some advanced economies —

Mr Speaker: Can we come to the questions, please?

Dr Tan Wu Meng: Yes, Sir. Let me ask the two supplementary questions. First, can the Minister share whether there have been any cases of Multi-system Inflammatory Syndrome documented so far in Singapore among our paediatric COVID-19 patients?

Secondly, given the very different experience of paediatric patients across some countries in the West, for example, in the US, there is an NBC news report on 14 August that stated "North Texas runs out of pediatric ICU beds amidst COVID surge", but at the same time, the British Medical Journal on 16 August mentioned that the UK experience is not as serious as what has happened in the US. So, can the Senior Minister of State also share, given the different experience on both sides of the Atlantic, what lessons can we learn from studying other countries' battles with COVID-19 to safeguard and support our children?

Dr Janil Puthucheary: Sir, I thank the Member for the questions. The short answer to the first question is no. There are no paediatric cases, such as what he has described. As for the different experience overseas, indeed, the lessons learnt are something that our various expert committees and professionals in various disciplines are looking at very, very closely.

There are a lot of lessons to be learnt but if I could summarise a few things. Our context matters. So, when we take these lessons from overseas, how they are applied here will depend, for example, on the baseline health of our population, whether it is child or adult; on access to care, and we are very fortunate that within the confines of our city, tertiary medical care is a very short distance away; on the general level of hygiene; and also, on the ability for our population to comply with various procedures or requirements, whether medical or social.

So, context is everything and the baseline health of our population is also very, very important. We cannot just simply take the raw numbers or the raw experience from overseas and expect that exactly the same thing will happen here in Singapore. But we must learn the lessons of their experience, often hard-won, so that we can better protect our population here.

Mr Speaker: Mr Yip Hon Weng.

Mr Yip Hon Weng (Yio Chu Kang): Thank you, Mr Speaker. I thank the Senior Minister of State for his reply. We read that the UK will be offering the COVID-19 vaccination to older children from 12 to 15 as soon as next week. The US Food and Drug Administration (FDA) may also authorise the use of the Pfizer vaccine for younger children from ages five to 11 by the end of the year.

When can we expect approval to be given in Singapore for our children to receive the vaccine and for what ages?

Dr Janil Puthucheary: Mr Speaker, we will continue to study the data from overseas. Some of it will depend on the applications made by the vaccine companies. But I think when the decisions are reached, we will certainly be quite clear and make full explanation to the public.