Source: Asia Pacific Region 2 – Singapore
It has been more than half a year since we entered Circuit Breaker, and more than four months since we started our gradual reopening. We have come a long way, ramping up healthcare capacity, contact tracing and testing capabilities, putting in place safe management measures in the community, workplaces and dormitories, and opening our borders in a safe and calibrated manner. With everyone’s efforts and sacrifices, we have been able to control the infection and keep community transmission low thus far.
2. To continue our journey of safe re-opening towards Phase Three, several conditions and enablers need to be in place. In particular, we must continue scaling up testing and tracing efforts as well as adhering to the safe management measures. This is how we can progressively resume more activities safely while keeping community transmission low.
3. Phase Three is not a return to the pre-COVID status quo ante. It will entail new ways of working and living, until the world has the virus under tight control (e.g. through more effective treatments and vaccines that are widely available). So we have to be prepared to stay in Phase Three for a prolonged period (potentially more than a year). Phase Three will also not be static. If we can put in place more enablers, there is scope for further reopening and scaling up of activities even within Phase Three.
Key Enablers for Phase Three
Continued Adherence to Safe Management Measures
4. We have seen a resurgence of COVID-19 in other countries as they open up to more activities or due to lack of adherence to safe management measures. To ensure that the situation in Singapore remains under control despite the continued presence of cases in our community, we will each have to keep up the habits and practices that we have painstakingly put in place over the past few months:
Testing to Enable More Activities
a) Small group sizes. Keeping group sizes small and limiting the number of contacts that we have slows down the rate of virus transmission and reduces the risk of super-spreading events. We will continue to set limits on group sizes, both in public spaces and visitors to the home.
b) Safe distancing. Safe distancing, including no intermingling between individuals and groups, remains a key measure in reducing the risk of spread. We will continue to set requirements on safe distancing, as well as to disallow or minimise interactions between groups.
c) Social responsibility. Mask-wearing and personal hygiene protect us and others from COVID-19. Persons with symptoms of acute respiratory infection should seek medical attention at the earliest opportunity and follow up with a Polymerase Chain Reaction (PCR) swab test if directed by the doctor.
Testing to Enable More Activities
5. To enable more activities to resume in a safe manner, the Multi-Ministry Taskforce is piloting the use of pre-event COVID-19 testing for larger-scale and higher-risk activities to reduce the risk of a COVID-19 case being present at the event.
6. Pre-event testing requires participants to an event or activity to be tested shortly before the event, either at the event venue itself or at a separate testing facility. Only participants who test negative for COVID-19 will be allowed to participate in the event. This helps to prevent positive cases from transmitting the disease to other people at the event.
7. Given the need for a shorter turnaround time for pre-event testing, we are exploring the use of antigen rapid tests which can return fairly accurate results quickly. This is part of our strategy to expand beyond the highly accurate PCR tests to have a range of tests to cater for various use cases. Due to the lower sensitivity of antigen rapid tests, there is still a possibility that a COVID-19 case could slip through to attend the event. Therefore there is still a need for safe management measures to be put in place, including mask-wearing, safe distancing, group size and capacity limits, to reduce the risk of transmission. The lower accuracy of antigen rapid tests also means there could be false positives, i.e. persons who are tested positive even though they are not infected.
8. The pilots will enable the Ministry of Health (MOH) to trial pre-event testing processes to identify different models that can be implemented more widely and allow more large-scale or higher-risk events to resume eventually. From mid-October to December 2020, we will be identifying selected events across different settings, such as business-to-business events, wedding receptions, live performances, and sports events to test different operational workflows for pre-event testing. For example, one business-to-business event where pre-event testing will be piloted is the Singapore International Energy Week next week. We will gather feedback from event organisers and participants to finetune these processes. If these pilots prove successful, we will assess how to make these tests available for more widespread use. For further information, please refer to this Factsheet on Pilots for Pre-event Testing.
Digital Contact Tracing Tools to Enable More Activities
9. Alongside safe management measures and scaled up testing, we need to continue to strengthen our contact tracing regime, leveraging our two key digital contact tracing tools – SafeEntry and TraceTogether. The active use of SafeEntry has significantly improved MOH’s ability to detect COVID-19 clusters quickly. At the same time, we need greater participation in the TraceTogether Programme to help us quickly identify close contacts of COVID-positive cases. These digital tools are critical for quickly ringfencing any cases that emerge as a result of larger group sizes and larger-scale activities. Without these tools, we may have multiple generations of spread and large clusters forming.
10. We will need a higher take-up rate for TraceTogether before we can start Phase Three. Local and international experience suggests that social interactions, which often take place in close proximity, sometimes without masks on, and often for prolonged periods, are key areas of spread. It is therefore imperative that there is higher adoption of TraceTogether, so that we are able to quickly contact trace and ringfence any infections.
11. Another prerequisite is to expand the deployment of TraceTogether-only SafeEntry, where visitors are required to check in to SafeEntry through either scanning the QR code using the TraceTogether App on your phone, or by presenting your TraceTogether Token to be scanned. This allows us to ensure that persons visiting places where people are likely to be in contact for prolonged periods, or where human traffic is high, have the TraceTogether App or Token. In this regard, we will progressively roll out TraceTogether-only SafeEntry to workplaces, schools, and more public venues, including cinemas, live performances, shopping malls, and F&B outlets.
12. We encourage everyone to download the App or collect a Token for use at the TraceTogether-only SafeEntry premises. TraceTogether tokens are now available for collection at 38 Community Centres/ Clubs (CCs) around Singapore, and are expected to be available at all 108 CCs by end-November 2020. Please refer to the TokenGoWhere website (https://token.gowhere.gov.sg) to find the latest schedule and locate a convenient site for collection.
Moving to Phase Three
13. With the above conditions and enablers in place, we will be able to move to Phase Three. The shift to Phase Three will entail the following adjustments. The exact timing of these changes will depend on our collective ability to cooperate with the requirements. Details of some of the measures which will be updated in the coming weeks are summarised in Annex.
Increasing Group Size
14. In Phase Three, the group size for gatherings outside the home could be increased from the present 5 persons to 8 persons. The number of visitors allowed to homes would similarly increase to 8.
Increasing Capacity Limits
15. Presently, public venues like museums and attractions are already open, subject to a capacity limit. Events like congregational worship services and wedding receptions can also be held in two zones of 50 persons. In Phase Three, these capacity limits could be increased, and we could allow events with multiple zones of 50 persons. All of these adjustments would have to be done in a controlled manner, setting by setting, over the course of Phase Three, and additional measures would apply for specific settings.
16. For example, wedding receptions are higher-risk activities, where people are gathered for a meal without their masks on, and there is a greater likelihood of social interactions. Any expansion in the number of attendees would therefore require additional safety measures, including having all the guests go through a pre-event test.
17. It is also critical to adhere to the safe management measures in these large-scale events. Therefore, Government agencies may also request video and photographic footage of the events, to facilitate checks and investigations against any breaches of the rules.
Considerations for Activities in Higher-Risk Settings
18. Higher-risk settings like bars, pubs, karaoke lounges and nightclubs are closed today as their activities pose a higher risk of transmission. Even at the start of Phase Three, we do not expect to open these venues. But we are prepared to consider a few limited pilots in these settings, subject to a more stringent set of measures, including pre-entry testing, to explore how the industry could resume safely. We will discuss these possibilities with the nightlife industry. But we have to be realistic that it will take a long time for the industry to fully re-open in its original form. Where there is non-resumption, the Government will put in place an assistance package to help business operators and owners transit and pivot to new areas.
Facilitating travel and re-opening of borders
19. Unlike larger countries which can keep their borders closed, our livelihoods and economic survival depend heavily on Singapore being open to the world and being a key international and travel hub. It is therefore not possible for Singapore to keep our borders closed indefinitely. We will have to gradually allow more travel to resume in a safe manner.
20. Through the unilateral opening of borders and Air Travel Bubbles, we are allowing travellers from low-risk countries/ regions (i.e. those which have comprehensive public health surveillance systems and displayed successful control over the spread of the COVID-19 virus) to enter Singapore with a COVID-19 test without the need to serve a Stay-Home Notice (SHN).
21. For travellers from higher-risk countries/ regions, our current approach is to subject them to SHN at home or at dedicated SHN facilities. We are exploring ways to deploy more frequent testing, coupled with other safeguards, to enable more travellers to enter Singapore without a need to serve SHN, while minimising the risk of transmission to the community.
22. Currently, Singaporeans Citizens (SC)/ Permanent Residents (PR)/ Long-Term Pass Holders (LTPH) who travel out of Singapore from 27 March 2020 onwards are responsible for their own inpatient medical bills, if they have onset of symptoms for COVID-19 within 14 days of their return to Singapore, and are unable to access government subsidies or insurance coverage (be it MediShield Life/ Integrated Plans or private insurance).  In line with the progressive move to reopen our borders, we will henceforth allow all SCs/ PRs/ LTPHs travelling overseas to access government subsidies and insurance coverage for their medical bills.
23. There is no change to the charging policy for SCs/ PRs/ LTPHs who departed Singapore before 27 March 2020, i.e. the Government will continue to pay for their inpatient medical bills for COVID-19 treatment upon return, if any.
Road to Phase Three and Beyond
24. As we make these adjustments towards a new COVID normal, the Multi-Ministry Taskforce will continue to explore parallel tracks such as vaccines, treatment, testing and other technologies which could enable us to further ease restrictions and resume connectivity with the world in a safe manner. The journey ahead may be long, but with the cooperation of everyone, including businesses, scientists, frontline workers, and the general public, we are confident of transiting smoothly to Phase Three and beyond, emerging stronger from this experience.
 The current exceptions are those who travel on permitted travel regimes (e.g. reciprocal green lanes) or students who travel overseas for full-time studies.