Expect Covid-19 wave in weeks ahead but rates of severe disease likely low, experts say

With many people planning to travel abroad this month and new Covid-19 sub-variants spreading globally, it is possible that Singapore could see increased regular transmission of the coronavirus in the weeks ahead, experts here said.

The future could be that Singapore will see more continuous regular transmission of the virus, causing mild disease, in fluctuations but not waves, said Professor Dale Fisher, an infectious diseases expert from the National University Hospital.

"This would be the case if the future mutations don't significantly change the behaviour of the virus. Waves may not come but they certainly could," he added.

However, the experts also stressed that it is the severity of the disease that matters more.

"At this stage, we can be confident that a wave involving severe disease is unlikely to occur soon but if it does, we have to be ready. As a community, we should be enjoying where we are now but aware of how things could change," Prof Fisher said.

Rates of severe disease are also likely to remain low even if transmission increases in the weeks ahead.

This would be due to three main reasons, said Professor Teo Yik Ying, dean of the Saw Swee Hock School of Public Health at the National University of Singapore.

One, Singapore has vaccinated some 96 per cent of the eligible population, and 76 per cent of the population have already received their third booster shot, so the population as a whole has a certain degree of protection against severe disease.

Two, with about 1.3 million reported cases of infection, of which the actual case count could be twice this number, that would mean that about 50 per cent of the population had already been infected, he said.

"Reinfections typically result in milder symptoms," he added.

Finally, Singapore continues to require the use of face masks in indoor settings, and this will go some way towards minimising super-spreading events.

The whole healthcare system has also become more resilient, so even if there is a spike in case numbers, it is unlikely to be as significant or exert as much pressure on the healthcare system as before, Prof Teo said.

The Straits Times had spoken to experts following Health Minister Ong Ye Kung's comments on Thursday (June 2) that the next Covid-19 wave could hit Singapore in July or August.

He had said Singapore is preparing for a Covid-19 wave driven by the BA.4 and BA.5 Omicron sub-variants, which were first detected in South Africa.

Prof Fisher said these new sub-variants do sometimes escape the immunity conferred by a previous infection or vaccination, but the protection a person gets against severe disease remains robust.

"It is absolutely appropriate that we remain in a state of readiness," he added.

Mr Ong had on Thursday also described institutional ways to prepare for the next wave, such as getting every healthcare setting - like nursing homes, community hospitals and private hospitals - to be ready to handle Covid-19 patients.

Associate Professor Alex Cook, vice-dean of research at the Saw Swee Hock School of Public Health, noted: "That may be another important difference between past and future waves. In the past, we needed a societal response as well as an institutional response, such as from the hospitals and the Government.

"With greater immunity and 'normalisation' of Covid-19, we should need less societal contributions to the fight. For instance, in the current epidemic state, there's little reason to continue to mandate indoor mask wearing or to limit foreign workers to one trip out of their dormitories a week."

On whether Singaporeans would need another booster soon, Prof Cook said: "At present, I don't think there's a compelling case for extending fourth shots to lower-risk groups, but in time this may be necessary."

Prof Teo added: "I expect we can take regular shots, very much like the influenza vaccine, but not necessarily mandated by the Government. I believe we will only have a mandate for regular booster shots when the scientific evidence actually shows the benefits and the need for it, which presently there is not."

This article was first published in The Straits Times. Permission required for reproduction.