'Prepare for the worst': Experts on how Singapore needs to be on its guard against Omicron

SINGAPORE - Preliminary findings point to Omicron causing milder disease, but Singapore needs to be on its guard against the new variant, say experts.

It is far better for the country's healthcare system to be overprepared, than for it to be caught off guard in the event that Omicron springs unexpected surprises, they told Insight.

This strategy would stand the country in good stead for new variants which could surface for years to come.

Singapore's high vaccination rates - that now include children under 12 - coupled with a growing pool of people receiving their booster shots, and a tried-and-tested regime of contact tracing, testing, and quarantining, the nation is in a good footing to ride out the coming wave, they said.

It is a matter of time before Omicron starts to circulate in the community, but delaying and slowing down community spread will help to buy the country time to roll out paediatric vaccinations and boosters, as well as ramping up healthcare capacity, dean of the Saw Swee Hock School of Public Health Teo Yik Ying said.

Though Omicron has yet to establish a foothold in Singapore, the country has already stepped up surveillance and testing of travellers and front-line workers, and also temporarily halted the introduction of any new vaccinated travel lane (VTL) arrangements, Prof Teo pointed out.

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The authorities also announced on Dec 14 that Singapore is preparing to increase its intensive care unit (ICU) capacity to 500 beds, up from the current 280.

ICU capacity was increased from 180 ICU beds to 280 beds at the peak of the Delta wave in Singapore around end-October.

Such "calibrated caution" is a good approach, said Associate Professor Alex Cook, vice-dean of research at the Saw Swee Hock School of Public Health.

Even though Omicron may turn out to be less deadly, more infections could ultimately lead to more deaths in absolute numbers.

"We shouldn't be like 'oh it's milder so it's not going to be a problem', but there's also no point despairing," Prof Cook said.

The Omicron variant replicates around 70 times faster than Delta and the original Covid-19 strain, though the infection severity is likely to be much lower, according to a University of Hong Kong study on Dec 15 that adds weight to the early on-ground observations from South African doctors.

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Separately, the variant was also found to be 4.2 times more transmissible in its early stage than Delta, according to a Japanese study. This is likely to confirm fears about how contagious the new strain is.

Part of Singapore's preparedness for unknown disease or any new highly virulent variant needs to be the healthcare's surge capacity, said Professor Dale Fisher, a senior consultant at National University Hospital's (NUH) Division of Infectious Diseases.

"This shouldn't be built around Omicron but it should be part of our intrinsic capacities to any new variant of consequence or any new emerging significant infectious disease," he said.

Allocating more healthcare resources to Covid-19, however, would potentially compromise on existing healthcare needs.

Calling it a difficult balancing act which the authorities have to strike, Prof Cook stressed that it is still "better to prepare for the worst and get it wrong than to prepare for the best and get it wrong".

It is natural that health authorities are risk averse and Singapore should be pleased with this fundamental premise, Prof Fisher said.

He stressed that new variants could surface for years to come.

"Moving forward towards a Covid-19 resilient nation, we also have to be resilient to the emergence of variants of concern. This is our fifth variant of concern and we should expect more. This may occur every few months and potentially for many years," Prof Fisher noted.

So the country must develop a robust yet sustainable response for new variants that does not undermine the security of travellers or disrupt the plans of those who are running large events, Prof Fisher explained.

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To date, not a single variant of concern has become a variant of high consequence, which means it causes increased disease severity or escapes from natural or vaccine-associated immunity to cause severe disease.

However, these remain possibilities that nations have to be on high alert for, he stressed.

Should Omicron indeed turn out to be a false alarm, then it can be seen as a practice run and a learning exercise, he added.

"However, societies cannot be held hostage to each new variant out of fear," Prof Fisher added.

As the country transits to endemic Covid-19, much has been done to ensure sufficient attention is given to both Covid-19 and non-Covid-19 needs.

There is also a real risk of neglecting other non-Covid-19 health issues, such as the "silent" epidemics of diabetes and mental health, said Dr Woo Jun Jie, senior research fellow in the governance and economy department at the National University of Singapore's Institute of Policy Studies.