Speech on Singapore’s Policy of Covid-19 Endemicity
The problem we have is that despite the explanations, many people still do not understand the meaning of treating the virus as endemic or the process of going towards endemicity.
First, treating Covid-19 as endemic means accepting that virus will always be circulating among us.
And if the virus is always circulating among us, we should not expect zero cases.
Second, we can’t reach endemicity without waves of transmission. This is the most difficult part of the journey.
And do not cry that the task force has lost their way when you see this surge of cases – because they have not lost their way. They are persevering towards endemicity.
A truly endemic state is reached when the virus is circulating among us without being the threat that it is now and without a large number of hospitalizations.
How does the virus become less of a threat?
Two ways.
The first is a very high rate of vaccination. The second is high natural immunity in the population.
The first of these two ways is (hopefully) clearly understood. If you are vaccinated, you are protected from getting a serious illness if you are infected.
𝗧𝗵𝗲 𝘀𝗲𝗰𝗼𝗻𝗱 𝗶𝘀 𝘁𝗵𝗲 𝗵𝗶𝗴𝗵 𝗻𝗮𝘁𝘂𝗿𝗮𝗹 𝗶𝗺𝗺𝘂𝗻𝗶𝘁𝘆 𝗶𝗻 𝘁𝗵𝗲 𝗰𝗼𝗺𝗺𝘂𝗻𝗶𝘁𝘆. 𝗧𝗵𝗶𝘀 𝗰𝗮𝗻 𝗼𝗻𝗹𝘆 𝗰𝗼𝗺𝗲 𝗮𝗯𝗼𝘂𝘁 𝘄𝗵𝗲𝗻 𝗽𝗲𝗼𝗽𝗹𝗲 𝗮𝗿𝗲 𝗶𝗻𝗳𝗲𝗰𝘁𝗲𝗱. 𝗧𝗵𝗲 𝗺𝗼𝗿𝗲 𝗶𝗻𝗳𝗲𝗰𝘁𝗶𝗼𝗻𝘀 𝘁𝗵𝗲𝗿𝗲 𝗮𝗿𝗲 (𝗮𝗻𝗱 𝗽𝗲𝗼𝗽𝗹𝗲 𝗿𝗲𝗰𝗼𝘃𝗲𝗿 𝗳𝗿𝗼𝗺 𝘁𝗵𝗲𝗶𝗿 𝗶𝗻𝗳𝗲𝗰𝘁𝗶𝗼𝗻) 𝘁𝗵𝗲 𝗴𝗿𝗲𝗮𝘁𝗲𝗿 𝘁𝗵𝗲 𝗻𝗮𝘁𝘂𝗿𝗮𝗹 𝗶𝗺𝗺𝘂𝗻𝗶𝘁𝘆 𝗶𝗻 𝘁𝗵𝗲 𝗽𝗼𝗽𝘂𝗹𝗮𝘁𝗶𝗼𝗻.
This is why you cannot reach endemicity without the waves of transmission. BECAUSE there can be no natural immunity without infections.
You can gallop towards the true state of endemicity in as short a time as possible by removing all restrictions, open all borders, or you can have a controlled journey towards there.
The former will lead to a surge of infections so high that the healthcare system cannot cope, and people die for lack of oxygen supplementation because there is no room for them. But the country will also reach endimicity faster.
So what is slowing Singapore down from being the first to reach this endemic state?
The human cost.
Because all lives matter.
This is why some restrictions are still in place. We’re not trying to stop transmission. We’re slowing it down to make sure our healthcare system is not overwhelmed so that every sick person can be cared for.
When the case loads in hospitals become more manageable, restrictions may be eased. This of course means cases will GO UP AGAIN.
𝗪𝗶𝘁𝗵 𝗲𝘃𝗲𝗿𝘆 𝘄𝗮𝘃𝗲 𝗼𝗳 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻, 𝘁𝗵𝗲 𝗻𝗮𝘁𝘂𝗿𝗮𝗹 𝗶𝗺𝗺𝘂𝗻𝗶𝘁𝘆 𝗶𝗻 𝘁𝗵𝗲 𝗽𝗼𝗽𝘂𝗹𝗮𝘁𝗶𝗼𝗻 𝗮𝗹𝘀𝗼 𝗶𝗻𝗰𝗿𝗲𝗮𝘀𝗲𝘀. 𝗧𝗵𝘂𝘀, 𝘄𝗶𝘁𝗵 𝗲𝘃𝗲𝗿𝘆 𝘄𝗮𝘃𝗲 𝗼𝗳 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻, 𝘁𝗵𝗲 𝗽𝗼𝗽𝘂𝗹𝗮𝘁𝗶𝗼𝗻 𝗯𝗲𝗰𝗼𝗺𝗲𝘀 𝗺𝗼𝗿𝗲 𝗿𝗲𝘀𝗶𝗹𝗶𝗲𝗻𝘁.
The brakes may be pulled on the RESTRICTIONS every now and then depending on the surge of each wave..
This is not a flip flop. This is to ensure the healthcare system remains intact to take care of you.
Going towards endemicity is not going to be a pretty sight.
How have we done?
It’s early days yet for an assessment but we have kept the number of fatalities as low as possible. That is to be noted.
We can do even better if those who are not vaccinated can be persuaded to get vaccinated.
Most of the deaths are from unvaccinated people. They come from a very small group of unvaccinated population.
Think about this. How many of these deaths could have been prevented if people were vaccinated?
What must you do? Get vaccinated!
After waves of transmission, we will eventually reach endemicity. The journey is not an easy one. It is made bearable and possible with vaccination.
Without vaccination, the cost will be a massive loss of lives.
Covid-19 is here to stay and endemicity is inevitable.
Dr Vivian Balakrishnan
Minister of Foreign Affairs
Republic of Singapore
October, 2021
