[Updated 21 January 2022]

Assessment of Omicron variant

International data and the experience of local cases suggest that the Omicron variant is likely to be more transmissible but less severe.

However, there has been a rise in the total number of confirmed Omicron cases which could likely signal the onset of an infection wave that could be greater than that of the Delta variant. This could put significant pressure on the healthcare system.

It is therefore important to update the healthcare protocols to prepare for this upcoming wave.


Revised healthcare protocols

Since 6 January 2022, our Healthcare Protocols have focused on managing COVID-19 cases based on the severity of their symptoms and individual risk factors. 

Lower-risk individuals with mild symptoms can now be immediately diagnosed by their primary care doctors via a healthcare provider-administered Antigen Rapid Test (ART) and recover safely under Protocol 2; whilst those assessed by their doctors as 1high risk or with significant 2symptoms will be managed under Protocol 1. These higher risk patients will also be assessed for placement on the Ministry of Health’s (MOH) Home Recovery Programme, or further management or monitoring in a care facility.

Reduction of maximum isolation period for fully vaccinated individuals and children below 12

As local studies have shown that the viral load for Omicron infections is lower than for Delta infections throughout the course of the infection period, we will shorten the maximum isolation period for fully vaccinated individuals and children below the age of 12 years old for both Protocols 1 and 2 from 10 days to 7 days. The maximum isolation period for unvaccinated individuals aged 12 years old and above will remain at 14 days for both Protocols 1 and 2. 

Expansion of Protocol 2 to more patient groups and settings

With effect from 21 Jan 2022, the age bracket suitable for Protocol 2 will include children aged 5 to 11 years old, regardless of their vaccination status. Those with non-emergency conditions, including children, should avoid seeking treatment at hospitals and consult their primary care doctor instead.

Those who test ART positive at non-clinical settings (e.g. unsupervised or employer supervised self swab tests) but who identify themselves as potentially at risk (see Annex) should  still visit a doctor for medical advice even if they feel well.  

Patients who are on Protocol 1, recovering well and whose symptoms have improved can also transit smoothly to Protocol 2. This means that they can be discharged earlier and return to normal activities if they test negative on a self administered ART taken 72 hours or more after their first positive COVID-19 test. 

Protocol 2 will be progressively applied to all low-risk, asymptomatic individuals who are in Protocol 1 settings, such as COVID Treatment Facilities, those who test positive for Pre departure Tests (PDT), Pre-event Testing (PET), Rostered Routine Testing (RRT) and mandatory traveller tests (e.g. On-arrival Tests (OAT) and tests taken at the end of Stay-Home Notice (SHN) periods), so long as their medical conditions allow it. 

A summary of the revised healthcare protocols is as follows:

Protocol 1:

If you are unwell

High-risk individuals1 or those with severe significant symptoms2

  • To undergo both ART and polymerase chain reaction (PCR) test.
  • Those with severe symptoms: the doctor will convey you to hospital for further assessment.
  • For the rest: the doctor will advise you to immediately return home and self-isolate in a room while waiting for your test result. 
    • If you test positive, MOH will contact you on your recovery journey. If assessed suitable you may recover under MOH’s Home Recovery Programme. Otherwise, you will be conveyed to a care facility

Low-risk individuals with mild symptoms:

  • Primary care doctors to administer healthcare ART
  • If positive, refer to Protocol 2.

Protocol 2:

If you are well* and test positive, or your condition assessed to be mild by a doctor

  • Self-isolate at home for at least 72 hours.

  • If well, may exit self-isolation and resume normal activities upon a negative self-administered ART result.

  • Those who continue to test ART positive to continue to self-isolate and self-test daily until:

  • they obtain a negative ART result; or

  • until Day 7 (for vaccinated individuals and children below 12 years old) or Day 14 (for unvaccinated/ partially vaccinated individuals aged 12 years old and above).

  • No Medical Certificate (MC) from a doctor if no symptoms. If doctor has assessed you to have a mild condition, will be issued an MC.

  • Return to the doctor of call 995 in emergency situations if symptoms worsen or do not improve with time.

Protocol 3:

If you are identified as a close contact of an infected person4

  • To be issued a 7-day Health Risk Warning.

  • Required to self-test with ART daily. Only leave home with negative ART test.

  • No further test needed if tested negative on Day 7.

 

*Annex: Conditions That Would Benefit from Further Clinical Assessment

Individuals with the following conditions are potentially at risk and should visit a doctor after testing positive for COVID-19, even if they are feeling well:

a. Fully vaccinated and aged 70 years and above;

b. Unvaccinated/partially vaccinated and aged 50 years and above;

c. Aged 5 years and below;

d. Had an organ transplant surgery in the past;

e. Have any disease or are taking any medication that weakens the immune system;

f. Have been diagnosed with cancer (including blood cancers) before; g. Are on dialysis;

h. Are diagnosed with HIV or AIDS;

i. Have a disease affecting your heart, lungs, kidneys, liver, or brain that required hospital admission in the last 6 months;

j. Are pregnant;

k. Are less than 12 years old and have any congenital condition or growth disorder that affects the heart, lungs or brain; or

l. Are less than 12 years old and have Diabetes Mellitus or hypertension.

The doctor will clinically assess their health status and severity of their symptoms. Individuals may still be deemed suitable for recovery at home (either under the doctor’s direct care or under the Home Recovery Programme) OR be conveyed to a care facility for closer monitoring and/or therapeutics.

 

 

1Includes elderly, pregnant women and persons with immunocompromised status

2Includes chest pain, shortness of breath, prolonged fever

3Day 1 is taken as the date of positive healthcare-administered ART

4Contact-tracing efforts would shift back towards self-reporting by family members and leveraging digital tools such as TraceTogether, and tight ringfencing of vulnerable settings such as hospitals, nursing homes, etc

For more information, please refer to MOH’s press release.

 

 

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