Singapore prepares for long term life - and death - with COVID-19

SINGAPORE: With just a few dozen COVID-19 deaths and one of the world's highest vaccination rates, Singapore wants to reopen for business - and is laying the groundwork to live with the coronavirus as it does other common diseases such as influenza.

Its medical experts say residents may see hundreds of deaths each year from endemic COVID-19, similar to the flu. That pragmatic approach could set an example for other countries looking to exit lockdowns as they ramp up their own inoculation programmes.

"The only way to have no deaths from a disease anywhere in the world is to eliminate the disease altogether and that has only been done for smallpox," said Paul Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection.

Singapore has reported only 44 COVID-19 deaths since the outbreak started in early January 2020. That compares with about 800 flu-related deaths in a typical year, according to doctors, in the country with a population of 5.7 million.

"While the idea of hundreds of COVID deaths seems shocking compared to the deaths so far and worth taking efforts to prevent, it is on par with influenza, which society hardly cares about," said Alex Cook, an infectious disease modelling expert at the National University of Singapore (NUS).

As many as 1,000 may die in the next year or two in Singapore if vaccinations among the elderly do not improve, he added.

Experts forecast that majority of the deaths will be among those in the oldest age group, who remain unvaccinated despite being eligible for nearly half the year.

The country's health minister, Ong Ye Kung said this month that as the economy opens up, Singaporeans must "be psychologically prepared that the death toll due to COVID-19 will likely also go up."

Three-quarters of Singapore's population is fully inoculated against the coronavirus, and the country is set to ease more restrictions in September when the vaccination rate hits 80%.

As of Aug. 16, 80% of those aged 70 years and older had been fully vaccinated, and 60-69 year-olds were at 88%.

Singapore reported six COVID-19 deaths in the last two weeks, none of whom were vaccinated.

Early results from mathematical models suggest that the expected number of deaths from seniors aged 60 and above will be about 480 in 2022, said Teo Yik Ying, dean of the Saw Swee Hock School of Public Health at NUS.

Other nations that had early successes with the virus, such as Australia, are also shifting their strategies to brace for more COVID-19 deaths in an era where the disease is here to stay. But as one of the world's most vaccinated countries, Singapore may be the first to show what that really means.

"If countries start to move towards an endemic COVID-19 strategy, the expectation is that there will be more related deaths, although it is still unclear how many of these will be excess mortality and how many would have occurred regardless of COVID-19," said Teo.