Three long years of pandemic living was announced to be at an end just last month, and many of us heaved a sigh of relief that the remaining measures of our pandemic response were finally behind us.
Given the serious and uncertain nature of the pandemic, it was a testament to the hard work, dedication and resilience of our nation – especially our frontline workers — that we pulled through. And now we have before us the Government’s internal review of our response being debated today, from which we all hope to be able to better inform our actions and decisions when facing the next public health crisis. While we have comments about the way the review has been conducted, I do believe the report is helpful in identifying the lessons we can take away to build back stronger.
First, I will touch on some comments and observations about the communications surrounding our pandemic response, before speaking about where I feel our focus should be as we move forward to build our resilience as a nation and as a people.
The White Paper states that effective communication and high levels of public trust were crucial in handling the crisis. Indeed many of us remember being glued to our screens each time the Prime Minister spoke, or a press conference was held by the Task Force, wondering what the latest updates would be, and what changes were awaiting us. Yet I think it is worth reiterating some observations that I made in my speech in this House in July 2021, just after the second ‘Heightened Alert’ phase was announced. It may seem like a distant memory today, but it was a time of great difficulty for our businesses. The spread of the Delta variant from the breach of our barriers at Changi Airport, along with the Jurong Fishery Port and infamous KTV clusters, meant that our businesses, and our restaurants in particular, had to constantly change plans at short and sharp notice, lurching from trying to adapt their operations to cater from one highly complicated set of rules to the next. It was also a source of great frustration for businesses and organisations that they often had to wait a few days for rules that were specific to their sector to be released.
I therefore believe the call we made in July 2021 is still relevant, and that we should ensure that we develop a roadmap for future use, clearly laying out support measures pegged to specific restriction levels. It would also be important to share how the authorities weigh up various factors in deciding what restrictions to impose, along with the level of support that will be meted out to individuals. While we all acknowledge that it is difficult to set these matters in stone, having more information and understanding about how decisions are made would be important for both businesses and individuals to plan forward, and be psychologically prepared for the various ups and downs that come with any large-scale pandemic like the one we have just come through.
Still on communications, one area which we perhaps could look into, is to work out a system of improving our existing structures to ensure that our agencies are able to more smoothly integrate the information they have, and to be efficient in processing this. I make this comment after receiving feedback from residents and friends who were subject to quarantine orders, who told me that they often received numerous calls from different departments of various ministries, each asking them for the exact same information which they had already provided. One even told me that an officer turned up at his home to issue a quarantine order the day after he returned to Singapore, after he had spent much time on the phone with and sending documents to various departments and was already cleared from needing to quarantine earlier that same morning due to being a recently recovered patient.
The shift to home-based quarantines (otherwise known as the Home Recovery Programme) – rather than quarantine in dedicated facilities – likewise also resulted in much confusion and jammed hotlines as worried Singaporeans tried to find out more about the new protocols.
One area which we also feel warranted more attention in the review and also our future plans, has been the impact that Covid has had on the mental well-being of our population, and the development of our children. As I mentioned in the recently concluded Budget debate, we appear to be reporting increased feelings of isolation and loneliness, and this has a direct impact on our life and healthy life expectancy. Also, many educators have said that they have noticed our younger children appear to be struggling more with mental health and developmental issues, and that the Singapore Youth Epidemiology and Resilience Study found high numbers of youth have reported mental health symptoms. Just yesterday, the Straits Times reported an MCI poll’s findings that while most Singaporeans believe they emerged from the pandemic in good shape, more households with children and elderly reported drops in quality of life compared with the general population. Likewise, 38 per cent. of youth aged 15-19 reported drops in equality of life, compared with 28 per cent. for the general population.
Yet there has been scant mention of well-being and mental health in the White Paper. Yet the pandemic led to job losses, business failures, school closures, and families spending extraordinary amounts of time together indoors, which have in turn led to unprecedented stress and pushed our coping mechanisms to breaking point. And on top of every day anxiety over catching an unknown and possibly fatal illness, individuals, families and businesses have had to cope with movement restrictions and ever-changing rules relating to what we can or cannot do. I hope that the promised protocols and provisions for mental health for Healthier SG will be made available as a matter of urgency, and that they will sensitively take into account the after effects of Covid and findings of the Mental Wellness Taskforce.
Mind the Gaps
And even as we move forward from Covid, we must not forget to pay special attention to the gaps that were exposed by the pandemic.
A 2021 paper by RSIS stated that residents in the lower income groups were more disproportionately hit by lockdown and movement restrictions, and that Malay respondents to the study were more likely to report adverse economic effects as a result of the movement restrictions. These areas bear special attention, as such groups may have fallen further behind, particularly in the wake of the high inflation we have been experiencing over the last year.
Additionally, as I mentioned in my speech during the Government’s White Paper on Singapore Women’s Development, I asked about what the effect the pandemic has been on the gender wage gap, and the effect of the chronic under-valuing and under-paying of work – paid and unpaid – that is traditionally done by women. This is despite this work being deeply important and essential, as all of us learnt first-hand during the lockdown days. While we have seen some wage adjustments to various sectors from education and care work, this does not address the hard work that needs to be done to ensure that our structures reflect the great value that we place on the work that these often invisible and overlooked workers do.
These points have been backed up by studies and data, such as the UN’s findings on the disproportionate adverse effect that Covid had on women and girls, including the negative impact on economic, physical, and mental well-being. There was also concern that women and children are being exposed to higher levels of domestic violence, and indeed in Singapore, there have been findings that family violence has increased from 2020 to 2022.
I also hope that attention can be given to the still little-known phenomenon that we often refer to as ‘long Covid’. This is what happens when survivors of Covid find themselves being plagued with a variety of effects long after they have recovered from the acute phase of the illness. These can range from gastrointestinal problems, fatigue, respiratory symptoms like shortness of breath, to cognitive impairments alongside psychological conditions such as depression and anxiety. And while findings are mixed, some studies have even suggested that women, older people and those of minority ethnicities appear to be more severely affected. There is natural concern about economic and health impact, adding to the hidden toll of the pandemic that we must not forget.
Indeed a recent meta-analysis published in the Lancet even seems to have found a worrying 45% of patients, regardless of hospitalisation status, still suffer from unresolved symptoms four months post infection. Indeed the Lancet recently also estimated too that approximately 65 million people worldwide are estimated to struggle with long Covid, and that one in ten people with long Covid stop working, resulting in extensive economic losses.
Given that we have reported more than 2.2 million Covid cases, even a small percentage of that is significant. While I acknowledge that the condition is poorly-understood, complex and variable, the Ministry of Health stated in April last year that it did not track the incidences of long Covid.
This is a missed opportunity, not only because it means many recovered patients — particular those for whom these after effects may not be severe — may be suffering in silence, it affects their productivity both at home and at the workplace, and they do not have access to the treatment and care they need to have a better quality of life. It also means we are not capturing data about whether certain groups are more adversely affected. This means that we are missing the chance to be able to provide more efficient, targeted measures of support and education for these groups to be given the timely and adequate levels of help they need. This has implications on the physical and mental well-being of our population, with an impact on our recent moves to a different approach to health and the expected increased care cost burden as our population ages.
Equally alarming too is the finding by Mercer Marsh Benefits that Singapore ranks lowest in Asia for help given by employers to make adjustments to the job to cater to employees suffering from long Covid.
Additionally, many people I speak to would mention they are ‘not quite the same’ after coming down with Covid, but are either unaware of or do not understand what ‘long Covid’ is. How do we ensure that sufferers are seeking both treatment and help, particularly for those whose livelihoods and abilities to either work or study have been affected by poorer or sub-optimal health? There is also a sense that weakened immunity post infection, coupled with the removal of social interventions to curb the spread of Covid has lead to the circulation of more cases of infectious illnesses like URTIs, and I hope that we can be mindful of this as we track workplace and educational performance for these affected individuals.
I would also like to seek a clarification now that we have fully shifted to living with Covid. I understand and appreciate that the full subsidies previously offered to patients suffering from Covid are being stepped down. In particular, Covid antivirals such as Paxlovid will remain fully subsidised for clinically eligible patients in outpatient settings, and further understand that hospitals will now start to charge for these important medications. Would the Minister be able to confirm that this is the case, and to explain the rationale behind such a move. After all, the drugs are meant to be prescribed to high risk patients who are thus more likely to be seen in hospital settings.
We owe our post-pandemic freedoms today to our everyday heroes, and I hope that we do right by them in repaying the debt that we owe them, by valuing them in concrete ways, and also by ensuring that the sacrifices made and lessons learnt along the way are implemented in any future public health crisis that we face.
For that, I support the Motion, thank you.