Experts say no need to distinguish linked/unlinked Covid-19 cases during endemic

Singapore — As the country begins to treat the Covid-19 virus as an endemic, it makes less sense to distinguish linked and unlinked cases, said public health and infectious disease experts.

On Wednesday (Sept 8), the Ministry of Health (MOH) announced that it would no longer report the number of linked and unlinked Covid-19 cases in its daily update, as this is “no longer as relevant as before.”

MOH also noted that with 81 per cent of the population already fully vaccinated, Singapore is one of the most highly vaccinated countries in the world.

It will then revamp its daily report to include “salient issues” such as the number of severe cases that are hospitalised or in the intensive care unit to ensure “hospital capacity is not overwhelmed.”

Linking cases helps authorities foresee clusters likely to become “explosive,” admitted Professor Paul Tambyah, president of the Asia-Pacific Society of Clinical Microbiology and Infection, on Thursday (Sept 9).

However, if Singapore accepts that the coronavirus is “well and truly endemic,” the number becomes less relevant, he added.

Prof Tambyah likened Covid-19 to other diseases such as dengue or tuberculosis in his statement.

He noted that Singapore does not differentiate linked and unlinked cases for other endemic diseases and only tracks clusters, especially among vulnerable groups, reported The Straits Times.

“When we stop linking cases, perhaps we accept that the virus is everywhere, and we can loosen up some restrictions,” Prof Tambyah added.

Dean of the National University of Singapore’s Saw Swee Hock School of Public Health, Professor Teo Yik Ying, noted that it is far more difficult to trace the links between cases amid high vaccination rates.

He noted that vaccinated individuals have milder symptoms or are asymptomatic, thus letting them slip under the radar.

“There can be several generations of asymptomatic spread, and then that chain is identified on the other side of the island. So unlinked cases are more expected, and we would not need to increase community restrictions,” said Professor Dale Fisher, a senior consultant in the National University Hospital’s infectious diseases division.

Meanwhile, the decision has also led to other individuals speaking out on the importance of tracking and publishing the numbers.

Chief executive officer of Temasek Holdings and wife of Prime Minister Lee Hsien Loong, Ho Ching, took to Facebook on Thursday to say that the country was not yet in the position to make such a decision.

“Unlinked cases are still relevant for the purpose of getting a sense whether we are having a runaway gallop or a steady trot,” said Mdm Ho.

“The unlinked cases gives us a very good indication of where we stand. We already have a good contact tracing team; hence reporting the unlinked cases should not be withheld,” added member of the public Jude Danker. /TISG

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