Hazel Poa Koon Koon

Speech on Vaccination Differentiated Safe Management Measures

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Adjournment Motion on 10 Jan 2022  – Vaccination Differentiated Safe Management Measures

Mr Speaker,

My family and I are fully vaccinated and not affected by the vaccination differentiated safe management measures or VDS.  However, I watch with concern the latest VDS measures.

With effect from 15 January, the unvaccinated will not be allowed to go back to their workplace even if they tested negative.  I am particularly disturbed by this latest measure that puts the livelihoods of the unvaccinated at risk.   Many Singaporeans are similarly concerned and anxious.

Former Singapore tennis player Jaime Wong started a petition on this issue on 1 Jan 2022.  She was a national tennis champion and represented Singapore in many international competitions including SEA games and the International Tennis Federation Fed Cup.  In her petition, she shared that with effect from 15 Jan she would no longer be able to continue her profession as a tennis coach nor enter the tennis school that she started because she is unvaccinated.  This petition has garnered over 6,000 signatures.  It is heartening to note that amongst them are fully vaccinated Singaporeans acting out of concern for the livelihoods of the unvaccinated.

We aspire to be an inclusive society.  This means that we need to accept differences, not just differences in race, language, religion or culture, but also differences in opinions and views.  We need to respect decisions that may be different from ours.

What is the justification for preventing the unvaccinated from returning to their workplace? 

It is not for fear of infecting others, because vaccination does not stop the transmission of Covid-19.  The risk is therefore mainly to themselves, not others.  They bear the brunt of their decision not to vaccinate.

I understand that the government is concerned about the health of the 52,000 unvaccinated employees.  But I also believe that these 52,000 people are at least as concerned about their own health and safety as the government is, if not more so.

They must have strong reasons, based on their own individual circumstances and personal medical history, for sticking to their decision not to vaccinate, despite the VDS measures that had been progressively put in place, placing various restrictions on their movements and activities.  To them, the risk or cost of vaccination must have been significant. This latest measure that threatens their livelihoods would just place them between a rock and a hard place.

There are many legitimate questions on the vaccines that are as yet unanswered.  For example, what are the long term effects, what are the effects of repeated jabs administered every 6 months?    Harbouring doubts about vaccination is not unreasonable.

When faced with a situation that is relatively new and where there are many gaps in our knowledge and information, it is always a good idea to keep an open mind. Treat current knowledge with caution and not be too absolute in our measures because new knowledge could emerge later to prove us wrong.  A good example would be the government’s stand on masks in the initial stage of the pandemic.  Let us learn from that experience.

Japan has a policy of no discrimination against the unvaccinated and they achieved a vaccination rate of 79% of their population, versus our 87%. So yes, our VDS probably pushed up our vaccination rate by a few percentage points, but there is the question of degree and the law of diminishing returns.

It is often said that punishment must fit the crime.  The same principle should apply to non-criminal actions as well.  The consequences that we seek to impose should befit the action.  In making the choice between the risk of covid infection and the risk of adverse effects of vaccination, and where the risk falls primarily on themselves, is the loss of livelihood a befitting penalty?

This ban on the unvaccinated returning to their workplace and thus risking their livelihoods is too harsh.   Even though the Government has asserted that every effort will be made to enable them to work from home, this is not always practical for every job affected.  The new measure is essentially licence to terminate.

And what is the expected benefit of imposing such a strong measure?  Even without this latest measure, on 5 Dec 2021, we achieved a vaccination rate of 96% of the eligible population then.  With the threat of loss of livelihood, will we achieve 97%? 99%?  Will the number of daily covid cases drop from 840 to 830?

Government policies are made based on macro considerations and statistics, designed to benefit the majority.  Just as there are exceptions to every rule, there will always be a small group who would be adversely affected.  While it is understandable that government policies cannot possibly cater to every single individual, we can at least recognize the existence of exceptions and leave room for them. Don’t put them between a rock and a hard place.

The Government has revealed that there are 52,000 unvaccinated employees.  What is the number of unvaccinated self-employed persons (SEP) or gig workers?  What is their breakdown by age and industry?  How many of them are expected to lose their jobs?  Has the Government studied the impact on these 52,000 unvaccinated employees and an unknown number of unvaccinated SEP before making its decision?

They are not mere statistics.  They have elderly parents. They have children.  For those who lose their current jobs because they are unvaccinated, what is the likelihood of them finding another?  Measures that threaten livelihoods should never be taken lightly.  They may become marginalized if they are unable to regain employment.  The prospect of an impending GST hike does not help matters.

Throughout the pandemic, the Government has taken great pains to keep our borders and our economy open, even at the risk of importing in Covid cases.  For the sake of economic gains, the Government has chosen to manage the health risk.  Please now extend the same consideration to the unvaccinated.  Recognise the importance to them of keeping their livelihood and allow them to manage their health risks.

What is the risk of overwhelming our healthcare system by allowing the 52,000 unvaccinated employees to return to their workplace?

Earlier today, the Minister for Health shared that the unvaccinated comprised two-thirds of the ICU cases.  This is presumably based on a period of time when our vaccination rate was lower and the proportion of unvaccinated people in the population higher.  Based on MOH statistics, our vaccination rate reached 50% on 18 Jul 2021.  Therefore, for the bigger part of 2021, more than half of our population is unvaccinated.  While it is undeniable that the unvaccinated are more prone to serious cases, attributing the high number of unvaccinated cases of ICU or death in 2021 to the current small number of unvaccinated is misleading.  These are not ratios we can use to project into the future.

Focusing on the 52,000 unvaccinated employees, I don’t have the information that will allow me to get a good estimate of the expected number that will fall seriously ill.  For example, the age breakdown of the unvaccinated is a key piece of information.  However, as a ball-park figure would help form a clearer picture by indicating the order of magnitude, I used whatever limited information I can find to arrive at a rough estimate.

Assuming the number of daily cases to be 800 out of a population of 5.5m, applying that proportion to the 52,000 unvaccinated employees gives us 7.6 cases.  Ministry of Health’s covid statistics from 1 May to 15 Dec 2021 showed that amongst the unvaccinated, the percentage of covid cases requiring ICU ranged from 0.051% to 0.53% for those aged 20 to 49, 2.4% for those aged 50 to 59, and 7.2% for those aged 60 to 69.  The 52,000 unvaccinated employees are working age, so assuming most of them are below the age of 60, I used the ICU rate of 2.4% which is the highest rate amongst the under 60.  Applying the rate of 2.4% on the 7.6 cases gives us 0.18 case requiring ICU per day. 

If the number of cases were to double to 1600 per day, that would give us 0.36 case requiring ICU.  If the number of daily cases reaches 3000, that would give us 0.68 ICU case.  Bear in mind, that Omicron is expected to be more infectious, but less severe, as shared by Minister for Health earlier today.

I would be happy to receive more accurate figures from MOH.  However, based on what I currently see, there does not appear to be any basis to fear that allowing the unvaccinated to return to their workplace would overwhelm our ICU facilities.

We urge the Government to rescind the ban on the unvaccinated returning to their workplace  from 15 Jan, and continue with the current arrangement of using testing as the means to control the spreading of Covid-19.

VDS on Children

The vaccination of children aged 5 to 11 started in Dec last year, with only the mRNA option.

There are differing schools of thought on covid vaccination, and even more so for the vaccination of children, with several medical doctors publicly opposing.  The unanswered question on the long term effects of mRNA vaccines is even more relevant for children, who have another 70 to 80 years ahead of them.

Parents are understandably uncertain and anxious.  Making the decision on behalf of their children is more stressful than making decisions for themselves.  Heavy on their minds is whether VDS will be imposed on their children.  In light of the fact that Covid-19 is milder in children, can the Government commit to not imposing VDS on children for at least another year to give parents more time to digest new information, monitor developments and perhaps wait for more vaccination options to become available?

At this point in time, is the Government able to give an indicative timeline for the assessment of inactivated virus vaccines like Sinovac for children, and the required conditions for approval?  This information will be helpful for parents making their decisions on the vaccination of their children.

In conclusion, we urge the Government to rescind the ban on the unvaccinated returning to their workplace from 15 Jan and commit to not imposing VDS on children for at least another 12 months.

Thank you.

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