Since the National Day Rally where Prime Minister Lee Hsien Loong announced that masking up would only be required on public transport and in healthcare settings, there has been a variety of responses to what the Ministry of Health (MOH) has termed a COVID-19 resilience phase.
We ask Dr. Loh Jiashen, Infectious Diseases Specialist, Farrer Park Hospital for his insights into what to look out for going forward.
One of the key points that PM Lee made in his national address on August 21 was that masking up would still be mandatory on public transport. As a country with a world-class system that the majority of residents depend on for getting around, this seems prudent in view of the heavy passenger loads each day.
Dr. Loh explains, “Public transport contains areas of high concentration. There is still benefit in masking up as a preventive measure where human concentration is high, as the risk and number of transmitted cases rise in tandem with human density.
“Also, public transport is a vital public function. It is important that people do not lose confidence in public transport. For these reasons, I can understand why masks are still mandated for public transport for now.”
On the other hand, should we start to adjust to not having our masks on when using buses or the Mass Rapid Transit?
“Moving forward when the caseload further decreases, it is conceivable that the mask mandate will be lifted for public transport. Many developed countries have already lifted mask mandates on public transport,” Dr. Loh said
Adding to the debate are concerns over riding in a taxi or private hire vehicle without the need for masks. Most commuters would imagine that the proximity between the passengers and driver is a factor to weigh.
On this, Dr. Loh points out that there is no evidence to categorically label private hire vehicles as having a higher risk of COVID-19 transmission than for public transport.
Variables such as how crowded the trains and buses are, whether the private hire vehicles are driven with open windows, and many other variables would impact on transmission.
Certainly a hot button issue for parents and teachers is the switch to students not having to have a mask on in school. Among these students are those in primary schools who may not be fully vaccinated against COVID-19.
PM Lee said that it would be safe in schools according to our government’s assessment and alluded to aiding the development and learning of these children.
“Children generally get very mild symptoms with COVID-19. Having a mask on impacts learning and physical activities and hence the risk-benefit ratio favors removing masks in schools,” Dr. Loh offered in relation to the issues at hand.
Continuing, he said, “In general, people or children if unwell, should wear masks and refrain from visiting crowded places. Certainly, MCs may be obtained to excuse oneself from official duties or classes if sick.
“It is very important to understand this change properly. PM Lee said that the use of masks will no longer be mandated. That does not mean that masks are not allowed. It merely means that with the current vaccination, low ICU, and low death rates and other reassuring circumstances in the pandemic currently, it is no longer necessary or justifiable to enforce with prosecution and punishment mask-wearing.
“Certainly, children can continue to wear masks if they choose to. It is simply that not wearing a mask will no longer and need no longer be unlawful.”
Yet, the danger of COVID-19 has not receded in the hearts and minds of many. Taking into account that according to MOH, 76 per cent of children here between the ages of five and 11 have completed the full regimen of vaccination; how does this factor into the discussion?
Dr. Loh said, “It is not too early to allow young primary school children to remove their masks. The vaccination rate in this age group is not relevant to this decision.
“In a recent paper published in the New England Journal of Medicine presenting local data, there are no differences cited in oxygen requirement, ICU admission and death rates between the vaccinated and unvaccinated children in this age group during the Omicron wave.”
