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Singapore lowers testing capacity after 'false positive case'; herd immunity 'too big a price to pay'

Amala Balakrishner
Amala Balakrishner • 6 min read
Singapore lowers testing capacity after 'false positive case'; herd immunity 'too big a price to pay'
Singapore has been lowering its Covid-19 testing capacity in the past few days due to an issue at a laboratory which resulted in 33 “false positive cases” on May 10.
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SINGAPORE (May 12): Singapore has been lowering its Covid-19 testing capacity in the past few days following an issue at a laboratory which resulted in 33 “false positive cases” on May 10.

This resulted from an “apparatus calibration issue” with one of the lab’s test kits, the Ministry of Health’s (MOH) director of medical services Associate Professor Kenneth Mak said at a press conference on Tuesday.

He added that the lab is now being given time to recalibrate and revalidate its test kits while working through its quality assurance processes.

Said Mak, “we lowered our testing capacity accordingly to give them some space to work through these processes. We anticipate that this should complete, very quickly, and we should be able subsequently to return back to our current full test capacity over the next few weeks”.

Prior to this incident, Singapore had been conducting over 7,000 Covid-19 tests a day. The MOH is now putting in place advisories and guidelines for laboratories involved to avoid such incorrect test results in future.

These include standard processes to be conducted such that the tests are performed correctly and the results produced are accurate, explained Mak.

He further noted that there may be situations where results come out as “presumptive positive” based on the test process. In such cases, he said there may be a need “for further complementary tests to be done”.

“We require the laboratories to perform all the confirmatory tests before the results are released so that we have greater confidence in the test results being accurate,” Mak emphasised.

“These are some of the processes that are currently being put in place as part of the quality assurance for all the local laboratories, and this would allow us to have continued confidence that the testing is done properly and the results coming up from the test are correct as well”.

Herd immunity a big price

In response to queries on whether Singapore will use ‘herd immunity’ through natural infection in the population, Mak stressed that this is not a strategy that the republic will adopt.

“It is too big a price to pay” he said as he explained that such a measure will lead to a higher number of deaths and infections while overwhelming Singapore’s healthcare system.

‘Herd immunity’ refers to a resistance to the spread of a contagious disease if a sufficient proportion of individuals become immune to it. The concept was initially adopted in the UK to handle the Covid-19 pandemic, but was done away with once the government realised it would overwhelm the local healthcare system and potentially result in thousands of deaths.

“If we assume that we’re going to let Covid-19 spread freely in our population, we will then have to accept the costs associated with more seniors getting ill, more seniors getting complications, and a significant number of seniors even dying from infection,” Mak pointed out.

“We will then also see high numbers of patients with Covid-19 potentially in our hospitals, in our Intensive Care Units and this is a situation which is very dangerous one”.

Mak also put forth that the only way for ‘herd immunity’ to be achieved is if a vaccination is prescribed.

Drawing reference to expert opinions, Associate Professor Vernon Lee, director of MOH’s Communicable Diseases Division noted that herd immunity can be achieved if 60 – 80% of the population is infected. However, he added that such figures are “best guesses”.

Lee, who was speaking at the same briefing as Mak noted that other countries that use serology tests – which analyses a person’s antibodies to ascertain if he is infected – recorded percentages of positives that were “way below” the threshold of herd immunity.

“So to get that kind of percentage to achieve herd immunity will require a large number of people to get infected. So far, I don’t think there’s any country in the world that has tried to use overall herd immunity as a strategy to combat Covid-19,” he observed.

Vigilance needed

Aside from the testing regimes adopted here, the Covid-19 multi-ministry task force noted that the transmission of Covid-19 within the community has dropped from an average of 30 cases daily in late-April to eight new cases in the past week.

This comes as the circuit breaker measures restricting the operations of non-essential services from Apr 7 has “shown promise”, noted Health Minister and chairman of the taskforce, Gan Kim Yong.

As at 12pm on May 12, there were 884 new Covid-19 cases in Singapore, taking the total number of infections here to 24,671. Among these are three Singaporeans and permanent residents, while migrant workers living in dormitories make up the remaining cases.

With three weeks left to Jun 1 when the circuit breaker restrictions are slated to end, the government has been re-starting economic activity gradually. May 5 saw the re-opening of traditional Chinese medicine retail halls and acupuncture therapy, while Tuesday marked the opening of barber shops and selected food outlets.

National Development Minister and co-chair of the taskfore Lawrence Wong added that the government is now "in a good position to plan forward" on having more workers resume work. This is as the republic is "steadily making progress in controlling the outbreak, both in the community as well as in the migrant worker dormitories".


See: Covid-19 infections among migrant workers expected to remain high amid aggressive testing

However, Gan cautions against complacency. “As we gradually lift the circuit breaker measures, there is a risk that the community cases may rise again. This has been the experience of many countries which have seen a second wave of infections after relaxing their social distancing measures,” he pointed out.

As such, he reiterated the need for Singapore to be “very careful, remain vigilant and minimise the risk of any sharp rise in cases or large clusters in the community”.

He added that even as some measures are eased progressively, there would still be a need for safe distancing and safe management to be exercised.

“We do not expect on Jun 1 to open everything and everything to go back to normal; we begin to celebrate and have parties”.

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