Statistics for COVID-19 Community Testing

Mr Gerald Giam Yean Song asked the Minister for Health (a) since 1 June 2020, how many people have been (i) randomly tested for COVID-19 (ii) diagnosed with COVID-19 as a result of random testing; and (b) what are the plans to step up random testing for COVID-19 in the community.

Mr Leon Perera asked the Minister for Health what is the current mean and median lead time between when COVID-19 swab testing is conducted and when the results of the test are made available to relevant parties.

COVID-19 testing is a key enabler in our efforts to fight COVID-19. Our testing strategy is focused on active case finding, as well as targeted surveillance on identified groups. Such testing is based on a holistic and concerted strategy to detect and ring-fence active infections as early as possible to prevent further transmission.

The majority of linked cases are detected through active case finding around confirmed cases. Once a case is detected, the Ministry of Health (MOH) will quickly contact-trace all potential close contacts and place them under quarantine. As part of the quarantine process, all persons-under-quarantine (PUQs) will be subjected to a swab polymerase chain reaction (PCR) test for COVID-19 at the start and end of the quarantine period. The swab test at the start allows us to quickly identify infected persons under quarantine, provide the appropriate medical support and expand the ring-fence of close contacts if necessary. The swab PCR test at the end will pick up any remaining cases who could have been incubating the virus at the start of his quarantine, and gives us additional assurance that the PUQ is not infectious before releasing him from quarantine. If the PUQ presents with symptoms during his quarantine, he will be tested for COVID-19 immediately.

MOH has also conducted special operations to test selected groups of individuals where there is a higher risk of transmission of COVID-19. Examples include the testing of identified households and their visitors at Block 111 Tampines Street 11, and the testing of bus drivers and staff working in public bus depots and interchanges. While the individuals tested were not close contacts of the confirmed cases, targeted deployment of such special testing operations allows earlier detection of any underlying cases among the group even if they are asymptomatic.

Beyond active case finding, MOH has put in place targeted surveillance testing in the community. First, PCR testing is provided for all individuals aged 13 and above diagnosed with acute respiratory infection (ARI) at first presentation to a doctor. As clinical and scientific evidence shows that an infected person is most infectious right before and immediately after the start of symptoms, testing all individuals diagnosed with ARI early allows MOH to detect infected individuals quickly to contain further spread. From 1 July 2020 to 16 August 2020, 76% of the patients aged 13 and older diagnosed with ARI at the Polyclinics and Public Health Preparedness Clinics (PHPCs) were PCR tested for COVID-19. Of these, a small percentage – 0.03% - tested positive, indicating that the community prevalence of COVID-19 is low. We continue to encourage all individuals who are unwell to seek medical attention immediately and adhere to the medical advice received.

As we re-open our borders and facilitate travel, we are also testing incoming travellers either on-arrival or during their Stay-Home Notice period, to detect cases and reduce onward community transmission.

Second, surveillance testing is also done for identified groups who are more vulnerable or have higher risk of exposure to COVID-19. For example, we have been conducting rostered routine testing (RRT) on targeted groups such as workers living in the migrant worker dormitories; workers who returned to work in the construction, marine and process sectors; and workers supporting our frontline COVID-19 operations. Currently, over 200,000 such individuals are tested every two weeks. In the last two-week cycle, about 200 of such individuals tested positive for COVID-19. Majority of these cases are likely to be past infections.

Third, as we reopen our economy and resume social activities, MOH will be expanding testing to more community groups. For a start, we have identified community groups such as taxi and Private Hire Car drivers, food delivery personnel, key vendors servicing foreign worker dormitories, as well as stallholders at selected hawker centres, markets and F&B establishments such as coffeeshops. While there has been no local evidence that these community groups are of higher risks of getting infected, MOH will be offering tests to them as part of our expanded testing and surveillance efforts given the nature of their working environment, such as the high frequency of interactions with members of public. These one-time testing operations will help to provide a better picture of population prevalence.

Agencies and private providers supporting the testing operations endeavour to turn-around the test results as soon as possible. The current mean and median lead time between the conduct of the swab test and when the test results are made available from the laboratories are 30 hours and 22 hours respectively. Confirmed cases will be notified by the relevant parties expeditiously for the necessary public health actions to be taken.