SINGAPORE – Most people who are vaccinated and contract Covid-19 will be put on home recovery from Wednesday (Sept 15), the Ministry of Health (MOH) said on Tuesday.

This care management model will apply to those who are fully vaccinated, aged 12 to 50 years old, have mild or no symptoms, and have no severe co-morbidities or illnesses, it added.

They should also not have household members above the age of 80 or who are in one of the vulnerable groups such as pregnant women, those with a weakened immune response or those with multiple co-morbidities.

Co-morbidity refers to the presence of two or more diseases or medical conditions in a patient.

The latest move is to reserve hospital capacity for those who truly need medical care, so that appropriate care can continue to be provided for all, even with higher infection numbers, said MOH.

When a person tests positive, home recovery can start immediately if he meets the criteria.

The individual will need to set aside a room with an attached bathroom, said MOH.

There is no need to go to a hospital or community care facility.

Covid-19 patients on home recovery will undergo an initial remote assessment by a telemedicine provider on the first day of their home recovery to ensure that they are clinically well.

These individuals will also be issued an isolation order and may be tagged with an electronic monitoring device to ensure they remain in their designated room at home.

Covid-19 patients who are on home recovery may contact the designated telemedicine service provider to arrange for a polymerase chain reaction (PCR) swab on Day 6 of the illness to end the home recovery period sooner, said MOH.

If the test result meets the discharge criteria – a negative test or low viral load – patients can be discharged from home recovery on Day 7.

Otherwise, home recovery period ends on Day 10 without further tests, so long as the patient is well. 

After discharge, Covid-19 patients will no longer be subject to any movement restrictions, although they should still minimise social interactions for the next seven days, said MOH.

They can ask the telemedicine service provider for a medical certificate of up to seven days if they require more time to rest and recuperate. This is in line with discharge protocols at medical facilities, MOH said.

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The ministry added that if an infected person is on home recovery and household members are quarantined, the infected person may be discharged earlier than his quarantined household members.

MOH said: “This is not illogical because for a fully vaccinated infected individual, the viral load will decrease very quickly and typically clears by Day 7. (But) for someone exposed to the virus and on (quarantine order), the viral load may take up to 10 days to build up and for the illness to manifest itself.”

MOH earlier said that from Sept 11, the quarantine period has been cut from 14 days to 10 days from the last exposure to a Covid-19 case, provided that the quarantined person tests negative for Covid-19 at the end of quarantine.

On Tuesday, MOH said quarantined individuals who received quarantine orders before Sept 11, have completed 10 or more days in quarantine and have a negative PCR test result will progressively have their quarantine orders rescinded earlier.

They will then have to continue to self-administer antigen rapid tests (ART) from Day 11 to Day 14 of their date of last exposure.

MOH said that now, about seven in 10 close contacts of community cases prefer to be quarantined at home, and that it has seen good compliance with home quarantine requirements.

It added that contact tracers will continue to conduct manual contact tracing for sensitive clusters such as schools, hospitals or markets frequented by seniors.

For less sensitive infection cases, an SMS will be sent to all newly confirmed Covid-19 cases, notifying them that under the Infectious Diseases Act, they are required to tell their household contacts to register themselves as household close contacts through an online portal.

Close household contacts must also provide the last date of exposure with the Covid-19 case and a contact number.

They will then receive an electronic quarantine order that will indicate the quarantine period and provide instructions on booking a PCR test. They can then go online to schedule entry and exit PCR tests at a regional screening centre near their home.

They will be allowed to travel to the regional screening centres for the PCR tests and collect free ART kits. They then have to administer their own ART daily and upload their results.
 
Should they feel unwell or in need of medical attention, they will also be given instructions to access 24/7 telemedicine services during their quarantine.

People whose homes are not suitable for quarantine can still request to be sent to a government quarantine facility, said MOH.

It added that from Tuesday, in line with the reduced quarantine period, health risk warnings and alerts will cover a period of 10 days from the date of last exposure to a Covid-19 case, down from 14 days previously.

Health risk warnings are issued to close contacts of Covid-19 cases based on TraceTogether data. These contacts have a smaller risk of infection than quarantined persons.

Such individuals are required to take one PCR test upon receiving the warning, self-isolate until they receive a negative result and conduct three ART self-tests over the 10-day period. They also have to do another PCR test at the end of the 10 days.

Health risk alerts are issued to those who had a relatively shorter duration of contact with a Covid-19 case based on TraceTogether data, or if their SafeEntry records from the past 14 days overlapped with an area of increased transmission.

They should monitor their health for the next 10 days and are strongly encouraged to go for a free PCR swab test and perform regular ART self-tests during the 10 days.

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