Are we past the COVID-19 Pandemic? Insights from Singapore

Objective: This study aims to examine the interplay between high policy stringency, vaccination rates and epidemiological outcomes to develop insights on COVID-19 policy transition in Singapore Methods: The CPTI (Categorising Policy & Technology Interventions) framework was used to classify reported interventions from January 2021 to October 2022. To analyse the impact of vaccine measures, an additional category was created. The highest monthly proportion of de-escalated measures was used as a basis to define the periods that mark the policy transition in Singapore i.e. Phase 2 and 3. Proportions of significantly escalated measures were calculated and analysed against full and booster vaccination rates, alongside epidemiological indicators - monthly total number of infections and deaths, and monthly average active hospitalisation and ICU cases. Results: Implementation of highly stringent policies were observed to have reduced in intensity as vaccination rates picked up from Phase 2 to 3. Containment measures were the most frequently and consistently adopted beside vaccine policies. Epidemiological indicators appeared to be generally lower in Phase 3 than Phase 2. Specifically, despite reduced intensity of stringent polices, hospitalisation and ICU cases were observed to remain relatively low when vaccination rates were correspondingly higher in Phase 3 compared to Phase 2. Conclusion: The descriptive analysis of COVID-19 policy shift in Singapore based on selected indicators preliminarily suggested its successful transition from the pandemic to endemic phase in its response strategies. A policy transition plan should consider the significance of vaccination rates in an exit strategy that protects the population against worse health outcomes.