As the national authority on environmental public health standards in Singapore, NEA undertakes a critical role to maintain these standards through research, ground surveillance, enforcement, licensing and outreach.
Monitoring Infectious Disease Threats
Singapore was one of the early adopters of tracking COVID-19 cases with wastewater surveillance, to detect and stem the growth of potential clusters. This was done by screening wastewater samples for the SARS-CoV-2 virus, which could be shed by infected individuals through their stools or sputum. From a modest eight sites in May 2020, NEA progressively expanded surveillance coverage to more than 500 sites across Singapore in 2022. We also scaled up our laboratory testing capacity through partnerships with local academia and private sector laboratories, and further enhanced our in-house laboratory capabilities with an automated liquid handling system co-developed with the Agency for Science, Technology and Research. As Singapore transits to COVID-19 endemicity, NEA’s focus on wastewater testing has shifted from early case detection to providing situational awareness on whether infections among the population are increasing or decreasing, independent of prevailing clinical test protocols and population healthcare-seeking behaviour. Wastewater surveillance provides a complementary, objective and independent indicator of the trajectory of COVID-19 infections. Beyond COVID-19, we are also looking to extend the use of the wastewater surveillance system to study other infectious disease threats.
Keeping Dengue at Bay
Singapore reported a significant decrease in dengue cases in 2021 with 5,258 cases – almost seven times lower than the 35,266 cases reported in 2020. This was likely due to the temporary cross-protective immunity arising from the large dengue outbreak from 2019 to 2020.
In 2021, NEA conducted 631,000 inspections for mosquito breeding, of which 6,300 were at construction sites. A total of 11,000 enforcement actions were taken against premises owners and occupiers for mosquito breeding, which included 690 enforcement actions and 43 Stop Work Orders issued to construction sites, and 64 contractors charged in court for repeat offences.
NEA launched the annual National Dengue Prevention Campaign in April 2021, ahead of the traditional peak dengue season, to rally community efforts in the fight against dengue. We introduced a new acronym 'B-L-O-C-K' to help the public remember the Mozzie Wipeout steps and common mosquito breeding areas, and refreshed the dengue cluster alert banners for greater public visibility. We also embarked on a nationwide publicity campaign on mass media channels and digital platforms to highlight how dengue could lead to severe health consequences.
Our volunteers and community partners supported with outreach activities to educate residents about breaking the dengue transmission chain. As most residents were still working and studying from home, dengue prevention reminders were shared on social media and chat platforms to raise greater awareness.
However, February 2022 saw a resurgence of dengue cases, likely attributed to the waning of the cross-protective immunity and coupled with the higher mosquito population and circulation of the less-common DENV-3 serotype. Responding to early signs of an outbreak, we activated the Inter-agency Dengue Task Force for intensive source reduction efforts in anticipation of a rise in cases. The National Dengue Prevention Campaign was once again brought forward to March 2022, where the new purple community alert banners were launched as part of the colour-coded Dengue Community Alert System to inform residents of the dengue situation in their estate. The purple alert banners were placed in non-dengue cluster areas with a persistently high Aedes aegypti mosquito population, serving as a visual reminder for proactive mosquito prevention measures to minimise the risk of dengue cluster formation.
NEA also engaged public agencies, Town Councils, and pest control and construction industries, to implement timely and regular intervention measures in their premises. These outreach efforts were amplified through extensive publicity on online and traditional media for community awareness.
Mitigating Aerosol Transmission Risks
Improving ventilation and indoor air quality in built environments is critical to mitigate the risk of transmission of diseases like COVID-19, which can be spread through virus aerosols in the air. Together with the Building and Construction Authority (BCA) and Ministry of Health, we worked with various government agencies to conduct field investigations to understand aerosol transmission risk in the built environment and recommend mitigation measures. The premises covered included hotels, preschools, Changi Airport, nursing homes, polyclinics, hawker centres and markets. We also worked with agencies to take carbon dioxide (CO2) readings at over 2,700 sampling locations, to assess if indoor spaces were sufficiently ventilated. Findings and recommendations were communicated to agencies and premises operators, including through customised webinars that reached an estimated 3,000 premises operators across various sectors. In addition, we developed advisories on CO2 monitoring and improving ventilation and indoor air quality amid the pandemic, as well as guidelines and whitelists for disinfectant and air cleaning products and technologies, to guide better consumer decision-making.
Safeguarding Against Waterborne Diseases
Following the amendments to the Environmental Public Health Act on 31 August 2021, premises owners and occupiers with Aerosol-Generating Systems, such as cooling towers, are required to register their cooling towers. In addition, higher-risk aquatic facilities (AF) such as water playgrounds, interactive water fountains and multi-use spa pools are required to be licensed. Prior to this, only swimming pools were licensed.
Premises owners and occupiers of cooling towers and AF are required to carry out water quality tests periodically to ensure that the water is properly disinfected to prevent transmission of waterborne infectious diseases. Test results are to be submitted to NEA for regulatory compliance, serving as early alerts to disease outbreak.
To keep the industry informed of these changes and regulatory requirements, we engaged 635 industry stakeholders in August 2021. The updated AF design requirements and existing requirements for cooling towers were incorporated into the Code of Practice on Environmental Health, which was published on 1 September 2021.
In tandem, the NEA ePortal was enhanced to enable registration and submission of test results for cooling towers, while the GoBusiness Licensing portal was enhanced to enable the licensing and submission of test results for AF.
Raising Environmental Sanitation Standards
Since 30 July 2021, the Environmental Sanitation regime has been progressively implemented in high-risk premises with vulnerable occupants or high footfall to ensure a safe environment. These include eldercare, youth and social service facilities, preschools, Ministry of Education schools, food centres and markets, and coffeeshops. The regime builds on existing hygiene and sanitation measures, by providing clear guidance on the minimum cleaning and disinfection frequencies and scope to ensure premises are properly cleaned and disinfected at all times.
The Code of Practice (COP) for Environmental Control Coordinators (ECC) was first published on NEA’s website in July 2021, with the second iteration published in December 2021. It details the roles and responsibilities of ECCs and Premises Managers, and guides ECCs in developing and executing an environmental sanitation programme for specified premises.
From 1 April 2022, the regime has been progressively extended to more premises which are publicly accessible, experience high footfall, or are congregation areas.
Stepping Up Cleaning and Disinfection
Proper cleaning and disinfection is necessary for public safety and to prevent the spread of diseases, particularly in the aftermath of an infectious disease outbreak. When the COVID-19 pandemic hit, NEA’s High Readiness Core team stepped up to oversee and provide on-site guidance for disinfection operations, covering more than 12,000 premises exposed to COVID-19 cases. For residential premises, we provided guidelines and advice on how to clean and disinfect homes effectively. We also handed out cleaning kits to people who were under quarantine and unable to leave their houses. For non-healthcare premises, we engaged premises owners to provide on-site guidance on the disinfection measures. NEA also collaborated with the Ministry of Manpower (MOM), Enterprise Singapore (ESG) and Singapore Tourism Board to reach out to more stakeholders, such as dormitory operators, hotels, building managements and Town Councils, to carry out disinfection of their premises and common areas visited by confirmed cases.
Improving Cleanliness of Public Toilets
The Toilet Improvement Programme aims to improve public toilet cleanliness and encourage good personal hygiene among users. Under the programme, NEA co-funds toilet improvement works in coffeeshops and hawker centres to improve user experience and enhance public hygiene.
As part of the Coffeeshop Toilet Improvement Programme, NEA helps coffeeshop operators and owners defray the cost of toilet improvement works, which include the adoption of new technologies that facilitate easier cleaning and maintenance. Those eligible can receive co-funding support for renovation, deep cleaning, and the training of cleaners.
Similarly, the Hawker Centre Toilet Improvement Programme provides support to Town Councils to improve public toilets in the hawker centres under their management. The programme focuses on improving toilet design and features, and adopting toilet technologies to facilitate easier cleaning and maintenance of toilets.
To ensure high hygiene and cleanliness standards of public toilets, NEA will continue to conduct inspections and enforcement against premises owners and operators for lapses.
Suppressing Dengue with Project Wolbachia
Novel vector control tools such as Project Wolbachia – Singapore will continue to complement conventional dengue control measures. In October 2021, small-scale test releases of non-biting male Wolbachia-Aedes mosquitoes commenced in the Marine Parade landed residential estate. This was to understand the behaviour of the released male Wolbachia-Aedes mosquitoes in such an environment, before a larger-scale deployment in April 2022 to cover five square kilometres within the estate. NEA also carried out releases at a few construction sites, as part of an overall strategy to achieve better suppression by covering different terrains and landscapes.
Since April 2022, releases of male Wolbachia-Aedes mosquitoes at Tampines and Yishun have been expanded to cover the entire towns. High-risk areas in Choa Chu Kang and Bukit Batok also continued to see targeted releases of male Wolbachia-Aedes mosquitoes. The results have been promising, with up to 98 per cent reduction in the Aedes aegypti mosquito population and up to 88 per cent reduction in dengue cases observed in Tampines and Yishun, after more than a year of releases.
Going Forward |
In the short term, NEA’s focus is to raise cleanliness and environmental hygiene standards for public health, which is vital in the ongoing COVID-19 pandemic. Beyond this, we are also building a national wastewater epidemiology and testing ecosystem, to serve as an additional surveillance indicator to assess the spread of disease in a community. We will continue to tackle high-rise littering and strengthen our partnership with stakeholders to keep Singapore clean. We will also look into improving indoor air quality.
Our medium-term priority is to develop new capabilities to counter the Dengue threat and enhance vector control operations. We endeavour to scale up key transformative initiatives such as Project Wolbachia, which has seen promising results in the fight against Dengue.
Our priority on the after-death front is to ensure the adequate provision of after-death facilities and enhance service standards of the funeral industry.
NEA’s vision is a clean and healthy Singapore with high public health standards, vital for a good quality of life for residents.
|
Expanding Our Memorial Facilities
The Inland Ash Scattering Garden at Choa Chu Kang Cemetery was launched in May 2021 to provide Singaporeans with an additional option for the management of cremated human remains in Singapore. Named the Garden of Peace @ CCK, NEA received about 900 applications for the scattering of ashes in 2021.
We also plan to introduce inland ash scattering services at the Garden of Serenity in the new Mandai Crematorium Complex. This will be completed together with the new complex, and is expected to be operational in 2024. More cremators and building fittings will be progressively installed in tandem with demand.