Singapore’s New Covid‑19 Playbook: Home Sweet Home for the Terminally‑Ill
Professor Dale Fisher Says “No More Mandatory Hospitalizations”
In a clear‑cut statement that could feel like a rom‑com twist, Prof Dale Fisher—also a senior consultant at National University Hospital’s Infectious Diseases wing—argued that if patients are fighting the final stages of life and test positive for Covid‑19, they should be allowed to finish their story at home.
“We’re past the panic phase,” Fisher told the Straits Times on Tuesday, November 2. “Not enforcing strict isolation anymore means we can give people who truly need it the chance to wrap up in familiarity.”
Why the 99‑Year‑Old’s Death Became a Case Study
The story that grabbed headlines was of a 99‑year‑old, terminally ill gentleman who, after a quick rapid test, found out he was Covid‑positive. He died peacefully at home at the behest of his family, sparking debate over the lack of clear guidelines.
- 98‑year‑olds (and younger) typically are not eligible for the home recovery programme, which nudges them toward external care facilities.
- Despite this, the man’s family had promised he would spend his last moments in the comfort of his own bedside.
- Dr Choo Wei Chieh, who cared for him and heads the home‑care firm Ninkatec, warned that sending him to hospital would have “pumped up the burden on already over‑stretched units.”
- He feared the patient would end up in intensive care, further straining the system.
Legal and Ethical Ground Rules
Dr Anita Lim, a bioethics scholar at NUS, chimed in: “There’s no law that forces any Covid‑positive patient to be hospitalized.”
- Any decision must balance the patient’s preferences, the caregivers’ wishes, and clinical judgement.
- Senior clinicians usually take the helm, but a second opinion can help, especially when time is tight.
- In urgent scenarios, the decision has to hinge on the best interests of the patient, guided by sound ethical principles.
Why Body Bagging Still Rocks the Scene
Some readers were perplexed about why bodies must be bagged when Singapore boasts high vaccination rates and a shift toward living with endemic Covid‑19. The National Environment Agency defended the practice, noting:
- Healthcare workers seal bodies in bags before placing them in airtight coffins.
- Funeral services trained by the National Centre for Infectious Diseases handle the final transfer.
- Risk of infection from a deceased person is low but not negligible (droplets or surface contact could still pose a threat).
Fisher added that as Singapore moves toward a “new phase,” these restrictions are “almost sunset”‑ready. He predicts that standard precautions, rather than extra layers, will suffice in time.
Bottom Line
Singapore is sliding into an era where the Covid‑19 burden is less about forced isolation and more about respectful care—especially for the terminally ill. If a patient and their family wish to finish at home, the experts say it’s both a humane choice and a smart systemic move.
