Singapore is experiencing a significant surge in COVID-19 cases. The number of COVID cases in the week of 27 April to 3 May 2025 rose to 14,200 cases, compared to 11,100 cases in the previous week.This increase is attributed to waning immunity and the spread of new variants. “At present, LF.7 and NB.1.8 (both descendants of the JN.1 variant) are the main COVID-19 variants circulating in Singapore, together accounting for more than two-thirds of locally sequenced cases. JN.1 is also the variant used in the formulation of the current COVID-19 vaccine,” the Ministry of Health has informed.The uptick in infections has led to increased hospitalizations, prompting officials to advise the public to remain vigilant.Symptoms associated with the current wave include cough, sore throat, nausea, vomiting, brain fog, and conjunctivitis. These symptoms are generally mild, but individuals are encouraged to monitor their health and seek medical attention if necessary.

Vaccination remains effective in protecting against severe illness

To mitigate the spread, the Ministry of Health recommends that high-risk groups, such as the elderly and immunocompromised, receive booster vaccinations. Additionally, the public is advised to practice standard precautions, including mask-wearing in crowded places, regular handwashing, and staying home when unwell.“Individuals at increased risk of severe COVID-19, such as those aged 60 years and above, medically vulnerable individuals or residents of aged care facilities, are recommended to keep updated with vaccinations, i.e. to receive an additional dose around one year after their last dose. Healthcare workers and persons living or working with medically vulnerable individuals are also encouraged to receive the vaccine.Other individuals aged six months and above who wish to receive the COVID-19 vaccine can continue to do so,” the Ministry of Health has said in a press release.

Is there a threat?

All of us have been hearing news of increasing number of patients with COVID being reported in various Southeast Asian countries, especially in Singapore, Hong Kong, Thailand this summer. So, what is disturbing? It is that this wave is increasingly affecting the populations in these countries and more so in these summer months, which are typically not the months where you have peak in these respiratory viruses. The good news is that the present variant which is causing COVID in these countries is not much different from what we experienced during the last waves of COVID.The variant being reported is JN.1 which is the last prominent dominant variant in the last COVID outbreak in various countries including US and the last surges because of this variant were reported in some countries about a year back,” says Dr Sandeep Budhiraja, Group Medical Director – Max Healthcare & Senior Director – Institute of Internal Medicine.The expert further explains, what we know of these variants which belong to the Omicron family is – they do not cause a serious or severe illness in most people. However, this is infectious and it spreads fast in a community region or a country. The precautions and the symptoms caused by this variant is more or less same as that of any typical COVID symptom. There are no differentiating symptoms and there is nothing very unique about this virus.The common-sense things such as social distancing, using mask, keeping yourself indoors if you are infected, and hand wash remain the main points. The other thing is that there has to be a very robust system of reporting cases between various countries, because that’s how one gets to know whether this virus is now crossing boundaries and spreading further into other countries in the world, especially in Asian countries. So, one is the robust mechanism of reporting from the countries which are presently reporting and for the countries which are in neighbourhood and that includes India, having a very strict vigilance over the people who are coming into the country, potentially could be carrying any infection. So, screening of such cases and quarantining them would become important if we start seeing these cases spreading outside of these two, three countries. Obviously, testing, and especially genomic surveillance, is very crucial to identify which particular strain is the prominent one causing the outbreak. And so that data then needs to be shared between the countries and within the country between different states. So, testing, of course, becomes important.

Why this surge happened?

Dr Budhiraja explains, “now, it’s being discussed and debated in the countries, especially Singapore and Hong Kong, as to why this resurgence has happened. So, I like to say here that first of all, one needs to know that COVID virus has always been there, although the numbers were so small that most people had really forgotten about its existence, but that’s not the case. These viruses after the peak pandemic stage is over, tend to remain in more endemic form and periodically have a tendency to cause these outbreaks and these outbreaks could be limited regional outbreaks or could again spread to neighbouring countries and cause a bigger outbreak.The reason being given is not that this virus is more virulent but probably to do with the waning immunity or the reducing immunity of population at large, especially since now the routine vaccinations have not been happening. So, over the years, the immunity of a person against COVID tends to go down, and it is being assumed that probably it’s the waning immunity in the community or population at large, which is causing this virus to come back. Definitely, the virus is not more virulent, that means it doesn’t cause severe cases or death, except in very high-risk individuals, people of old age, immunocompromised, and with various medical comorbidities.”

So, what should a country like India do?

“Obviously remain on vigil, be alert to any cases coming into the country, being alert to any increase in the numbers of flu-like illnesses being reported. Any such case which comes where there is a suspicion, especially a traveller should be tested, genomic surveillance testing should be done and of course, the person should then isolate himself or herself. At this stage, other than this, any mass advice for people at larger population base is not required because India has yet not reported any increased number of cases.The last reported was about less than 100 active cases of COVID in the country, which is at a very baseline level. In case one sees increasing cases being reported, then one may have to reconsider our vaccination strategy, especially the booster dosing, and especially for people who are at high risk which I said, elderly people, people with medical comorbidities, people with organ failures, and people who are on immunosuppressive medications, etc. So, this is the high-risk group which we may have to address specifically. There are no reports of this virus causing increased mortality than the last wave, but as a country, as a nation, one has to keep the antennae high, be alert. In case one starts to see cases coming in, then of course, preparedness to cater to the surge would have to be implemented. But I can clearly say, there is absolutely no need to panic, there is no panic-like situation. But one has to be alert and vigilant over the next several weeks to see how this outbreak which has happened in certain regions of Asia effects rest of the world,” Dr Budhiraja explained.