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New Zealand adopts Apple-Google contact tracing framework for COVID-19; S’pore chooses to distribute more TraceTogether tokens

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Earlier this week on Tuesday (8 December), New Zealand authorities announced that it has adopted the Exposure Notification Framework developed by Apple and Google in the country’s contact tracing app for COVID-19, which is set to be released today.

About 2.4 million people have installed the NZ COVID Tracer app, with 90 per cent using smartphones that are compatible with Bluetooth tracing.

“Kiwis deserve a summer break more than ever this year but we cannot take our eye off the ball. The prospect of another outbreak should serve as a rock under our beach towels. That’s no bad thing,” said Chris Hipkins, the country’s Minister for COVID-19 Response.

ZDNet reported that the source code will also be released on Friday (11 December).

It was said that app users who test positive for COVID-19 will be able to alert other app users who may have been exposed to the virus.

The authorities, on the other hand, will not know whether the user has received an alert unless the user has requested information.

Mr Hipkins said that while it is “vitally important” for New Zealanders to adopt Bluetooth tracing to speed up contact tracing, he believes that people will still need to continue scanning QR codes “wherever we go”.

“QR codes allow us to create a private record of the places we’ve been, while Bluetooth creates an anonymised record of the people we’ve been near,” he said.

As such, combining the use of both QR codes and Bluetooth would help public health units and the National Investigation and Tracing Centre to rapidly identify and isolate close contacts, said Mr Hipkins.

“That continues to be the primary method for contact tracing in New Zealand,” he remarked.

As for New Zealanders who have no access to the app, Mr Hipkins said no decisions were made as to whether the proposed contact tracing cards will be rolled out now.

However, he highlighted that the cards, or other wearables, would potentially form part of a broader system of interoperable technologies.

“The recent community trial of the cards with the Te Arawa COVID-19 Response Hub has highlighted that a partnership with regards to any future rollout of cards or wearables will be essential in increasing community trust and participation with contact tracing technologies,” said Mr Hipkins.

S’pore govt refused to adopt Apple-Google contact tracing system

Over in Singapore, the government had refused to adopt Apple and Google’s Exposure Notification Framework for COVID-19 contact tracing.

It instead mooted the TraceTogether contact tracing app, which many users have observed does not work on equal measure across different smartphone operating systems such as iOS and Android.

Minister-in-charge of the Smart Nation initiative Vivian Balakrishnan previously said that Apple’s iOS suspends Bluetooth scanning when the app is running in the background, which would require iOS users to use the app in the foreground without interference by other applications.

To solve this, the government distributed a portable and wearable device, namely the TraceTogether token, to citizens who have difficulties in accessing the TraceTogether app.

Commenting on issues with the distribution of TraceTogether tokens, Workers’ Party (WP) member Gerald Giam said the Government should roll out a “working contact tracing phone app” and adopt Apple and Google’s Exposure Notification Framework instead of issuing tokens that cost about S$110 million.

“This will enable the app to run effectively on all smartphones, maximise adoption, protect privacy, enable cross-border interoperability and, most importantly, become a real weapon in our battle against COVID-19,” he wrote in a blog post in June.

Mr Giam noted that TraceTogether’s current protocol prevents the app from running a Bluetooth scan in the background. The Exposure Notifications protocol, on the other hand, is implemented at the operating system level which allows for more efficient operation as a background process.

“The Exposure Notifications System provides both privacy protections and privileged operating system access to allow contact tracing apps to work on almost all smartphones, even when they are locked,” he noted.

Mr Giam believes that by adopting the technologies developed by Apple and Google, the government will then only need to issue tokens to 9 per cent of residents who do not own a smartphone which will be “saving taxpayers over S$100 million”.

Dr Balakrishnan, however, claimed that the Exposure Notification Framework is less effective in Singapore’s local context and that the “graph” would not be available to the contact tracers.

“Although a potential close contact would be notified by the system, there would be no way to identify how, when and whom the person was infected by or passed the infection to,” the Minister replied to Mr Giam in a Facebook post.

Dr Balakrishnan went on to say that not everyone can afford a smartphone, and even so, many smartphone models cannot operate the BlueTrace protocol – TraceTogether’s protocol – or the Exposure Notification protocol well, which explains why issuing wearable devices would be more convenient.

“Perhaps my medical background makes me feel strongly that patients should be informed of a diagnosis, implications and options by a human being – and not a machine,” he added.

Minister Vivian Balakrishnan urges public not to rush even as TraceTogether token demand spikes

The distribution of tokens kicked off in September at 38 community centres (CCs) across the country.

However, it was reported that TraceTogether tokens demand had spiked right after the government announced in October that TraceTogether use will be made mandatory to gain entry at public venues.

The Smart Nation and Digital Government Group had to temporarily suspend token distributions due to the long queues formed at certain CCs, before resuming on 29 October with one constituency at a time to “better match demand”.

Commenting on the high demand of tokens, Dr Balakrishnan urged the public not to rush and assured that there would be more than enough tokens to be distributed.

“We will adjust the numbers supplied to meet the demand, obviously, and our contracts allow us to make those necessary adjustments,” he remarked.

Dr Balakrishnan disclosed that while the current target number of tokens to be produced is about 2.7 million, this number can be adjusted in accordance with demand.

“I would also make the assurance that the implementation of the TraceTogether-only Safe Entry programme will not proceed until we make sure that everyone has access to either a token or the app and is comfortable using it,” the Minister added.

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Survey reveals one-third of Singaporean youth struggle with severe mental health issues

A national study by the Institute of Mental Health reveals that 30.6% of Singaporean youth suffer from severe symptoms of depression, anxiety, or stress, driven by factors like excessive social media use, body image concerns, and cyberbullying. The findings emphasize the need for early intervention and targeted mental health strategies.

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A significant portion of Singapore’s youth are experiencing severe mental health challenges, according to a comprehensive national survey conducted by the Institute of Mental Health (IMH).

The National Youth Mental Health Study (NYMHS), released on 19 September 2023, found that 30.6% of individuals aged 15 to 35 reported severe or extremely severe symptoms of depression, anxiety, or stress, with key risk factors including excessive social media use, body shape concerns, and experiences of cyberbullying.

The study, which surveyed 2,600 Singaporean citizens and permanent residents, highlights the growing mental health concerns among Singaporean youth and suggests the need for more targeted interventions and support systems.

Mental Health Issues Prevalent Among Youth

Anxiety was the most common mental health issue, with 27% of respondents reporting severe or extremely severe symptoms, followed by depression (14.9%) and stress (12.9%).

These findings underscore the high prevalence of mental health issues among young people, particularly in those aged 15 to 24, who were more likely to report severe symptoms compared to older participants.

According to the IMH, young people who were female, single, unemployed, or had lower levels of education or household income were more prone to severe mental health symptoms.

For example, youth with monthly household incomes below S$5,000 were more likely to experience severe anxiety​.

Key Risk Factors: Social Media, Body Image, and Cyberbullying

The study identified three major factors linked to severe mental health symptoms:

  1. Excessive Social Media Use: Around 27% of respondents reported using social media for more than three hours daily, which was associated with a significantly higher likelihood of severe mental health issues. Youth with excessive social media use were 1.5 to 1.6 times more likely to experience severe symptoms of depression, anxiety, or stress​.
  2. Body Shape Concerns: About 20.2% of youth had moderate to severe concerns about their body image. These individuals were 4.9 times more likely to experience severe depression, 4.3 times more likely to experience severe anxiety, and 4.5 times more likely to suffer from severe stress​. Such concerns were often linked to social media exposure, which can perpetuate unrealistic beauty standards and increase dissatisfaction with one’s body.
  3. Cyberbullying: One in five youth (21%) reported being victims of cyberbullying. These individuals were approximately twice as likely to report severe mental health symptoms compared to those who had not experienced such harassment​. The anonymity and pervasive nature of online bullying exacerbates the mental health toll on young people, according to the study.

Demographics at Higher Risk

The study found that specific demographics were more vulnerable to mental health issues. Young people aged 15 to 24 were more likely to experience anxiety, depression, and stress, particularly females, those who were single, and those with lower levels of education, such as junior college or vocational qualifications​.

The Malay ethnic group was also found to have a higher prevalence of severe mental health symptoms compared to other ethnic groups​.

Barriers to Seeking Help and Sources of Support

Although about 69.1% of those with severe mental health symptoms sought help—primarily from family and friends—a significant portion of young people hesitated to seek professional support.

The top reasons included concerns about privacy, fear of judgment, and doubts about the effectiveness of professional services​.

Among those who sought help, family and friends were the most common sources of support (57.9%), followed by self-help measures (31.1%) and medical services (20.1%)​.

However, the reluctance to seek professional help highlights the need for continued efforts to destigmatize mental health treatment and increase awareness of available services.

Protective Factors: Resilience, Social Support, and Self-Esteem

The study also identified factors that helped mitigate mental health challenges. Youth who reported higher levels of resilience, perceived social support, and self-esteem were significantly less likely to experience severe symptoms of depression, anxiety, or stress.

This suggests that fostering strong support networks and building resilience in youth could play a critical role in improving their mental well-being​.

Government Response and Preventive Measures

The findings of the NYMHS support Singapore’s broader National Mental Health and Well-Being Strategy, launched in October 2023, which adopts a whole-of-government and whole-of-society approach to addressing mental health concerns. Schools have already begun integrating mental health education into their curricula, equipping students with the knowledge and skills to manage their well-being.

Additionally, the government introduced the Parenting for Wellness toolbox in September 2023 to help parents manage their children’s screen time and promote healthy social media usage.

A guide on responsible social media use, expected to be released by mid-2025, will offer further strategies to mitigate the negative impacts of excessive screen time and online harassment​.

Future Implications and Policy Development

Associate Professor Swapna Verma, chairman of IMH’s medical board and co-principal investigator of the study, emphasized the importance of early intervention.

“Not all individuals with severe or extremely severe symptoms of depression or anxiety have a clinical condition, but being in such states for a prolonged period of time can be detrimental to their well-being,” she said​.

The study’s data will help policymakers and healthcare providers develop more targeted approaches to address the mental health needs of Singapore’s youth, especially those most at risk.

Associate Professor Mythily Subramaniam, IMH’s assistant chairman of medical board (research), stressed the need to pay attention to issues like excessive social media use and cyberbullying, noting their “tremendous impact on youth mental health” and the importance of preventive measures​.

Support for Youth Facing Mental Health Challenges

Young people dealing with mental health challenges in Singapore have access to various resources:

  • CHAT (Centre of Excellence for Youth Mental Health): CHAT offers a safe and confidential space for youth to seek help through online and face-to-face mental health assessments and support.
  • Institute of Mental Health (IMH): IMH provides a comprehensive range of mental health services, including outpatient consultations and inpatient care. Youth in crisis can also seek immediate assistance from the 24-hour Mental Health Helpline at 6389 2222.
  • Samaritans of Singapore (SOS): SOS offers emotional support for those feeling distressed or experiencing suicidal thoughts. Their 24-hour hotline is 1767.
  • Health Promotion Board’s National Care Hotline: This hotline provides immediate emotional support for those in need and can be reached at 1800-202-6868.
  • Counselling Services: School-based counsellors, as well as community-based services such as TOUCH Youth, provide further avenues of support for young people grappling with mental health issues.
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Health

Malaysia reports new mpox case in man without recent international travel

Malaysia has confirmed its first mpox case of 2024 in a male patient, the Health Ministry reported. The patient is in isolation and stable, with authorities monitoring his contacts. This brings the total confirmed cases since July 2023 to ten, all from clade II.

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MALAYSIA: The Malaysian Health Ministry confirmed a new case of monkeypox (mpox) in a male citizen, marking the country’s first confirmed case of 2024.

The patient, who began showing symptoms on 11 September, is currently in isolation and in stable condition.

The ministry, in a statement issued Tuesday (17 September), revealed that the patient first experienced fever, sore throat, and cough, followed by the appearance of rashes on 12 September.

He has no recent history of international travel within the past 21 days, and authorities are in the process of identifying and monitoring his close contacts, following strict standard operating procedures (SOPs).

“Out of the 58 suspected mpox cases referred to the ministry this year, one case has been confirmed positive for mpox clade II as of 16 September,” the ministry stated.

“All 10 cases reported in Malaysia since July 2023 have been from clade II.”

The Health Ministry had earlier reported that Malaysia recorded a total of nine mpox cases since the first detection on 26 July 2023, with the most recent case reported in November 2023.

All previous cases had links to high-risk activities, but no deaths were reported.

Global Context and National Preparedness

Mpox was declared a Public Health Emergency of International Concern (PHEIC) for the second time on 14 August this year, due to the rapid spread of the clade Ib variant, particularly from the Democratic Republic of Congo (DRC) and neighboring African nations.

In response, Malaysia’s Health Ministry activated its national crisis response centre on 16 August to enhance readiness and coordinate preventive measures.

The ministry advised the public to take precautions, including maintaining personal hygiene and avoiding direct contact with individuals suspected or confirmed to be infected with mpox.

High-risk individuals experiencing symptoms such as fever, swollen lymph nodes, and rashes are urged to seek immediate medical attention.

Mpox is caused by the monkeypox virus (MPVX) and spreads through close contact with symptomatic individuals.

The incubation period is typically between 5 and 21 days, and patients remain contagious until all lesions have dried up and fallen off.

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