Health
S’pore employers can compel staff who decline to be vaccinated to bear additional COVID-19-related costs
Workers in selected sectors in Singapore will be required to either be vaccinated or undergo regular testing from 1 October, starting with the public service.
In an updated advisory issued on Monday (23 Aug), the Ministry of Manpower (MOM) said that under the “Vaccinate or Regular Test” (VoRT) regime, employers will be required to bear some costs that are “necessary and common” for both vaccinated and unvaccinated employees.
Employers, however, can require medically eligible but unvaccinated employees, excluding employees who are medically ineligible for mRNA vaccines, to bear additional costs such as COVID-19 related expenses.
“These expenses can be recovered either through salary deductions or by requiring these employees to pay the relevant service provider directly,” said MOM.
Unvaccinated employees may be discharged later from treatment or may be served with longer periods of movement restrictions such as Stay-Home Notices compared to vaccinated employees, the ministry added.
“In such situations, employers can require that the additional days a medically eligible but unvaccinated employee has to serve, be taken from existing leave entitlements.
“If leave entitlements have been exhausted, employers may require such an employee to go on no-pay leave,” said MOM.
Employers may also opt to exclude these employees from medical benefits associated with COVID-19 such as insurance coverage.
The frequency of testing can be derived from the frequency under the Ministry of Health (MOH)’s guidelines, such as twice a week for unvaccinated employees in selected sectors.
A test done under the existing Fast and Easy Testing (FET) or the Rostered Routine Testing (RRT) regime, namely either a Polymerase Chain Reaction (PCR) test or supervised FET, also counts towards this requirement, said the ministry.
Unvaccinated employees may also be required to undergo Pre-Event Testing (PET) before participating in workplace events.
Smaller group sizes may also be arranged when unvaccinated employees participate in such events, especially those involving mask-off activities, in line with the prevailing MOH guidelines.
While employers may continue to deploy unvaccinated employees in higher-risk activities with regular testing, they can also decide whether to redeploy these employees to another job with lower risk of COVID-19 infection, commensurate with the employee’s experience and skills, as per existing redeployment policies, said MOM.
If there are no existing redeployment policies within the organisation, the terms and conditions for redeployment should be mutually agreed between employers and employees, the ministry added.
Employers can also, on their own accord, implement other workplace measures.
In doing so, employers must be prepared to justify to employees and/or the Government in the event of a dispute that such measures are reasonable and necessary for business operations and to better protect the health and safety of all employees, MOM said.
Such measures may be mutually agreed upon by the union and the employer.
MOM stressed, however, that employers should not any under circumstances terminate or threaten to terminate the service of an employee on the basis of their vaccination status alone.
Employers should also not place employees on no-pay leave for an extended duration without their mutual consent in writing.
However, employers may exercise their right to contractually terminate employment if unvaccinated employees do not comply with reasonable vaccination differentiated workplace measures, said the ministry.
Health
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.
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:
- 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.
- 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.
- 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.
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.
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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