New machine automates filling of Covid-19 vaccines into syringes, easing workload of nurses in S'pore - The Straits Times

SINGAPORE - Covid-19 vaccinations will now become a simpler, less tedious process for nurses, with the help of a machine that can automatically fill injection syringes.

The first of its kind in Singapore, the Automated Vaccine Inoculation Dispenser (Avid) system weighs less than 25kg and is able to fill six vaccine syringes in less than five minutes.

This innovative solution uses a combination of robotic parts, smart sensors and digital technologies.

The time taken for a nurse to manually fill six syringes varies, and is affected by factors like how experienced and how tired the nurse is.

The system reduces the workload of the nurses and removes the need for them to manually fill the syringes, allowing them to focus on caring and communicating with the people receiving the vaccines. It also reduces the possibility of human error, especially if the nurse is fatigued.

The machine is currently used to fill the Pfizer-BioNTech vaccine but can be customised to fill other vaccines.

Currently, Avid has been deployed at seven vaccination centres islandwide, with the first deployment at Senja-Cashew Community Club in early July. Thomson Medical operates the vaccination centre there.

Vaccination centres should be able to cater to at least 2,000 people a day, it was previously reported.

Avid was developed by researchers from the Agency for Science, Technology and Research's (A*Star) Advanced Remanufacturing and Technology Centre and Singapore Institute of Manufacturing Technology, in collaboration with local systems integrator Sysmatic Global.

The idea was first mooted by Deputy Prime Minister Heng Swee Keat, who challenged the team earlier this year to develop a solution to the tedious process.

A prototype was built in early July, six weeks after the idea was conceptualised. Thereafter, a production machine, which is more compact and cost-effective and had eliminated the teething problems the team earlier faced, was then built.

Some challenges included the fact that the syringes were not precisely identical and there could be slight variations in needle angle. Should the needle angle deviate too much, the system will not fill that syringe.

The team at Sysmatic Global also did not necessarily have a background in biomedical sciences.

Mr Khoo Kiak Nee, director of Sysmatic Global, said: "The A*Star team was very helpful and provided us with a lot of information very quickly. These are the things that we learn from them as a small and medium-sized enterprise, something which we would not have been able to do by ourselves."

The Automated Vaccine Inoculation Dispenser is able to fill up to six syringes in less than five minutes. ST PHOTO: NG SOR LUAN

If needed, new machines can be quickly assembled, taking only about three to four weeks to build from scratch.

Dr David Low, chief executive officer of the Advanced Remanufacturing and Technology Centre, said: "After we developed the protoype, we worked with the Health Ministry, and Senja-Cashew CC was selected by (the ministry). We were very fortunate that the Thomson Medical team was very receptive."

He added: "One of the biggest challenges in rolling out automation is not the problem itself, but whether it will be accepted by the people, so we were quite worried at the start. Of course, there was initial concern from the nurses on issues such as whether the machine is safe, and we took all their feedback and incorporated it to make it user-friendly and cost-effective."

Nurses need only less than an hour to learn how to operate the machine, which uses a three-pin plug.

Similar prototypes have been built abroad, with one in Thailand costing around $100,000. The system built here is a few times cheaper.

The immediate focus for the team now is to make sure the seven Avid systems are stable, and to develop more systems if there is a call to expand deployment to other vaccination centres.

"That is our near-term focus - to make sure that Singapore's vaccination exercise is smooth, has sufficient capacity and our nurses are not overstressed, especially with booster shots coming up," Dr Low said.

"We would also not say no if there is an overseas request for Avid, and it will be good to help with the global vaccination exercise. That'll be our mid-term goal, if there is a call to export some of these machines."

Nurse Nellie Tan, 47, fixing a vial of vaccine into the Automated Vaccine Inoculation Dispenser. ST PHOTO: NG SOR LUAN

How the system works:

1. The empty syringes and diluted Pfizer-BioNTech vaccine is loaded into the machine.

Typically, nurses will have to extract individual doses of the vaccine (0.3ml for the Pfizer-BioNTech vaccine) using syringes. One vial contains six doses after dilution.

2. The nurse closes the door of the machine and presses the "start" button.

3. The Avid extracts the vaccine from the vial into the six syringes, tapping each syringe to get rid of the air bubbles trapped inside. It also automatically uncaps and recaps the syringes.

4. After the six syringes have been filled, the nurse removes them and does a visual check on each syringe to ensure it is correctly filled.

5. Pre-filled syringes can be prepared based on the number of bookings received that day.

6. There are two layers of visual checks. The first is done by the nurse operating the machine, and the second is done by the nurse at each station when a person is about to injected.

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2021-09-30 06:12:52Z
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How Fumio Kishida might steer Japan as the next Prime Minister - The Straits Times

TOKYO - Mr Fumio Kishida, the man set to become Japan's 100th Prime Minister, has vowed to appoint a ministerial aide on human rights issues, rattling China.

The 64-year-old also supports beefing up Japan's coast guard, in a nod to the move by China earlier this year to allow its coast guard to use force against foreign vessels in territory that it claims. Mr Kishida is also in favour of passing a parlimentary resolution to condemn China's treatment of the Uighur minority in Xinjiang.

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2021-09-29 14:20:15Z
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Fumio Kishida set to be Japan's next PM after winning ruling party LDP election - The Straits Times

TOKYO – Elite conservative power brokers defeated public sentiment on Wednesday (Sept 29) as Japan’s former foreign minister Fumio Kishida was elected by the ruling Liberal Democratic Party (LDP) as its choice for the next Prime Minister.

The 64-year-old will be sworn in next Monday when the Diet convenes to choose Mr Yoshihide Suga’s successor, in a vote that is merely procedural given the LDP coalition’s majority in both chambers of Parliament.

Mr Kishida’s most immediate task will be to unite a divided party with an eye on a general election that must be held by November, as four-year Lower House lawmaker terms are due to expire on Oct 21.

“The LDP leadership election is over. Let us all face the Lower House and (next year’s) Upper House elections as one,” Mr Kishida said in his acceptance speech.

“We must put together a stimulus package of tens of trillions of yen by the end of the year and beyond that important problems are piling up for our nation – a new capitalism and realising a free and open Indo-Pacific, as well as dealing with the low birth rate,” he added.

A moderate party stalwart who was a right-hand man to former prime minister Shinzo Abe, Mr Kishida is seen within the LDP’s conservative ranks as a safe pair of hands, but perceived by the public as boring.

The public’s favourite for the next PM is administrative reform and vaccination minister Taro Kono, 58, who lost to Mr Kishida over two rounds of voting on Wednesday.

Mr Kono is an English-speaking media darling whose maverick reformist credentials do not sit easy with the LDP’s conservative base, even as the public regards him highly on his ability to bash through bureaucratic red tape to get things done.

Both men were neck in neck in the first round, when two former internal affairs ministers were also in the fray. Of the 762 votes cast, Mr Kishida won 256 votes, narrowly edging out Mr Kono by one vote. Ms Sanae Takaichi, 60, a staunch conservative backed by Mr Abe, scored 188 votes while Ms Seiko Noda, 61, whose platform is children- and women-centric, earned 63 votes.

As none of the candidates scored more than half of the votes, the top two finishers faced off in a run-off where Mr Kishida scored 257 votes and Mr Kono, 170 votes, of the 427 ballots cast.

The breakdown of the party rank-and-file votes, however, clearly showed Mr Kono as the favourite in 39 out of Japan’s 47 prefectures.
Mr Kono said in his concession remarks that he lost due to “his own lack of ability”, apologising to his supporters and vowing to support Mr Kishida with all his might and pledging to do his best where he is needed.

Political scientist Toru Yoshida of Doshisha University in Kyoto, told The Straits Times: “LDP lawmakers seem to have been quite relaxed to see that the party’s support has received a boost with Suga’s resignation.”

He added: “They might have felt more secure with Kishida, who opts for a more harmonised style of leadership, than with Kono, in their choice to keep the status quo.”

Mr Kishida, in a victory press conference, alluded to his weaknesses and vowed to listen to the voices of the people and win them over step by step. With Mr Abe and Mr Suga having faced flak for being out of touch, he repeatedly said that he will “sincerely explain” the government’s position to the public.

He added that he will continue Suga-era policies on climate change and digital transformation. 

On the campaign trail, Mr Kishida also pledged to strengthen Japan’s security ties with its like-minded partners, while saying that Japan must boost its defence spending to cope with growing security threats including around the Taiwan Strait.

But in a move that is bound to upset China, Mr Kishida has vowed to appoint a special ministerial aide on human rights.

He has also pledged at least 30 trillion yen (S$365.4 billion)  in stimulus spending to achieve what he has termed a “new form of capitalism” that embodies fairer wealth distribution, noting that Mr Abe’s signature Abenomics policies had catalysed social inequality.

Mr Kishida, whose grandfather and father were Lower House politicians representing their ancestral Hiroshima prefecture, is a ninth-term lawmaker who was first elected in 1993.

He is second time lucky, having competed in last year’s LDP leadership race to succeed Mr Abe, which he lost to Mr Suga.

He is known for his ability to hold his liquor. As foreign minister, he duelled with his Russian counterpart Sergei Lavrov to see how long they could keep a diplomatic conversation going over copious amounts of Russian vodka and Japanese sake.

He has three sons with his wife Yuko. His eldest son Shotaro, 30, is following in his footsteps and is now working as his secretary. 

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2021-09-29 10:01:05Z
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Nursing homes to test all residents, maintain separate zones to prevent spread of Covid-19 - The Straits Times

SINGAPORE - Dividing premises into distinct zones for staff and residents and testing for all residents are some of the measures nursing homes have adopted to minimise the spread of Covid-19.

This comes as the Ministry of Health (MOH) reported on Tuesday (Sept 28) that five more seniors aged between 69 and 79 had died from Covid-19 complications, and more senior centres reported new cases in the last week.

On Tuesday, MOH reported a total of 11 Covid-19 cases at Man Fatt Lam Elderly Joy Daycare Centre in Bedok, while Windsor Convalescent Home in Pasir Panjang reported 39 cases and Woodlands Care Home in Woodlands had 24 cases.

Cases were also reported at Orange Valley Nursing Home in Simei and Jamiyah Nursing Home in West Coast about two weeks ago.

In response to queries from The Straits Times, the Agency for Integrated Care (AIC) said nursing homes have stepped up the frequency of Covid-19 testing for their staff from once every two weeks to twice a week.

"Nursing homes have also begun testing for all residents from Sept 27 as an additional safeguard. Frequent testing will enable any infection to be detected earlier and managed," AIC added.

To limit the spread and impact of Covid-19 within nursing homes in the event of a positive case, nursing homes have divided their premises into distinct zones.

Residents and staff are assigned to a zone and must stay within that area, with no intermingling across zones.

While residents diagnosed with the infection are mostly taken to hospitals for treatment and close monitoring, AIC said that suitable residents may be admitted to MOH's community treatment facilities that provide "more comprehensive medical coverage than nursing homes, and can manage seniors who are stable or have mild symptoms".

Containment measures are also in place to prevent more staff and residents being infected, such as an incident response team, which comprises the nursing home, along with public health, laboratory and hospital partners. The team works to detect, ring-fence and care for Covid-19 cases.

If staff members become infected and are placed in quarantine, the Government said it would help bring in more manpower to ensure services are not disrupted in affected homes.

AIC said affected nursing homes can also tap the #StrongerThanBefore fund for their expenses.

"This fund helps community care providers defray additional operational costs incurred as a result of the heightened precautionary measures required. This includes the need for increased cleaning and disinfection of the premises," AIC said.

The Government has also been working closely with nursing homes to facilitate vaccination for seniors. Vaccinations are carried out by either the home's nursing team or by mobile vaccination teams.

As at Sept 24, 80 per cent of residents in nursing homes have received both doses of the vaccine, while 90 per cent have received the first dose, AIC said.

The agency supports about 14,000 residents across 80 nursing homes.

AIC urged all unvaccinated residents to take the jab as soon as possible as they are among the most vulnerable and the vaccine can increase their protection against severe illness.

"For residents and next of kin who are still uncertain about taking the vaccination or booster shot, nursing homes will continue to engage them on a regular basis, and to address any further questions they may have," the agency added.

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2021-09-29 08:12:41Z
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Fumio Kishida set to become Japan's next prime minister after winning party vote - CNA

TOKYO: Japan's ruling Liberal Democratic Party (LDP) elected former foreign minister Fumio Kishida its new leader on Wednesday (Sep 29), setting him on course to become the next prime minister of the world's third-largest economy.

The soft-spoken centrist defeated popular vaccine chief Taro Kono in an unusually close race to succeed Prime Minister Yoshihide Suga, who decided to step down after just a year in office.

Kishida defeated Kono, a former defence and foreign minister, in a second-round run-off vote. Two female contenders, Sanae Takaichi, 60, and Seiko Noda, 61, dropped out after the first round.

The winner of the party poll is almost certain to become prime minister because of its majority in parliament's lower house.

With masks on, the LDP's parliamentary members, including Suga and former prime minister Shinzo Abe, gathered in the ballroom of a Tokyo hotel to cast their votes from 1pm (12pm, Singapore time). Their ballot box was closed about 30 minutes after they voted in lines.

Last year, LDP factions rallied around Suga after Abe quit following his nearly eight-year tenure, citing ill health. But Suga's ratings tanked over his handling of the pandemic, prompting him to announce his departure ahead of a general election that must be held by Nov 28.

While Kono had the highest numbers in public polls, Kishida has a bland image but a stronger support base from party members in parliament.

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2021-09-29 06:45:42Z
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US CDC admits it raised Hong Kong's Covid-19 risk rating in error - The Straits Times

HONG KONG (BLOOMBERG) - The US Centres for Disease Control and Prevention (CDC) said it mistakenly flagged Hong Kong as a growing risk for coronavirus when it raised its travel warnings for the city and Singapore earlier this week. 

Hong Kong’s increase was done unintentionally, the agency said on Tuesday (Sept 28). 

The city’s status has returned to Level 1, indicating a low risk, on the CDC’s website, a spokesman said. The level is the lowest of the agency's four-tiered travel health notice system. 

Singapore remains at a Level 3 after its risk rating was raised this week by the CDC amid the largest outbreak the South-east Asian city-state has experienced since the pandemic began.  Anyone who has not been vaccinated should avoid non-essential trips to Singapore given its “high level” of Covid-19, according to the agency.

“All travelers may be at risk for getting and spreading Covid variants,” the agency said when it increased its travel advice for Singapore by one notch to Level 3. The CDC’s highest travel health notice is Level 4. 

The CDC’s decision to boost Hong Kong to Level 2 was immediately perplexing. The rating is given to locations with a “moderate level” of coronavirus. It includes a recommendation that non-essential travel to the area be avoided by anyone who is unvaccinated and has a higher risk of severe illness from Covid-19. 

But while Singapore has reported almost daily caseloads of more than 1,000 since mid-September, Hong Kong has seen fewer than 10 cases almost every day since late August. There has not been a locally transmitted infection in Hong Kong since mid-August, data shows, and it has yet to experience an outbreak of the Delta variant. 

The United States, by contrast, is in the midst of another Covid-19 resurgence as its vaccination rollout stalls. The country added almost 117,966 cases on Monday, and saw more than 2,000 deaths from the virus.  The primary criteria for determining CDC travel health notices for destinations as large as Hong Kong and Singapore are the number of recent cases and the trajectory of new cases, according to the CDC’s website. 

The threshold for Level 2, for example, is 50-99 new cases over the past 28 days, for every 100,000 local residents. The Level 3 threshold is 100-500, the website said. 

Testing data is also assessed, according to the CDC, but there’s room for less-explicit factors to play a role, too. “Additional information such as hospitalizations and imported case counts may be considered when inconsistencies or other concerns are reported,” the CDC site said. 

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2021-09-29 01:49:34Z
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Japan to fully lift Covid-19 emergency as cases fall dramatically nationwide - The Straits Times

TOKYO - Japan appears to be out of the woods from a Covid-19 wave because of the contagious Delta variant of the coronavirus, allowing Prime Minister Yoshihide Suga to end an ongoing state of emergency as planned at midnight on Thursday (Sept 30) in one of his last acts in office.

Mr Suga's successor will be chosen on Wednesday by the ruling Liberal Democratic Party in an internal party election with four candidates vying for the post. A tight race is expected between vaccination minister Taro Kono and former foreign minister Fumio Kishida.

The Diet will convene next Monday to confirm the new PM, which will be a formality since the LDP's coalition has a majority in both houses of Parliament.

There were 1,723 cases nationwide on Tuesday - down from the peak of 25,868 infections on Aug 20. Tokyo, which is about three times larger than Singapore in size and population, had just 248 cases, down from a high of 5,773 on Aug 13.

Singapore's Covid-19 battle has rarely made headlines in Japan until recently, with domestic media citing the ongoing Delta-linked surge as a cautionary tale against letting the guard down even as vaccinations take off.

Mr Suga, likewise, on Tuesday urged vigilance given that the looming winter months may trigger a sixth wave with indoor heating causing poorer ventilation and as millions are expected to criss-cross the country for homecoming visits.

His year-long tenure as Prime Minister has been marred by plenty of criticism over seemingly never-ending Covid-19 curbs - Friday will only be the 29th day this year that Tokyo is not under an emergency or quasi-emergency - and his inability to communicate with the public.

But he leaves behind a country that is a lot more confident in coping with future waves of Covid-19.

"I know that there were many people who were critical about me, but we can say that these treatments and vaccines are effective, and we do truly see a light at the end of the tunnel," Mr Suga told a news conference on Tuesday.

"From now on we must assume that we will live with the virus, and make our society more resilient so as to balance daily activities and anti-virus measures."

Among other things, Mr Suga stressed that a framework is now in place to ensure that hospital beds can be secured more quickly in case of future Covid-19 waves.

He noted how up to 130,000 people have had to recuperate at home in the fifth wave, while he had taken flak for a controversial policy to hospitalise only the sickest Covid-19 patients. Many, however, died at home after their condition worsened.

Further, despite being slow off the blocks in its vaccination programme, Japan has not only already fully immunised 58 per cent of its population but is on track to double-dose all those who are keen by November.

Mr Suga said that the country has already secured 200 million doses of vaccines for booster shots - which will be more than necessary for its entire population - and will progressively start administering them by year-end.

Meanwhile, Japan has been beefing up its arsenal of Covid-19 treatments with a fifth drug, sotrovimab by Britain's GlaxoSmithKline and the US' Vir Biotechnology, approved on Monday.

On the same day, pharmacies were also allowed to begin sales of self-test antigen rapid test kits that Mr Suga hoped would quell worries of infection.

"The fight will now enter a new phase. Vaccine roll-out is accelerating. The risk of infection was high but we were able to contain this, while neutralising antibody treatments have helped to reduce the number of severe cases," Mr Suga said.

All this has given rise to an optimism that might finally be warranted among a public that has been quick to pass judgment on Mr Suga's missteps, and slow to give him credit for the successful Tokyo 2020 Olympics and Paralympics.

Much of Japan has been under a Covid-19 emergency for the most part of the year. Dr Shigeru Omi, who leads the government panel of experts, said that among other things, the "shock factor" of constant bad news including the soaring Covid-19 infection figures could have led to people exercising more awareness, resulting in the steep plunge in cases.

Tokyo had just 248 cases, down from a high of 5,773 on Aug 13, 2021. PHOTO: AFP

What will change from Friday?

Japan's Covid-19 state of emergency or the looser quasi-emergency that is ongoing in 27 prefectures will end as scheduled on Thursday. But Prime Minister Yoshihide Suga said restrictions will only be "gradually eased" to prevent a rebound of a sixth Covid-19 wave, with measures subject to another review next month.

Eating out

Food and beverage establishments under emergency areas were requested to observe an all-day alcohol ban and an 8pm curfew on dine-in service. Many ignored these restrictions despite the risk of a fine of up to 300,000 yen (S$3,655).

From Friday, restaurants and bars whose Covid-19 countermeasures have been certified by prefecture authorities may serve alcohol until 8pm and open for dine-in service until 9pm.

Event size

From Friday, event capacity will be capped to either half the size of a venue or 10,000 people, whichever is lower. This has been eased from the maximum 5,000 people under the state of emergency. Events that do not involve loud cheering may proceed at full capacity.

Quarantine measures

Leisure travel is still barred, but from Friday, vaccinated residents or other visa holders will have their quarantine cut from 14 days to 10 days. Japan recognises only its approved vaccines, currently Pfizer, Moderna and AstraZeneca.

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2021-09-28 13:55:32Z
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