Singapore’ s Ministry of Health said it has asked hospitals to defer non-urgent surgeries and admissions until further notice, in a bid to increase potential capacity after the city state saw its first fatality caused by complications from Covid-19 in nearly two months over the weekend. The capacity measures – which also include limiting accident and emergency visits only for life-threatening or other emergency conditions, and encouraging remote consultations instead of in-person medical visits where possible – come amid a flare-up of cases in a country that has been one of the world’s most successful in containing the virus. An 88-year-old Singaporean woman with a history of cancer and cardiac failure died on Saturday after she was treated at Tan Tock Seng Hospital, where a cluster of more than three dozen cases has been identified since last week . The cluster is Singapore’s first in a hospital and raises concern that the city’s hard-won success is slipping, potentially threatening efforts to open up a long-awaited travel bubble with Hong Kong and host major upcoming summits including the World Economic Forum and Shangri-La Dialogue . “There will be many more” cases in the hospital as patients there are more susceptible given many hadn’t been vaccinated and were already sick with other illnesses, said Leong Hoe Nam, an infectious disease doctor at Singapore’s Mount Elizabeth Hospital. “Unfortunately, they are easy targets for a Covid-19 superspreader, and in turn patients who have been infected can be new superspreaders,” he said, adding that he has no doubt the government will contain the cluster. Singapore has largely halted the spread of the virus, but virtual elimination is being challenged by sporadic flare-ups. In a bid to stay at zero local cases, the government – much like those in New Zealand, Australia, Hong Kong and China – reacts aggressively to small numbers of infections. Singapore’s Covid-19 hospital cluster, reinfections – causes for concern? Already, fewer people have been allowed at malls and large stores since Saturday and campsites were closed for two weeks. Singapore will also reduce the operating capacity of attractions to 50 per cent from 65 per cent for a week from May 7, and urged people to limit social gatherings to two per day and stay home where possible. At 2.21 million doses given as of April 18, Singapore has inoculated 19.4 per cent of its population so far, with fewer than half having received both jabs. The country registered 16 new coronavirus cases in the local community on Thursday, its highest daily number since July 11, and 10 more infections on Monday, according to Ministry of Health data. Singapore tightens coronavirus measures amid fears over hospital cluster Before the latest spate of infections, Singapore had several months of low single-digit or no new cases thanks to strict measures that include mandatory mask-wearing, restricted travel and high testing and overall treatment capacity. All of the cases found on Monday were either patients or staff at Tan Tock Seng Hospital or close contacts who had already been placed on quarantine, according to the government. Philippines’ Duterte receives Sinopharm vaccine Philippine President Rodrigo Duterte received his first shot of a Covid-19 vaccine on Monday, weeks after saying he would waive his chance to get inoculated, as the country struggles to secure jabs amid a resurgence in infections. Officials said Duterte was given the vaccine made by China’s Sinopharm – the same one secretly administered to members of his security team last year before any shot had been given regulatory approval. Photos posted on the Facebook page of a close aide showed a masked Duterte, wearing an unbuttoned denim shirt over a white T-shirt and braces – sitting in a chair as Health Secretary Francisco Duque injected him. “He was vaccinated not only to protect his health from Covid-19 but also to encourage our citizens to get vaccinated,” Senator Christopher “Bong” Go posted. “As a senior citizen, he was among the priority for vaccination.” A Facebook Live video of the event cut out moments before the needle punctured the 76-year-old Duterte’s upper left arm, but photos showed the injection. “I feel good and I have been expecting this shot, vaccination, a long time,” Duterte said as Duque, wearing a blue medical gown, mask, face shield and latex gloves, prepared to give the injection in front of the cameras. Thailand reports record daily deaths Thailand on Monday reported a record number of daily coronavirus deaths, the health ministry said, as the Southeast Asian country grapples with a third wave of infections. After managing to largely control the virus for around a year through shutdowns and strict border controls, Thailand has faced a spike in cases since early April that is proving harder to control and putting pressure on parts of the medical system. The ministry reported 31 deaths, taking the total number of Covid-19 fatalities to 276. There were 2,041 new cases, making the country’s overall tally 71,025 since the pandemic began last year. The new outbreak, which includes the highly transmissible B.1.1.7 variant first detected in Britain , has accounted for more than half of total cases and deaths since the start of the pandemic. Thailand aims to have 70 per cent of the population vaccinated against Covid-19 by the end of the year, though the roll-out of vaccines has been slower compared with some neighbouring countries. Registration for vaccinating the general public began on Saturday, with about 16 million people aged over 60 or those with pre-existing medical conditions getting priority. Mass inoculations are set to begin in June, when the first batch of what is targeted to reach 61 million locally manufactured AstraZeneca doses becomes available. Malaysia makes AstraZeneca vaccine optional Malaysia will begin a parallel Covid-19 inoculation programme this week for people who chose to receive the AstraZeneca vaccine, after it was removed from an ongoing roll- out because of public fears over its safety, a minister said on Monday. Reports of possible links to very rare blood clots have dented confidence in the shot in Malaysia and elsewhere. AstraZeneca has pointed to regulator recommendations that the vaccine is safe and effective, though some countries have suspended its use due to rising unease or limited it to certain age groups. Malaysia, which received its first 268,000 AstraZeneca vaccine doses in April, said it would allow people to choose to receive the jab on a first-come, first-serve basis. The decision was made after around 8,000 people cancelled online vaccination registrations following the government’s announcement that the shot would be part of the nationwide roll-out, Science Minister Khairy Jamaludin told reporters. Data also showed increased vaccine hesitancy with some people not showing up to appointments after AstraZeneca was included, he said. “The number of cancellations was rising, and this resulted in (authorities) deciding that we should carve out AstraZeneca from the mainstream national immunisation programme,” Khairy said. Will Malaysia’s move to drop AstraZeneca shot fuel vaccine hesitancy? Slots for 268,000 doses were filled in just three hours after bookings opened on Sunday, he said, adding the programme that starts on Wednesday would be expanded when more doses arrive. Malaysia is set to receive 12.8 million doses of the AstraZeneca vaccine, with the next shipment of 1.1 million doses expected to arrive this month. Khairy said authorities had also decided to limit the use of the vaccine developed by China’s Sinovac Biotech to those aged 60 years or older. Separately, Health Minister Adham Baba noted a marked increase in Covid-19 patients suffering acute symptoms, possibly due to new strains. Malaysia on Sunday reported its first case of a variant first identified in India, which experts say may have mutations that would make it more transmissible, cause more severe disease or evade vaccine immunity. The government has also detected 48 cases of the South African variant and eight of the British variant as of May 1, Adham said. Pakistan warns virus battle at ‘critical’ phase Pakistan has closed land crossings with Iran and Afghanistan for travellers and slashed international flights as the government warned of a “critical” few weeks ahead in the battle against Covid-19. The border restrictions were announced on Sunday as the country prepared to mark the Muslim holiday of Eid al-Fitr, which usually sees the mass movement of people between cities and villages as well as the return of migrant workers and overseas Pakistanis for celebrations. Pakistani officials have anxiously watched the coronavirus crisis unfolding in neighbouring India . ‘The trauma won’t go away’: India’s Covid-19 surge is straining mental health The Civil Aviation Authority said on Saturday that from Wednesday, 80 per cent of flights would be suspended for two weeks, mainly from the Middle East, until mid-May when the Eid holidays are over. Foot crossings with Iran and Afghanistan would also be sealed, the country’s coronavirus task force said, adding that trade would be exempt. Flights and land crossings with neighbouring India – reeling from a devastating outbrea k with hundreds of thousands of new cases a day – were closed before the pandemic because of political tensions. Impoverished Pakistan is struggling to contain a third wave of infections, with more than 800,000 cases and 18,000 deaths declared. Only a small fraction of its 220 million population has been vaccinated. Planning minister Asad Umar, who has been leading the government response to the outbreak, said the next two weeks are “critical”, as health authorities rushed to increase intensive care capacity. Last year, Pakistan saw a spike in cases following Ramadan and Eid. Mosques have remained open throughout the month of Ramadan, with few adhering to social distancing guidelines during huge nightly gatherings of worshippers. Private gatherings, shops and restaurants have faced tight restrictions, with the army mobilised to help enforce rules. New Zealand to open another travel bubble New Zealand will open a travel bubble with the tiny Cook Islands this month, adopting quarantine-free arrangements similar to those already established with Australia, Prime Minister Jacinda Ardern said. Ardern said the bubble with the South Pacific island state of about 20,000 people would open on May 17 and initially involve about three flights a week. “Two-way quarantine-free travel is a significant step in both countries’ Covid-19 recovery, and a direct result of both New Zealand and the Cook Islands’ successful response to the pandemic,” she said. The remote Cook Islands is one of few places in the world to remain coronavirus-free, while New Zealand has eliminated community transmission and recorded only 25 deaths in a population of 5 million. The Cook Islands is self-governing in “free association” with New Zealand, meaning that while it administers its own affairs, Cook Islanders are both New Zealand citizens and Cook Islands nationals. As a result, there are more expatriate Cook Islanders living in New Zealand than on the islands. Pacific island nations beat coronavirus, but now face economic devastation “[The bubble] will mean families can reconnect, commercial arrangements can resume and Kiwis can take a much-welcomed winter break and support the Cook Islands’ tourism sector and recovery,” Ardern said. A long-awaited travel bubble between New Zealand and Australia opened last month , and has been hailed as a major milestone in restarting a global travel industry gutted by the pandemic. New Zealand opposition leader Judith Collins said Wellington should now prioritise opening travel bubbles with Tonga and Samoa, two Pacific island nations that have detected no community cases of Covid-19. Nepal suspends all domestic, international flights Nepal has decided to suspend international and domestic flights amid a surge in Covid-19 cases, the country‘s communications minister said on Monday. All domestic flights will be suspended from midnight on Monday, while international flights will be halted from midnight on Wednesday, according to minister Parbat Gurung. “The flights will remain suspended until May 14,” he said. Details have not yet been made public but the decision will not affect chartered and humanitarian flights, according to officials. This decision comes at a time when the government is struggling to contain the spread of coronavirus cases although several areas in the country remain under strict lockdown. In Kathmandu, hospitals have run out of intensive care space, beds and oxygen, according to media reports. On Sunday, Nepal logged 7,137 new coronavirus cases as the total tally surpassed 336,000. The country shares 1,100 miles of open border with its southern neighbour India, currently being ravaged by a second wave of Covid-19. Reporting by Bloomberg, Reuters, Agence France-Presse, DPA