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Singapore will no longer cover the medical costs of Covid-19 patients who are eligible to get vaccinated against the virus but choose not to; arguing that unvaccinated patients are straining the country’s hospital systems.

According to the country’s Health Ministry on Monday, they will begin charging Covid-19 patients who are unvaccinated by choice on Dec. 8. Those who are not eligible for the shots will be exempt from the rule, it said, including children under 12 and people with certain medical conditions.

The policy change means the government will start charging all unvaccinated COVID-19 patients admitted to hospitals and designated “COVID-19 Treatment Facilities” on or after Dec. 8. Those patients can still use their regular health care financing arrangements to pay their bills where applicable.

The health care announcement comes as Singapore’s recent surge of infections appears to be tapering off. Singapore has recorded roughly 2,851 new COVID-19 cases per day in the past week, compared with averaging over 3,700 cases per day two weeks ago. According to government data, the vast majority of infections, 98.7%, are mild or asymptomatic cases, thanks in large part to the city’s high vaccination rate.

“Under this system, bills for the unvaccinated will still be highly supported and highly subsidized,” Health Minister Ong Ye Kung said at a press conference on Monday.

Singapore’s unvaccinated population is small. The city-state reports that 85% of its population is fully vaccinated; 18% have received a booster dose. But Singapore’s recent COVID-19 surge has strained the city’s health resources. Singapore has recorded 358 deaths in the past month, representing 70% of the 511 COVID-19–related deaths it has logged since the beginning of the pandemic. Singapore reported on Monday that 68.5% of the city’s intensive care units are occupied by COVID-19 patients and unvaccinated individuals make up a disproportionate number of those beds.

Singapore is one of the former “COVID zero” countries that had no tolerance for any cases early in the pandemic. But now it’s employing a two-pronged strategy to live with COVID: reopening quarantine-free travel from countries like the United States while maintaining social distancing restrictions, like five-person limits at indoor restaurants, to keep cases down.