17 May 2021
Today is Day 20 of TTSH's response to the COVID-19 cluster at Ward 9D. We have taken tough, but necessary measures to contain it. The last case of exposure in our wards was more than 2 weeks ago. The cases reported since then were already under active surveillance in isolation at the National Centre for Infectious Diseases (NCID) or in quarantine.
Working closely with the Ministry of Health (MOH), we will be safely and progressively reopening our hospital for admissions. As we turn the corner, we remain vigilant of hidden infections amongst new admissions from the community. We will monitor the situation closely, continue our active measures and strengthen our defence. At the same time, we will see to the care for our patients and further ramp up support at NCID to respond to the ongoing community transmission.
Containment Measures
Since 28 April, we have put in multiple containment measures to ringfence the cluster at Ward 9D. This included close contacts who are patients, visitors, and staff. In addition, we have extended the measures to include the safety and well-being of our patients and staff in the rest of the hospital and across our campus. Our containment measures are complemented by MOH's wider ring in the community to do mass testing of patients and visitors who had been to our hospital during this period.
Our hospital's containment measures included rapid hospital contact tracing to quarantine or isolate close contacts; locking down wards where confirmed cases have been; conducting PCR testing for all inpatients and staff on campus; enhancing clinical surveillance of inpatients and staff for ARI symptoms; and ceasing admissions to our hospital, visits to our wards, and discharges to long term care. At the same time, staff and patient movement across our hospital has been minimised. To do so, medical, nursing, allied health and support staff were re-assigned to work in segregated zones and on split team arrangements.
As of today, we have completed six rounds of testing for all inpatients and two rounds for all 12,000 staff on campus. The swabbing results for all sweeps have consistently returned negative. This gives us added assurance that the containment measures are tight, and our processes have been in place across the hospital. As we progressively reopen our hospital, we will continue to monitor the situation closely and stay vigilant and strengthen our defences.
Safe and Progressive Reopening
With the Ministry's support, we are ready to resume admissions from 18 May at 8 am. We are mindful that in reopening, we will have to stay vigilant and continue to monitor our inpatients and our new admissions, especially with the ongoing community transmission. To start off, SCDF will convey urgent ambulance cases to our Emergency Department from 8am to 8pm daily. We will also see to urgent clinic appointments and electives during this period.
In our reopening and to reduce the risk of hidden infections, we will take a three-pronged approach to bolster our lines of defence during this pandemic. We will strengthen our protocols to test more regularly, monitor closely, and protect our patients and staff.
Caring for Our Patients in the Pandemic
As we resume admissions, all patients who are admitted will be swabbed on admission, on a regular schedule during their stay, and prior to their discharge. This regular inpatient testing will help to detect asymptomatic cases and other cases that may be incubating the virus. If detected, they can be isolated immediately, and close contacts put on quarantine.
All inpatients will be on surgical masks if they can tolerate wearing a mask based on their medical condition. Clinical surveillance is enhanced with proactive monitoring and testing of all inpatients who develop ARI (Acute Respiratory Infection) symptoms.
Patients who have been inflight during the last 2 weeks, and are assessed to be medically fit for discharge, with consistent negative test results will be discharged and placed on either Stay-Home Notice (SHN) or Quarantine Order (QO) by MOH. Their well-being will continue to be monitored throughout.
Visitor restriction will continue to be in place and will be aligned with other hospitals in due course. For the next 2 weeks, we shall allow for 1 pre-registered visitor per patient with a limit of one visit per day for up to 30 min. Visitors are to be masked at all times, and refrain from eating and drinking during their visit to our wards.
Facilities-wise, we have intensified cleaning regimes across all wards and the entire hospital. We have increased the frequency of cleaning in our wards from once to twice a day, with dedicated housekeepers for every ward. We have also increased the disinfection of all high touch surfaces to twice a day. During this period of heightened vigilance, training for our housekeeping team and cleaning audits will be intensified to ensure a high standard. This intensified cleaning is a further step-up beyond the enhanced cleaning during the pandemic. It is complemented by deep cleaning and enhanced decontamination using Ultraviolet and Hydrogen Peroxide Vapour for affected areas. We will also be exploring measures to enhance the ventilation of our general wards, including the addition of exhaust fans and portable HEPA filters.
Caring for Our Staff during this Pandemic
Our progressive reopening will be phased with the return of staff who have been serving their quarantine or leave of absence. With more cases in the community, we are taking enhanced measures to protect our staff to ensure their well-being. Following the all-clear from the earlier rounds of staff swabs, in line with MOH's directive, all our staff will now undergo Routine Rostered Testing (RRT) at regular intervals.
Staff will continue to adhere to the enhanced staff surveillance protocols with mandatory twice-daily temperature monitoring and sick leave surveillance. We have also set up an ARI clinic for our staff on campus so that they can seek timely care. PPE has been stepped up across the hospital to protect our staff. Our enhanced staff policies during this pandemic are constantly reviewed in keeping with national restrictions and tighter measures within our hospital. These measures will ensure the safety of our staff in caring for our patients.
Our staff have been operating in this pandemic mode since January 2020. Their health and well-being is essential to our continuing fight against COVID-19. The hospital has introduced a suite of staff well-being efforts including welfare officers at each department, mindfulness sessions on zoom, morale boosters, and a staff support staff programme to support those who need help in coping with the added stress during this challenging period. We have also strengthened communications with our 12,000 staff, through live townhalls on our internal social media platform, staff chat-bot, intranet, CEO tribunes and leadership support at all levels. Our staff have shown their resilience and we stand together in our response on the frontlines of this pandemic.
These last few weeks have not been easy for our staff and patients and their families. We appreciate their understanding and strong support throughout this challenging period. We are also thankful for the outpouring of goodwill and the strong rally by our community to support our hospital during this pandemic. It has brought much comfort and cheer for our staff. Thank you very much for supporting our frontliners at TTSH.
"As we safely and progressively reopen our hospital, we will pivot our pandemic response to the increasing cases in the community. Our measures have been tough but necessary in containing the cluster at our hospital. As we turn the corner, we must continue to stay vigilant, monitor the situation and look after one another in staying the fight against COVID-19." – Dr Eugene Soh, CEO TTSH.