People visiting critically ill patients at hospitals may stay for more than 20 minutes, must undergo Covid-19 test from June 21

From 21 June 2021, the Ministry of Health said that every visit at public and private healthcare institutions should not last more than 20 minutes except for selected extension of visitation time under extenuating circumstances. Hospitals under NUHS – NUH, NTFGH and AH – will implement the measures from 22 June 2021.

Singapore hospitals trial bringing care to patients’ homes

The Ministry of Health Office for Healthcare Transformation (MOHT) has partnered NUHS to drive the NUHS@Home pilot programme to care for patients in their homes. Dr Stephanie Ko, Associate Consultant, Division of Advanced Internal Medicine, Department of Medicine, NUH, shared how providing medical care at home has the potential to be more patient-centred and reduce the possibility of hospital-acquired infections, while lowering cost and increasing bed capacity. Ms Tay Yee Kian, Assistant Director of Nursing, Advanced Practice Nurse, Regional Health System Office, NUHS, said that such a shift in care delivery requires a significant mindset change from both medical professionals and patients. Patients can be assured that the type of treatments they receive will be on par with that in hospitals, with five consultants from NUH’s Division of Advanced Internal Medicine and Alexandra Hospital’s Department of Medicine taking turns to provide care.
 
The pilot is expected to be concluded in September 2021 and provide valuable findings for evaluation of this care model.

New measure will help against virus, but some have concerns

The Straits Times cited Prof Paul Tambyah, Deputy Director of Infectious Diseases Translational Research Programme, NUS Medicine, who said that it was logical to extend the requirement of mandatory pre-departure testing to Singaporeans and Permanent Residents who are returning from lower-risk places as the risk classifications can change rapidly. Prof Teo Yik Ying, Dean of NUS Saw Swee Hock School of Public Health (SSHSPH), said that implementing the new measure may be more challenging than expected as not every jurisdiction will have commercial polymerase chain reaction testing capacity that is accredited and trustworthy. 

专家：本地社区病例 两周内趋稳令人鼓舞 (Experts: Five cases in Westgate store do not rule out possible transmission in public toilets)

Lianhe Zaobao cited Prof Teo Yik Ying, Dean of NUS Saw Swee Hock School of Public Health (SSHSPH), and Dr Louisa Sun, Associate Consultant, Infectious Diseases and Chronic Programme, Alexandra Hospital (AH), who commented on the possible risk of transmissions in public toilets as masks would be removed and how close contact between individuals remain as a high risk of transmission. Prof Teo also shared that workers such as cleaners who are working in high-risk areas should be vaccinated and receive training on personal protection. 

Cleaners in higher-risk areas get priority for vaccination

Vaccinations helped S'pore avoid second circuit breaker, says expert

​At the latest webinar on COVID-19 updates in Singapore organised by NUS Medicine, experts shared that vaccinations are a more sustainable way of protecting the population, though the current slew of fairly aggressive COVID-19 curbs are necessary. 

International Nurses’ Day (12 May 2021)

​In a live Zoom interview on ‘Asia First’ morning show on CNA, Alexandra Hospital (AH) Nurse Clinician K. Nitiah from Urgent Care Centre and Dr Michael Yong, Group Chief of the National University Health System's (NUHS) Psychology Medicine were invited to the ‘live’ segment to talk about the stresses and sacrifices made by nurses in Singapore to mark International Nurses’ Day. Sister Nitiah said that although the going over the past year and counting has been tough and mentally stressful, it helps to have strong team spirit and teamwork to rise up to the challenge, and also be psychologically prepared for the long haul in fighting the pandemic.  She said having built-in coping mechanism such as team, family and most importantly, the nation’s support, is key. Dr Yong suggested the psyche of nurses the world over in being ‘the strong one’, the face to fight the pandemic, and being there for patients and their families to lean on in trying times like this. He listed the initiatives by which nurses in turn can cope with the work stress and for the organisation to help to look out for signs which warrant support and assistance for nurses.  

Covid-19 Pandemic: Healthcare workers face increased stress, burnout, mental health issues

​The National University Health System's (NUHS) Group Chief for Psychological Medicine Dr Michael Yong and Alexandra Hospital's (AH) Nurse Clinician Nitiah were interviewed by CNA on International Nurses’ Day to talk about the impact Covid-19 has had on those at the frontlines of the battle against the coronavirus – from physical aspects like exhaustion, to the mental strain from the caseload and deaths, and the toll on the profession in general.

专家：社区无关联病例虽增加但仍受控 新港航空泡泡不至于会取消 (Experts: Unlinked community transmission on the rise but under control; Singapore-Hong Kong air travel bubble may not get cancelled)

​The Singapore-Hong Kong air travel bubble may not start if the threshold of a seven-day moving average of five or fewer unlinked community cases in either city is breached.  In Singapore, the number of unlinked Covid-19 cases in the community increased from five cases in the week before to seven cases in the past week. 

Public healthcare institutions step up as use of telemedicine grows

IHIS data captured that during Covid-19 last year, telemedicine numbers had been on the rise. The report captured that the National University Health System (NUHS), which conducts more than 3,000 specialist outpatient and allied health teleconsultations each month, plans to expand its telehealth service to more patients, said group chief digital officer Peter Forbes. Teleconsultations, via video or phone calls, are now only offered for repeat visits, and the level of physical assessment needed is one of the considerations when selecting patients for telehealth, he noted. NUHS is working on videos to help patients use its telemedicine service, added Mr Forbes. Dr Teng Gim Gee, the head of Alexandra Hospital's chronic programme and lead of telemedicine, added that about 10 per cent of the hospital's patients have opted for telemedicine.

• The Straits Times Online, 19 April 2021

Telemedicine use continues in Singapore even as COVID-19 outbreak is under control

​IHIS data captured that during COVID last year, telemedicine numbers had been on the rise.  The report captured that the National University Health System (NUHS), which conducts more than 3,000 specialist outpatient and allied health teleconsultations each month, plans to expand its telehealth service to more patients, said group chief digital officer Peter Forbes. Teleconsultations, via video or phone calls, are now only offered for repeat visits, and the level of physical assessment needed is one of the considerations when selecting patients for telehealth, he noted. NUHS is working on videos to help patients use its telemedicine service, added Mr Forbes. Dr Teng Gim Gee, the head of Alexandra Hospital's chronic programme and lead of telemedicine, added that about 10 per cent of the hospital's patients have opted for telemedicine.

Nurses reflect on their experiences in new book

A new book, Missy Reflections, was launched by AH yesterday. Featuring 61 reflections from 55 nurses, AH nurses conceived, wrote and edited the book while the hospital’s medical board chairman, Associate Professor Khoo See Meng, provided the illustrations.
 
The book’s creation was led by chief nurse Margaret Lee. She said, “As nurses, we are in a privileged position to connect with people from all walks of life in the course of our work. Lessons come alive in our practice environment through the patients we care for, the caregivers we support and the colleagues from all job groups we collaborate with in the service of health and healthcare.” Ms Lee hopes the book will allow the public to understand more about the nursing profession.
 
A recovered Covid-19 patient, who wished to be known only as Mr Ng, presented a bouquet of sunflowers to Ms Lee at the book’s launch. Mr Ng recalled that when he was at AH between mid-February and early March last year, the nurses would sit outside the wards to ensure that patients did not fall when they got up at night. Some of the nurses would do this even during their break time. “To me, this image is the strongest… and I think that speaks volumes of their care and love for the patients.”
 
AH chief executive Jason Phua said at the book’s launch, “They say heroes come in capes. I say heroes come in nursing scrubs.”

mRNA vaccines best at protecting against variants

Straits Times quoted A/Prof David Allen, NUS Medicine, who presented findings on the mRNA COVID-19 vaccines at the monthly webinar, "COVID-19 Season 2: Update from Singapore" on 25 March 2021. A/Prof Allen explained that the success of mRNA vaccines is likely due to the high levels of antibody and T-cell response they induce in the body.

The webinar brought together local and international experts to discuss the latest medical and scientific findings around the coronavirus and it was hosted by A/Prof Allen along with Prof Dale Fisher, Group Director of Medicine, NUHS, and Dr Louisa Sun, Associate Consultant for the infectious diseases team at NUH and AH.

• The Straits Times, 29 March 2021
• The New Paper, 29 March 2021

Hurting the hands that heal: Cases of abuse, harassment of public healthcare workers on the rise

In an online article following Min’s comment on the uptrend of abuses of HCWs in Parliament recently, SNC Pauline Chong of AH was quoted. She said, “Nurses under such circumstances may feel discouraged and down when they encounter such patients,” she added, noting that it is important during induction and refresher training to educate nurses on psychology and human behaviours.”
 
Ms Chong added that AH makes the distinction between patients who are angry, aggressive and depressed and those who are mentally ill, under stress or experiencing anxiety.”

Reinfection possible as immunity wanes over time: Experts

Experts whom ST spoke to shared that those who have recovered from COVID-19 can get re-infected as immunity gained against the virus can wane over time. However, this is difficult to predict as each person’s antibody levels and longevity of the antibodies can also differ from person to person. This view was supported by Prof Teo Yik Ying, Dean of SSHSPH, and Prof Dale Fisher, Senior Consultant, NUH Division of Infectious Diseases and NUS Yong Loo Lin School of Medicine. A/Prof Alex Cook, Vice Dean of Research, NUS Saw Swee Hock School of Public Health, further added that this does not substantially change the core strategy to contain COVID-19 and people should continue to adhere to public health measures.
 
In a separate article, Lianhe Zaobao quoted Dr Louisa Sun, Infectious Diseases Associate Consultant at Alexandra Hospital, who said that reinfection is rare, but all viruses mutate naturally, and the current strain of Covid-19 may have mutated from the peak of the virus last year. She added that the current safe management measures should be exercised to prevent reinfection.