Covid-19 heroes get a boost

​In an ST report on local initiatives that recognise health workers, it was mentioned that more than 25,000 healthcare workers from 11 healthcare institutions including National University Hospital and Tan Tock Seng Hospital have been given complimentary one-year membership to the Fuzzie Corporate Club, which offers discounts and privileges from over 600 brands in Singapore. Dr Janice Lam, Consultant, Department of Ophthalmology, National University Hospital, said that it is a useful and meaningful gift to healthcare workers, and the special perks boost healthcare workers’ morale. The report also carried a photo of Alexandra Hospital healthcare workers with their care packs.

用药学问大 遵医嘱服药可降并发症风险 (Importance of medication adherence and the benefits of Pharmacy Outreach)

​Ng Teng Fong General Hospital and Alexandra Hospital pharmacists jointly participated in this interview featuring medicine reconciliation and pharmacy outreach programmes.  Good medicine adherence and management can prevent complications such as stroke, heart failure and kidney failure. Poor adherence to medications may increase the risk of such complications occurring. The article also discussed polypharmacy and how prevalent it is with seniors.  There are also tips dished out by pharmacists on how one can take charge of one’s medication.

专家：通过疫苗达群体免疫已不实际 与冠病共存我国须以三类措施三步防疫 (Experts: No longer practical to achieve herd immunity through immunisation, Singapore must adopt three measures in three phases to co-exist with COVID-19)

​A review article written by a group of authors including A/Prof Vernon Lee, Director of Communicable Diseases, MOH, Prof Teo Yik Ying, Dean of NUS Saw Swee Hock School of Public Health and A/Prof Alex Cook, Vice-Dean of Research, NUS Saw Swee Hock School of Public Health, highlighted that the endemic state for COVID-19 is attainable with vaccination and staggered relaxation of safety prevention measures. The article was published in the August issue of the Annals, an official medical journal of the Academy of Medicine, Singapore.

Prof Dale Fisher, Senior Consultant, Division of Infectious Diseases, National University Hospital, noted that many patients with COVID-19 are asymptomatic and people may eventually treat it the same way as flu and dengue fever, where no large-scale testing would be conducted to detect cases.

专家：若重症患者人数稳定 则无须担心确诊人数增加 (Experts: No need to worry about increase in COVID-19 cases as long as the number of severely ill patients is stable

On the constant high number of community cases, Prof Teo Yik Ying, Dean of NUS Saw Swee Hock School of Public Health (SSHSPH) opined that the situation is a new norm signifying COVID-19 becoming an endemic disease. Prof Teo said that while the number of cases has increased, the number of severely ill patients in ICU has remained stable, similar to other countries with high vaccination rates, such as Israel, United States and the United Kingdom.

Dr Louisa Sun, Consultant at the Infectious Diseases and Chronic Programme at Alexandra Hospital, opined that the rise in number of cases was expected and believed that the number of patients with severe medical complications could be kept under control as the vaccination rate in Singapore continues to rise. She also noted that the endemic new norm should not stop the public from observing COVID-19 measures.

Niat bantu pesakit atasi sebab-sebab lain (Patient care remains priority)

​Nia Nasyitah Binte Zulkifli (Senior Radiographer, Radiology, Ng Teng Fong General Hospital) explained that she understood the uniform policy when she joined the healthcare industry five years ago. She believes that with the revised policy where Muslim nurses in the public healthcare sector will be allowed to wear tudungs with their uniforms if they wish to, there will be a greater representation of Muslim females in the healthcare sector. She also feels that the tudung will not hinder healthcare workers in their care for patients.

Nur Shafawati Kamsani (Senior Physiotherapist, Alexandra Hospital) said of the tudung policy, "Allowing tudung to add on with our uniform reflect an inclusive workforce which opens doors of opportunities and options for young Muslim women to pursue a career in healthcare."

• Berita Harian, 4 September 2021, Pastikan tugas pekerja jagaan kesihatan tidak terjejas

专家：接种者虽可传播病毒 疫苗仍显著减少死亡及重症 (Experts: Vaccine significantly reduces death and serious illness although vaccinated individuals can still spread virus)

​Lianhe Zabao quoted Prof Dale Fisher, Senior Consultant, Division of Infectious Diseases, National University Hospital (NUH) who commented that the world is now facing a third wave of pandemic. During the last two waves, there was a strong correlation between the infection rate and the mortality rate. For the current third wave, countries with low vaccination rates are experiencing the same situation and while those with high vaccination rates have significantly lower mortality rates.

专家：冠病轻症者回家休养 可减轻医院负担但社区风险待估 (Experts: Mild COVID-19 cases recovering at home can ease hospitals’ burden but its social risk remains to be seen)

Ministry of Health (MOH) announced recently the pilot plan of allowing some COVID-19 patients with mild symptoms to stay in the hospital for a few days before being allowed to be quarantined at home until they recovered. Lianhe Zaobao quoted Prof Teo Yik Ying, Dean of NUS Saw Swee Hock School of Public Health (SSHSPH), who commented that the risk in this plan is that the family members of the infected may also get the virus, but if the whole family is vaccinated, the risk will be greatly reduced.

Dr Louisa Sun, Consultant of Infectious Diseases and Chronic Programme at AH, said that if there are many family members sharing a bedroom, bathroom or dining room, that would not be an ideal isolation environment.

我国本月有九死例 专家：死者很可能感染德尔塔毒株 (Experts: Nine deaths this month – likely to be infected with Delta strain)

​Lianhe Zaobao quoted Prof Teo Yik Ying, Dean of NUS Saw Swee Hock School of Public Health, who commented that most of the death cases were older people who had not been vaccinated, and this could serve as a warning to others to get vaccinated. Prof Tan warned that elderly with other conditions should strictly follow precautionary measures after vaccination. This includes mask-wearing, hand washing and avoiding crowds. Prof Tan emphasised that vaccination only serves as a layer of protection and it must be combined with other prevention measures to truly protect everyone.

Dr Louisa Sun, Consultant of Infectious Diseases and Chronic Programme at Alexandra Hospital, said that while the Delta strain has a higher rate of hospitalisation, severe illness or even death, it largely depends on the patient’s age and medical history.

Hospital di sini sedia tampung kes ICU (Hospitals here are ready to accommodate ICU cases)

On whether hospitals in Singapore have the capacity to accommodate intensive care for the rising number of severe COVID-19 cases, Prof Dale Fisher, Senior Consultant, Division of Infectious Diseases, National University Hospital, said hospitals here have measures to deal with the potential surge in high-risk or serious cases. They involve managing the beds for these patients, the supply of personal protective equipment, ventilators and drugs, as well as the staff needed to care for them.

 At Alexandra Hospital, two wards were turned into COVID-19 wards between late April and last month. Alexandra Hospital Chief Operating Officer, Mr Jeffrey Chun said the hospital will also renovate a general ward early next year to equip it with negative pressure rooms that can be quickly turned into intensive care unit (ICU) rooms for COVID-19 patients. Dr Liew Mei Fong, Director of Alexandra Hospital's ICU said this is to accommodate more medical equipment that is essential in the care of COVID-19 patients. She added that ICU doctors have completed intensive care medicine training, on top of their own speciality training, while the ICU nurses have also undergone specialised training.

Pengorbanan jururawat sepanjang pandemic (The sacrifices of nurses throughout the pandemic)

Nurses are frontline workers who have sacrificed a lot in their duties throughout the pandemic. Although Singapore celebrated Nurses' Day on 1 August, Berita Harian tells its readers that nurses should continue to be appreciated, no matter the time, for their contributions and the huge roles they play.

The paper highlights the stories of two nurses who share their extensive experience of serving in healthcare, including Syairah Mohd Reduan, a community nurse at National University Health System CareHub and Nur Syahidah Rahmat, a senior staff nurse at Alexandra Hospital's Intensive Care Unit.

"Perhaps before this pandemic, many had the impression that nursing was a low-skilled job. But I am confident in what I am doing and my contributions," shared CareHub's Syairah, a mother of three with nine years of nursing experience.

 When Covid-19 struck last year, Alexandra Hospital's Syahidah stepped up to be deployed to the Intensive Care Unit at the National Centre for Infectious Diseases for four months. Being a nurse in the field of critical care, according to Syahidah, requires diligence, and one cannot be too emotional even when a patient dies. Instead, one needs to stay motivated and focus on other patients in order to help them recover.

• Berita Harian, 14 August 2021, Page 6, Profile on Syairah Mohd Reduan
• Berita Harian, 14 August 2021, Page 6, Profile on Nur Syahidah Rahmat

Singapore’s ICU capacity not likely to be exhausted, says expert

​Serious Covid-19 cases are unlikely to overwhelm intensive care unit (ICU) capacity in Singapore, as hospitals here work to strike a balance between the needs of severe coronavirus cases and other critical care patients.

Health Minister Ong Ye Kung also reassured the public, saying that up to 1,000 ICU beds can be made available for critically ill Covid-19 patients if needed.

At Alexandra Hospital (AH), two wards were turned into Covid-19 wards between late April and last month. Its chief operating officer Jeffrey Chun said it is a "tight balancing act" of ensuring enough beds for Covid-19 patients while making sure that other patients have access to the care they need. He also said the hospital will also renovate a general ward early next year to equip it with negative pressure rooms that can be quickly turned into ICU rooms for Covid-19 patients.

Dr Liew Mei Fong, director of the hospital's ICU, said: "There will be provisions for more equipment such as mechanical ventilators, invasive monitors, continuous cardiac monitoring and dialysis machines, to name a few." She said ICU doctors have completed intensive care medicine training, on top of their own speciality training. Nurses in the ICU also undergo specialised training.

The Straits Times cited Prof Dale Fisher, Senior Consultant, Division of Infectious Diseases, National University Hospital, who said that hospitals have measures to deal with the potential surge in high-risk or serious cases. They involve managing the beds for these patients, the supply of personal protective equipment, ventilators and drugs, as well as the staff needed to care for them. He also highlighted the vaccination rate in Singapore which is 73 per cent as of 11 August, as fully vaccinated people are less likely to fall seriously ill. He added that hospitals can make some predictions by seeing the number of elderly unvaccinated patients with mild disease, and if any of the indicators reach concerning levels, the country could see strengthened community measures.

• The New Paper, 13 August 2021, Page 2, ICU capacity here not likely to be exhausted, says expert

Thinner crowds at hospitals as visitor ban kicks in

On the first day of the barring of visits to hospital wards islandwide, crowds were seen at several local hospitals but most of the people were there for outpatient treatment.  NUHS said its hospitals have tightened measures for all patients, visitors, caregivers and accompanying individuals. Caregivers and those accompanying them are required to keep their visits short, and are not allowed to eat or drink in the wards, among other rules. Report added four patient groups are exempted on a case-by-case basis from the rules barring visitors. They include patients who are very ill, babies or children, and mothers due to give birth or who have given birth. Patients who require additional support from caregivers – such as those who have mental incapacities and family members undergoing caregiving training – will also be exempted, but limited to one visitor each day for no more than 30 minutes at the patient’s bedside.

A 'change agent' who has widened role of nurses

Three NUHS nurses – Ms Margaret Lee Kwee Hiang, Chief Nurse at Alexandra Hospital (AH), Ms Katherine Leong Shiao Peng, Assistant Director of Nursing and Advanced Practice Nurse (APN), Khoo Teck Puat - National University Children's Medical Institute (KTP-NUCMI), National University Hospital (NUH), and Dr Shefaly Shorey, Assistant Professor at the NUS Alice Lee Centre for Nursing Studies – received the President's Award for Nurses from President Halimah Yacob at a virtual award ceremony yesterday.

Described as a change agent in healthcare leadership in The Straits Times, CN Margaret started a system at AH that allows nurses to take the lead in caring for certain groups of patients, such as those who are undergoing certain treatments, those in rehabilitation, and patients who are almost ready to be discharged. She commented to CNA Digital that nurses have strong support from doctors and allied health colleagues partnering them in this unique model of care. Last year, when Covid-19 measures led to restrictions in hospital visitorship, the mostly elderly patients at AH were left without caregivers by their side. CN Margaret is now piloting a project in which caregivers are involved in the patient's hospital care.

In an interview with CNA, Dr Shorey, the first university academic to win the award, shared more about the "Train-the-Trainer" programme to educate nurses in vaccine administration and standardise practices for the nation's vaccination roll out. Dr Shorey also champions research in parenting and children's health.

The New Paper featured ADoN Leong, Singapore's first paediatric-APN working in oncology, who said that she is honoured and she would receive the award on behalf of all nurses in Singapore, who are in the same mission together. 8world highlighted that she bonds well with her patients and their caregivers who would treat her as family and send her Mothers' Day greetings. One of her previous patients was inspired by the care that she received and became her nursing colleague.

• The Straits Times Online, 14 July 2021
• Channel NewsAsia, 14 July 2021
• Channel NewsAsia, Singapore Tonight, 14 July 2021
• Channel NewsAsia, 15 July 2021
• The New Paper, 15 July 2021, Page 13, Nurses who leads by example
• Mediacorp 8world, 14 July 2021
• Berita Mediacorp, 14 July 2021

Over half of seniors polled unlikely to use telemedicine

A survey by the Singapore Eye Research Institute (Seri) during the circuit breaker last year found that about 55 per cent of 520 people aged 60 and above were unlikely to use digital medical services if the Covid-19 pandemic continues. Although half the respondents agreed that telemedicine would be helpful in reducing non-essential contact in clinics and hospitals, 77 per cent of them said they were uncomfortable with artificial intelligence (AI) interpreting their medical results.

Seeking healthcare online has become a more well-known option as a result of the pandemic. In May alone, more than 8,000 teleconsultations were done by institutions under the National University Health System (NUHS), said Mr Peter Forbes, NUHS' group chief digital officer.

Telemedicine is not just limited to video consultations with doctors, phone calls, chatbots and AI. Physiotherapy, rehabilitation, and even audiology services are being done over Zoom.

For instance, Ng Teng Fong General Hospital's audiology department offers tele-audiology services, which include connecting to a patient via a video call, and connecting to the patient's hearing device so that the audiologist can adjust the patient's hearing aid remotely.

Dr Gary Lee, the hospital's head of audiology, said patients aged 60 and above were seven times less likely to opt for tele-audiology sessions compared with younger patients: "The most commonly cited reasons include tele-audiology features being too complicated, the lack of technological skills and a general preference for face-to-face consultations.

But Dr Lee observed that live demos in the hospital or clinic and technical support from caregivers make elderly patients feel more comfortable to use tele-audiology in follow-up sessions.

Dr Teng Gim Gee, head of Alexandra Hospital's chronic programme, said digital platforms or apps can be designed with older patients in mind, so that they will be more receptive to telemedicine: "(These include) ease of access, intuitive design, larger font size, and simplifying the steps needed. For example, many have problems turning on audio upon launching Zoom."

• The New Paper Online, 5 July 2021

本地社区疫情虽受控 专家：公众仍须保持谨慎 (Even as community transmission of Covid-19 remains under control, experts advise caution)

Community cases of Covid-19 have remained in the single-digits over the past five days, while unlinked cases have been decreasing steadily – experts say these signs indicate that the pandemic is effectively under control.

Dr Louisa Sun, Consultant of Infectious Diseases and Chronic Programme at Alexandra Hospital, says this is to be expected with the government carefully easing safe management measures in phases. However, she said it is too early to celebrate and that everyone should continue to be vigilant to prevent another major outbreak of infection.

Prof Teo Yik Ying, Dean of NUS Saw Swee Hock School of Public Health (SSHSPH), commented that most of the COVID-19 cases for the past two months were due to the more infectious Delta variant strain, therefore the public should continue to remain vigilant. He explained that there are bound to be some hidden cases in the community, especially in the context of steadily increasing vaccine coverage, where many vaccinated people will not display obvious symptoms.