TIGHTENED MEASURES TO REDUCE HOSPITAL COVID-19 TRANSMISSION AND PRESERVE HOSPITAL CAPACITY

With the rise in COVID-19 cases in the community, more COVID-19 cases have been detected amongst hospital staff, patients, and visitors. The detection of these cases had led to ward closures and staff quarantine which had impacted some hospitals, putting a strain on hospital bed capacity and staffing at a time when more hospital beds are ramped up to care for hospitalised COVID-19 patients. To safeguard hospital capacity, the Ministry of Health (MOH) will introduce tightened measures at all public, community and private hospitals from 24 September 2021. We seek the understanding and cooperation of patients, their family members and loved ones as we work to safeguard them and hospital staff and reduce the risk of COVID-19 transmission in our healthcare institutions.

Visitor Management Measures

2. All visitations to hospital wards¹ will be suspended for a period of four weeks, from 24 September to 23 October 2021 (both dates inclusive). However, the following patient groups will be allowed visitation on a case-by case basis, as assessed by the hospital: 

a. Patients who are in critical condition; 
b. Paediatric patients;
c. Birthing/post-partum mothers; and 
d. Patients requiring additional care support from caregivers. Examples include assistance of inpatients who have mental incapacities or family members who are undergoing caregiver training to better care for their loved ones after hospital discharge. 

3. The above patient groups would be allowed only one pre-designated visitor, with one visit per day. Patients who are in critical condition may be allowed up to five pre-designated visitors, with a maximum of two visitors at the patient’s bedside at any one time. 

4. All visitors approved to visit will need to produce a valid negative antigen rapid test (ART) or polymerase chain reaction (PCR) test result obtained within the last 24 hours of each visit, as administered or supervised by MOH-approved COVID-19 test providers (including tests performed at Quick Test Centres). This is a mandatory requirement for all visitors, regardless of the individual’s vaccination status, except for persons who have recovered from COVID-19 and are able to present a valid Pre-Event Test (PET) exemption notice².

5. All visitors approved to visit must don face masks with good filtration capability at all times. These include surgical masks and reusable masks that are made of two layers of fabrics. There must be no eating or drinking in the inpatient wards. Visitors must not use the patients’ toilets in the wards and must avoid sitting on patients’ beds.

ART Surveillance Testing For ED Patients 

6. The Emergency departments (ED) of our hospitals are usually crowded.  Currently patients presenting with acute respiratory infection (ARI) symptoms at the hospitals’ ED or 24-hour emergency clinic will be segregated from the other patients. However, with more COVID-19 cases presenting pre-symptomatically or asymptomatically, testing will be needed to reduce the risk of COVID-19 transmission at the ED.

7. From 24 September, the following groups of higher-risk patients, regardless of vaccination status³, will be required to undergo mandatory ART testing at the EDs / 24-hour emergency clinic:

a. Patients who are lodged in ED beds for prolonged observation in the short stay unit or Extended Diagnostic and Treatment Unit (or in the observation bay/wards in the private hospitals); and
b. Patients who are required to undergo mask-off assessment and/or procedures lasting for 15 minutes or more 

Accompanying persons allowed to stay with the patients throughout the observation period (beyond 30 minutes) will also be subjected to the ART test. The government will subsidise the costs of ART for both vaccinated and unvaccinated patients until the end of 2021. Accompanying persons may have to pay for the tests, depending on the hospitals.

8. We urge those who have non-emergency conditions or mild symptoms to avoid seeking treatment at the hospitals and consult a General Practitioner (GP) or Urgent Care Centres instead. For those who are concerned that you may be infected with COVID-19, you may proceed to a Swab and Send Home (SASH) clinic instead. The SASH GPs will assess the severity of your symptoms and perform COVID-19 diagnostic tests when needed to confirm your health status. This will allow patients with more severe illnesses and who require emergency urgent care to be attended to quickly and helps to preserve hospital capacity for those who truly need hospital care.

9. To identify staff with COVID-19 infections early, MOH has also increased surveillance testing frequency for hospital staff, as well as vendors who work in the hospital.

10. MOH will review and calibrate these measures regularly in line with the evolving situation, and we seek the understanding and cooperation of all Singaporeans, as the measures will safeguard our hospital staff and patients and reduce the risk of COVID-19 transmission in our healthcare institutions.

[1] Includes public acute hospitals, community hospitals and private hospitals

[2] Recovered individuals (within last 270 days) can obtain a PET Exemption Notice from any clinic offering ART or PCR testing services.

[3] Patients who had recovered from a previous COVID-19 infection less than 270 days ago would be exempted from the surveillance testing but should be tested by PCR if symptomatic.