Bracing for impact: operational upshots from the National Centre for Infectious Diseases Screening Centre (Singapore) during the COVID‐19 outbreak

Abstract

To combat the ongoing COVID‐19 pandemic, Singapore has adopted a rigorous screening approach that involves aggressive contact tracing, rapid isolation of confirmed or suspect cases, and immediate ring‐fencing of emerging local clusters and hotspots. Our screening centre team has been involved in running Singapore's designated screening centre since the end of January this year. With a well‐defined blueprint and substantial pre‐outbreak preparatory work, initial operations at our screening centre commenced within a day on activation and full operational status was attained in 3 days. As of 8 April 2020, the screening centre had screened more than 14,000 patients. We have adopted a “whole‐of‐hospital” approach, enlisting the help from other departments and subspecialties to augment manpower. Meticulous infrastructure planning to facilitate patient flow and strict measures to prevent nosocomial transmission and occupational exposure were instituted to safeguard both the staff and patients. This paper aims to describe our key takeaways in the course of operations and discuss the challenges encountered.

The chronicles of COVID

“…The strongest associations were found to be travel and known contact. In “Patient Factors Associated With SARS‐CoV‐2 in an Admitted Emergency Department Population,” Haimovich et al 3 had similar findings in a review of their patients in Connecticut, but also noted an association with hypoxia, increasing age, fever, and anemia.…”

“…This brief commentary is intended to accompany the journal's podcast on several articles. [1][2][3][4][5][6][7][8][9] The 2019 novel coronavirus (COVID-19) has occupied most of our personal and professional lives this year. This August edition of the journal has 9 contributions about the pandemic and our colleagues' Collectively, the 9 articles in the August edition of JACEP Open provide a broad description of both the COVID epidemiology and the health care response.…”

Dynamic emergency department response to the evolving COVID‐19 pandemic: the experience of a tertiary hospital in Singapore

“…Before this, these cases were received at the National Centre for Infectious Diseases (NCID), a purpose-built facility that had been designated to lead the national response. 7,13 At that point in time, NCID was screening 100-200 patients a day with the numbers steadily increasing. Plans were thus made for our ED to accommodate the diverted patient flow, which approximated 30-40 patients a day.…”

“…On March 20, 2020, as part of the national containment response, our hospital was tasked with receiving COVID‐19 suspect cases referred from primary care and transported by a dedicated ambulance service. Before this, these cases were received at the National Centre for Infectious Diseases (NCID), a purpose‐built facility that had been designated to lead the national response 7,13 . At that point in time, NCID was screening 100–200 patients a day with the numbers steadily increasing.…”

“…We also describe the challenges faced in rapidly converting various patient areas to support higher-acuity care. As of the time of writing, although multiple studies have described their institution's ED response to COVID-19 at various timepoints, 4,[6][7][8] to the best of our knowledge, an overall multiphased ED response guided by evolving COVID- 19 epidemiology has yet to be described in the peer-reviewed literature.…”