UPDATE ON HOSPITALS’ CAPACITY AND MANPOWER SITUATION IN MANAGING THE COVID-19 SURGE

The Ministry of Health (MOH) continues to support our hospitals to expand bed and manpower capacity and to stand up more COVID-19 Treatment Facilities (CTFs), in order to handle the larger number of community cases. This will allow us to stay on course in the Stabilisation Phase to achieve COVID-19 resiliency as a nation.

2. Community infections have been around 3,000 a day for the past few days.  The doubling time has slowed, from 6 to 8 days three weeks ago to about 10 to 12 days now. Nevertheless, the large daily numbers have placed significant strain on our healthcare system. Our healthcare workers – who have now been stretched for almost two years – are bearing the brunt of the burden. If not for our high vaccination rates, the workload of our healthcare workers would have been many times heavier.

Update on the Hospital Situation

3. The majority of COVID-19 patients (98.4%) continue to be asymptomatic or report mild symptoms. Only a small percentage require oxygen supplementation in a hospital (1.3%) or intensive care unit (ICU) care (0.1%). Currently, around 7% of COVID-19 patients are admitted into hospitals because of more severe symptoms or pre-existing medical risks which require close observation. As a result, about 20% of hospital beds in acute and community public hospitals are taken up by COVID-19 patients.

4. ICU beds are disproportionately occupied by seniors 60 years and older who are unvaccinated or only partially vaccinated. They represent 1.5% of our total population, but currently account for two-thirds of the patients requiring ICU care.  The occupancy of critically ill cases in ICU was 23.5% yesterday.
 
5. The occupancy for COVID-19 isolation beds has risen from 62% in July 2021 to 85% for October 2021, despite our efforts to set aside more beds. Over the past three months, the number of patients seeking medical attention at the Emergency Departments (EDs) after testing positive for COVID-19 has increased by eight times. Many of them were admitted, mostly for precautionary observation.

6. Consequently, the waiting time at public hospitals from the EDs to admission for non-COVID patients has increased by 34% from July 2021 to September 2021. This is in part due to the lower number of beds now available for non-COVID patients.

Continued Efforts to Ramp Up Bed Capacity and Healthcare Manpower

7. To cope with the increase in cases, MOH has been proactively working with public, community and private hospitals to set aside more beds for COVID-19 patients. The number of COVID-19 beds has increased from 900 to 2,500 over the last three months. Of these, about 170 are ICU beds, and another 100 can be stood up to handle ICU cases at short notice. At the same time, hospitals have been asked to prioritise resources for COVID-19 patients by reducing less urgent surgeries and appointments. Our hospitals have thus cut down on non-urgent and non-life threatening care, deferring about 20% of their total regular load, to alleviate the pressure on their capacity and manpower.

8. A key resource constraint we now face is our healthcare manpower. Our public healthcare institutions and private healthcare providers have redeployed existing staff and recruited additional short-term manpower to ramp-up beds. We are also bringing in more manpower by reaching out to individuals registered with the Singapore Healthcare Corps, including both healthcare professionals and laypersons. We have also approached nurses who are registered with the Singapore Nursing Board but who are currently not in active practice.

9. The response has been encouraging. About 900 individuals of all ages have stepped forward in response to our call to duty. We are progressively referring them to the public hospitals to match them with suitable roles, based on the institution’s needs and the individual’s experience and availability. The possible deployments vary across institutions and care settings, and include being deployed to the additional COVID-19 facilities that we have stood up, such as the CTFs.

10. We thank all who have signed up. Those who are interested can visit go.gov.sg/shc-covidops to contribute to our nation’s fight against COVID-19.

Ensuring the Long Term Sustainability of the Healthcare System

11. Given our high vaccination rates of over 83% who have now completed their primary series, and with over 98% of COVID-19 infected individuals recovering with no or mild symptoms, home recovery is a safe and suitable model to right-site the care management of most COVID-19 cases. Therefore the Home Recovery Programme (HRP) has become the default care management protocol for many patients.

12. However, the continued rise in cases will most likely mean a correspondingly growing number of infected persons, especially among the vulnerable elderly who will need some level of hospital or CTF care. To make best use of our hospital facilities and beds, we have been admitting those who are stable but require closer monitoring (because of their advanced age or underlying medical conditions) to CTFs where their care and close monitoring needs will be better met.

13. We have stood up five CTFs over the past two weeks; Bright Vision Hospital, NTUC Health Nursing Home (Tampines), Connect@Changi, Oasia Hotel@Novena and part of Yishun Community Hospital. Together, the five CTFs currently have over 1,200 beds. Private operators have been commissioned to run some of the CTFs or ramp up their existing infrastructure to be CTFs. We are on track to add on 2,500 more beds by the end of the month, bringing our total CTF capacity to 3,700 beds.

14. As MOH continues to adjust our protocols and further strengthen our support for those on HRP, we strongly urge those who have non-emergency conditions to avoid seeking treatment at the hospitals and to consult their own family doctor or General Practitioner (GP) instead. Those who are asymptomatic but are concerned they may be infected with COVID-19 can perform their own ART self-test, and self-isolate for 72 hours if their ART test result is positive. This allows those with more severe illnesses and who are in need of emergency care to be attended to quickly and helps to preserve our hospital capacity for those who truly need acute hospital care.

Continued Commitment to Providing Appropriate Medical Care to Patients 

15. We urge Singaporeans to play your part to protect the healthcare system and help lighten the burden now placed on our healthcare workers. All of us need to be socially responsible to take care of ourselves and others around us through vaccination, regular testing and adherence to isolation protocols where needed. Continued adherence to our Safe Management Measures will also dampen the rate of transmission and keep the number of new cases at a manageable level. We urge those who are eligible for their booster vaccination dose to get it as soon as they become eligible.

16. We assure all Singaporeans that everyone who requires medical care, whether for COVID-19 or other conditions, will continue to receive appropriate care even as we do our best to overcome the challenges arising from this current wave of COVID-19 infections.