INTRODUCTION
The Coronavirus Disease 2019 (COVID-19) outbreak which was first
reported in Wuhan, China, was declared by the World Health Organization
to be a Public Health Emergency of International Concern on January 30,
2020, and a pandemic on March 11, 2020.1
In Singapore, the first case of human COVID-19 infection was reported on
January 23, 2020. Singapore has a land area of
721.5km2 and is served by less than 20 acute
hospitals. As of March 31, 2020, this small city-state with a population
of 5.6 million, has a total of 926 confirmed cases.2
Rapidly accumulating anecdotal reports from China identify
otolaryngologists as high-risk healthcare workers (HCW) who are more
susceptible to the COVID-19 infection due to the anatomy we
treat.3,4 The first documented physician death due to
COVID-19 nosocomial infection, on January 25, 2020, was that of an
otolaryngologist in Wuhan.5
We report the adaptations of Singapore’s largest tertiary
Otorhinolaryngology – Head and Neck Surgery department in preserving
operationality while navigating the heightened risks during this
outbreak. This was carried out via a four-pronged approach, taking into
consideration our experience from the Severe Acute Respiratory Syndrome
(SARS) outbreak in 2003. Temporal adaptations were implemented as we
continually gain understanding of the disease.