Challenges encountered
Setting up the isolation area was challenging. The department had to
take into account the flow of patients through the centre, whilst
ensuring segregation of other patients from those requiring isolation.
The centre was able to achieve this with no impact on UOGC services and
without having to create makeshift temporary clinics.
Response to an evolving outbreak is dynamic and the UOGC isolation team
has to be quick to adapt to the latest recommendations by the hospital
and MOH. Figure B illustrates the timeline of changes implemented in
UOGC. Our team works closely with the ID department, and regularly
reviews and revises our protocols.
One of the difficulties encountered was false declarations made by
patients at triage. This compromises the safety of our staff and other
patients. Patients are forewarned of the consequences of false
declaration, which may lead to prosecution under the Infectious Disease
Act [9] prior to signing it. Patients found to
have breached Stay Home Notice or made false declarations were reported
to the relevant government authorities.
The welfare of the isolation team is a key priority for our department.
Stress and fatigue from working in the frontlines for extended shift
hours are inevitable [10]. Dedicated en-suite call
rooms are allocated to the isolation team to avoid cross contamination
with the regular on-call team. Unwell staff are encouraged to seek
medical attention and given medical leave. Doctors are granted dedicated
rest following their week-long service. The hospital instituted a
dedicated phone line for staff requiring mental and emotional support.
Senior doctors took on shared workload to reduce manpower fatigue
amongst the juniors. Regular feedback is gathered to optimise working
conditions and streamline the workflow. The isolation team has received
strong support from members of the public via letters of encouragement
and gifts of gratitude.