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.