How are our hospitals coping with the pandemic? |

Covid endemic hospital Singapore
Image by mohamed Hassan from Pixabay

With social gatherings and dining-in being limited to a maximum of two people – among a slew of measures – implemented for the next month from yesterday (Sep 27), it has thrown a spanner in the works for Singapore’s transition to living with an “endemic” Covid-19.

Many people are confused and perplexed about the ever-changing (safe-distancing) rules and messaging surrounding Covid-19. If it’s going to be endemic, shouldn’t we be opening up instead of closing off? Some people have also been critical of the number of deaths in the wake of accepting the disease as endemic.

It’s a tough balance to take between ensuring public safety and managing the effect of a long-term lockdown, but the main messaging is that the public should take on more personal responsibility in ensuring not just their own health, but also those that live with them.

Hear from the hospital frontliners

You may have read the news about how the latest strategy is to get those with mild or no symptoms to self-isolate at home. According to the latest data, 95% of cases reported daily are either asymptomatic or mild. Since they don’t require hospital care, it would be better for them to self-isolate to relieve the burden of Singapore’s hospitals, allowing them to focus on seriously ill patients – not just for those suffering from Covid-19, but also those needing hospital care for every other ailment. 

So how are our hospitals coping with our current numbers? On September 23, a Reddit thread by “haisufu” asking healthcare workers for the situation on the ground is sobering. 

Redditor PartTimeBomoh says: “Our healthcare system functioning at the brink of capacity is something that has been going on since before COVID. If you wonder about what is happening now, everyday it seems there is a new white tent open.”

“The usual load is there, but this 1k+ COVID cases a day is real. This is not an imaginary thing, this is a huge additional burden added on the existing strain which was already at its limit. We are functioning now on 120% capacity all on the goodwill of healthcare workers.”

Judging from numerous posts, hospital occupancy rate is in the high 90% mark, with some hitting 120% over the last few weeks, according to Redditor denkidoggo. Some hospitals have had to open new wards every week to keep up with case numbers, with the risk of running out of manpower or compromising on other services, according to user Xethrion, who says, “I’ve heard that things in other hospitals are even more dire, with them resorting to lodging two or three patients in what was supposed to be a single bedded isolation room, just to keep up with demand.”

It’s not just the influx of patients that’s keeping our healthcare frontliners overworked – the number of healthcare workers going on MC for testing positive also add to the burden. In addition, they have to work in truly uncomfortable situations: donning restrictive N95 masks, goggles, and the full PPE gear every day to attend to patients takes a toll on them too. 

Redditor repressednomoreok says, “Just for my morning shift today, we had 4 staff on MC. We don’t even have time to use the toilet or have proper meals. Heck, we haven’t gotten a proper break from 2020… and here we are in 2021… either our annual leave gets cancelled or we are being told to come back and work during our day off due to the lack of manpower… healthcare system is always understaffed, underpaid, undervalued and with Covid around, it just makes things so much worse.”

According to user vancomyxin who’s a nurse at NCID: “One nurse is taking 6-8 patients while juggling both staff nurse work and junior work, hardly have the time to go for a break or even toilet breaks.”

When it comes to the situation at the A&E department, there seems to be a curious trend. Redditor Due_Engineering6144 says that “many patients come in for bicycle/sport related injuries” – this could be related to the fact that travelling overseas is difficult, so people pick up other hobbies for their R&R.

Don’t go to the hospital unless it’s an emergency

Other reasons cited by healthcare workers for the high capacity at hospitals is that people come in for cases that could be handled by GPs.

Healthcare workers are concerned that the hospitals are flooded with “many paranoid ppl coming for post vaccination related illnesses which honestly can be seen by your GP instead of flooding emergency” (Due_Engineering6144). User mnwe810 who’s a nurse added: “if you are in the AnE and can walk/complain about the long wait, you probably don’t belong there. Please go to GP or polyclinic first.”

Fellow healthcare worker Shaooooo echoed: “Please don’t go to the hospital for things you can handle at home or can wait to go to the GP or polyclinic. You’re exposing yourself and also increasing the load on the entire hospital.”

While everyone is anxious with everything that’s going on at the moment, we also need to keep in mind that healthcare workers need our compassion. We all have to do our part to help ease the burden on our healthcare workers, who are working harder than anyone right now. 

“We are really overworked, and don’t have time to keep picking up calls especially when most of the time family members are requesting for daily updates from doctors, and please don’t verbally abuse us for something out of our control. Doctors are also extremely overworked, and have so many patients,” adds nurse mnwe810.

As it stands, Singapore is bolstering its hospital capacity to cope with a possible surge to more than 5,000 daily cases. To cope with the influx of Covid-19 patients, the authorities plan to have up to 1,600 hospital beds if needed, up from the 1,000 previously planned, with almost 300 ICU beds that can be available at short notice.

But even in a best case scenario – even if we do have the manpower to support the influx of ICU cases – should we really do that? With exhausted workers, there’s bound to be some repercussions. 

Be responsible, ease the burden of our healthcare workers

To ease the burden on our healthcare system, experts agree that the messaging surrounding Covid-19 as a deadly disease needs to change – that the vaccinated should treat it as something that’s manageable, and that they should be accountable for their own actions should they test positive. This includes self-isolation and the monitoring of their own conditions at home, rather than going to the hospital as the first course of action (unless their symptoms are severe).

Kenneth Mak of the Ministry of Health (MOH), said on Friday that about 40% of the infected are recovering at home and between 15-20% are at hospitals – the rest are at community care facilities. 

As we’ve seen in New Zealand’s case, locking down would no longer be effective since there’s no way to eliminate the Covid-19 virus. The current surge of cases reminds us not to be complacent, and to not underestimate the virus. Despite Singapore’s safe management measures, the Delta variant is driving up daily cases much more quickly than many expected, as it has the ability to mutate to ensure its own survival.

Regardless of what the public messaging is, at the end of the day, it’s up to all of us to take necessary precautions to prevent ourselves from being infected. While it may be asymptomatic or mild for most of the vaccinated, one can’t discount the effects of long Covid, or the fact that we could unknowingly infect an older person who could get seriously ill. 

Before we complain about another CB or HA, spare a thought for the vulnerable, and our healthcare workers who are working hard to take care of all their patients.