The number of Covid-19 patients warded in hospital has been declining in the few weeks as the Covid-19 situation in Singapore stabilised.

Here is a quick look at two key numbers:

May 1: 1,741 patients hospitalised in general wards and 23 patients in the Intensive Care Unit (ICU).

June 12: 239 patients hospitalised and two patients in the ICU.

Frontline nurses returning to non-Covid-19 wards were not isolated or swabbed for Covid-19

With fewer Covid-19 patients in the hospital, some nurses have returned to their original roles while some Covid-19 wards have been been reconverted to its usual operations.

Two nurses, who wish to remain anonymous, wrote to Mothership separately in May and June to share their concerns about their immediate redeployment to non-Covid-19 wards.

Nurse A, who identified herself as a nurse from Tan Tock Seng Hospital (TTSH), said that she was deployed to care for patients at the National Centre for Infectious Disease (NCID).

Nurse B shared similar experiences as Nurse A, saying that the nurses who were previously caring for Covid-19 patients were told to return to their job scopes without any isolation or swab tests.

Accounts & concerns from the nurses

Both nurses were concerned if the protocol put in place currently is sufficient.

A said that TTSH had been "aggressively shifting" their staff from the normal wards to NCID to meet the needs of the rising number of patients from March to May.

Medical workers from various departments were deployed to help at NCID during this period and there was a rotation of doctors and a small group of nurses between NCID and TTSH.

With the decline in the number of Covid-19 patients, a much larger group of nurses has returned to care for patients in the non-Covid-19 wards. These wards include elderly and those with pre-existing conditions.

These nurses were not required to do swab tests or be isolated prior to resuming work at non-Covid-19 wards.

While the medical workers were well protected by the personal protective gears (PPEs), they were previously exposed to the Covid-19 with the interaction they had with Covid-19 patients.

And with hidden cases remain lurking in the community, Nurse A questions if more should be done to ensure that nurses returning to their original duties are certainly clear of Covid-19.

"If the virus can be detected in nursing home staff and preschool educators, what’s the chances of it being detected in us, the nurses who work in Covid-19 unit as well as the non-Covid elderly patients?"

Nurse B revealed that they were previously told not to interact with nurses who are not taking care of Covid-19 patients.

"Our ward manager keeps telling us not to mix or interact between Covid-19 nurses and non-Covid-19 nurses. Then suddenly the ward manager said the protocol is not that strict anymore, you can just go back to clean wards."

Nurse B was quick to add that the wards that were being converted back to non-Covid-19 wards underwent deep cleansing.

TTSH: Our staff do not pose added risk to our community or workplace

In response to queries from Mothership, TTSH said that they appreciate the suggestion of conducting testing for healthcare workers returning from Covid-19 duties.

This was raised in a regular staff dialogue channel as well.

"At TTSH and NCID, the safety and protection of our staff are paramount," TTSH said in their statement.

They also added that the measures taken are "considered and calibrated based on clinical evidence and guidance from the Ministry" and they will conduct regular reviews to make improvements accordingly.

The hospital assured that current measures like wearing PPEs and strict infection control have been effective with high compliance among staff.

It has also put in place "enhanced measures, strict mask-up in all areas, and increased cleaning routines" to keep the environment safe.

With that, TTSH does not require their healthcare workers to be routinely tested for Covid-19.

The staff will however be monitored for their health, temperature and respiratory symptoms.

"Testing will be done based on clinical indication and according to MOH guidelines" and "our staff do not pose added risk to our community or workplace," TTSH stated.

MOH: Selected healthcare workers will need swab tests

The Ministry of Health (MOH) told Mothership that all healthcare workers caring for Covid-19 patients are provided with necessary PPEs and are trained to observe strict infection control practices.

These healthcare workers have to don N95 masks, face shields, disposable gowns and gloves while at work and take a shower and change into clean clothes before leaving the premises when they go off duty.

There are also various precautionary measures put in place at healthcare institutions since January and the health of healthcare workers are monitored by regular checks.

MOH confirmed that the healthcare workers are not required to undergo a swab test when they are rotated back to serve regular patients.

However, they will be tested if they "present with acute respiratory infection symptoms, are close contacts of confirmed cases, or are returning from quarantine/ isolation orders, as an additional precaution".

NCID study concluded infection control & prevention procedures in Singapore’s public hospitals adequate

On May 4, Minister for Health Gan Kim Yong said that in parliament keeping the healthcare workers safe is a key priority to the government.

Gan, the co-chair of the Multi-ministry Task Force, cited a National Centre for Infectious Diseases (NCID) study that suggested no established epidemiological links showing that the infected healthcare workers were infected in the line of duty.

NCID announced on April 29 that a study was underway at NCID, TTSH and National University Hospital (NUH) to assess the extent of Covid-19 exposure and infections amongst healthcare workers in Singapore.

To-date, close to 1,100 healthcare workers have been enrolled in the study.

Initial results from testing conducted between February and early April 2020 suggests that none of these workers had antibody results indicative of Covid-19 infection at the time that they joined the study.

This is despite some staff having worked with Covid-19 patients for at least two months prior to the time of blood taking.

NCID concluded that the finding provides strong evidence that infection control and prevention procedures in Singapore’s public hospitals have been adequate to protect frontline healthcare workers.

The study follow-up is expected to be till third quarter of 2021.

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Top photo via TTSH/Facebook