Abstract
Staff surveillance is crucial during the containment phase of a pandemic to help reduce potential healthcare-associated transmission and sustain good staff morale. During an outbreak of SARS-COV-2 with community transmission, our institution used an integrated strategy for early detection and containment of COVID-19 cases among healthcare workers (HCWs). Our strategy comprised 3 key components: (1) enforcing reporting of HCWs with acute respiratory illness (ARI) to our institution's staff clinic for monitoring; (2) conducting ongoing syndromic surveillance to obtain early warning of potential clusters of COVID-19; and (3) outbreak investigation and management. Over a 16-week surveillance period, we detected 14 cases of COVID-19 among HCWs with ARI symptoms. Two of the cases were linked epidemiologically and thus constituted a COVID-19 cluster with intrahospital HCW-HCW transmission; we also detected 1 family cluster and 2 clusters among HCWs who shared accommodation. No transmission to HCWs or patients was detected after containment measures were instituted. Early detection minimized the number of HCWs requiring quarantine, hence preserving continuity of service during an ongoing pandemic. An integrated surveillance strategy, outbreak management, and encouraging individual responsibility were successful in early detection of clusters of COVID-19 among HCWs. With ongoing local transmission, vigilance must be maintained for intrahospital spread in nonclinical areas where social mingling of HCWs occurs. Because most individuals with COVID-19 have mild symptoms, addressing presenteeism is crucial to minimize potential staff and patient exposure.
Highlights
Our institution, Singapore General Hospital (SGH) is the largest public tertiary-care hospital in Singapore, with 1,785 beds
Over the 16-week study period (January 1, 2020, to April 22, 2020), a total of 2,250 healthcare workers (HCWs) presented to the staff clinic or emergency department of our institution with a diagnosis of acute respiratory illness (ARI)
The major finding of this study was that containment of severe acute respiratory syndrome (SARS)-CoV-2 among HCWs is feasible if vigilance is maintained through ongoing surveillance, and mitigating measures are triggered early upon the detection of a potential cluster
Summary
Singapore General Hospital (SGH) is the largest public tertiary-care hospital in Singapore, with 1,785 beds. SGH has a total of 9,322 HCWs: 1,187 medical staff, 3,914 nursing staff, 1,777 allied health personnel, and 2,444 ancillary personnel. SGH shares a campus with other institutions under the same hospital group: namely the Singapore National Eye Centre (910 HCWs), National Cancer Centre, Singapore (1,092 HCWs), National Heart Centre, Singapore (1,328 HCWs), and National Dental Centre, Singapore (513 HCWs). The staff of these institutions utilize the staff clinic at SGH and share on-campus facilities. We evaluated our institution’s strategy for early detection and containment of potential COVID-19 outbreaks among HCWs working on the same hospital campus over a 16-week study period
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