COVID-19 Pandemic In Singapore Research Articles

Singapore's COVID-19 crisis decision-making through centralization, legitimacy, and agility: an empirical analysis

Decision-making during health crises differs from routine decision-making and is constrained by ambiguity about evolving epidemiological situations, urgency of response, lack of evidence, and fear. Recent analyses of governance and decision-making during COVID-19, focusing on leadership qualities, involvement of specific stakeholders, and effective resource management, do not adequately address a persisting gap in understanding the determinants of decision-making during health crises at the national level. We undertook a study to understand the processes and characteristics of decision-making during the COVID-19 pandemic in Singapore. We used a case study approach and collected empirical evidence about public health decision-making, using a combination of key informant interviews and focus group discussions with stakeholders from government, academia and civil society organizations. We argue that administrative centralization and political legitimacy played important roles in agile governance and decision-making during the pandemic in Singapore. We demonstrate the role of the Singapore government's centralization in creating a unified and coherent governance model for emergency response and the People's Action Party's (PAP) legitimacy in facilitating people's trust in the government. Health system resilience and financial reserves further facilitated an agile response, yet community participation and prioritization of vulnerable migrant populations were insufficient in the governance processes. Our analysis contributes to the theory and practice of crisis decision-making by highlighting the role of political and administrative determinants in agile crisis decision-making. This study is funded by the U.S. Centers for Disease Control and Prevention through a Cooperative Research Agreement (NU2HGH2020000037).

Early Puberty Trend during the COVID-19 Pandemic in Singapore: A Retrospective Review in a Single Tertiary Centre.

We aimed to study the trend of referrals for precocious puberty during the COVID-19 pandemic compared to pre-COVID years, explore the differences in the demographic and clinical features, and evaluate the contributing factors. The cases referred for assessment of PP from 2018-2021 to our endocrine centre were grouped into pre-COVID (2018-2019) and COVID (2020-2021) years. Cases fulfilling the diagnosis of PP included the onset of thelarche <8 years in females and 4 ml testicular volume <9 years in males. The PP was further differentiated as Isolated Thelarche (IST) and Central Precocious Puberty (CPP). Early menarche was defined as menarche <10 years old. There were more referrals for PP and more diagnosed as CPP during the COVID-19 pandemic, predominantly among females. There were more endocrine tests done and more cases received treatment. None of the abnormal magnetic resonance imaging (MRI) pituitary findings required surgical intervention. The body mass index (BMI) was found to be positively associated with the risk of getting CPP with a crude-odd ratio (COR) of 1.8, P <0.001, and early menarche (COR 2.1, P <0.001). We found a significant increase in the referrals of PP and diagnosis of CPP during the COVID-19 pandemic. Higher BMI was found to be associated with CPP and early menarche.

Effective leadership styles to boost employees’ work outcomes during COVID-19 pandemic: perspective of facilities management professionals

PurposeThis study investigated what are the effective leadership styles and practices that boost employees’ work outcomes during the COVID-19 pandemic from the perspective of facilities management professionals (FMPs).Design/methodology/approachThree predominant leadership styles (transformational, transactional contingent reward and disaster management) were operationalized into 38 leadership practices (X variables) and 8 work outcomes (Y variables). The explanatory sequential research design was adopted. Online questionnaire survey was first conducted on FMPs who managed facilities during the critical periods of COVID-19 pandemic in Singapore. In-depth interviews were then carried out with subject matter experts to elaborate on the quantitative findings.FindingsDuring the pandemic, FMPs were significantly stressed at work, but also experienced significant job satisfaction and satisfaction with their leaders/supervisors. Statistical results revealed a range of leadership practices that are significantly correlated with FMPs’ work outcomes. One leadership practice is critical as it affects 4 of the 8 FMPs’ work outcomes - frequently acknowledging employees’ good performance during the pandemic.Research limitations/implicationsThe study explored 3 leadership styles. There are other styles like laissez faire and servant leadership that might also affect work outcomes.Practical implicationsBased on the findings, suggestions were provided to organizations that employ FMPs on how to improve their work outcomes during a crisis such as a pandemic.Originality/valueThe novelty is the discovery that in the context of a global disaster such as the COVID-19 pandemic, the most relevant leadership styles to boost employees’ work outcomes are transactional contingent reward and disaster management leadership. The study adds to knowledge by showing that not one leadership style is superior – all 3 styles are complementary, but distinct, forms of leadership that need to work in tandem to boost FMPs’ work outcomes during a crisis such as a pandemic.

Diagnostic accuracy and photographic quality of in-patient teledermatology during the COVID-19 pandemic in Singapore

Diagnostic accuracy and photographic quality of in-patient teledermatology during the COVID-19 pandemic in Singapore

Impact of Perceived Safety and Barriers on Physical Activity Levels in Community-Dwelling Older Adults During the COVID-19 Pandemic in Singapore: A Cross-Sectional Mixed Methods Study.

This descriptive cross-sectional mixed methods study conducted in Singapore aimed to describe community-dwelling older adults' differences in physical activity (PA) based on perceived safety to exercise, barriers to PA, and preferred modes of PA during a pandemic. Out of 268 older adults, 25.4% felt unsafe to exercise during the pandemic. More participants who felt unsafe were aged 75years and older (72.1% vs. 57.0%, p = .028) and lacked formal education (54.4% vs. 37.0%, p = .040). Barriers included difficulties exercising with masks, family concerns, and exercise center closures. Those who felt unsafe were significantly more likely to exercise at home and had significantly shorter duration of exercise and walks per week (2.72 vs. 4.50hr, p = .002). Perceived barriers and exercise preferences should be considered when developing programs to improve older adults' PA during pandemics.

Home-based learning during school closure in Singapore: perceptions from the language classrooms.

The outbreak of the COVID-19 pandemic in Singapore has resulted in the adoption of home-based learning (similar to remote or distance learning' worldwide) due to periodic school closures in Singapore. The media and academia have diverse views on the effectiveness of this alternative mode of education. This study draws data from teachers' interviews and students' focus group discussions of an ongoing large-scale baseline study on mother tongue education to reveal teachers' and students' perceptions of home-based learning. Findings showed that the participating teachers generally mimicked physical lessons online during home-based learning, and they faced difficulties in monitoring students' tasks online. Though students enjoyed the freedom of doing their learning tasks at their own pace, they were concerned with the lack of teachers' support and the social-emotional support from peers. With the feedback and reflections from teachers and students, it was observed that despite the availability of technology and online infrastructure, teachers need readiness for transiting between physical teaching and online instruction, whereas students need readiness for self-directed learning. From students' feedback, it was also noted that parents need readiness for educational technology and support for their children. To better prepare teachers, students, and parents for home-based learning, it is recommended that the developers provide more dedicated resources that take into consideration the different characteristics (e.g. orthography) of each language subject. Parents should also assume a greater role in monitoring their children's learning on behalf of the teachers for better effect in home-based learning.

Examining work from home practices during the COVID-19 pandemic in Singapore: Predictors of motivation and productivity

Examining work from home practices during the COVID-19 pandemic in Singapore: Predictors of motivation and productivity

Examining work from home practices during the COVID-19 pandemic in Singapore: predictors of motivation and productivity

Examining work from home practices during the COVID-19 pandemic in Singapore: predictors of motivation and productivity

Wastewater surveillance of SARS-CoV-2 and chemical markers in campus dormitories in an evolving COVID − 19 pandemic

In this study, we report the implementation of a comprehensive wastewater surveillance testing program at a university campus in Singapore to identify Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infected individuals and the usage of pharmaceuticals and personal care products (PPCPs) as well as other emerging contaminants (ECs). This unique co-monitoring program simultaneously measured SARS-CoV-2 with chemical markers/contaminants as the COVID-19 situation evolved from pandemic to endemic stages, following a nationwide mass vaccination drive. SARS-CoV-2 RNA concentrations in wastewater from campus dormitories were measured using real-time reverse transcription-polymerase chain reaction (RT-qPCR) and corroborated with the number of symptomatic COVID-19 cases confirmed with the antigen rapid test (ART). Consistent results were observed where the concentrations of SARS-CoV-2 RNA detected in wastewater increased proportionately with the number of COVID-19 infected individuals residing on campus. Similarly, a wide range of ECs, including disinfectants and antibiotics, were detected through sensitive liquid chromatography with tandem mass spectrometry (LC-MS/MS) techniques to establish PPCPs consumption patterns during various stages of the COVID-19 pandemic in Singapore. Statistical correlation of SARS-CoV-2 RNA was observed with few ECs belonging to disinfectants, PCPs and antibiotics. A high concentration of disinfectants and subsequent positive correlation with the number of reported cases on the university campus indicates that disinfectants could serve as a chemical marker during such unprecedented times.

Continued demographic shifts in hospitalised patients with COVID-19 from migrant workers to a vulnerable and more elderly local population at risk of severe disease

Objectives: In the early months of the COVID-19 pandemic in Singapore, the vast majority of infected persons were migrant workers living in dormitories who had few medical comorbidities. In 2021, with the Delta and Omicron waves, this shifted to the more vulnerable, elderly population within the local community. We examined evolving trends among the hospitalised cases of COVID-19.Methods: All patients with polymerase chain reaction-positive SARS-CoV-2 admitted from February 2020 to October 2021 were included and subsequently stratified by their year of admission (2020 or 2021). We compared the baseline clinical characteristics, clinical course, and outcomes.Results: A majority of cases were seen in 2020 (n = 1359), compared with 2021 (n = 422), due to the large outbreaks in migrant worker dormitories. Nevertheless, the greater proportion of locally transmitted cases outside of dormitories in 2021 (78.7% vs 12.3%) meant a significantly older population with more medical comorbidities had COVID-19. This led to an observably higher proportion of patients with severe disease presenting with raised inflammatory markers, need for therapeutics, supplemental oxygenation, and higher mortality.Conclusion: Changing demographics and the characteristics of the exposed populations are associated with distinct differences in clinical presentation and outcomes. Older age remained consistently associated with adverse outcomes.

Ethics of participation and social inclusion of older persons in research: lessons learned from the COVID-19 pandemic in Singapore

The COVID-19 pandemic brought about safe distancing measures that are unprecedented. This article details the impact of the pandemic across research studies involving older persons in Singapore, and assesses the different strategies used to adapt to their needs in the context of evolving public health measures. The pandemic exposed diverse experiences of vulnerability among older persons, pushing for critical reflections on ethics of participation and social inclusion as the new research normal. We emphasize the importance of practicing flexibility: consideration for differentiated approaches to recruitment and data collection that should be proactively embedded in research designs for older persons during the pandemic and beyond.

Associations between Work-Family Balance, Parenting Stress, and Marital Conflicts during COVID-19 Pandemic in Singapore.

As part of the "Circuit-breaker" social distancing measure to address COVID-19, the government of Singapore closed schools and workplaces from April to May 2020. Although this helped reduce transmission rates, for working parents, this period had been a challenging experience of working from home while providing care for children full-time. Problems in the work-home interface can have a significant impact on parenting and marital harmony. We analyzed data from 201 married and employed parents in Singapore using online surveys. Latent profile analysis was used to identify profiles of parents' work-family balance (WFB) and spousal and employer support. Linear regression was used to examine links between profiles with parenting stress and marital conflicts. Results indicated three distinct profiles of WFB and social support levels: (a) Strong (43%), (b) Moderate (38%), and (c) Poor (19%). Mothers were more likely than fathers to be in the Moderate and Poor profiles. One key finding is that profiles characterized by poorer WFB were found to be linked with higher parenting stress and increased marital conflicts. There are important variations in parents' abilities to balance work and family and levels of social support received. Lock-downs can affect parenting and marital harmony especially for parents with poor WFB and weak social support. Any attention given to supporting working parents is vital and urgent to counter any problems in the work-family interface during a lockdown.

Impact of COVID-19 on barriers to dispatcher-assisted cardiopulmonary resuscitation in adult out-of-hospital cardiac arrests in Singapore

ObjectiveFewer out-of-hospital cardiac arrest (OHCA) patients received bystander cardiopulmonary resuscitation during the COVID-19 pandemic in Singapore. We investigated the impact of COVID-19 on barriers to dispatcher-assisted cardiopulmonary resuscitation (DA-CPR). MethodsWe reviewed audio recordings of all calls to our national ambulance service call centre during the pandemic (January-June 2020) and pre-pandemic (January-June 2019) periods. Our primary outcome was the presence of barriers to DA-CPR. Multivariable logistic regression was used to assess the effect of COVID-19 on the likelihood of barriers to and performance of DA-CPR, adjusting for patient and event characteristics. ResultsThere were 1241 and 1118 OHCA who were eligible for DA-CPR during the pandemic (median age 74 years, 61.6 % males) and pre-pandemic (median age 73 years, 61.1 % males) periods, respectively. Compared to pre-pandemic, there were more residential and witnessed OHCA during the pandemic (87 % vs 84.9 % and 54 % vs 38.1 %, respectively); rates of DA-CPR were unchanged (57.3 % vs 61.1 %). COVID-19 increased the likelihood of barriers to DA-CPR (aOR 1.47, 95 % CI: 1.25–1.74) but not performance of DA-CPR (aOR 0.86, 95 % CI: 0.73 – 1.02). Barriers such as ‘patient status changed’ and ‘caller not with patient’ increased during COVID-19 pandemic. ‘Afraid to do CPR’ markedly decreased during the pandemic; fear of COVID-19 transmission made up 0.5 % of the barriers. ConclusionBarriers to DA-CPR were encountered more frequently during the COVID-19 pandemic but did not affect callers’ willingness to perform DA-CPR. Distancing measures led to more residential arrests with increases in certain barriers, highlighting opportunities for public education and intervention.

Sport participants’ well-being during the COVID-19 pandemic: the roles of nostalgia, resilience, and curiosity

ABSTRACTIn the context of a pandemic, this study uses the broaden-and-build theory of positive emotions to examine how feelings of nostalgia could have a positive effect on well-being through willingness to explore novel behaviours and resilience. In total, 328 sport participants were recruited during the COVID-19 pandemic in Singapore. Results indicated that nostalgia positively affected individuals’ willingness to explore novel behaviours and resilience. Willingness to explore novel behaviours had a positive effect on resilience. In addition, both willingness to explore novel behaviours and resilience positively affected well-being. The findings of this study expand the body of knowledge on the role of nostalgia and its impact on psychological resources that sport participants can potentially gain in spite of the reduction in their time participating in sport due to pandemic restrictions.

Beyond Asian ‘mask culture’: understanding the ethics of face masks during the Covid-19 pandemic in Singapore

ABSTRACT During the Covid-19 pandemic, face masks became widely used and sometimes mandatory anti-infection devices across the world. While anti-mask protests emerged in several Western countries, nearly universal mask-wearing is commonly seen in Asian countries. Journalistic and popular accounts suggest that an Asian ‘mask culture’ explains the acceptance of mask-wearing and associates mask culture with political authoritarianism in Asian countries. Based on in-depth interviews conducted with residents of Singapore, an Asian city-state that implemented a mask mandate in 2020, we uncover a wide diversity of beliefs, motivations, and practices of mask-wearing that challenges the existence of a homogeneous ‘mask culture’. Drawing on a recent theoretical movement known as the anthropology of ethics, we draw attention to individual judgments and engagements with cultural norms and obligations in order to characterise how it became ‘desired and desirable’ for a diverse population of Singapore residents to wear masks.

Agility of facilities management organizations during the COVID-19 pandemic: lessons learnt for future pandemics

PurposeThis study aims to investigate how agile facilities management (FM) organizations were during the COVID-19 pandemic in Singapore, examine the agile strategies adopted and extracted lessons learnt for managing facilities in future pandemics.Design/methodology/approachData were collected using a questionnaire coupled with in-depth interviews with FM professionals.FindingsThe FM sector experienced significant challenges such as increased operating cost and shortage of FM staff. FM organizations were assessed to be agile as they overcame challenges swiftly, made rapid changes to their service offerings as the situation evolved, engaged facility owners actively and adopted strategies that were flexible and responsive. They also adopted health-centric employee care.Research limitations/implicationsThe research was conducted during the pandemic. The final verdict of FM organizations’ agility and the most effective practices may only be known when the COVID-19 pandemic ends.Practical implicationsLessons learnt for FM to manage future pandemics were crystalized. These include reducing reliance on manpower, boosting technology adoption and personalized employee engagement.Originality/valueThis study added to knowledge by testing and confirming that the agility theory and its six metrics of agility comprising flexibility, velocity, responsiveness, collaboration, visibility and competence may be used by FM organizations to be agile in a crisis or disruption. Its originality is the discovery of a new construct – health-centric employee care – that is needed to further boost FM organizations’ agility performance in a pandemic. Health-centric employee care involves practices to reduce intra-staff transmission of the virus and individualized employee support to build resilience.

Medical and nursing students' perceptions of online learning and pandemic preparedness during COVID-19 in Singapore

Introduction: During the first wave of the COVID-19 pandemic in Singapore, clinical attachments for medical and nursing students were temporarily suspended and replaced with online learning. It is unclear how the lack of clinical exposure and the switch to online learning has affected them. This study aims to explore their perceptions of online learning and their preparedness to COVID-19 as clinical postings resumed. Methods: A cross-sectional study was conducted among undergraduate and graduate medical and nursing students from three local universities, using an online self-administered survey evaluating the following: (1) demographics; (2) attitudes towards online learning; (3) anxieties; (4) coping strategies; (5) perceived pandemic preparedness; and (6) knowledge about COVID-19. Results: A total of 316 responses were analysed. 81% agreed with the transition to online learning, most citing the need to finish academic requirements and the perceived safety of studying at home. More nursing students than medical students (75.2% vs 67.5% p=0.019) perceived they had received sufficient infection control training. Both groups had good knowledge and coping mechanisms towards COVID-19. Conclusions: This study demonstrated that medical and nursing students were generally receptive to this unprecedented shift to online learning. They appear pandemic ready and can be trained to play an active part in future outbreaks.

The Effects of Dangerous World Beliefs on COVID-19 Preventive Behaviors in Singapore: The Moderating Role of Public Health Communication

ABSTRACT This research purposes to examine the role of strategic communication, specifically the effectiveness of government's crisis communication messages at the onset of COVID-19 pandemic in Singapore, on disease preventive behaviors. It employed a mixed method research approach by first carrying out a content analysis of 7128 news headlines on COVID-19 to confirm our presupposition that the media may be communicating messages that the world order is being threatened. Informed by our findings that 90% of news reports were framed to suggest a dangerous world, we surveyed 453 respondents in the main study, and tested if people's beliefs in a dangerous world (BDW) were linked to their disease preventive behaviors (DPB), and whether such a link was modulated by how effective they perceived the government's pandemic communication. As predicted, results revealed that the perceived effectiveness of the government's pandemic communication trumped the effects of beliefs in a dangerous world such that the link between BDW and DPB was significant only when the perceived effectiveness was low. Further analysis of the effects of specific communication dimensions on disease preventive behaviors suggests that public health communication needs to be strategically calibrated to offer personally relevant messages that are informative and objective. (199 words)

An Agile Systems Modeling Framework for Bed Resource Planning During COVID-19 Pandemic in Singapore.

BackgroundThe COVID-19 pandemic has had a major impact on health systems globally. The sufficiency of hospitals' bed resource is a cornerstone for access to care which can significantly impact the public health outcomes.ObjectiveWe describe the development of a dynamic simulation framework to support agile resource planning during the COVID-19 pandemic in Singapore.Materials and MethodsThe study data were derived from the Singapore General Hospital and public domain sources over the period from 1 January 2020 till 31 May 2020 covering the period when the initial outbreak and surge of COVID-19 cases in Singapore happened. The simulation models and its variants take into consideration the dynamic evolution of the pandemic and the rapidly evolving policies and processes in Singapore.ResultsThe models were calibrated against historical data for the Singapore COVID-19 situation. Several variants of the resource planning model were rapidly developed to adapt to the fast-changing COVID-19 situation in Singapore.ConclusionThe agility in adaptable models and robust collaborative management structure enabled the quick deployment of human and capital resources to sustain the high level of health services delivery during the COVID-19 surge.

Modelling effectiveness of COVID-19 pandemic control policies using an Area-based SEIR model with consideration of infection during interzonal travel.

This paper studies the effectiveness of several pandemic restriction measures adopted in Singapore during the COVID-19 outbreak. To this end, the classical Susceptible-Exposed-Infectious-Recovered (SEIR) model widely used to describe the dynamic process of epidemic propagation is extended to an area-based SEIR model with the consideration of exposure to infections during commute and quarantine. The proposed model considers infections within areas and infections occurred during the commute of individuals. A case study of the Singapore MRT system is presented to show the effectiveness of pandemic restriction policies implemented in Singapore, namely social distancing, work shift and Circuit Breaker (CB) and phase advisories. A long-term investigation of COVID-19 pandemic in Singapore is performed, and the disease transmission dynamics in 2020–2021 (which covers the first wave and second wave of COVID-19 pandemic in Singapore) is modelled.