SINGAPORE — Some hospitals are converting wards into intensive care units (ICUs), and all hospitals with employees trained in intensive care who are now in other roles have been asked to consider redeploying them back to ICU support duties after refresher training, the authorities said on Tuesday (April 28).

These are some of the Government’s efforts to build up the capacity of ICUs during the Covid-19 crisis. They were outlined at a press conference on Tuesday held by a multi-ministry task force spearheading Singapore’s response to the pandemic.

Health Minister Gan Kim Yong, who co-chairs the task force, was responding to a question on the Government's plans to boost ICU capacity as the number of Covid-19 cases here continues to climb. As of Tuesday, 21 patients are in intensive care, 1,689 patients are still in hospital and 12,120 people are isolated and cared for at community facilities.

Associate Professor Kenneth Mak, director of medical services at the Ministry of Health, said that various hospitals were planning to convert wards into ICUs and negative-pressure isolation wards — special wards designed to keep air within the ward as a precaution.

“That process of conversion has been taking place over the last few weeks,” Assoc Prof Mak said, adding that these hospitals have already at least doubled their capacity.

The authorities have also been buying extra equipment, including ventilators and monitoring equipment, to ensure these extra beds are properly equipped with the facilities to support the care of critically ill patients.

Efforts are also under way to enlarge the pool of healthcare professionals working at these ICUs.

Assoc Prof Mak said that the authorities have asked all hospitals to consider reassigning ICU-trained staff members back to clinical duties to support these expanded units, should these workers have taken up other roles.

“Those who have previously been trained and are proficient in ICU care, but now have been deployed in other roles, will also undergo refresher training to make sure that they retain the competencies.” 

The authorities have also invited former nurses who have ventured into other careers to consider returning to nursing. More training will be provided to ensure that they are ready to assume the role if the extra ICU beds are filled, Assoc Prof Mak said.

He added that all hospitals have reduced non-urgent clinical work to allow ICU beds to be reserved for those who truly need them.

Mr Gan said that Singapore has also expanded its capacity for community care facilities, which house Covid-19 patients with no or mild symptoms, or those who have largely recovered from the disease. These facilities — including the Singapore Expo Convention and Exhibition Centre — can now house 10,000 people. The plan is to scale this up to 20,000 by the end of June.

Community recovery facilities can now accommodate more than 2,000 beds. By the end of June, the aim is to expand this to more than 10,000 beds.

These spaces will house patients who remain well on the 14th day after diagnosis of the illness and generally do not need further medical care.

Most of the people who have contracted Covid-19 in Singapore have had a relatively mild illness or no symptoms, and do not need extensive medical intervention, Mr Gan said. About 30 per cent require closer medical observation because of factors such as underlying health conditions or old age.

MORE TESTING

In the battle against Covid-19, the Government is also looking to do more testing, Mr Gan said. How it does so will depend on how the pandemic plays out in the next few weeks or months, and how the authorities decide to roll back the circuit breaker measures, which began on April 7 to slow transmission. They are due to run till June 1.

“We do want to test as many (people) as possible, but there is also a natural limit and also some strategic logic to whom we test and how we test, and a lot will depend on how we intend to open up the circuit breaker measures,” he said.

“So we need to look at the risk areas and where are the areas that are safer to loosen up first. And as we open them up, what can we do to make sure that we can open them in a safe way?”

For example, if the Government decides to allow certain economic activities to resume, it may then decide to step up testing of certain workers in those sectors, he said.

“If some of the measures we roll back do not involve high-risk areas, we may not have to employ testing. We may just need to step up safe distancing measures.”

National Development Minister Lawrence Wong, who co-chairs the task force, said on Tuesday that as Singapore expands its testing capacity, it is also studying new testing technologies that can be used here.

He noted that the current test administered for Covid-19 takes time and needs to be run through a laboratory.

“People are developing faster, point-of-care tests, so we will examine all of these technologies as they come to the market and look at expanding the full suite of testing capabilities,” he said.

But he added that testing is just one part of the overall strategy that Singapore will deploy at some point down the track when it seeks to gradually roll back circuit breaker measures and allow the resumption of certain economic activities.

“(Testing) has to be complemented with other measures, whether it is quarantine, safe distancing, as well as… the use of tech for faster contact tracing,” he said.