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TTSH Covid-19 cluster: No protocol breach found yet, ward's airflow and ventilation among factors under probe

SINGAPORE — Preliminary investigations into what led to the Covid-19 cluster at Tan Tock Seng Hospital (TTSH) suggested that there was no specific lapses in processes and protocols among hospital workers, a Ministry of Health official said.

A view of a ward in Tan Tock Seng Hospital.

A view of a ward in Tan Tock Seng Hospital.

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SINGAPORE — Preliminary investigations into what led to the Covid-19 cluster at Tan Tock Seng Hospital (TTSH) suggested that there was no specific lapses in processes and protocols among hospital workers, a Ministry of Health official said.

Associate Professor Kenneth Mak, the ministry’s director of medical services, said that “among various other hypotheses that (the task force is) entertaining” are issues with airflow and ventilation at a particular ward, since the infected cases had clustered around a single ward, which is Ward 9D.

The Government’s Covid-19 task force, of which he is a member, is not ruling out that the spread could stem from patients and visitors not wearing masks at the wards, as suggested by a reporter during a press conference on Tuesday (May 4).

The TTSH cluster is now made up of 40 people, including staff members, current and past patients and visitors. One 88-year-old patient, who was warded in Ward 9D from April 14 and was confirmed to have Covid-19 on April 28, died from complications due to the disease last Saturday.

The cluster started after a 46-year-old nurse in the hospital’s Ward 9D tested positive for Covid-19 on April 27 after developing a cough, sore throat and body aches.

On why the transmissions at TTSH were so widespread and whether they are related to issues with the hospital’s standard operating procedures, Assoc Prof Mak said that the authorities could not give a definitive answer yet because investigations into the source and spread of the disease are still incomplete.

“We are looking at various possibilities. Of course, (the reporter has) mentioned one — is it because of not wearing masks or a lack of discipline in maintaining discipline in infection control?”

He then said that cases had clustered around one ward, so the task force is exploring the possibility that there are other local influences. “Particularly related to the ward, that (factors) may have also influenced a super-spreading event occurring, leading to these cases.”

Local influences may include airflow and ventilation issues at the ward, he added.

There is nothing conclusive at the moment until the studies are complete.

“We are exploring all possibilities and we are taking precautions accordingly, as we manage existing patients admitted in Tan Tock Seng Hospital,” he said.

As for protocols not being followed, Assoc Prof Mak said: “In the initial investigations so far, we have not identified any specific breach in processes and protocols that TTSH had put in place that staff members have to carry out. 

“But of course, investigations are still ongoing. And until we complete those investigations, I will not be able to give you a definitive reply to that particular question.”

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TTSH Tan Tock Seng Hospital Covid-19 coronavirus MOH

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