Docs, nurses at S'pore hospital emergency departments feel strain of coping with Covid-19 patients

One healthcarw worker that stimated 75 per cent of emergency department walk-ins have been Covid-19-related cases since late August.
One healthcare worker estimated that 75 per cent of emergency department walk-ins have been Covid-19-related cases since late August.ST PHOTO: LIM YAOHUI

SINGAPORE - As healthcare workers in intensive care units (ICU) of hospitals grapple with the latest wave of Covid-19 cases, their counterparts tending to such patients in emergency departments (EDs) are also feeling the strain.

Doctors and nurses said they have been noticing more people turning up at EDs with mild Covid-19 symptoms after a positive antigen rapid test (ART).

Registered nurse Melissa (not her real name), who works in the ED at a public hospital, estimated that 75 per cent of ED walk-ins have been Covid-19-related cases since late August.

"Before that, about 50 per cent at the ED were Covid-19 cases. Now, more people are streaming in because they are paranoid and fearful, despite having no or mild symptoms," she told The Sunday Times.

On Oct 27, 5,324 new infections were reported in Singapore, the first time the daily case number breached the 5,000 mark since cases spiked in late August.

Like Melissa, healthcare workers ST spoke to declined to reveal their names and, in some cases, their hospital because of work policies.

Around half of those who sought treatment at the ED after testing positive were eligible for the Covid-19 home recovery programme (HRP), said Melissa.

"They are fully vaccinated and had mild symptoms. They wanted to be admitted because they were afraid, but we did not have the capacity to take care of them."

The HRP has been the default care arrangement for everyone, except certain groups, since Oct 10.

Partially or unvaccinated individuals aged 50 and older, vaccinated people aged 80 and older, and children below one year old are excluded from this arrangement.

Doctors have also noticed the rise in paranoia in Covid-19 patients.

"There is a marked increase in anxiety among people due to the rising case count," said Dr James, as he recalled seeing a patient with mild symptoms who insisted on being admitted to the hospital.

"It seems like the number of people calling 995 has also doubled," he said.

"This has resulted in a manpower crunch where one medical officer often has to take on the workload of two to three people."

The Ministry of Health and the Singapore Civil Defence Force on Oct 25 urged the public not to dial 995 for non-emergency cases, including those with Covid-19.

They said almost half of Covid-19 patients who called for emergency medical services recently did not require urgent treatment.

Dr Loh, who works at the ED of another hospital, said patients with mild symptoms who turn up at hospitals out of fear present EDs with a difficult choice.

"In general, we are unable to turn patients away as they may come back in a worse condition without appropriate medical care.

"Hospital bed occupancy rates regularly exceed 100 per cent. Newly admitted patients will have to wait in temporary beds for up to 48 hours."

The manpower crunch has led to some healthcare workers from non-Covid-19 wards being deployed to Covid-19 wards.

Julia, an enrolled nurse at Singapore General Hospital (SGH), said she was one of 16 nurses deployed from an orthopaedic ward to a Covid-19 general ward in August after a day's training.

In response to queries, a spokesman for SGH said: "As all SGH nurses are trained in infection prevention and control, those deployed to a Covid-19 ward will undergo a one-day orientation to familiarise themselves with the new work environment."

Julia said: "Being a healthcare worker isn't easy. But all of us here know we are in the same boat. We're pushing on and trying our best to get Singapore through this pandemic."

Said Dr James: "People need to learn the difference between ailments that can be treated at home and severe symptoms as it will ease the load on healthcare workers."