Doctors, nurses struggle to cope as Covid-19 patients flock to A&E depts, many with mild symptoms

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SINGAPORE - Hospitals and healthcare workers are struggling to cope with a flood of Covid-19 patients seeking treatment in the accident and emergency (A&E) department, many with mild or no symptoms and who do not require immediate medical attention.

This is despite the Ministry of Health (MOH) announcing that test centres will be open for those looking to take a supervised self-administered antigen rapid test (ART) for free, and get the results reflected in their HealthHub record.

MOH said last week that this was to ease the pressure on hospitals, general practitioner (GP) clinics and polyclinics, to help them focus on patients who need medical attention.

When The Straits Times spoke to doctors in the various A&E departments of public hospitals, many said they continue to see droves of patients who have tested positive on ART kits but display little or no symptoms, stretching waiting times as well as the already thinning resources and strained manpower.

The doctors and healthcare workers requested anonymity, so their names have been changed.

Remy, 30, a doctor who works in the A&E department of a public hospital, said that the most recent surge of Omicron cases has hit the emergency departments hard, with senior and junior doctors seeing double the number of patients per shift on a daily basis.

He said: "Many of these patients have the mindset that because they have presented themselves to the A&E department, they need to be seen immediately."

According to 26-year-old A&E doctor Claire, about two-thirds of patients she saw were assessed to be at the third level of priority for care, P3. Some symptoms that fall into the P3 level are sprains, minor injuries, minor abdominal pain, vomiting, fever, rashes, and mild headaches.

The bloated queues meant that frustration would set in as patients faced ever increasing wait times.

Claire said: "Just a few days ago I got screamed at for making a patient wait six hours without any updates and had to call the hospital's security personnel."

While those working in the A&E departments are bearing the brunt of patient surges, other hospital departments are feeling the knock-on effects.

Working as a consultant in the internal medicine department, Michael, 40, gave the example of dialysis patients who test positive and hence are not able to visit dialysis centres but who also cannnot be assigned a bed due to the volume of other patients.

This, he said, was the first time he had encountered such numbers in his decade-long career.

Staff nurse Shuqi, 26, said that the ward she works in would have to operate with one or two fewer nurses, as they would be sent to help the overloaded A&E department.

She said: "We should have six staff for a 38-bed ward, meaning one nurse staff to six patients, but now we have to run with just four nurses, which is almost double the workload."

Another doctor, Jeanette, 28, said that the surge caused a tenfold increase in patients within a month at her workplace in a Covid-19 rehabilitation facility.

While this means that manpower would be even further stretched, it is the mental stress caused by the self-entitled attitude of patients that can push many overworked healthcare workers past the breaking point.

"When they make a request which goes against hospital and government protocol and it is denied, they start to insist. Ergo, it was never really a request to begin with, but a demand," she said, adding that "if the public took more initiative to find out these protocols, and trusted doctors with doing their job, it would be less taxing".

The view was echoed by Claire, who said: "All we want to do is help. We really need the patients and their family members to be more understanding, and help us help them."

Remy said he saw many patients who, despite being young and healthy, would report symptoms that were out of proportion.

"Some request to go to the isolation facilities even though they may be able to self-isolate if their family is willing to cooperate to rearrange living arrangements," he said.

"A big chunk of non-emergency cases stem from patients being entitled. Even though MOH has called for the public to spare healthcare resources, I'm not sure that this request will be met with social responsibility. People, unfortunately, will always try to game the system."

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