SINGAPORE - About 75 seniors with Covid-19 have been admitted to Singapore's first community treatment facility (CTF) so far, Dr Wong Kirk Chuan, chief operating officer of Woodlands Health, which runs the CTF, said on Thursday (Sept 30).
The Ministry of Health (MOH) announced on Sept 19 that the facility would be set up in response to rising Covid-19 cases here over the last month.
Located on the site of the NTUC Health Nursing Home in Tampines, the CTF opened and began receiving its first patients on Sept 23, just one week after MOH approached Woodlands Health for assistance, said Dr Wong.
It is meant to care for elderly patients who are stable and mildly symptomatic, but have underlying chronic illnesses or comorbidities - such as a weakened immune system - that put them at higher risk of getting sicker.
Having the facility operational will help hospitals, which have come under strain in recent weeks, to admit more seriously ill Covid-19 patients.
Dr Wong said that on Sept 16, the ministry asked Woodlands Health to quickly set up a facility in the community that can take care of seniors with Covid-19.
"We were looking for facilities that would allow us to deliver care, with minimal renovation, to our seniors in their 80s and 90s, safely and with appropriate medical and nursing support," he explained.
Within 24 hours, the nursing home was identified as a suitable place and its management agreed to let Woodlands Health use the facility "for the foreseeable future".
Woodlands Health, which had previously set up and managed community care facilities (CCFs), such as those at D'Resort NTUC and Expo, tapped its past experience to set up the new CTF.
Dr Nicholas Chew, chairman of Woodlands Health's medical board, said: "We leaned on our staff who had set up the Expo site, so the learning curve was very short. They had the experience and we essentially ended up pulling together the same team that had set up Expo (CCF) and transplanting what they had learnt, as well as tweaking it based on the location."
Some adjustments had to be made as the patients at the new CTF would be elderly rather than young, but in general, "it was a matter of us tweaking workflows rather than inventing anew everything we had done before", said Dr Chew.
Aside from Woodlands Health staff, manpower was also brought in from private sector partners that had helped at Expo, as well as the Health Promotion Board, National Skin Centre, Tan Tock Seng Hospital and the National Centre for Infectious Diseases.
Resorts World Sentosa also provided manpower to help with operations, and Integrated Health Information Systems helped set up and provide the health technology, including a telehealth system.
So far, three of the facility's five floors have been opened and are receiving patients, and more will be opened if necessary, said Dr Wong. The CTF has a capacity of about 250 beds.
Dr Chew said that since Covid-19 patients in the CTF are all seniors above the age of 60, they tend to have more chronic diseases and are possibly more frail.
"Therefore, the care that we're designing... needs to be more age-appropriate," he explained.
This means deploying geriatrics-trained staff who can help manage chronic diseases and assist the seniors with rehabilitation.
The CTF also has various diagnostic facilities on-site, such as ultrasound devices and X-ray machines. Simple blood tests can be carried out, with samples sent to partner laboratories.
One key aspect of looking after seniors with Covid-19 is ensuring that their physical fitness does not deteriorate, said Dr Chew.
"These are people who are in the community - they are extremely ambulant, they are actually doing very well. But if we (admit them) into an environment where they have to lie down, they would decondition very quickly," he said.
To address that, physiotherapists and occupational therapists have been brought in to engage the elderly patients daily with exercises and activities. This will ensure that they are still fit by the time they are discharged, said Dr Chew.
Announcing the community care plan on Sept 19, MOH said: "This will augment our hospital capacity, so that only those who actually need close and specialised medical attention, such as oxygen supplementation and intensive care, receive their medical care in our hospitals."
Although it is still early days, patients are generally expected to stay for about 10 to 21 days at the CTF, depending on their conditions.
Dr Chew said there is no fixed programme for the patients, but aside from the daily exercises they are encouraged to take part in, TVs and Wi-Fi are also provided and there are communal spaces where they can interact with one another and play games such as mahjong as well.
MOH previously said it plans to establish more of these CTFs in future. While Woodlands Health is currently not involved in these, Dr Wong said it will share the lessons it has learnt with these facilities and their operators.